An observational study today in The Lancet that involved seriously ill adults hospitalized with confirmed COVID-19 early in the outbreak in Wuhan, China, found that advanced age, signs of sepsis, and blood clotting issues were all risk factors for in-hospital death.

Knowing these risk factors could help healthcare providers identify COVID-19 patients with a poor prognosis early on, according to the authors of the retrospective cohort study, which involved patients hospitalized from Dec 29, 2019, to Jan 31, 2020.

A high Sequential Organ Failure Assessment score (5.65; 95% confidence interval [CI], 2.61 to 12.23; < 0.0001) —indicating sepsis—and a d-dimer test result greater than 1 microgram per liter (to identify serious blood clots) indicated a poor prognosis, the researchers found.

This is the first and largest study of the risk factors linked to severe COVID-19 infection and death in hospitalized adults who either died or were released from the hospital, the authors said. Of 191 patients, 137 were released, and 54 (28%) died in the hospital.

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Co-existing conditions portend poor prognosis

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