Risk Factors associated with In-Hospital Death in Adult COVID-19 Patients in Karachi, Pakistan: A Retrospective Chart Review
DOI:
https://doi.org/10.51253/pafmj.v74iSUPPL-2.4652Keywords:
Coronavirus, Complication, Death, Intensive care, Mortality.Abstract
Objective: To identify the risk factors associated with in-hospital mortality of COVID-19 patients in the largest Navy hospitals in Pakistan.
Study Design: Retrospective chart review.
Place and Duration of Study: Department of Medicine, Pakistan Navy Station Shifa Hospital, Karachi Pakistan, from Apr to May 2020.
Methodology: All patients who died in the Intensive care unit of Pakistan Navy Station Shifa Hospital, Karachi during study period, having polymerase chain reaction positive COVID-19 infection were included. The data recorded included basic demographics (age, gender and length of stay in hospital), documentation of co-morbidities (e.g. diabetes mellitus, ischemic heart disease and other medical and surgical problems), need for mechanical ventilation and most probably cause or contributory factor to the death of the patient. Descriptive statistics were used for calculating mean and frequencies. Chi-square test was used to determine the association between variables of the study,
Results: A total of 22 cases were included. There were 21 males. The mean age was 65.7 years. Most 12(56.5%) of the patients were more than 65 years of age. Diabetes Mellitus was the most common risk factor in 15(69%) patients followed by hyperten-sion 13(59%) and ischemic heart disease in 10(45%). The hospital admission ranged from 1 to 19 days with a mean of 7.13 days.
Conclusion: We identified length of stay, mechanical ventilation, age >65 years, pneumonia and DIC are the potential risk factors for in-hospital mortality in severely ill COVID-19 patients. This audit can guide the clinicians working in resource constrained areas, ....
Downloads
References
Ge H, Wang X, Yuan X, Xiao G, Wang C, Deng T, et al. The epidemiology and clinical information about COVID-19. Eur J Clin Microbiol Infect Dis 2020; 39: 1011-1019.
https://doi.org/10.1007/s10096-020-03874-z
World Health Organization. Coronavirus disease (COVID-19). Situation Report – 158. Available at https://www.who.int/ docs/default-source/coronaviruse/situation-reports/20200626-covid-19-sitrep-158.pdf?sfvrsn=1d1aae8a_2 Accessed on 27th June 2002.
Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci 2020; 77: 8-12. https://doi.org/10.1016/j.jocn.2020.05.017
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. The Lancet. 2020; 395(10223): 497-506.
Vincent JL, Taccone FS. Understanding pathways to death in patients with COVID-19. Lancet Respir Med. 2020; 8: 430-432.
https://doi.org/10.1016/S2213-2600(20)30165-X
Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, et.al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020 Apr 12: S0091-6749(20)30495-4.
https://doi.org/10.1016/j.jaci.2020.04.006 Epub ahead of print.
Wang K, Zhang Z, Yu M, Tao Y, Xie M. 15-day mortality and associated risk factors for hospitalized patients with COVID-19 in Wuhan, China: an ambispective observational cohort study. Intensive Care Med. 2020 Apr 23: 1–3.
https://doi.org/10.1007/s00134-020-06047-w Epub ahead of print.
Martins-Filho PR, Tavares CSS, Santos VS. Factors associated with mortality in patients with COVID-19. A quantitative evidence synthesis of clinical and laboratory data. Eur J Intern Med. 2020; 76: 97-99. https://doi.org/10.1016/j.ejim.2020.04.043
Government of Pakistan. Official COVID-19 website. Available at http://covid.gov.pk/ Accessed on 27th June 2020.
Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020; 368: m1091.
https://doi.org/10.1136/bmj.m1091
Lorente-Ros A, Monteagudo Ruiz JM, Rincón LM, Ortega Pérez R, Rivas S, Martínez-Moya R, et.al. Myocardial injury determination improves risk stratification and predicts mortality in COVID-19 patients. Cardiol J. 2020 Jun 26.
https://doi.org/10.5603/CJ. a2020.0089 Epub ahead of print.
Wang L, He W, Yu X, Hu D, Bao M, Liu H, et al. Coronavirus Disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect 2020.
https://doi.org/10.1016/j.jinf.2020.03.019
Wynants L, Van Calster B, Bonten MM, Collins GS, Debray TP, De Vos M, et al. Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal. bmj. 2020 Apr 7; 369.
Walter LA, McGregor AJ. Sex-and Gender-specific Observations and Implications for COVID-19. West J Emerg Med. 2020 Apr 10; 21(3): 507-509. https://doi.org/10.5811/westjem.2020.4.47536
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 28; 395(10229): 1054-1062.
https://doi.org/10.1016/S0140-6736(20)30566-3
Erratum in: Lancet. 2020 Mar 28; 395(10229): 1038.
Hakeem R, Fawwad A. Diabetes in Pakistan: epidemiology, determinants and prevention. Journal of diabetology. 2010 Sep 1; 1(3): 3.
Du RH, Liang LR, Yang CQ, Wang W, Cao TZ, Li M, et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020 7; 55: 2000524.
https://doi.org/10.1183/13993003.00524-2020
Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy. JAMA. 2020 Mar 23.
https://doi.org/10.1001/jama.2020.4683. Epub ahead of print
Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 May; 46(5): 846-848.
https://doi.org/10.1007/s00134-020-05991-x Epub 2020 Mar 3. Erratum in: Intensive Care Med. 2020 Apr 6.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Imran Ahmad, Farooq Azam Rathore, Muhammad Nadir Khan, Sheikh Nabi Buksh Nazir
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.