CLINICO-EPIDEMIOLOGICAL PROFILE OF COVID-19 PATIENTS ADMITTED TO TERTIARY CARE MEDICAL COLLEGE HOSPITAL IN SOUTH INDIA
DOI:
https://doi.org/10.22159/ajpcr.2024v17i11.52900Keywords:
Coronavirus disease 2019, Intensive care unit admission, Severe respiratory failureAbstract
Objective: This is a retrospective study done in tertiary care medical college hospital in south India to look for clinico-epidemiological profile of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU). This study can help us in identifying the risk factors leading to increased mortality. Hence, identifying these factors can help us in modifying the treatment depending on the risk factors that are present.
Methods: All patients who are diagnosed with COVID-19 with reverse transcription polymerase chain reaction positivity admitted to ICU are enrolled. Data are collected retrospectively by analyzing the medical case records and looking for all parameters, such as age, sex, underlying comorbidity, method of oxygen therapy, degree of severity, and inflammatory markers. All these data are analyzed and compared between survivors and non-survivors.
Results: 81% were male patients in comparison to female patients contributing to 19%. 55% were <60 years and 45% were >60 years. Non-survivors had a mean age of 64.5 years. Average days of hospital admission, ICU admission, and onset of hypoxia after symptom onset were 4.2 days, 8.5 days, and 7.8 days, respectively. Average PaO2 and P/F ratio was 81.25 and 165.9, respectively. The average P/F ratio in non-survivors was 144 compared to survivors having 187. The average high-resolution computed tomography score on admission and discharge was 12.4 and 11.9, respectively. Regarding inflammatory markers average lactate dehydrogenase (LDH), Ferritin, and interleukin-6 were 462, 618.2, and 130.56, respectively. Non-survivors had increased LDH with a mean of 538.3 when compared to survivors having a mean of 421.4.
Conclusion: This study showed that there is increased mortality with an increase in age, especially >60 years. Severe respiratory failure with P/F ratio<144 had increased mortality. Patients with increased LDH showed an increase in mortality.
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References
World Health Organization. WHO Director-General’s Opening Remarks at the Media Briefing on COVID19. Geneva: World Health Organization; 2020.
Government of Kerala. Available from: https://dashboard.kerala.gov.in/ covid/index.php [Last accessed on 2022].
Chilamakuri R, Agarwal S. COVID-19: Characteristics and therapeutics. Cells. 2021;10:206.
Leung C. The incubation period of COVID-19: Current understanding and modelling technique. Adv Exp Med Biol. 2021;1318:81-90.
Long B, Carius BM, Chavez S, Liang SY, Brady WJ, Koyfman A, et al. Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation. Am J Emerg Med. 2022;54:46-57.
Pereira AB, Pereira FS, Araújo JÉ, Brasil RP, Oliveira AM, Lima SS, et al. Clinical-epidemiological profile of COVID-19 patients admitted during three waves of the pandemic in a tertiary care center, in Belém, Pará, Amazon Region of Brazil. Viruses. 2024;16:1233.
Zhang JJ, Dong X, Liu GH, Gao YD. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin Rev Allergy Immunol. 2023;64:90-107.
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323:2052-9.
Tambe MP, Parande MA, Tapare VS, Borle PS, Lakde RN, Shelke SC, et al. An epidemiological study of laboratory confirmed COVID-19 cases admitted in a tertiary care hospital of Pune, Maharashtra. Indian J Public Health. 2020;64:S183-7.
Dave M, Sharma M, Poswal L, Bedi V, Deval N, Vijayvargiya R. Epidemiology, clinical profile and outcome of COVID-19 patients admitted in dedicated covid hospital in Southern Rajasthan. Int J Curr Res. 2020;12:11914-8.
Graff K, Smith C, Silveira L, Jung S, Curran-Hays S, Jarjour J, et al. Risk factors for severe COVID-19 in children. Pediatr Infect Dis J. 2021;40:e137-45.
