21,392 COVID-19 patients constituted one of the largest cohort studies to date
As of February 27, 2020, 70,233 COVID-19 cases were reported in Hubei Province, including confirmed, clinical, suspected, and asymptomatic cases, some of which were excluded from diagnosis during follow-up. Among them, 21,392 cases were selected for our interview and included in this study. Table S3 shows the comparison of the general demographic characteristics of the included and excluded cases; the two groups had a similar fatality rate (4.77% versus 5.00%, p = 0.21). However, the included participants were more likely to be males and be of a young age. There was no loss to follow-up during the follow-up period, and 1,020 patients died of COVID-19, giving an overall CFR of 4.77% in Hubei. The CFR across different characteristics is presented in Table 1. Patients aged 60 years and older presented the highest fatality rate (14.05%) compared with other groups. A relatively higher fatality rate was observed among males (5.87%) than females (3.58%). Patients with comorbidities had a higher fatality rate (11.33%) than those without (2.98%). An increasing fatality rate was found with higher disease severity, with the highest in the critical level (48.59%).
The patients with a longer interval between symptom onset and diagnosis had a higher fatality rate (7.87% for those longer than 14 days and 4.27% for those fewer than 7 days). Patients admitted to hospital before February 8 had a higher fatality rate (5.97%) than those admitted after February 8, 2020 (2.41%). Relatively higher fatality rates were also present among patients with higher WBC counts (16.50%), a lower count (8.86%) and percentage (8.59%) of lymphocytes, and a higher percentage of neutrophils (7.93%). Differential CFRs were also found across different strata of other factors, such as level of admitted hospital, occupation, and residence.
Cite this article
Wu, R., Ai, S., Cai, J., Zhang, S., Qian, Z., Zhang, Y., Wu, Y., Chen, L., Tian, F., Li, H., Li, M. and Lin, H. Predictive Model and Risk Factors for Case Fatality of COVID-19: A Cohort of 21,392 Cases in Hubei, China. The Innovation 1 (2), 100022 (2020). doi: 10.1016/j.xinn.2020.100022