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How do COVID-19 symptoms progress and what causes death?

What are the signs, symptoms and stages of COVID-19, and what causes death in COVID-19? How long do you spend in the ICU with COVID-19? How long do you have COVID-19 before you die?

Medically reviewed by Melisa Puckey, BPharm Last updated on Apr 7, 2020.

Official Answer


What are the stages and symptoms of COVID-19?

  • Day 1: The symptoms usually start with a fever, a dry cough and mild breathing issues which may get worse over the next week. You also may have symptoms of a sore throat, coughing up mucus, diarrhea, nausea, body aches and joint pain.
  • Day 7: Breathing may become difficult or laboured. This is called dyspnoea.
  • Day 9: Sepsis may start, this is the body's extreme response to an infection that can lead to organ failure or injury.
  • Day 10-12: People who have mild COVID-19 start to have an improvement in their fever and cough, but in serious cases their fever and cough continues.
  • Acute respiratory distress syndrome (ARDS) starts to be diagnosed, this is a respiratory problem when there is widespread inflammation in the lungs.
  • Day 12: This is the median day to be admitted into the intensive care unit (ICU). 
  • Day 15: Acute kidney and cardiac injury becomes evident.
  • Day 18.5: The median time it takes from the first symptoms of COVID-19 to death is 18.5 days.
  • Day 22: This is the median amount of days it takes for COVID-19 survivors to be released from hospital 

A study published in The Lancet studied the patients who were hospitalized with COVID-19 and compared details of the patients who passed away and patients that survived.

This figure below shows the progression and duration of the major symptoms of COVID-19 in survivors and non-survivors for hospitalized patients in the study. 

progression and duration of the major symptoms of COVID-19

Facts and figures of patients who were hospitalized with COVID-19

Figures from the above study show:

  • 191 people hospitalized with COVID 19
  • 28% (54) patients died from COVID-19
  • 72% (137) patients survived COVID-19
  • 26% (50) of patients went into intensive care unit (ICU)
  • 78% (39) patients who went into ICU passed away
  • 22% (11) patients who went to ICU survived
  • 8 days was the median length of stay in ICU
  • 11 days was the median total length of stay in hospital 
  • 22 days was the time from first symptom until discharge from hospital for survivors
  • 18.5 days from first symptoms until death for non-survivors
  • 20 days median length of time for viral shedding, starting at first day of symptoms
  • 52 years old median age for survivor
  • 69 years old median age for non-survivor

What health complications of COVID-19 cause you to die?

COVID-19 is well known for breathing problems, but other health complications also contribute towards the death from COVID-19. It is often a combination of these health problems that cause the body to fail and ultimately result in death.

  COVID-19 Deaths (n=54) COVID-19 Survivors (n=137)
Sepsis 100% (54) 42% (58)
Respiratory failure 98% (53) 36% (50)
Acute respiratory distress syndrome (ARDS) 93% (50) 7% (9)
Heart failure 52% (28) 12% (16)
Septic shock 70% (38) 0
Blood coagulation issues 50% (27) 7% (10)
Acute cardiac injury 59% (32) 0.7% (1)
Acute kidney injury 50% (27) 0.7% (1)
Secondary infection 50% (27) 0.7% (1)
Low protein blood levels 37% (20) 1.5% (2)
Acidosis (body fluids are too acid) 30% (16) 0.7% (1)

Can blood tests be used to help determine the severity level of COVID-19 illness?

Lymphocyte levels: In COVID-19 survivors the blood lymphocyte counts are high and increase after day 7, when compared to patients that pass away who have severely low lymphocyte counts 

D-dimer, high-sensitivity cardiac troponin I, serum ferritin, lactate dehydrogenase, and IL-6 levels: These were all clearly elevated in non-survivors compared to the survivors. These levels in non-survivors all increased dramatically after approximately 2 weeks.


  • What is the death rate for people hospitalized with COVID-19? 28%
  • What is the survival rate for people hospitalized with COVID-19? 72%
  • What rate of hospitalized COVID-19 patients go into the intensive care unit (ICU)? 26%
  • What percentage of COVID-19 patients who go into the ICU die? 78%
  • What percentage of COVID-19 patients who go into the ICU survive? 22%
  • How many days from onset of first symptoms of COVID-19 until ICU admission? 12 days (median)
  • What is the median length of stay in ICU for COVID-19 patients? 8 day (median)
  • How many days is the median hospital stay for COVID-19 patients? 11 days 
  • How long does it take from the first COVID-19 symptoms until hospital discharge? 22 days (median)
  • How long is viral shedding in COVID-19 patients, starting from the first day of symptoms? Until death or in survivors it is 20 days (median)
  • What is the average age of a hospitalized COVID-19 survivor? 52 years old
  • What is the average age of a hospitalized COVID-19 who dies? 69 years old
  • How many days from first COVID-19 symptoms until death for hospitalized patients? 18.5 days

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