A new observational study provides insight into what groups of people are at risk with the coronavirus outbreak.

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The fact that the virus is more dangerous to older people is well known, but what other groups of people are at risk? A new observational study provides more insight.

The research is based on a group of 191 confirmed patients in Wuhan and offers new insights. In addition to old age, diabetes, and high blood pressure also appear to be a significant risk factor and increase the chances of ending in critical condition or death. Of the studied 191 patients, 137 fully recovered while 54 people died in the hospital.

Scientists studied the course of the disease, enabling them to identify some risk factors. Additionally, the authors of the study provided new data on viral shedding, which reveal that the median duration of viral shedding was 20 days in survivors, and the virus was detectable until death in the 54 non-survivors.

Continued viral shedding insinuates that patients might still be able to spread COVID-19. However, the scientists advise that the duration of viral shedding is determined by the severity of the disease severity, and noted that all studied patients were hospitalized, 66 percent of whom had serious or critical illness. Furthermore, the predicted period of viral shedding was restricted by the low recurrence of respiratory specimen collection and the absence of measurable genetic material detection in samples.

Dr. Zhibo Liu, one of the authors of the study, stated that underlying factors like high blood pressure, diabetes, showing signs of sepsis on admission to the hospital, and being of old age were significant factors in the deaths of patients.

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The research is only observational. So the conclusions are purely based on what researchers have seen happen. So researchers cannot definitively explain why, for example, the elderly are more likely to become seriously ill after being exposed to the new coronavirus. However, Liu suspects that poorer outcomes for those that are of old age might be partially due to age-related weakening of the immune system and heightened inflammation, which could promote viral replication in addition to more prolonged responses to inflammation, causing permanent harm to the organs like the heart and brain.

According to professor Bin Cao, co-lead author, prolonged viral shedding as discovered in their study has important implications for guiding decisions regarding isolations, precautions, and antiviral treatment in patients. He recommends that negative tests for COVID-19 should be required before patients are discharged from the hospital.

The study also provides new insight into the course of the disease. One thing to note, however, is that the research only regards patients that have been hospitalized. These patients do not represent the average patient. The median duration of fever was approximately 12 days for survivors, a number similar to that of non-survivors. It turns out that the cough lasts for a long time. Approximately 45% of survivors still had a cough on discharge from the hospital.

Shortness of breath would last for approximately 13 days for survivors. However, it would last until death in non-survivors. On average, 22 days elapsed between the time the survivors contracted the virus and the moment they were allowed to leave the hospital. The people who succumbed to the infection died, on average, 18.5 days after becoming sick. In comparison to survivors, patients who died were more likely to be older, averaging at 69 years old versus an average of 52 years for surviving patients.

Most of the patients were men (62%), and the average patient was middle-aged with a median age of 56. Approximately half of the patients had underlying chronic conditions. The most common underlying conditions were diabetes (19%) and high blood pressure (30%).

The research is published in the science journal: The Lancet and is one of many done on the Coronavirus. Scientists around the world are working around the clock to get a grip on the virus. If you are interested and would like to know more details about this study, be sure to check it out via the link below.

Sources and further reading: The Lancet press release / Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study