Prognosis

The case fatality rate is approximately 35%.[154] This fatality rate is lower than previously reported rates in the literature as cohort studies generally include only patients who are sick enough to require hospitalisation.[5][8][9][26]

Age ≥50 years has been associated with more severe presentation, worse outcomes, and a higher risk of mortality.[5][27] In one cohort study, mortality increased with increasing age to reach 75% in patients >60 years of age.[8]

Presence of comorbidities (e.g., diabetes mellitus, chronic renal impairment, heart disease, obesity) increases the risk of acute respiratory failure and worse outcomes.[5][8][9][26][81]

Natural course of infection

As the clinical presentation is highly variable and ranges from no symptoms to rapidly progressive pneumonia, the natural course is also variable.

The median time from symptom onset to death ranges from 16.5 to 20.5 days in cohort studies.[8][27] Median time to viral clearance, documented by negative real-time reverse transcription polymerase chain reaction (RT-PCR) on respiratory specimens, is 11 days (range 6 to 35 days).[5][155] In patients who survived, median time from symptom onset to discharge from hospital was 27 days (range 20 to 31.5 days).[27]

Recurrence of infection in patients who have recovered has not been reported. There are currently no data on whether previous infection offers protection against future infection.

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