Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India

https://doi.org/10.4081/monaldi.2021.1724

Authors

  • Yamini Marimuthu | yaminivaishnavidevi@gmail.com Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru , India. https://orcid.org/0000-0003-0599-2945
  • Radhika Kunnavil Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru , India. https://orcid.org/0000-0002-2066-7836
  • NS Anil Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru , India.
  • Sharath Burugina Nagaraja Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru , India. https://orcid.org/0000-0002-6599-5753
  • N Satyanarayana Department of General Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, India.
  • Jeetendra Kumar ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, India.
  • Bojja Ramya ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, India.

Abstract

COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19.  This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention.  Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

References

World Health Organization. WHO Timeline - COVID-19. 2020. Available from: https://www.who.int/news-room/detail/08-04-2020-who-timeline---covid-19

World Health Organization. Weekly epidemiological update - 10 November 2020. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update---10-november-2020

Ministry of Health and Family Welfare. COVID-19 India. Gov. India. 2020. Available from: https://www.mohfw.gov.in/

Nishiura H, Kobayashi T, Suzuki A, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect Dis 2020;94:154–5. DOI: https://doi.org/10.1016/j.ijid.2020.03.020

Adhikari SP, Meng S, Wu Y-J, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infect Dis Poverty 2020;9:29. DOI: https://doi.org/10.1186/s40249-020-00646-x

Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507–13. DOI: https://doi.org/10.1016/S0140-6736(20)30211-7

Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9. DOI: https://doi.org/10.1001/jama.2020.1585

Colaneri M, Sacchi P, Zuccaro V, et al. Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020. Euro Surveill 2020;25:2000460. DOI: https://doi.org/10.2807/1560-7917.ES.2020.25.16.2000460

Chen J, Lu H, Melino G, et al. COVID-19 infection: the China and Italy perspectives. Cell Death Dis 2020;11:1–17. DOI: https://doi.org/10.1038/s41419-020-2603-0

Salinas-Escudero G, Carrillo-Vega MF, Granados-García V, et al. A survival analysis of COVID-19 in the Mexican population. BMC Public Health 2020;20:1616. DOI: https://doi.org/10.1186/s12889-020-09934-5

Li X, Xu S, Yu M, et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol 2020;146:110–8. DOI: https://doi.org/10.1016/j.jaci.2020.04.006

Chen L, Zhang B, Ti M, et al. Clinical course of severe and critically ill patients with coronavirus disease 2019 (COVID-19): A comparative study. J Infect 2020;81:e82–4. DOI: https://doi.org/10.1016/j.jinf.2020.05.021

Zheng Z, Peng F, Xu B, et al. Risk factors of critical and mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020;81:e16–25. DOI: https://doi.org/10.1016/j.jinf.2020.04.021

National Institutes of Health [Internet]. Phase 3 clinical trial of investigational vaccine for COVID-19 begins. 2020. Available from: https://www.nih.gov/news-events/news-releases/phase-3-clinical-trial-investigational-vaccine-covid-19-begins

National Centre for Disease Control [Internet]. The updated case definitions and contact-categorisation. New Delhi: 2020. Available from: https://ncdc.gov.in/WriteReadData/l892s/89568514191583491940.pdf

World Health Organization. Global Adult Tobacco Survey (GATS) Indicator Guidelines: Definition and Syntax. 2009. Available from: https://www.who.int/tobacco/surveillance/en_tfi_gats_indicator_guidelines.pdf

Song J, Hu W, Yu Y, et al. A comparison of clinical characteristics and outcomes in elderly and younger patients with covid-19. Med Sci Monit 2020;26:e925047. DOI: https://doi.org/10.12659/MSM.925047

StataCorp. Stata Statistical Software: Release 14. 2017.

Galbadage T, Peterson BM, Awada J, et al. Systematic review and meta-analysis of sex-specific COVID-19 clinical outcomes. Front Med 2020;7:348. DOI: https://doi.org/10.3389/fmed.2020.00348

Maleki Dana P, Sadoughi F, Hallajzadeh J, et al. An Insight into the sex differences in COVID-19 patients: What are the possible causes? Prehosp Disaster Med 2020;35:438-41. DOI: https://doi.org/10.1017/S1049023X20000837

Salvati L, Biagioni B, Vivarelli E, Parronchi P. A gendered magnifying glass on COVID-19. Clin Mol Allergy 2020;18:14. DOI: https://doi.org/10.1186/s12948-020-00129-2

Mueller AL, Mcnamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY) 2020;12:9959–81. DOI: https://doi.org/10.18632/aging.103344

Perrotta F, Corbi G, Mazzeo G, et al. COVID-19 and the elderly: insights into pathogenesis and clinical decision-making. Aging Clin Exp Res 2020;32:1599–608. DOI: https://doi.org/10.1007/s40520-020-01631-y

Okuno F, Arai M, Ishii H, et al. Mild but prolonged elevation of serum angiotensin converting enzyme (ACE) activity in alcoholics. Alcohol 1986;3:357–9. DOI: https://doi.org/10.1016/0741-8329(86)90053-4

Mallet J, Dubertret C, Le Strat Y. Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review. Prog Neuro-Psychopharmacology Biol Psychiatry 2021;160:110070. DOI: https://doi.org/10.1016/j.pnpbp.2020.110070

Cai G, Bossé Y, Xiao F, Kheradmand F, Amos CI. Tobacco smoking increases the lung gene expression of ACE2, the Receptor of SARS-CoV-2. Am J Respir Crit Care Med 2020;201:1557–9. DOI: https://doi.org/10.1164/rccm.202003-0693LE

Abayomi A, Odukoya O, Osibogun A, et al. Presenting symptoms and predictors of poor outcomes among 2,184 patients with COVID-19 in Lagos State, Nigeria. Int J Infect Dis 2020;102:226–32. DOI: https://doi.org/10.1016/j.ijid.2020.10.024

Li L, Sun W, Han M, et al. A study on the predictors of disease severity of COVID-19. Med Sci Monit 2020;26:8. DOI: https://doi.org/10.12659/MSM.927167

Jain V, Yuan J-M. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health 2020;65:533–46. DOI: https://doi.org/10.1007/s00038-020-01390-7

Apicella M, Campopiano MC, Mantuano M, et al. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol 2020;8:782–92. DOI: https://doi.org/10.1016/S2213-8587(20)30238-2

Mitchell F. Vitamin-D and COVID-19: do deficient risk a poorer outcome? Lancet Diabetes Endocrinol 2020;8:570. DOI: https://doi.org/10.1016/S2213-8587(20)30183-2

Ajaimy M, Melamed ML. Covid-19 in patients with kidney disease. Clin J Am Soc Nephrol 2020;15:1087–9. DOI: https://doi.org/10.2215/CJN.09730620

Downloads

Published
2021-05-17
Info
Issue
Section
COVID-19 - Collection of articles on the Coronavirus outbreak
Keywords:
COVID-19, SARS CoV-2, risk factors, survival analysis, mortality
Statistics
  • Abstract views: 1930

  • PDF: 118
How to Cite
Marimuthu, Yamini, Radhika Kunnavil, NS Anil, Sharath Burugina Nagaraja, N Satyanarayana, Jeetendra Kumar, and Bojja Ramya. 2021. “Clinical Profile and Risk Factors for Mortality Among COVID-19 Inpatients at a Tertiary Care Centre in Bengaluru, India”. Monaldi Archives for Chest Disease, May. https://doi.org/10.4081/monaldi.2021.1724.