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Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study.
Akhtar, Hashaam; Khalid, Sundas; Rahman, Fazal Ur; Umar, Muhammad; Ali, Sabahat; Afridi, Maham; Hassan, Faheem; Saleh Khader, Yousef; Akhtar, Nasim; Khan, Muhammad Mujeeb; Ikram, Aamer.
  • Akhtar H; Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan.
  • Khalid S; School of Chemical and Materials Engineering, National University of Science and Technology, Islamabad, Pakistan.
  • Rahman FU; Department of Medicine, Benazir Bhutto Hospital, Rawalpindi, Pakistan.
  • Umar M; Centre for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan.
  • Ali S; Department of Gynecology and Obstetrics, Pakistan Air Force Hospital, Islamabad, Pakistan.
  • Afridi M; Department of Biotechnology, Quaid I Azam University, Islamabad, Pakistan.
  • Hassan F; CT Angiography Department, Armed Forces Institute of Cardiology, Rawalpindi, Pakistan.
  • Saleh Khader Y; Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan.
  • Akhtar N; Department of Infectious Diseases, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
  • Khan MM; Department of Infectious Diseases, Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan.
  • Ikram A; Department of Virology, National Institutes of Health, Islamabad, Pakistan.
JMIR Public Health Surveill ; 7(12): e32203, 2021 12 14.
Article in English | MEDLINE | ID: covidwho-1572241
ABSTRACT

BACKGROUND:

COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan's population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19.

OBJECTIVE:

COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups.

METHODS:

A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender.

RESULTS:

This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality.

CONCLUSIONS:

Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: Asia Language: English Journal: JMIR Public Health Surveill Year: 2021 Document Type: Article Affiliation country: 32203

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Aged / Humans Country/Region as subject: Asia Language: English Journal: JMIR Public Health Surveill Year: 2021 Document Type: Article Affiliation country: 32203