Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2.

From the authors:

We appreciate the thoughtful comments of H-J. Yang and co-workers in their correspondence addressing the predictors of mortality for patients with coronavirus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Their comments are very helpful to improve the expression and increase the quality of our paper [1].

We agree that the first question of the 95% confidence interval of pre-existing cardiovascular or cerebrovascular diseases was incorrect. Since all indicators are in the multivariate logistic regression analysis, the 95% confidence intervals of the other three indicators are modified. We have corrected the 95% confidence intervals for age ≥65 years, pre-existing concurrent cardiovascular or cerebrovascular diseases, CD3+CD8+ T-cells ≤75 cells·μL−1 and cardiac troponin I ≥0.05 ng·mL−1 in a revised version of the table according to the the author correction notice in this issue of the European Respiratory Journal. Many studies have found the same results, that prevalent cardiovascular disease is associated with higher mortality and severity of COVID-19 [2-4]. Furthermore, Shi et al. [5] found that patients with cardiac injury (elevated TnI) have a worse prognosis, suggesting specific target organ damage by SARS-CoV-2. Our findings were likely to be generalisable to other populations worldwide.

We completely agree with H-J. Yang and co-workers that in clinical practice, a patient may undergo some laboratory examinations (such as blood regular test) several times, and the results of the same test for the same patient may be different from one time to another. The information for all patients, including demographic data, clinical characteristics, laboratory parameters and outcomes, were collected prospectively upon hospital admission in our study. We further add the time of that laboratory parameters were obtained in the methods.

Overall death rate is the ratio of the number of dead individuals in a certain period to the average population number in the same period. The main difference between overall death rate and case fatality rate (CRF) is that overall death rate refers to the frequency of death from a certain disease at a certain time, while CRF is used to describe the severity of a certain disease. We have carefully studied the methods for estimating the case fatality ratio for a novel, emerging infectious disease [6]. As of midnight on 24 March 2020, the numbers of Chinese confirmed COVID-19 pneumonia cases were 81 218 and deaths were 3281. The confirmed case fatality rate was calculated using the formula: number of cumulative death/cumulative number of confirmed cases. We consent that the overall death rate from COVID-19 pneumonia is an incorrect expression. So, the overall death rate has been corrected to “confirmed case fatality rate”.

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