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?

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

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

How long do you have COVID-19 before you die?

Official Answer

by Drugs.com

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-19start 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)Sepsis100% (54)42% (58)Respiratory failure98% (53)36% (50)Acute respiratory distress syndrome (ARDS)93% (50)7% (9)Heart failure52% (28)12% (16)Septic shock70% (38)0Blood coagulation issues50% (27)7% (10)Acute cardiac injury59% (32)0.7% (1)Acute kidney injury50% (27)0.7% (1)Secondary infection50% (27)0.7% (1)Low protein blood levels37% (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.

Summary

• 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

This is, How long do you have COVID-19 before you die? Average 18.5 days.