Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India
Objectives Primary objective was to study the clinicodemographic profile of hospitalised COVID-19 patients at a tertiary-care centre in India. Secondary objective was to identify predictors of poor outcome.Setting Single centre tertiary-care level.Design Retrospective cohort study.Participants Conse...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e056464.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584079327887360 |
|---|---|
| author | Prashant K Singh Lokesh Tiwari Alok Ranjan Prakriti Gupta Prabhat Kumar Singh Yogesh Kumar Yankappa N Amrita Banerjee C M Singh |
| author_facet | Prashant K Singh Lokesh Tiwari Alok Ranjan Prakriti Gupta Prabhat Kumar Singh Yogesh Kumar Yankappa N Amrita Banerjee C M Singh |
| author_sort | Prashant K Singh |
| collection | DOAJ |
| description | Objectives Primary objective was to study the clinicodemographic profile of hospitalised COVID-19 patients at a tertiary-care centre in India. Secondary objective was to identify predictors of poor outcome.Setting Single centre tertiary-care level.Design Retrospective cohort study.Participants Consecutively hospitalised adults patients with COVID-19.Primary and secondary outcome measures Primary outcome variable was in-hospital mortality. Covariables were known comorbidities, clinical features, vital signs at the time of admission and on days 3–5 of admission, and initial laboratory investigations.Results Intergroup differences were tested using χ2 or Fischer’s exact tests, Student’s t-test or Mann-Whitney U test. Predictors of mortality were evaluated using multivariate logistic regression model. Out of 4102 SARS-CoV-2 positive patients admitted during 1-year period, 3268 (79.66%) survived to discharge and 834 (20.33%) died in the hospital. Mortality rates increased with age. Death was more common among males (OR 1.51, 95% CI 1.25 to 1.81). Out of 261 cases analysed in detail, 55.1% were in mild, 32.5% in moderate and 12.2% in severe triage category. Most common clinical presentations in the subgroup were fever (73.2%), cough/coryza (65.5%) and breathlessness (54%). Hypertension (45.2%), diabetes mellitus (41.8%) and chronic kidney disease (CKD; 6.1%) were common comorbidities. Disease severity on admission (adjusted OR 12.53, 95% CI 4.92 to 31.91, p<0.01), coagulation defect (33.21, 3.85–302.1, p<0.01), CKD (5.67, 1.08–29.64, p=0.04), high urea (11.05, 3.9–31.02, p<0.01), high prothrombin time (3.91, 1.59–9.65, p<0.01) and elevated ferritin (1.02, 1.00–1.03, p=0.02) were associated with poor outcome on multivariate regression. A strong predictor of mortality was disease progression on days 3–5 of admission (adjusted OR 13.66 95% CI 3.47 to 53.68).Conclusion COVID-19 related mortality in hospitalised adult patients at our center was similar to the developed countries. Progression in disease severity on days 3–5 of admission or days 6–13 of illness onset acts as ‘turning point’ for timely referral or treatment intensification for optimum use of resources. |
| format | Article |
| id | doaj-art-8fa2284a87c94957808368fc60bcfa7f |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-8fa2284a87c94957808368fc60bcfa7f2025-01-27T17:10:13ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-056464Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from IndiaPrashant K Singh0Lokesh Tiwari1Alok Ranjan2Prakriti Gupta3Prabhat Kumar Singh4Yogesh Kumar5Yankappa N6Amrita Banerjee7C M Singh8Surgery, All India Institute of Medical Sciences, Patna, Bihar, IndiaDepartment of Pediatrics, All India Institute of Medical Sciences Patna, Patna, Bihar, IndiaCommunity and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, IndiaPediatrics, All India Institute of Medical Sciences, Patna, IndiaDirector, All India Institute of Medical Sciences, Patna, IndiaJawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (Deemed-to-be-University), Belgaum, Karnataka, IndiaDepartment of Pediatrics, All India Institute of Medical Sciences, Patna, Bihar, IndiaPediatrics, All India Institute of Medical Sciences, Patna, Bihar, IndiaCommunity and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, IndiaObjectives Primary objective was to study the clinicodemographic profile of hospitalised COVID-19 patients at a tertiary-care centre in India. Secondary objective was to identify predictors of poor outcome.Setting Single centre tertiary-care level.Design Retrospective cohort study.Participants Consecutively hospitalised adults patients with COVID-19.Primary and secondary outcome measures Primary outcome variable was in-hospital mortality. Covariables were known comorbidities, clinical features, vital signs at the time of admission and on days 3–5 of admission, and initial laboratory investigations.Results Intergroup differences were tested using χ2 or Fischer’s exact tests, Student’s t-test or Mann-Whitney U test. Predictors of mortality were evaluated using multivariate logistic regression model. Out of 4102 SARS-CoV-2 positive patients admitted during 1-year period, 3268 (79.66%) survived to discharge and 834 (20.33%) died in the hospital. Mortality rates increased with age. Death was more common among males (OR 1.51, 95% CI 1.25 to 1.81). Out of 261 cases analysed in detail, 55.1% were in mild, 32.5% in moderate and 12.2% in severe triage category. Most common clinical presentations in the subgroup were fever (73.2%), cough/coryza (65.5%) and breathlessness (54%). Hypertension (45.2%), diabetes mellitus (41.8%) and chronic kidney disease (CKD; 6.1%) were common comorbidities. Disease severity on admission (adjusted OR 12.53, 95% CI 4.92 to 31.91, p<0.01), coagulation defect (33.21, 3.85–302.1, p<0.01), CKD (5.67, 1.08–29.64, p=0.04), high urea (11.05, 3.9–31.02, p<0.01), high prothrombin time (3.91, 1.59–9.65, p<0.01) and elevated ferritin (1.02, 1.00–1.03, p=0.02) were associated with poor outcome on multivariate regression. A strong predictor of mortality was disease progression on days 3–5 of admission (adjusted OR 13.66 95% CI 3.47 to 53.68).Conclusion COVID-19 related mortality in hospitalised adult patients at our center was similar to the developed countries. Progression in disease severity on days 3–5 of admission or days 6–13 of illness onset acts as ‘turning point’ for timely referral or treatment intensification for optimum use of resources.https://bmjopen.bmj.com/content/12/6/e056464.full |
| spellingShingle | Prashant K Singh Lokesh Tiwari Alok Ranjan Prakriti Gupta Prabhat Kumar Singh Yogesh Kumar Yankappa N Amrita Banerjee C M Singh Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India BMJ Open |
| title | Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India |
| title_full | Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India |
| title_fullStr | Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India |
| title_full_unstemmed | Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India |
| title_short | Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India |
| title_sort | clinicodemographic profile and predictors of poor outcome in hospitalised covid 19 patients a single centre retrospective cohort study from india |
| url | https://bmjopen.bmj.com/content/12/6/e056464.full |
| work_keys_str_mv | AT prashantksingh clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT lokeshtiwari clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT alokranjan clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT prakritigupta clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT prabhatkumarsingh clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT yogeshkumar clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT yankappan clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT amritabanerjee clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia AT cmsingh clinicodemographicprofileandpredictorsofpooroutcomeinhospitalisedcovid19patientsasinglecentreretrospectivecohortstudyfromindia |