RESUMO
ObjectivesThis study aims to describe the demographic and clinical profile and ascertain the determinants of outcome among hospitalised COVID-19 adult patients enrolled in the National Clinical Registry for COVID-19 (NCRC). MethodsNCRC is an on-going data collection platform operational in 42 hospitals across India. Data of hospitalized COVID-19 patients enrolled in NCRC between 1st September 2020 to 26th October 2021 were examined. ResultsAnalysis of 29,509 hospitalised, adult COVID-19 patients [mean (SD) age: 51.1 (16.2) year; male: 18752 (63.6%)] showed that 15678 (53.1%) had at least one comorbidity. Among 25715 (87.1%) symptomatic patients, fever was the commonest symptom (72.3%) followed by shortness of breath (48.9%) and dry cough (45.5%). In-hospital mortality was 14.5% (n=3957). Adjusted odds of dying were significantly higher in age-group [≥]60 years, males, with diabetes, chronic kidney diseases, chronic liver disease, malignancy, and tuberculosis, presenting with dyspnea and neurological symptoms. WHO ordinal scale 4 or above at admission carried the highest odds of dying [5.6 (95% CI: 4.6, 7.0)]. Patients receiving one [OR: 0.5 (95% CI: 0.4, 0.7)] or two doses of anti-SARS CoV-2 vaccine [OR: 0.4 (95% CI: 0.3, 0.7)] were protected from in-hospital mortality. ConclusionsWHO ordinal scale at admission is the most important independent predictor for in-hospital death in COVID-19 patients. Anti-SARS-CoV2 vaccination provides significant protection against mortality.
RESUMO
IntroductionThe global pandemic of novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China, in December 2019, and has since spread worldwide.[1] This study attempts to summarize current evidence regarding major inflammatory markers, severity predictors and its impact on outcome, which provide current clinical experience and treatment guidance for this novel coronavirus. MethodsThis is a retrospective observational study done at an urban teaching covid-19 designated hospital. Hospital data were analysed with aim of studying inflammatory markers, predictors and outcome. Patients were classified in Mild, Moderate, Severe & Critical categories of COVID cases. Their clinical parameters, laboratory investigations, radiological findings & Outcome measures were studied. Strength of association & correlation of those parameters with severity and in-hospital mortality were studied. ResultsA total 204 (N) patients were clinically classified into different severity groups, as per MOHFW and qCSI(quick Covid Severity Index) guidelines, as Mild (34), Moderate (56), Severe (39) and Critical (75). The mean(SD) age of the cohort was 55.1+13.2 years; 74.02% were male. Severe COVID-19 illness is seen more in patients more than 50 years of age. COVID-19 patients having IHD develop worse disease with excess early in-hospital mortality. Respiratory rate & Heart Rate on admission are correlated with severe and stormy disease. Among Inflammatory markers, on admission LDH, D-Dimer and CRP are related with severity and excess in-hospital death rate. ConclusionAdvanced age, male gender, IHD, Respiratory Rate & Heart Rate on admission were associated with severe covid-19 illness. S. Lactate Dehydrogenase & D-dimer was associated with severe covid-19 illness and early in-hospital death.
