COVID-19 and Mortality

The novel coronavirus disease (COVID-19) has scourged the world ever since its outbreak in December 2019 in Wuhan, China. The disease tends to be asymptomatic or mild in nearly 80% of the patients. However, around 5% of the patients tend to have critical disease complicated by acute respiratory distress syndrome (ARDS), shock and multiple organ failure. Mortality in COVID-19, as represented by the case-fatality rate (CFR), is around 6% (as of June 4, 2020). The CFR of COVID-19 is lower as compared to other coronavirus-related diseases like the Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS), however, it is likely to increase as we reach the end of the pandemic. The CFR also varies widely from one nation to another with the maximum mortality being hitherto reported from the European nations and the least from Singapore, Cambodia, Vietnam and Iceland. The common causes of death in COVID- 19 include respiratory failure, consequently leading to ARDS, pulmonary thromboembolism, shock and multiple organ failure. Advancing age and presence of comorbid illness are consistently associated with an increased risk of death, while certain biochemical and hematological parameters, notably C-reactive protein, IL-6, cardiac troponin, D-dimer and absolute count can also help predict mortality in patients with COVID-19.

Keywords: ACE2, ARDS, Case-fatality rate, Comorbidities, COVID-19, Cytokine storm, D-dimer, Death, Diabetes mellitus, Hypertension, IL-6, Lymphopenia, Mortality, Mortality rate, Novel coronavirus disease, Old age, SARS-CoV-2, Shock, Thromboembolism, Troponin.