|
 
 |
| ORIGINAL ARTICLE |
|
| Year : 2021 | Volume
: 15
| Issue : 1 | Page : 4-7 |
|
A retrospective study at a tertiary care center in North India: Epidemiological, clinical characteristics and comorbidities among deceased patients with COVID 19 infection
Poonam Gupta, Anubha Srivastava, Sujit Kumar, Siddhartha Pandey, Virey Vireshwr Goyal
Department of Medicine, MLNMC, Prayagraj, Uttar Pradesh, India
| Date of Submission | 12-Nov-2021 |
| Date of Decision | 01-Jan-2022 |
| Date of Acceptance | 26-Jan-2022 |
| Date of Web Publication | 13-Apr-2022 |
Correspondence Address:
Dr. Siddhartha Pandey
Room No 205 PG Boys Hostel, Swaroop Rani Hospital, Prayagraj - 211 002, Uttar Pradesh
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/upjimi.upjimi_3_21
BACKGROUND AND AIM: To describe epidemiological, clinical characteristics and comorbidities among deceased patients with COVID-19.
MATERIALS AND METHODS: Retrospective study among deceased patients with COVID-19 infection at SRN Hospital MLN Medical College a Tertiary Care Centre for COVID 19, Prayagraj (U. P) India. The study included patients who succumbed to COVID-19 between May 5, 2020 and February 8, 2021.
RESULTS: A total of 497 patients were taken in the study. Mean age was 59.07 years with majority of them being males 350 (71%) and 147 (29%) females. The mean duration of illness was 5.9 days. The most common symptoms were breathlessness 472 (94.9%) and fever 383 (77%). Diabetes (48%) and hypertension (42%) were the most common comorbidities among the deceased. At the time of presentation, 328 (66%) patients had heart rate >100/min and 461 (92.8%) patients had respiratory rate >24/min. Mean oxygen saturation was 69%. The mean duration of hospitalisation is 4.7 days.
CONCLUSION: Majority of the patients who contracted the illness and died due to COVID-19 were elderly, males with diabetes and hypertension. At the time of presentation, the majority had respiratory distress of acute onset. Elderly population with comorbidities are more prone to disease and have higher chances of respiratory failure and death.
Keywords: COVID-19, epidemiological, North India
How to cite this article:
Gupta P, Srivastava A, Kumar S, Pandey S, Goyal VV. A retrospective study at a tertiary care center in North India: Epidemiological, clinical characteristics and comorbidities among deceased patients with COVID 19 infection. J Intern Med India 2021;15:4-7 |
How to cite this URL:
Gupta P, Srivastava A, Kumar S, Pandey S, Goyal VV. A retrospective study at a tertiary care center in North India: Epidemiological, clinical characteristics and comorbidities among deceased patients with COVID 19 infection. J Intern Med India [serial online] 2021 [cited 2023 Mar 24];15:4-7. Available from: http://www.upjimi.com/text.asp?2021/15/1/4/343028 |
| Introduction | |  |
The 2019-nCoV causing an ongoing outbreak of respiratory illness called novel coronavirus pneumonia which has infected many populations till date. The WHO subsequently recommended as COVID-19. The WHO declared COVID-19 as a global health emergency at the end of January 2020. Even though the virus is causing mild disease in many, the course of illness may be severe, leading to hospitalization and even death in the elderly or those with comorbid conditions.[1]
| Materials and Methods | | |
This study was conducted in Swaroop Rani Hospital, MLN Medical College, Prayagraj, Uttar Pradesh which is a tertiary care center dedicated to COVID-19. It was a retrospective observational study. The epidemiological and clinical features of patients presenting to this centre between May 5, 2020 and February 8, 2021, were recorded. A total of 497 patients admitted in COVID ICU SRN Hospital who died during the hospital stay were taken in this study. Patients were diagnosed to have COVID-19 by reverse transcription-polymerase chain reaction at the Department of microbiology MLN Medical College, Prayagraj or referred from other facilities.
