Presentation of COVID-19 Disease and the Impact of Patient’s Comorbidities on Its Hospital Outcome: An Observational Study in a COVID-19 Dedicated Hospital



Abstract Views
414

Downloads
384

Citations

Share

##plugins.themes.bootstrap3.article.sidebar##

Submitted Mar 27, 2021
Published Apr 17, 2021
10.24018/ejmed.2021.3.2.788

Abstract viewed = 414 times

Table of Contents

##plugins.themes.bootstrap3.article.main##

Background: Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that initially started in Wuhan, China, and spread exponentially across the globe infecting human being irrespective of age, sex and ethnicity. Given the nature of this virus, there is much still to be learned. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms (e.g., common cold) to more severe diseases such as bronchitis, pneumonia, severe acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. Comorbidity is an important factor in COVID-19 pandemic outcome often leading to rapid and severe progression of the disease process, even death.

Objective: This study was carried out to see the socio-demographic characteristics and presenting features of COVID-19 disease as well as to assess impact of comorbidities on its hospital outcome.

Methods: This observational study was carried out in the COVID-19 dedicated hospital of Faridpur from April 2020 to September 2020 for a period of 06 month. All clinically suspected patients confirmed by RT PCR were included as cases. Data were collected by detailed history from patients then those were checked, verified for consistency and edited for result. After editing and coding, the coded data were analyzed by using the SPSS\PC software package.

Results: A total of 627 patients were included in the study of which 552 were treated in COVID ward and 75 patients were treated in ICU. Among COVID ward admitted (552) patients 354 (64.13%) were male and 198 (35.86%) were female with a male to female ratio of 1:0.56; young adult patients (19 to 50 years) were more affected and admitted (62.86%) and people living in urban area were more affected (52.71%) than rural area (47.28%). Fever, cough and shortness of breath (63.04%, 45.47% and 42.39% respectively) were predominant symptoms. Regarding comorbidities, 44.20% patients have one or more comorbidities whereas 55.79% patients have no comorbidity. Hypertension (17.57%) was the predominant comorbid condition followed by Diabetes (15.94%), ischemic heart disease (05.61%), COAD (05.61%), CKD (2.3%), Stroke (1.44%), Heart failure (0.54%) and Cancer (0.36%). A total of 75 patients needed ICU support; most of them were elderly patients (64 out of 75). Regarding hospital outcome, 96.74% (534 out of 552) COVID ward patients and 45.34% (34 out of 75) of ICU admitted patients discharged uneventfully whereas 03.2% COVID ward patients and 54.66%of ICU admitted patients expired. Deaths were more in elderly patients (n=43; 72.88%). Common comorbidities found among the patients who expired were Hypertension, Diabetes and Ischemic heart diseases (42.37%, 37.28% and 16.94% respectively).

Conclusion: The predominant number of patients presented with fever, cough and shortness of breath in our setting. The percentage of COVID-19 hospitalizations resulting in death remains high among elderly patients and those with one or more comorbid conditions. Therefore, elderly patients and those with comorbidities should take all necessary precautions to avoid getting infected with SARS CoV-2.

Keywords: Coronavirus, COVID-19, SARS-CoV-2, Clinical features, Comorbidity

Downloads

Download data is not yet available.

