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    2 Comments for this article
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    Another antihypertensive drug may impact incomes
    Zaur Gasimov, MD | Research Institute of Cardiology
    Wide use of combination of hydrochlorothiazide with ACEinh, ARB, and furosemide may impact outcomes in hypertensive patients with COVID-19, because patients with COVID-19 often have very high level of D-dimer, therefore HCTZ and and furosemide may contribute to blood clotting, which may increase mortality rate.
    CONFLICT OF INTEREST: None Reported
    Clinical characteristics of patients from COVID19 death
    Basil Fadipe, MBBS | Justin Fadipe Centre/ All Saints College of Medicine
    Some further clinical information could be informative: 

    A. What is length of time to death from diagnosis of COVID19?

    B. What is length of time between admission and mechanical ventilation support?

    C. What is length of time from mechanical ventilation to death?

    D. If lack of intensivists is taken to suggest delayed intubation, could presence of intensivists also create an intubation bias with premature and unnecessary intubations?

    E. Recent observations have not supported the assumption that mortality is reduced by intubation per se. Isn’t it important that standard controlled prospective studies need be done
    to assess the role of intubation vs non intubation in clinically matched groups?

    F. Silent hypoxemia in acute respiratory events raises new questions. It would be interesting to know if there were antemortem neurological symptoms and signs in these cases that may suggest blunting of brain stem reflexes to explain the “silent hypoxemia."
    CONFLICT OF INTEREST: None Reported
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    Research Letter
    Critical Care Medicine
    April 10, 2020

    Clinical Characteristics of Patients Who Died of Coronavirus Disease 2019 in China

    Author Affiliations
    • 1Department of Critical Care Medicine, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
    • 2Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
    • 3Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
    • 4Medical Intensive Care Unit, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing, China
    JAMA Netw Open. 2020;3(4):e205619. doi:10.1001/jamanetworkopen.2020.5619

    The outbreak of coronavirus disease 2019 (COVID-19) has been very severe in China.1 As of March 2020, many tens of thousands of patients have had confirmed COVID-19, and cases have been increasing daily.2 The mortality is much higher in Wuhan, China, than in other cities.3 To understand the characteristics of patients who die of COVID-19, we analyzed 168 patients with COVID-19–induced pneumonia who died.

    This case series’ study protocol was approved by each local institutional ethics committees. Written informed consent was waived owing to the urgent need to collect data. Data were obtained from 21 hospitals in Wuhan, China. Demographic, comorbidity, and respiratory support data for 168 patients who died of COVID-19 between January 21 to 30, 2020, in these hospitals were collected. All patients were diagnosed as having COVID-19 according to World Health Organization guidance.3 All patients underwent nucleic acid testing by reverse transcription–polymerase chain reaction testing, and their results were positive for COVID-19. Categorical variables were described as numbers (proportions) and continuous variables were described as medians and interquartile ranges (IQRs). Data were analyzed from February 8 to February 10, 2020.

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