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Immediate and antecedent causes of mortality in hospitalised Indian patients with COVID-19
B Y Keerthi1, K Saritha2, Chirali Shah3
1Department of General Medicine, Telangana Institute of Medical Sciences and Research, Gachibowli, Hyderabad, India, 500032.
Insights
COVID-19 mortality in adults was primarily linked to older males with comorbidities like hypertension and diabetes. Acute respiratory distress syndrome and secondary infections significantly increased mortality risk, with anemia also identified as an independent factor.
Area of Science:
- Medical Research
- Epidemiology
- Public Health
Background:
- COVID-19 significantly impacted global health, necessitating understanding of mortality factors in hospitalized patients.
- Comorbidities and patient demographics are crucial in assessing COVID-19 outcomes.
Purpose of the Study:
- To determine the immediate and antecedent causes of mortality in adult COVID-19 patients.
- To analyze the role of comorbidities and disease severity in COVID-19 related deaths.
Main Methods:
- Retrospective analysis of 571 deceased COVID-19 patients from August 2020 to May 2021.
- Data collection included medical certificates of cause of death (MCCD) and hospital records.
- ICMR protocol used for illness severity grading; clinical, radiographic, and lab data assessed disease progression.
Main Results:
- Mortality was highest in males aged 50+ with comorbidities; hypertension (47.99%), diabetes (39.4%), and anemia (34.6%) were prevalent.
- Acute respiratory distress syndrome (72.33%) and secondary infections (6.83%) were major contributors to mortality.
- Anemia was identified as an independent risk factor for mortality.
Conclusions:
- Comorbidities, particularly in older males, are key factors in COVID-19 mortality.
- Anemia prevalence and its independent role in mortality warrant further investigation and clinical consideration.
- Risk stratification and management strategies for COVID-19 patients should incorporate comorbidity assessment and hemoglobin levels.
Abstract:
It is of interest to assess the immediate and antecedent causes of mortality amongst adult COVID-19 infected patients with or without comorbidities admitted in an exclusive COVID-19 hospital was conducted the between August 2020 to May 2021. The immediate and antecedent causes were collected from the medical certificate of cause of death (MCCD). Remaining data was extracted from the hospital's record. ICMR protocol was used to grade severity of illness at admission into mild, moderate and severe categories. Clinical status during hospitalisation and most recent radiographic and laboratory data were used to assess disease progression and outcome. This study includes data from 571 people, who died at our centre between August 2020 and May 2021. Patients registered without any co-morbidity were 146 with mean age of 57.53 years; (33/146) were females and (110/46) males. Hypertension (274, 47.99%) was found in a moderately large number of patients followed by diabetes (225, 39.4%) and anaemia (199, 34.6%). Increase in risk of mortality of COVID-19 was found maximum in patients with acute respiratory distress syndrome (72.33%), followed by secondary infections (6.83%). Mortality recorded in this study was mainly in males of older age (50 years and above) with at least one co-morbidity. Anaemia was also prevalent amongst these patients and considered as an independent factor for mortality. Hence, recording of comorbidities and haemoglobin levels may help as a guideline to develop risk stratification and management of patients with COVID-19 to reduce overall mortality.
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