CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY FROM TERTIARY CARE CENTER IN NORTH INDIA

Authors

  • THAKUR SK Department of Orthopedics, AFMS, New Delhi, India. 2Department of Community Medicine, AFMS, New Delhi, India.
  • HIREMATH RAVISHEKAR N Department of Community Medicine, AFMS, New Delhi, India.
  • CHOUDHARY SK Department of Orthopedics, AFMS, New Delhi, India.
  • MAHESH KRISHNA KULKARNI Department of Aviation Medicine, AFMS, New Delhi.
  • PRIYANKA PATEL Assistant Hospital Administrator, GMERS Medical College and General Hospital, Himmatnagar, Gujarat, India.
  • NARENDER YADAV Department of Radiology, AFMS, New Delhi, India.
  • SHIVI GUPTA Department of Medicine, AFMS, New Delhi, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i5.44456

Keywords:

Clinical profile, Outcome, COVID-19

Abstract

Objective: An acute respiratory infection of unknown origin was first detected in Wuhan, China, and reported to the WHO on December 31, 2019, and within a month, this outbreak was declared as a Public Health Emergency of International Concern. This study was carried out with an objective to assess the spectrum of clinical presentations and host-related factors in outcome of COVID-19 during the first wave.

Methods: This study was a retrospective observational study on 427 laboratory conformed COVID-19 cases at tertiary care center in North India during 6 months of the first wave. The demographic data, clinical profiles, comorbid conditions, treatment given, duration of hospital stay, and outcome were collected on a predesigned pro forma by the investigator himself and entered a Microsoft Excel sheet and analyzed using SPSS version 17.0 software.

Results: Mean age of the study participants was 48.70 years. Majority (34.89%) belonged to above 60 years. About 74% were male. Mean duration of symptoms before detection was 1.30 and mean duration of hospital stay was 11.98 days. Majority had fever (73.54%) followed by myalgia (49.88%). About 85.48% had more than 3 symptoms and 69.32 had symptoms for less than 3 days before getting detected. About 40.52% had comorbidities and only 14.05% had history of contact with COVID confirmed case. Only 8.2% were asymptomatic while 23.19% had severe symptoms. Majority 91.57% were admitted to hospital while only 8.43% were put under home isolation. About 74% were positive on rapid antigen test (RAT) while 29.51% needed RT PCR test to turn positive. About 28.1% had bilateral pneumonia on chest X-ray findings. About 6.3% of were pregnant ladies. The overall mortality rate of our hospital during that 6-month period was 4.69%. Out of all parameters, only age category was statistically significant associated with outcome on discharge while other variables such as comorbidity, symptom duration, and severity of disease during admission did not show any statistically significant association.

Conclusion: This single-center study provided the spectrum of clinical presentations and host-related factors in outcome of COVID-19 during the first wave which may help in decrease the burden of disease, minimize social disruption, and reduce the economic impact associated with a pandemic. Early detection, admission, and treatment of individuals with comorbidities and elderly would increase the recovery from the disease, thereby reduce mortality.

Downloads

Download data is not yet available.

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.

Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan China: The mystery and the miracle. J Med Virol 2020;92:401-2. doi: 10.1002/jmv.25678, PMID 31950516

AIIMS and ICMR. Clinical Guidance for Management of Adult Covid-19 Patients; 2021. Available from: https://covid.aiims.edu/ clinical-guidance-for-management-of-adult-covid-19-patients [Last accessed on 2022 Jan 01].

Sahu KK, Mishra AK, Lal A, Sahu SA. India fights back: COVID-19 pandemic. Heart Lung 2020;49:446-8. doi: 10.1016/j. hrtlng.2020.04.014, PMID 32527575

Chatterjee P, Nagi N, Agarwal A, Das B, Banerjee S, Sarkar S, et al. The 2019 novel coronavirus disease (COVID-19) pandemic: A review of the current evidence. Indian J Med Res 2020;151:147-59. doi: 10.4103/ijmr.IJMR_519_20, PMID 32362642

Samaddar A, Gadepalli R, Nag VL, Misra S. The enigma of low COVID-19 fatality rate in India. Front Genet 2020;11:854. doi: 10.3389/fgene.2020.00854, PMID 32849833

Worldometer. Coronavirus Update (Live); Available from: https://www. worldometers.info/coronavirus [Last accessed on 2021 Jan 01].

