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Epidemiology and Risk Factors of COVID-19-Related Mortality
Debarchan Barman Roy1, Vandana Gupta2, Shalini Tomar1
1Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Insights
COVID-19 patients with both diabetes and hypertension face higher mortality risks. Identifying severe disease indicators like low oxygen saturation and high creatinine is crucial for better patient outcomes.
Area of Science:
- Infectious Diseases
- Epidemiology
- Critical Care Medicine
Background:
- The COVID-19 pandemic in India revealed various patient characteristics linked to poor outcomes.
- Understanding these factors is vital for managing hospitalized patients effectively.
Purpose of the Study:
- To identify epidemiological and clinical factors associated with COVID-19 mortality in Indian patients.
- To pinpoint predictors of adverse outcomes in a tertiary-care setting.
Main Methods:
- Retrospective observational study of 141 COVID-19 patients at AIIMS, New Delhi.
- Analysis of medical history, demographics, comorbidities, clinical findings, and laboratory data.
- Multivariate logistic regression to identify mortality predictors.
Main Results:
- Hypertension was the most frequent comorbidity; diabetes with hypertension worsened outcomes.
- Low oxygen saturation, need for oxygen, and high prognostic scores correlated with poor outcomes.
- COVID-19 severity, co-existing diabetes and hypertension, low systolic blood pressure, and elevated creatinine predicted higher mortality.
Conclusions:
- COVID-19 patients with combined diabetes and hypertension are a high-risk group.
- Prompt vaccination strategies should target this high-risk demographic.
- Severe disease, oxygen therapy, and intensive care interventions are linked to unfavorable outcomes.
Abstract:
Introduction During the coronavirus disease 2019 (COVID-19) pandemic in India, several characteristics of hospitalized COVID-19 patients, based on demographics, mortality predictors, and presence of comorbidities, were found to be associated with poor outcomes. The objective of this study was to identify such epidemiological and clinical characteristics among the patients admitted at a tertiary-care center in India that may have predisposed them to COVID-19-related mortality. Methods This retrospective observational study conducted at the Department of Medicine, All India Institute of Medical Sciences, New Delhi, in May 2021 included 141 COVID-19 confirmed patients. The medical history, demographic characteristics, comorbidities, clinical findings, and laboratory data of each patient were obtained. The data were analyzed to identify significant clinical and laboratory parameters that led to the adverse final outcomes. Results Hypertension was the most common comorbidity and the presence of diabetes with hypertension led to poorer final outcomes. Lower oxygen saturation and requirement of oxygen supplementation at admission along with worse prognostic scores during admission led to poorer outcomes. Twenty-seven patients needed non-invasive ventilation (NIV) during the hospital course, and all ultimately landed up among the 56 patients who were managed on invasive mechanical ventilation (IMV). Multivariate logistic regression analysis performed identified COVID-19 severity at admission, co-existence of hypertension and diabetes mellitus, systolic blood pressure less than 90 mm Hg, and serum creatinine greater than 1.2 mg/dL to be associated with higher COVID-19 mortality. Conclusion COVID-19 patients having the co-existence of diabetes and hypertension constitute a high-risk group and may be targeted by prompt vaccination strategies. The presence of severe disease along with a need for oxygen therapy and other intensive care interventions ultimately led to unfavorable outcomes.
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