References

  1. Brewster DJ, Chrimes N, Do TB, Fraser K, Groombridge CJ, Higgs A, et.al. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID‐19 adult patient group. Med J Aust. 2020 Jun; 212(10): 472-81. doi:10.5694/mja2.50598. Epub 2020 May.
     Google Scholar
  2. Lauer SA, Grantz KH, Bi Q,Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID‐19) from publicly reported confirmed cases: estimation and application. Ann Intern Med.2020 Mar ;172: 577– 82, doi:10.7326/M20-0504.
     Google Scholar
  3. Dai J, Yang L, Zhao J. Probable Longer Incubation Period for Elderly COVID-19 Cases: Analysis of 180 Contact Tracing Data in Hubei Province, China. Risk Manag Healthc Policy. 2020; 13: 1111–17.doi: 10.2147/RMHP.S257907.
     Google Scholar
  4. Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: prevalence, pathophysiology, prognosis, and practical considerations. Diabetes Metab Syndr. 2020;14(4):303–10.doi: 10.1016/j.dsx.2020.04.004.
     Google Scholar
  5. Sanyaolu A, Okorie C, Marinkovic A, Patidar R, Younis K, Desai P, et al. Comorbidity and its Impact on Patients with COVID-19.SN Compr Clin Med. 2020 Jun 25: 1–8.doi: 10.1007/s42399-020-00363-4.
     Google Scholar
  6. Gansevoort RT, Hilbrands LB.CKD is a key risk factor for COVID-19 mortality. Nat Rev Nephrol. 2020 Aug. https://doi.org/10.1038/s41581-020-00349-4.
     Google Scholar
  7. Zhao Q, Meng M, Kumar R, Wu Y, Huang J,Lian N,et al.The impact of COPD and smoking history on the severity of COVID-19: a systemic review and meta-analysis. J Med Virol. 2020 May;92(10)1–7.doi: 10.1002/jmv.25889.
     Google Scholar
  8. Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: a comparison with young and middle-aged patients. J Infect. 2020 Mar; 80(06): E14-E18. DOI: https://doi.org/10.1016/j.jinf. 2020.03.005.
     Google Scholar
  9. Macera M, Angelis GD, Sagnelli C, Coppola N, Vanvitelli COVID-19 Group. Clinical Presentation of COVID-19: Case Series and Review of the Literature. Int J Environ Res Public Health. 2020 Jul; 17(14): 5062.doi: 10.3390/ijerph17145062.
     Google Scholar
  10. Cortis D. On Determining the Age Distribution of COVID-19 Pandemic. Front Public Health. 2020 May; 8: 202. doi:10.3389/fpubh. 2020.00202.
     Google Scholar
  11. Liu Y, Mao B, Liang S, Yang J-W, Lu H-W, Chai Y-H, et al. Association between age and clinical characteristics and outcomes of COVID-19. Eur Respir J.2020 May;55(5):2001112. doi:10.1183/13993003.01112-2020.
     Google Scholar
  12. Kulkarni SV, Chauhan H. COVID-19 in Different Age Groups of Children: Initial Impression from Integrated Disease Surveillance Programme (IDSP) under National Centre for Disease Control (NCDC). Indian J Pediatr. 2020 Jul; 87:674–5. Doi:10.1007 /s12098-020-03457y.
     Google Scholar
  13. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA.2020;323(20):2052-59. doi:10.1001/jama.2020. 6775.
     Google Scholar
  14. Gupta S. The age and sex distribution of COVID-19 cases and fatalities in India. medRxiv 187953 [preprint]. 2020 [Jul 16]. doi:10.1101/2020.07.14.20153957.
     Google Scholar
  15. Paudel SS. A meta-analysis of 2019 novel corona virus patient clinical characteristics and comorbidities. Research Square 148580 [preprint].2020 [Apr 08]. Available from doi: 10.21203/rs.3.rs-21831/v1.
     Google Scholar
  16. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet.2020 Feb 15;395 (10223):497-506. doi:10.1016/S0140-6736(20)30183-5.
     Google Scholar
  17. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis.2020 May;94:91-5.doi:10.1016/j.ijid.2020.03.01. Epub 2020 Mar 12.
     Google Scholar
  18. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet.2020 Mar 28 ;395 (10229): 1054-62. doi:10.1016/S0140-6736(20)30566-3.
     Google Scholar
  19. Garg S, Kim L, Whitaker M, O’Halloran A, Cummings C, Holstein R, et al. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019- COVID-NET, 14 States. MMWR. 2020 April 17;69(15):458-64.
     Google Scholar
  20. Ioannidis JPA. Global perspective of COVID-19 epidemiology for a full-cycle pandemic. Eur J Clin Invest. 2020;00: e13423. doi: 10.1111/eci.13423
     Google Scholar
  21. Bialek S, Boundy E, Bowen V, Chow N, Cohn A, Dowling N et al. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) -United States, February 12-March 16, 2020. MMWR: Morb Mortal Wkly Rep. 2020 Mar 27;69(12): 343-46. doi: 10.15585/mmwr .mm6912e2.
     Google Scholar
  22. Loannidis JPA, Axfors C, Contopoulos-Ioannidis DG. Population-level COVID-19 mortality risk for non-elderly individuals overall and for non-elderly individuals without underlying diseases in pandemic epicenters. Environ Res. 2020 Sep; 188:109890. doi doi:10.1101/2020.04.05.20054361.
     Google Scholar
  23. Oke J, Heneghan C.Global COVID-19 case fatality rates. 2020 [internet publication]. Centre for Evidence-Based Medicine;2020.
     Google Scholar
  24. Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-6. doi:10.1001/jama.2020.4683.
     Google Scholar
  25. Franki R. Comorbidities the rule in New York’s COVID-19 deaths. Hospitalist. 2020; [Accessed June 1, 2020, https://www.the-hospitalist.org/hospitalist/article/220457/coronavirus-updates/comorbidities-rule-new-yorks-covid-19-deaths].
     Google Scholar