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Updated on 24th April 2020

COVID-19 is a new disease for everyone, including doctors and scientists. Various studies and a lot of research is ongoing to find a cure and vaccine for this viral infection.

Doctors have been searching for different ways to save patients with severe symptoms of COVID-19 which are inability to breathe, persistent pain in the chest, sudden confusion (delirium) and bluish discolouration of the face. So far, doctors have stated that people with high blood pressure (hypertension), diabetes, heart disease, chronic kidney disease, lung disease and cancer are at a high risk of developing severe symptoms of COVID-19 if they get the infection.

As of 24th April 2020, more than 1.9 lakh people had died due to COVID-19 infection: most of them were over 60 years old, while many others developed severe complications such as sepsis, respiratory failure, septic shock and multiple organ failure. 

Here in this article, we will tell you about the possible causes of deaths in people suffering from COVID-19 infection.

  1. Common causes of death in patients with severe COVID-19 infection
  2. Possible causes of death in COVID-19
  3. Doctors for Causes of death in COVID-19 patients

Various studies have been done on the people who have been severely affected by COVID-19 infection. The following are some studies which have been done on people who died due to serious complications of COVID-19:

1. The Lancet - a peer-reviewed journal - published an article on 11 March 2020 based on a small study from China which stated that half of the patients who had the worst results from COVID-19 infection were the ones who developed sepsis. It was concluded that sepsis was one of the common complications seen in critical patients of COVID-19. Sepsis is a life-threatening reaction of the body towards an infection that tries to invade different organs. Sepsis can lead to multiple organ damage. 

2. A study published on 27 February 2020 in the journal JAMA stated that over 2,000 patients, out of the 44,672 confirmed cases of COVID-19 in Wuhan, China, were critically ill and required intensive care and ventilator support for breathing. The patients who died experienced respiratory failure, septic shock, and multiple organ failure. Respiratory failure is a condition in which the lungs fail to deliver oxygen which increases the level of carbon dioxide in the blood. A person having respiratory failure would not be able to breathe and would have an increased heart rate. 

3. Another article in JAMA, published on 11 March 2020, stated that most of the critically ill patients of COVID-19 suffered from septic shock and organ damage like acute kidney injury. These critically ill patients were at a high risk of dying because of COVID-19. 

4. In a study published on 20 March 2020, it was concluded that patients who were critically ill were suffering from severe pneumonia, Acute respiratory distress syndrome (ARDS), sepsis and septic shock. These people were at a high risk of death due to COVID-19 infection.

Based on these research findings, some of the most common causes of death in COVID-19 patients are:

  • Sepsis
  • Septic shock
  • Multiple organ failure
  • Respiratory distress and failure

Scientists are still trying to find the cause behind the deaths of so many people due to this infectious disease. 

Medical caregivers have stated that some patients were so critical that even after admitting the patients to the ICU, giving them mechanical ventilation, vasopressors and renal replacement therapy, they didn't survive. (Read more: Ventilators for patients with severe COVID-19)

This is because when these patients were admitted to the hospital, their Sequential Organ Failure Assessment (SOFA) and D-dimer levels were comparatively high. SOFA is the score which helps in determining the number and severity of failed organs. Increased D-dimer levels indicate an increased risk in abnormal blood clotting which can be seen during acute pulmonary embolism.

Another reason for the deaths was the lack of medical facilities. Due to the limited medical equipment, beds or machines, life-sustaining therapies could not be given to patients - this affected older people and those living with comorbidities or profound disabilities, the most.

Another major reason for deaths was cytokine storm. According to various studies, when the SARS-CoV-2 virus enters the body, the body’s immune system activates the cytokines (inflammatory cells) which deploy the immune cells to fight against the virus. This leads to slight inflammation in that localised area. But in some cases, the cytokines are released in an enormous amount which leads to hyperinflammation. This cytokine storm causes cell death, which can damage the organ and even cause death in patients. In COVID-19 patients, the cytokine storm is mostly seen in the lungs which cause respiratory failure.

In a recent study published in the journal, Jama, on 22nd April 2020, it was concluded that people who require mechanical ventilation (ventilators) are at a higher risk of dying than those who didn’t. The study included 5700 patients who were hospitalized with COVID-19 infection in New York City. During the due course of hospitalization, 373 patients were admitted to the intensive care unit (ICU) for the treatment, while 320 were intubated and were put up on a ventilator, 81 patients were treated with kidney replacement therapy and 553 people died. Amongst the patients who were put up on the ventilator, 88.1% of them died. This proved a point that people who require ventilator support for breathing are at a constant risk especially if they are above the age of 65 years.

Dr. Neha Gupta

Dr. Neha Gupta

संक्रामक रोग

Dr. Lalit Shishara

Dr. Lalit Shishara

संक्रामक रोग

Dr. Alok Mishra

Dr. Alok Mishra

संक्रामक रोग

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RemdesivirRemdesivir Injection15000.0
Fabi FluFabi Flu Tablet3500.0
CoviforCovifor Injection5400.0
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References

  1. Shebl E, Burns B. Respiratory Failure. [Updated 2019 Dec 6]. In: StatPearls [Internet].
  2. Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 20]. In: StatPearls [Internet].
  3. Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. Published online March 11, 2020. doi:10.1001/jama.2020.3633
  4. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242. doi:10.1001/jama.2020.2648
  5. Science Direct (Elsevier) [Internet]; Clinical course and mortality risk of severe COVID-19
  6. Science Direct (Elsevier) [Internet]; Understanding pathways to death in patients with COVID-19
  7. Science Direct (Elsevier) [Internet]; Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
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