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Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From

Limalemla Jamir¹, Mukesh Tripathi², Sumita Shankar³

¹Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Mangalagiri, IND.

|January 17, 2022

Insights

Frontline police officers critically ill with COVID-19 had higher mortality with male gender and mechanical ventilation. Early diagnosis, prone positioning, and povidone-iodine use improved survival in this essential worker group.

Area of Science:

Epidemiology
Public Health
Critical Care Medicine

Background:

Police personnel served as essential frontline workers during the COVID-19 pandemic.
Assessing outcomes in critically ill police officers is crucial for understanding disease impact on this demographic.

Purpose of the Study:

To evaluate factors associated with critical illness and mortality in police personnel due to COVID-19.
To identify risk and protective factors influencing survival among hospitalized police officers with severe COVID-19.

Main Methods:

Retrospective observational study of 266 critically ill COVID-19 patients (police personnel) in India.
Analysis of survival correlates including BMI, blood group, comorbidities, and treatments (oxygen, ventilation, medications, povidone-iodine).
Cox proportional hazard analysis was employed to determine risk and protective factors.

Main Results:

Overall mortality was 38%, with increased risk linked to male gender and mechanical ventilation.
Higher age and BMI correlated with increased mortality in bivariate analysis.
Protective factors included timely diagnostic testing, prone positioning, and povidone-iodine use.

Conclusions:

Male gender and mechanical ventilation increased COVID-19 mortality in critically ill police personnel.
Prompt diagnosis, prone positioning, and povidone-iodine use were associated with reduced mortality.
These findings highlight specific interventions and patient characteristics influencing outcomes in this high-risk occupational group.

Read full analysis

Abstract

Background And Aims:

Police personnel have been key frontline workers throughout the coronavirus disease 2019 (COVID-19) pandemic. This study was conducted to assess the correlates and outcomes of critically ill police personnel.

Methods:

This retrospective observational study analyzed key parameters of hospitalized police personnel who were critically ill with COVID-19 in Andhra Pradesh, India, between June and October 2020. Survival was analyzed for correlation with body mass index, ABO/Rh blood group, co-morbidities, treatment (oxygen therapy, prone positioning, mechanical ventilation, remdesivir, Ivermectin, oral and nasal topical povidone-iodine). We also performed Cox proportional hazard analysis with relevant function plots.

Results:

The majority of the 266 patients were male (n = 259; 97.4%) and obese (75.2%). The overall mortality of patients was 38% (n = 101). COVID-19 mortality increased significantly with age (p = 0.019) and BMI (p = 0.030) in the bivariate analysis. There was no significant difference between blood group (p = 0.297), co-morbidity (p = 0.582) and COVID-19 outcome. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the risk factors for COVID-19 mortality were males (HR 4.89, 95% CI: 1.020-23.430) and ventilator therapy (HR 7.5, 95% CI: 4.527-12.296). The protective factors were symptom onset to reverse transcription polymerase chain reaction (RT-PCR) report interval (HR 0.36, 95% CI: 0.158-0.814), prone positioning (HR 0.43, 95% CI: 0.197-0.915), and use of povidone iodine (HR 0.43; 95% CI: 0.273-0.692).

Conclusion:

COVID-19 mortality among critically ill hospitalized police personnel was reduced by time to diagnostic test result, prone positioning, and povidone-iodine use and increased with male gender and mechanical ventilation.

Keywords:

covid-19 covid-19 mortality mechanical ventilation police personnel povidone iodine prone positioning remdesivir

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