Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 19;6(3):137.
doi: 10.3390/tropicalmed6030137.

Clinical Mortality Review of COVID-19 Patients at Sukraraj Tropical and Infectious Disease Hospital, Nepal; A Retrospective Study

Anup Bastola  1 , Sanjay Shrestha  2 , Richa Nepal  2 , Kijan Maharjan  2 , Bikesh Shrestha  2 , Bimal Sharma Chalise  2 , Pratistha Thapa  3 , Pujan Balla  3 , Alisha Sapkota  4 , Priyanka Shah  4
Affiliations

Clinical Mortality Review of COVID-19 Patients at Sukraraj Tropical and Infectious Disease Hospital, Nepal; A Retrospective Study

Anup Bastola et al. Trop Med Infect Dis. .

Abstract

Coronavirus Disease 2019 (COVID-19) has challenged the health system worldwide, including the low and middle income countries like Nepal. In view of the rising number of infections and prediction of multiple waves of this disease, mortalities due to COVID-19 need to be critically analyzed so that every possible effort could be made to prevent COVID-19 related mortalities in future. Main aim of this research was to study about the mortalities due to COVID-19 at a tertiary level hospital, in Nepal. This was a retrospective, observational study that included all inpatients from Sukraraj Tropical and Infectious Disease Hospital, who were reverse transcriptase polymerase chain reaction positive for SARS-COV-2 and died during hospital stay from January 2020 till January 2021. Medical records of the patients were evaluated. Out of 860 total admissions in a year, there were 50 mortalities in the study center. Out of 50 mortalities, majority were males (76%) with male to female ratio of 3.17:1. Most were above 65 years of age (72%) and had two or more comorbidities (64%). The most common comorbidities among the patients who had died during hospital stay were hypertension (58%) followed by diabetes mellitus (50%) and chronic obstructive airway disease (24%). The median duration from the symptom onset to death was 18 days, ranged from the minimum of 2 days till maximum of 39 days. D-dimer was found to be >1 mg/L in 58% cases and ferritin was >500 ng/ml in 42% patients at presentation. A total of 42% patients had thrombocytopenia, 80% patients had lymphocytopenia and 60% had Neutrophil to Lymphocyte ratio >11.75 with the mean NLR of 18.38. Of total mortalities, 16% patients also showed microbiological evidence of secondary infection; Male gender, age more than 65 years, multiple comorbidities with lymphocytopenia, elevated Neutrophil lymphocyte ratio and elevated inflammatory markers were risk factors found in majority of mortalities in our study. These findings could be utilized for early triage and risk assessment in COVID-19 patients so that aggressive treatment strategies could be employed at the earliest to reduce mortalities due to COVID-19 in future.

Keywords: COVID-19; Nepal; mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Age and Gender wise distribution of total COVID-19 patients admitted in STIDH (N = 860).
Figure 2
Figure 2
Distribution of total patients admitted in STIDH by severity of COVID-19 (N = 860).
Figure 3
Figure 3
Outcome of total patients admitted in STIDH (N = 860).
Figure 4
Figure 4
Age and gender wise distribution of mortalities in STIDH (n = 50).
Figure 5
Figure 5
Distribution of co-morbidities among mortalities in STIDH (n = 50).
Figure 6
Figure 6
Distribution of symptoms at presentation among mortalities at STIDH (n = 50).
Figure 7
Figure 7
Distribution by hematological picture of the mortalities in STIDH (n = 50).
Figure 8
Figure 8
Treatment according to the gender of patients who died.
See this image and copyright information in PMC

References

    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X. 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. - DOI - PMC - PubMed
    1. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H., Wang W., Song H., Huang B., Zhu N. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet. 2020;395:565–574. doi: 10.1016/S0140-6736(20)30251-8. - DOI - PMC - PubMed
    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 2020;382:727–733. doi: 10.1056/NEJMoa2001017. - DOI - PMC - PubMed
    1. WHO Coronavirus (COVID-19) Dashboard|WHO Coronavirus (COVID-19) Dashboard with Vaccination Data. [(accessed on 7 July 2021)]; Available online: https://covid19.who.int/
    1. Bastola A., Sah R., Rodriguez-Morales A.J., Lal B.K., Jha R., Ojha H.C., Shrestha B., Chu D.K., Poon L.L., Costello A. The first 2019 novel coronavirus case in Nepal. Lancet Infect. Dis. 2020;20:279–280. doi: 10.1016/S1473-3099(20)30067-0. - DOI - PMC - PubMed

LinkOut - more resources