Clinical characteristics and outcomes of COVID-19: Experience at a major tertiary care center in Pakistan
| Autor: | Kiren Habib, Naveera Khan, Iffat Khanum, Syed Faisal Mahmood, Zehra Abdul Muhammad, Nosheen Nasir |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Critical Care Logistic regression Microbiology Severity of Illness Index Tertiary Care Centers chemistry.chemical_compound Young Adult Virology Internal medicine Diabetes mellitus Severity of illness Medicine Humans Pakistan Young adult Aged Aged 80 and over Creatinine business.industry Septic shock COVID-19 General Medicine Middle Aged medicine.disease Respiration Artificial Infectious Diseases chemistry COVID-19 Nucleic Acid Testing Carrier State Etiology Population study Parasitology Female Steroids business |
| Zdroj: | Journal of infection in developing countries. 15(4) |
| ISSN: | 1972-2680 |
| Popis: | Introduction: Limited data exist on clinical characteristics and outcomes of hospitalized COVID-19 patients in low-middle income countries. We aimed to describe the clinical spectrum and outcomes of hospitalized COVID-19 patients at a tertiary-care center in Karachi, Pakistan. Methodology: We conducted an observational study of adult COVID-19 patients hospitalized between February-June 2020. Patients with a discharge diagnosis of COVID-19 and PCR positivity were included. We created logistic regression models to understand association of clinical characteristics with illness severity and in-hospital mortality. Results: The study population comprised 445 patients [67% males, median age 53 (IQR 40-64) years]. Majority of patients (N = 268; 60%) had ≥ 1 co-morbid [37.5% hypertension, 36.4% diabetes]. In-hospital mortality was 13%. Age ≥ 60 (aOR] =1.92; 95 %CI = 1.23-3.03), shortness of breath (aOR=4.43; 95% CI=2.73-7.22), CRP ≥150mg/L (aOR:1.77; 95% CI=1.09-2.85), LDH ≥ 500 I.U/L (aOR:1.98; 95% CI=1.25-3.16), Neutrophil-to-Lymphocyte ratio (NLR) ≥5 (aOR:2.80; 95%CI = 1.77-4.42) and increase in serum creatinine (aOR:1.32; 95%CI=1.07-1.61) were independently associated with disease severity. Septic shock (aOR: 13.27; 95% CI=3.78-46.65), age ≥ 60 (aOR: 3.26; 95% CI=1.07-9.89), Ferritin ≥ 1500ng/ml (aOR: 3.78; 95% CI=1.21-11.8), NLR ≥ 5 (aOR: 4.04; 95% CI=1.14-14.35) and acute kidney injury (aOR: 5.52; 95% CI=1.78-17.06) were independent predictors of in-hospital mortality. Conclusions: We found multiple predictors to be independently associated with in-hospital mortality, except diabetes and gender. Compared to reports from other countries, the in-hospital mortality among COVID-19 patients was lower, despite a high burden of co-morbidities. Further research is required to explore reasons behind this dichotomy. |
| Databáze: | OpenAIRE |
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