Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience
Sandeep Budhiraja, Aakriti Soni, Vinitaa Jha, Dr Abhaya Indrayan, Arun Dewan, Omender Singh, Yogendra Pal Singh, Indermohan Chugh, Vijay Arora, Rajesh Pande, Abdul Ansari, Sujeet Jha
doi:10.1101/2020.11.16.20232223
Objective: To describe the clinical profile and factors leading to increased mortality in coronavirus disease (COVID-19) patients admitted to a group of hospitals in India.
Design: A records-based study of the first 1000 patients with a positive result on real-time reverse transcriptase-polymerase-chain-reaction assay for SARS-CoV-2 admitted to our facilities. Various factors such as demographics, presenting symptoms, co-morbidities, ICU admission, oxygen requirement and ventilator therapy were studied. Results: Of the 1000 patients, 24 patients were excluded due to lack of sufficient data. Of the remaining 976 in the early phase of the epidemic, males were admitted twice as much as females (67.1% and 32.9%, respectively). Mortality in this initial phase was 10.6% and slightly higher for males and steeply higher for older patients. More than 8% reported no symptoms and the most common presenting symptoms were fever (78.3%), productive cough (37.2%), and dyspnea (30.64%). More than one-half (53.6%) had no co-morbidity. The major co-morbidities were hypertension (23.7%), diabetes without (15.4%), and with complications (9.6%). The co-morbidities were associated with higher ICU admissions, greater use of ventilators as well as higher mortality. A total of 29.9% were admitted to the ICU, with a mortality rate of 32.2%. Mortality was steeply higher in those requiring ventilator support (55.4%) versus those who never required ventilation (1.4%). The total duration of hospital stay was just a day longer in patients admitted to the ICU than those who remained in wards.
Conclusion: Male patients above the age of 60 and with co-morbidities faced the highest rates of mortality. They should be admitted to the hospital in early stage of the disease and given aggressive treatment to help reduce the morbidity and mortality associated with COVID-19.
Conflict of Interest: The authors report no conflict of interest. Ethical Approval: This study was approved by the ethics committee of MaxHealthcare (RS/MSSH/DDF/SKT-2/IEC/IM/20-16) Author contributions: Study conception and design: SB,AS. Acquisition, analysis, or interpretation of data: AI, VJ, AD, OS, YPS, IC, VA,RP,AA, AS. Drafting of the manuscript: AS. Critical revision of the manuscript for important intellectual content: SB, AI, VJ, SJ. Statistical analysis and interpretation: AI. Administrative, technical, or material support: VJ, AD, OS, YPS, IC, VA, RP, AA. Study supervision: SB, SJ, VJ. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Competing Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no support from any organization for the submitted work and no competing interests with regards to the submitted work.
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'abstract': '<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>To '
'describe the clinical profile and factors leading to increased mortality in coronavirus '
'disease (COVID-19) patients admitted to a group of hospitals in '
'India.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>A records-based '
'study of the first 1000 patients with a positive result on real-time reverse '
'transcriptase-polymerase-chain-reaction assay for SARS-CoV-2 admitted to our facilities. '
'Various factors such as demographics, presenting symptoms, co-morbidities, ICU admission, '
'oxygen requirement and ventilator therapy were '
'studied.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 1000 '
'patients, 24 patients were excluded due to lack of sufficient data. Of the remaining 976 in '
'the early phase of the epidemic, males were admitted twice as much as females (67.1% and '
'32.9%, respectively). Mortality in this initial phase was 10.6% and slightly higher for males '
'and steeply higher for older patients. More than 8% reported no symptoms and the most common '
'presenting symptoms were fever (78.3%), productive cough (37.2%), and dyspnea (30.64%). More '
'than one-half (53.6%) had no co-morbidity. The major co-morbidities were hypertension '
'(23.7%), diabetes without (15.4%), and with complications (9.6%). The co-morbidities were '
'associated with higher ICU admissions, greater use of ventilators as well as higher '
'mortality. A total of 29.9% were admitted to the ICU, with a mortality rate of 32.2%. '
'Mortality was steeply higher in those requiring ventilator support (55.4%) versus those who '
'never required ventilation (1.4%). The total duration of hospital stay was just a day longer '
'in patients admitted to the ICU than those who remained in '
'wards.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Male patients '
'above the age of 60 and with co-morbidities faced the highest rates of mortality. They should '
'be admitted to the hospital in early stage of the disease and given aggressive treatment to '
'help reduce the morbidity and mortality associated with COVID-19.</jats:p></jats:sec>',
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