ABSTRACT
Introduction: Whilst most patients during the COVID pandemic made an uneventful recovery, there was a significant minority in whom the disease was severe and unfortunately fatal. This survey aims to evaluate independent risk factors for those who died of COVID compared to survivors and to identify any markers for improvement in future management. Methods: Medical records of all COVID patients admitted to two multi-ethnic, inner city acute district general hospitals over a 6-week period in 2020 were examined. Data collected included demographic details, medical comorbidities, and type of ward where they received care. Multivariable analysis using stepwise backward logistic regression was conducted to examine independent risk factors for those who died from COVID compared to survivors. Results: Of 951 patients admitted with COVID, 284 died[30%]. Compared to survivors(n=667), univariate analyses revealed COVID deaths were associated with increasing age[mean(CI): 79.3(77.9-80.7)vs64.7(63.4-66.0);P<0.001], Black African [16.2%vs11.7%;p<0.001] & South-Asian [12%vs9.1%;p<0.001] ethnicity, Hypertension [64.4%vs49.5%;p<0.001],ChronicHeartDisease(CHD)[40.1%vs20.7%;p<0.001], Chronic Respiratory Disease [17.6%vs12.0%;p=0.02] Chronic Kidney Disease [18%vs11.1%;p=0.004], Chronic Neurological Disease 43.3%vs23.7%;p<0.001]. Gender, Diabetes, asthma, obesity, Chronic Liver Disease and immunosuppression (disease or treatment related) were not associated with increasing mortality. Death rates between those in general wards vs intensive care were comparable[4.7%vs2.5%;p=0.1]. Multivariable analyses showed age 60-70 [OR 2.3], age>70 [OR 6.5], Black Caribbean [OR 1.6], and CHD [1.5] were independent risk factors for COVID deaths. Discussion: This large multi-ethnic study showed that age>60, Black Caribbean, and chronic heart disease were independent risk factors for COVID deaths. This study provides valuable information on independent prognostic implications for COVID, which can be used in future interventional studies aiming to improve COVID outcomes or in audits of clinical practice.