ABSTRACT
Background: The severity of disease and mortality due to coronavirus disease (COVID-19) was found to be high among patients with concurrent medical illnesses. Serum biomarkers can be used to predict the course of COVID-19 pneumonia. Data from India are very scarce about predictors of mortality among COVID-19 patients. Methodology: In the present retrospective study of 65 RT-PCR confirmed COVID-19 patients, we retrieved data regarding clinical symptoms, laboratory parameters, and radiological grading of severity. Further, we also collected data about their hospital course, duration of stay, treatment, and outcome. Data analysis was done to compare the patient characteristics between survivor and non-survivor groups and to assess the predictors of mortality. Results: The mean age of the study population was 56.23 years (SD, 12.91) and most of them were males (63%); 81.5% of patients survived and were discharged, whereas 18.5% of patients succumbed to the disease. Univariate analysis across both groups showed that older age, diabetes mellitus, higher computed tomogram (CT) severity score, and raised levels of laboratory parameters viz, D-dimer, CPK-MB (creatine kinase), and lactate dehydrogenase (LDH) were associated with increased mortality among hospitalized patients. On multivariate analysis, elevated levels of serum D-dimer (odds ratio, 95% CI: 10.98, 1.13-106.62, p = 0.04) and LDH (odds ratio, 95% CI: 19.15, 3.28-111.87, p = 0.001) were independently associated with mortality. Conclusion: Older patients, diabetics, and patients with high CT severity scores at admission are at increased risk of death from COVID-19. Serum biomarkers such as D-dimer and LDH help in predicting mortality in COVID-19 patients.
ABSTRACT
Background The data on the impact of coronavirus disease 2019 (COVID-19) on interstitial lung disease (ILD) is still limited. To the best of our knowledge, there has been no study from India to date to assess the impact of COVID-19 in patients with preexisting ILD. We undertook this study to assess the clinical outcome of ILD patients admitted to our hospital with COVID-19. Methods In this retrospective observational study, records of reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients with preexisting ILD who were admitted to the hospital in the period from May 1, 2020, to April 30, 2021, were obtained from the hospital database. The clinical outcomes of the patients were recorded. Univariate analysis was performed to find relation between various predetermined risk factors for mortality and those with significant p values (p<0.05) were subjected to multiple logistic regression to determine independent risk factors. Results In our study of 28 patients, the overall mortality was 35.7%. On comparing the parameters associated with increased mortality, there was no effect of age, gender, comorbidities, type of ILD, CT thorax findings on diagnosis, use of corticosteroids and antifibrotics in the past, spirometric findings on mortality. On multivariate analysis, the significant parameters were interleukin 6 (IL-6), p=0.02, OR=1.020 (1.006-1.043) and D-dimer, p=0.04, OR=2.14 (5.55-1.14). Conclusion COVID-19 in patients with pre-existing ILD has a comparatively higher mortality. D-dimer and IL-6 are significant predictors of mortality in ILD patients infected with COVID-19.