Highlights: Thoughts and prayers, but not the nice kind.
Among patients who developed severe disease, the median time to dyspnea (ed. difficult or labored breathing) from the
onset of illness or symptoms ranged from 5 to 8 days, the median time
to acute respiratory distress syndrome (ARDS) from the onset of illness or symptoms ranged from 8 to 12 days,
Case fatality was higher for patients with comorbidities:
10.5% for those with cardiovascular disease, 7.3% for those with diabetes, and approximately 6% for those with chronic respiratory disease, or cancer.1,6,14,36,38,41,42
Prior stroke, diabetes, chronic lung disease, and chronic kidney disease have all been associated with increased illness severity and adverse outcomes.
Serious heart conditions, including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension, may put people at higher risk for severe illness from COVID-19.
People with hypertension may be at an increased risk for severe illness from COVID-19 and should continue to take their medications as prescribed. At this time, people whose only underlying medical condition is hypertension are not considered to be at higher risk for severe illness from COVID-19.43,44
And
obesity is another condition increasing risks.
From the CDC (I guess they haven't removed all science yet):
COVID-19 guidance, tools, and resources for healthcare workers.
www.cdc.gov
Illness Severity
The largest cohort reported of >44,000 persons with COVID-19 from China showed that illness severity can range from mild to critical:36
- Mild to moderate (mild symptoms up to mild pneumonia): 81%
- Severe (dyspnea, hypoxia, or >50% lung involvement on imaging): 14%
- Critical (respiratory failure, shock, or multiorgan system dysfunction): 5%
In this study, all deaths occurred among patients with critical illness, and the overall case fatality rate was 2.3%.36 The case fatality rate among patients with critical disease was 49%.36 Among children in China, illness severity was lower with 94% having asymptomatic, mild, or moderate disease; 5% having severe disease; and <1% having critical disease.16 Among U.S. COVID-19 cases with known disposition, the proportion of persons who were hospitalized was 19%.37 The proportion of persons with COVID-19 admitted to the intensive care unit (ICU) was 6%.37
Clinical Progression
Among patients who developed severe disease, the median time to dyspnea (ed. difficult or labored breathing) from the
onset of illness or symptoms ranged from 5 to 8 days, the median time
to acute respiratory distress syndrome (ARDS) from the onset of illness or symptoms ranged from 8 to 12 days, and the median time to ICU admission from the onset of illness or symptoms ranged from 10 to 12 days.5,6,10,11 Clinicians should be aware of the potential for some patients to rapidly deteriorate one week after illness onset. Among all hospitalized patients, a range of 26% to 32% of patients were admitted to the ICU.6,8,11 Among all patients, a range of 3% to 17% developed ARDS compared to a range of 20% to 42% for hospitalized patients and 67% to 85% for patients admitted to the ICU.1,4-6,8,11 Mortality among patients admitted to the ICU ranges from 39% to 72% depending on the study and characteristics of patient population.5,8,10,11 The median length of hospitalization among survivors was 10 to 13 days.1,6,8
Risk Factors for Severe Illness
Patients in China with no reported underlying medical conditions had an overall case fatality of 0.9%. Case fatality was higher for patients with comorbidities: 10.5% for those with cardiovascular disease, 7.3% for those with diabetes, and approximately 6% for those with chronic respiratory disease, or cancer.1,6,14,36,38,41,42 Prior stroke, diabetes, chronic lung disease, and chronic kidney disease have all been associated with increased illness severity and adverse outcomes. Serious
heart conditions, including heart failure, coronary artery disease, congenital heart disease, cardiomyopathies, and pulmonary hypertension, may put people at higher risk for severe illness from COVID-19. People with hypertension may be at an increased risk for severe illness from COVID-19 and should continue to take their medications as prescribed. At this time, people whose only underlying medical condition is hypertension are not considered to be at higher risk for severe illness from COVID-19.43,44