How do COVID-19 symptoms progress and what causes death?
Medically reviewed by Melisa Puckey, BPharm. Last updated on April 7, 2020.
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?
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.
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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