Predictors of Mortality of COVID-19 cases In Benazir Bhutto Hospital Rawalpindi
Background: There has been a global epidemic of COVID-19 caused by novel corona virus (SARS-2). Current research aims to study the demographic, clinical characteristics and co-morbidities in COVID-19 related deaths. Methodology: This observational (descriptive) study was conducted at BBH Rawalpindi based on data from 1st March-15th June 2020 after ethical approval. Inclusion criteria was the deceased COVID PCR positive cases (>18 years age) of both the genders. Exclusion criteria was negative PCR, doubtful diagnosis and expiry outside the hospital setting. Data was collected from hospital record and family members. Demographic details, symptoms, duration of hospital stay, co-morbidities, type of ventilatory support were documented. Data analysed by SPSS, significant p<0.05. Results: There were 54 expiries from1st March to 13th June, 42(78%) males & 12(22%) females. Mean age was 54.24+12.78 years. 76% had various comorbidities, i.e., diabetes (57%), hypertension (54%), ischemic heart disease (20%); stroke, cancer, COPD and hypothyroidism (<10% each). Most frequent cause of death was acute respiratory distress syndrome due to Covid-19. Two patients died of sepsis and multiorgan failure. 64% of patients received mechanical ventilation and 35% oxygen via non-rebreather mask. There was average 4 days on invasive mechanical ventilator. 51-60 years had longest duration of illness and hospitalization till death, while 20-30 years had the shortest. The average mortality climbed up (25% to 57%) from April to May 2020. Conclusion: COVID-19 claims significant mortality. The risk factors for mortality being age above 50 years, male gender, co-morbidities like diabetes, hypertension, ischemic heart disease, need for mechanical ventilation upon admission and longer duration of illness. There is need to intensify the vaccination and prevention in the community keeping in mind these high-risk groups. The high-risk cases, need to be aggressively managed to reduced mortality and improve outcome.
WHO. Rolling updates on coronavirus disease (COVID-19). https://www.who.int/emergencies/diseases/ novel-coronavirus-2019. Accessed 20 March 2021.
Alshukry A, Ali H, Ali Y, Al-Taweel T, Abu-Farha M, AbuBaker J, Devarajan S, Dashti AA, Bandar A, Taleb H, Al Bader A. Clinical characteristics of Coronavirus Disease 2019 (COVID-19) patients in Kuwait. PloS one. 2020 Nov 20;15(11):e0242768.
Zhang B, Zhou X, Qiu Y, Feng F, Feng J, Jia Y, Zhu H, Hu K, Liu J, Liu Z, Wang S. Clinical characteristics of 82 death cases with COVID-19. medRxiv. Published online February. 2020;27:2020-02.
Xie J, Tong Z, Guan X, Du B, Qiu H. Clinical Characteristics of Patients Who Died of Coronavirus Disease 2019 in China [published correction appears in JAMA Netw Open. 2020 May 1;3(5):e208147]. JAMA Netw Open. 2020;3(4):e205619. Published 2020 Apr 1. doi:10.1001/jamanetworkopen.2020.5619.
Characteristics of SARS-CoV-2 patients dying in Italy Report based on available data on May 21st,
Ussaid A, Riaz B, Rafai W, Anwar S, Baig F, et al. Clinical Characteristics of 47 Death Cases With COVID-19: A Retrospective Study at a Tertiary Center in Lahore. Cureus. 2020 12;12(12):e12039. doi: 10.7759/cureus.12039. PMID: 33457138; PMCID: PMC7797435.
Peckham, H., de Gruijter, N.M., Raine, C. et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat Commun 2020; 11:6317. https://doi.org/10.1038/s41467-020-19741-6
Karlberg, J., Chong, D. S. Y. & Lai, W. Y. Y. Do Men Have a Higher Case Fatality Rate of Severe Acute Respiratory Syndrome than Women Do? Am. J. Epidemiol. 2004. https://doi.org/10.1093/aje/kwh056.
Alghamdi, I. G. et al. The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive epidemiological analysis of data from the Saudi Ministry of Health. Int J. Gen. Med.2014; 7, 417-23.
Korea Centers for Disease Control and Prevention (KCDC) Status of COVID-19 in Korea. [Accessed 29 May 2020]. Available at:http://ncov.mohw.go.kr/bdBoardList_Real.do? brdId=1&brdGubun=11&ncvContSeq=&contSeq=&board_id=&gubun=
Istituto Superiore di Sanità Epidemia COVID-19. [Accessed 10 May 2020]. Available at: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_2-aprile-2020.pdf.
Novosad P, Jain R, Campion A, Asher S. COVID-19 mortality effects of underlying health conditions in India: a modelling study. BMJ Open. 2020 Dec 16;10(12):e043165. doi: 10.1136/bmjopen-2020-043165. PMID: 33328263; PMCID: PMC7745455.
Roedl, Kevin et al. “Mechanical ventilation and mortality among 223 critically ill patients with coronavirus disease 2019: A multicentric study in Germany.” Australian critical care: official journal of the Confederation of Australian Critical Care Nurses vol. 34,2 (2021): 167-175. doi:10.1016/j.aucc.2020.10.009
Rasheed, R., Rizwan, A., Javed, H. et al. Socio-economic and environmental impacts of COVID-19 pandemic in Pakistan—an integrated analysis. Environ Sci Pollut Res (2021). https://doi.org/10.1007/s11356-020-12070-7
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