Figueroa R, Molina P, Villalobos A, Cecilia Canto-Costal A, Patrón D, Aguilar I, et al. 541: Impact of time interval from covid-19 symptom onset to hospitalization: An outcome analysis. Crit Care Med. 2024 Jan;52(1):S244.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
Oda T, Hagiwara E, Yamaya T, Ogura T. Timeline of oxygen demand in patients with COVID-19 pneumonia. Intern Med. 2022 Dec 15;61(24):3651-8.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475-81.
Sinatti G, Santini SJ, Tarantino G, Picchi G, Cosimini B, Ranfone F, et al. PaO2/FiO2 ratio forecasts COVID-19 patients’ outcome regardless of age: A cross-sectional, monocentric study. Intern Emerg Med. 2022;17:665-673.
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574-81.
Yazdi NA, Ghadery AH, SeyedAlinaghi S, Jafari F, Jafari S, Hasannezad M, et al. Predictors of the chest CT score in COVID-19 patients: A cross-sectional study. Virol J. 2021;18:225.
Salahshour F, Mehrabinejad MM, Nassiri Toosi M, Gity M, Ghanaati H, Shakiba M, et al. Clinical and chest CT features as a predictive tool for COVID-19 clinical progress: Introducing a novel semi-quantitative scoring system. Eur Radiol. 2021;31:5178-88.
Nagra D, Russell M, Yates M, Galloway J, Barker R, Desai SR, et al. COVID-19: Opacification score is higher in the right lung and right lung involvement is a better predictor of ICU admission. Eur Respir J. 2020;56:2002340.
Nolley EP, Sahetya SK, Hochberg CH, Hossen S, Hager DN, Brower RG, et al. Outcomes among mechanically ventilated patients with severe pneumonia and acute hypoxemic respiratory failure from SARS-CoV-2 and other etiologies. JAMA Netw Open. 2023;6(1):e2250401.
Sjoding MW, Admon AJ, Saha AK, Kay SG, Brown CA, Co I, et al. Comparing clinical features and outcomes in mechanically ventilated patients with COVID-19 and acute respiratory distress syndrome. Ann Am Thorac Soc. 2021;18(11):1876-85.
Msemburi W, Karlinsky A, Knutson V, Aleshin-Guendel S, Chatterji S, Wakefield J. The WHO estimates of excess mortality associated with the COVID-19 pandemic. Nature. 2023;613:130-7.
Romero Starke K, Reissig D, Petereit-Haack G, Schmauder S, Nienhaus A, Seidler A. The isolated effect of age on the risk of COVID-19 severe outcomes: A systematic review with meta-analysis. BMJ Glob Health. 2021;6:e006434.
Bonanad C, García-Blas S, Tarazona-Santabalbina F, Sanchis J, Bertomeu-González V, Fácila L, et al. The effect of age on mortality in patients with COVID-19: A meta-analysis with 611,583 subjects. J Am Med Dir Assoc. 2020 Jul;21(7):915-8.
Gu Y, Wang D, Chen C, Lu W, Liu H, Lv T, et al. PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients. Sci Rep. 2021;11:7334.
Parada-Gereda HM, Avendaño JM, Melo JE, Ruiz CI, Castañeda MI, Medina-Parra J, et al. Association between ventilatory ratio and mortality in patients with acute respiratory distress syndrome and COVID 19: A multicenter, retrospective cohort study. BMC Pulm Med. 2023;23:425.
Sidhwani SK, Mirza T, Khatoon A, Shaikh F, Khan R, Shaikh OA, et al. Inflammatory markers and COVID-19 disease progression. J Infect Public Health. 2023 Sep;16(9):1386-91.
Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med. 2020;38(9):1722-6.
Linarez Ochoa NE, Rodríguez G, Reyes ID, Rico Rivas KM, Ramírez C, Durón RM. Differences in inflammatory markers between coronavirus disease 2019 and sepsis in hospitalised patients. Clin Epidemiol Glob Health. 2022;15:101059.
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