Predictors of mortality among post-COVID-19 discharged patients in Northern India (preprint)

ABSTRACT

Background: The one-year postdischarge allcause mortality rate of COVID19 disease is 7.87 % with the majority of patients readmission and mortality occurring within the first 30 days postdischarge. Objective: Understanding predictors of mortality will help in prioritising patient care and preventive approaches. Methods: Ours a single centre unmatched case control study at a tertiary care centre in northern India, conducted from April 2020 to September 2022. The data was extracted retrospectively from the electronic hospital medical records of patients and by trained physicians using standardised data extraction sheet. Results: A total of 184 patients were enrolled with 92 cases and 92 controls. The mean age of patients was 49.3 {+/-} 17.53 years. The mortality group had a higher mean age (53.24 {+/-} 18.53 yrs) as compared to the control group (45.37 {+/-} 15.58 yrs) [p, 0.002]. Bivariate analysis revealed a significant difference in the two groups with respect to O2 saturation at admission [Case, 91.12 {+/-} 12.49 %, control, 95.46 {+/-} 5.01 %, p, 0.003); Maximum O2 flow rate [L/min] (Case, 11.01 {+/-} 22.2, Control, 6.41 {+/-} 13.31, P, 0.04); ICU need (p, 0.005), Cancer (p, 0.001), O2 need at discharge (p, 0.001) and AKI (p, 0.007). On multiple regression analysis, Cancer (aOR, 2.469; 95% CI, 1.183-5.150, p,0.016), ICU admission (aOR, 2.446; 95% CI, 1.212-4.938, p, 0.013), Oxygen at discharge (aOR, 2.340; 95% CI, 0.971-5.640, p, 0.0586) and Acute kidney injury (aOR, 5.6; 95% CI, 2.351-13.370, p, 0.00) only found to be significant. Conclusion: Oxygen requirement at discharge (2.3 times), Malignancy (2.4 times), ICU admission (2.4 times), and Acute Kidney Injury (5.6 times) were risks of death among COVID19 recovered patients, post discharge. The presence of these variables would warrant a close follow up for these patients in order to decrease post COVID mortality.