| Results | | |
A total of 497 patients who succumbed to COVID-19 were taken in this study. The mean age was 59.07 years [Table 1] and there was a male (71%) preponderance among the study population [Figure 1]a. Majority of patients were elderly, 61–80 years of age group (43.9%) [Figure 1]b. The mean duration of illness was 5.9 days [Figure 1]c. The most common symptoms at the time of presentation were breathlessness (94.9%) and fever (77%) followed by cough (34.8%), myalgia, and fatigue (25.7%) [Figure 2]d. | Figure 1: (a) Distribution of patients based on sex (b) age-wise distribution of patients (c) duration of illness before admission (d) comorbidities among the patients
Click here to view |
 | Figure 2: (a) Heart rate at the time of presentation (b) respiratory rate at the time of presentation (c) oxygen saturation at the time of presentation (d) symptoms at the time of presentation (e) duration of hospitalisation
Click here to view |
The mean duration of hospitalization was 4.7 days [Figure 2]e.
Among clinical parameters [Table 2], majority (66%) of patients had tachycardia (heart rate >100/min) [Figure 2]a. Most of the patients who presented to the hospital had respiratory rate >24/min (92.8%) [Figure 2]b and mean oxygen saturation of 69% at room air [Figure 2]c. The most common comorbidities among the deceased were diabetes (48%) and hypertension (42%) followed by chronic kidney disease (25%), coronary artery disease (7%), and COPD (11.7%) [Figure 1]d.
| Discussion | | |
The following set of epidemiological and clinical data of 497 patients provides an overview of a suspected group of population which were severely affected by Severe acute respiratory syndrome coronavirus 2 and will further aid in laying down strategies for prevention and management of this ongoing epidemic. In this study, it could be observed that the majority of patients were elderly in the age group of 61–80 years (43.9%). There was a male preponderance which accounted for 71% of the total, similar findings were reported by Grasselli et al.[2] from Italy among 1591 patients infected with COVID-19 where 82% of the patients were male. The most common symptoms at the time of presentation were breathlessness (94.9%) and fever (77%) followed by cough (34.8%), myalgia and fatigue (25.7%), Bhandari et al.[3] in their study observed Fever (48%) as the most common symptom followed by cough and shortness of breath. Diabetes (48%) and hypertension (42%) were the most common comorbidities among the deceased followed by chronic kidney disease (25%), coronary artery disease (7%) and COPD (11.7%). In a similar study published in New York by Richardson et al.[4] among 5700 patients hospitalised with COVID 19 infection, the most common comorbidities were hypertension (56.6%), obesity (41.7%), and diabetes (33.8%).[3] The mean duration of illness at the time of admission was 5.9 days supported by the study done by Zhao et al.[5] on 77 patients with a median time of illness onset to the admission of 5 days. It is evident from the data in this study that majority of the patients had tachycardia (66%), increased rate of breathing (92.8%), and mean oxygen saturation of 69% at the time of presentation. From our understanding from this study, it could be perceived that elderly males with comorbidities were at higher risk of contracting the severe disease.
| Conclusion | | |
The present study provides an insight into various epidemiological and clinical parameters of patients who succumbed to COVID-19. It could be observed that elderly patients with comorbidities were more prone to contracting the virus and had a more severe disease progression. There was a male preponderance among deceased. This study provides an insight to lay down preventive strategies and the development of more severe diseases among the population at risk.
Take home message
Elderly male patients who have comorbidities are at higher risk of developing severe disease. Another proposed reason for developing a more severe disease can be a delay in seeking medical attention as evident from a mean duration of illness of 5.9 days during this pandemic.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.  |
| 2. | Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS CoV 2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020;323:1574-81. |
| 3. | Bhandari S, Shaktawat AS, Sharma R, Dube A, Kakkar S, Banerjee S, et al. A preliminary clinico epidemiological portrayal of COVID 19 pandemic at a premier medical institution of North India. Ann Thorac Med 2020;15:146-50. [Full text] |
| 4. | Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID 19 in the New York City Area. JAMA 2020;323:2052-9. |
| 5. | Zhao W, Yu S, Zha X, Wang N, Pang Q, Li D, et al. Clinical characteristics and durations of hospitalized patients with COVID 19 in Beijing: A retrospective cohort study. Cardiovascular Innovations and Applications 2021;6:33-44. |
[Figure 1], [Figure 2]
[Table 1], [Table 2]
|
Search Pubmed for