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Clinical features, demography, and predictors of outcomes of SARS-CoV-2 infection at a tertiary care hospital in India: A cohort study

Elavarasi et al., Lung India, doi:10.4103/lungindia.lungindia_493_21
Aug 2021  
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Mortality -137% Improvement Relative Risk Remdesivir  Elavarasi et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 1,755 patients in India (April - June 2021) Higher mortality with remdesivir (p<0.000001) c19early.org Elavarasi et al., Lung India, August 2021 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 2017 hospitalized patients in India, showing higher mortality with remdesivir in unadjusted results, however no group details are provided and this result is subject to confounding by indication, with authors suggesting treatment was more likely for more severe patients.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; substantial unadjusted confounding by indication likely.
Study covers ivermectin, zinc, and remdesivir.
risk of death, 136.6% higher, RR 2.37, p < 0.001, treatment 146 of 403 (36.2%), control 207 of 1,352 (15.3%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Elavarasi et al., 12 Aug 2021, retrospective, India, peer-reviewed, 31 authors, study period April 2021 - June 2021.
This PaperRemdesivirAll
Clinical features, demography, and predictors of outcomes of SARS-CoV-2 infection at a tertiary care hospital in India: A cohort study
Dr Sushma Bhatnagar, Arunmozhimaran Elavarasi, Harikrishna Raju Sagiraju, Rohitkumar Garg, Brajesh Ratre, Prashant Sirohiya, Nishkarsh Gupta, Rakesh Garg, Anuja Pandit, Saurabh Vig, Ram Singh, Balbir Kumar, Vedprakash Meena, Naveet Wig, Saurabh Mittal, Sourabh Pahuja, Karan Madan, Randeep Guleria, Anant Mohan, Tanima Dwivedi, Ritu Gupta, Ashimajain Vidyarthi, Rama Chaudhry, Arghya Das, Laxmitej Wundavalli, Angelrajan Singh, Sheetal Singh, Sunil Kumar, Manisha Pandey, Abhinav Mishra, Karanvirsingh Matharoo
Lung India, doi:10.4103/lungindia.lungindia_493_21
Background: The "second wave" of the COVID-19 pandemic hit India from early April 2021 to June 2021. We describe the clinical features, treatment trends, and baseline laboratory parameters of a cohort of patients with SARS-CoV-2 infection and their association with the outcome. Methods: This was a retrospective cohort study. Multivariate logistic regression models were fitted to identify clinical and biochemical predictors of developing hypoxia, deterioration during the hospital stay, and death. Results: A total of 2080 patients were included. The case fatality rate was 19.5%. Among the survivors, the median duration of hospital stay was 8 (5-11) days. Out of 853 (42.3%%) of patients who had COVID-19 acute respiratory distress syndrome at presentation, 340 (39.9%) died. Patients aged >45 years had higher odds of death as compared to the 18-44 years age group. Vaccination reduced the odds of death by 40% (odds ratio [OR] [95% confidence interval [CI]]: 0.6 [0.4-0.9], P = 0.032). Patients with hyper inflammation at baseline as suggested by leukocytosis (OR [95% CI]: 2.1 [1.5-3.1], P < 0.001), raised d-dimer >500 mg/dL (OR [95% CI]: 3.2 [2.2-4.7], P < 0.001), and raised C-reactive peptide >0.5 mg/L (OR [95% CI]: 3.7 [2.2-13], P = 0.037) had higher odds of death. Patients who were admitted in the 2 nd week had lower odds and those admitted in the 3 rd week had higher odds of death.
Conflicts of interest There are no conflicts of interest. 1.2 (0.9-1.6), 0.199 1 (0.7-1.5), 0.980 1 (0.6-1.7), 0.943 1.1 (0.7-1.9), 0.708 Primary condition (Reference: COVID) Non-COVID 3.5 (1.7-7.2), 0.001 1.2 (0.4-3.5), 0.705 0.8 (0.3-2•6), 0.729 0.5 (0.1-1.8), 0.266 Mucor 0.5 (0.1-4.0), 0.472 0.9 (0.1-11), 0.940 Vaccinated 0.7 (0.5-1.0), 0.060 0.6 (0.4-0.9), 0.032 0.5 (0.3-0.9), 0.014 0.6 (0.3-0.9), 0.042 Symptom onset to hospitalization (Reference: 1 week) 2 weeks 0.6 (0.5-0.9), 0.003 0.6 (0.4-0.9), 0.027 0.5 (0.3-0.8), 0.002 0.5 (0.3-0.8), 0.003 3 or more weeks 1.9 (1.1-3.4), 0.032 0.9 (0.4-2.2), 0.828 0.6 (0.2-1.9), 0.372 0.5 (0.1-1.9), 0.336 Asymptomatic 1.1 (0.
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Late treatment
is less effective
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