CDC. Coronavirus Disease 2019 (COVID-19): People who are at Higher Risk for Severe Illness. Atlanta: United States Department of Health and Human Services, Centers for Disease Control and Prevention (US); 2020. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html. [Last accessed on 2020 Oct 17].

World Health Organization. Coronavirus Disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. [Last accessed on 2020 Oct 17].

Da Silva AL, Moreira JC, Martins SR. COVID-19 and smoking: A high-risk association. Cad Saúde Publ 2020;36:e00072020.

Falahi S, Kenarkoohi A. Sex and gender differences in the outcome of patients with COVID-19. J Med Virol 2021;93:151-2. doi: 10.1002/ jmv.26243, PMID 32603509

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. doi: 10.1016/S0140-6736(20)30183-5, PMID 31986264

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet 2020;395:507- 13. doi: 10.1016/S0140-6736(20)30211-7, PMID 32007143

Gaur A, Meena SK, Bairwa R, Meena D, Nanda R, Sharma SR, et al. Clinico-radiological presentation of COVID-19 patients at a tertiary care center at Bhilwara, Rajasthan, India. J Assoc Physicians India 2020;68:29-33. PMID 32602678

Bhandari S, Bhargava A, Sharma S, Keshwani P, Sharma R, Banerjee S. Clinical profile of COVID-19 infected patients admitted in a tertiary care hospital in North India. J Assoc Physicians India 2020;68:13-7. PMID 32610859

Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR, Barr RG, et al. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: Retrospective case series. BMJ 2020;369:m1996. doi: 10.1136/bmj.m1996, PMID 32471884

Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20_133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. BMJ 2020;369:m1985. doi: 10.1136/bmj.m1985, PMID 32444460

Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: Prospective cohort study. BMJ 2020;369:m1966. doi: 10.1136/bmj.m1966, PMID 32444366

Halpin DM, Faner R, Sibila O, Badia JR, Agusti A. Do chronic respiratory diseases or their treatment affect the risk of SARS-CoV-2 infection? Lancet Respir Med 2020;8:436-8. doi: 10.1016/S2213- 2600(20)30167-3, PMID 32251625

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. doi: 10.1056/NEJMoa2002032, PMID 32109013

Van Gerwen M, Alsen M, Little C, Barlow J, Naymagon L, Tremblay D, et al. Outcomes of patients with hypothyroidism and COVID-19: A retrospective cohort study. Front Endocrinol (Lausanne) 2020;11:565. doi: 10.3389/fendo.2020.00565, PMID 33013686

Schoenfeld PS, Myers JW, Myers L, LaRocque JC. Suppression of cellmediated immunity in hypothyroidism. South Med J 1995;88:347-9. doi: 10.1097/00007611-199503000-00019, PMID 7886534

Khan DS, Hamid LR, Ali A, Salam RA, Zuberi N, Lassi ZS, et al. Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: A systematic review and meta-analysis. BMC Preg Childbirth 2021;21:801. doi: 10.1186/s12884-021-04250-1, PMID 34852783

Singh H, Kaur K, Ghai SK, Gurmeet P, Agarwal R, Dutt V, et al. Viral clearance in COVID-19 patients admitted in designated COVID hospital in Western India. Int J Commun Med Public Health 2021;8:4303-6. doi: 10.18203/2394-6040.ijcmph20213528

Kumar N, AbdulRahman A, AlAli S, Otoom S, Atkin SL, AlQahtani M. Time till viral clearance of severe acute respiratory syndrome coronavirus 2 is similar for asymptomatic and non-critically symptomatic individuals. Front Med (Lausanne) 2021;8:616927. doi: 10.3389/fmed.2021.616927

Published

07-05-2022

How to Cite

SK, T., H. RAVISHEKAR N, C. SK, M. K. KULKARNI, P. PATEL, N. YADAV, and S. GUPTA. “CLINICAL PROFILE AND OUTCOME OF COVID-19 PATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY FROM TERTIARY CARE CENTER IN NORTH INDIA”. Asian Journal of Pharmaceutical and Clinical Research, vol. 15, no. 5, May 2022, pp. 128-31, doi:10.22159/ajpcr.2022.v15i5.44456.

Issue

Section

Original Article(s)