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. 2022 Jan-Feb;39(1):16-26.
doi: 10.4103/lungindia.lungindia_493_21.

Clinical features, demography, and predictors of outcomes of SARS-CoV-2 infection at a tertiary care hospital in India: A cohort study

Arunmozhimaran Elavarasi  1 , Hari Krishna Raju Sagiraju  2 , Rohit Kumar Garg  3 , Brajesh Ratre  4 , Prashant Sirohiya  4 , Nishkarsh Gupta  4 , Rakesh Garg  4 , Anuja Pandit  4 , Saurabh Vig  4 , Ram Singh  4 , Balbir Kumar  4 , Ved Prakash Meena  3 , Naveet Wig  3 , Saurabh Mittal  5 , Sourabh Pahuja  5 , Karan Madan  5 , Randeep Guleria  5 , Anant Mohan  5 , Tanima Dwivedi  6 , Ritu Gupta  6 , Ashima Jain Vidyarthi  7 , Rama Chaudhry  7 , Arghya Das  7 , LaxmiTej Wundavalli  8 , Angel Rajan Singh  8 , Sheetal Singh  8 , Sunil Kumar  9 , Manisha Pandey  10 , Abhinav Mishra  10 , Karanvir Singh Matharoo  10 , Sushma Bhatnagar  4
Affiliations

Clinical features, demography, and predictors of outcomes of SARS-CoV-2 infection at a tertiary care hospital in India: A cohort study

Arunmozhimaran Elavarasi et al. Lung India. 2022 Jan-Feb.

Abstract

Background: The "second wave" of the COVID-19 pandemic hit India from early April 2021 to June 2021. We describe the clinical features, treatment trends, and baseline laboratory parameters of a cohort of patients with SARS-CoV-2 infection and their association with the outcome.

Methods: This was a retrospective cohort study. Multivariate logistic regression models were fitted to identify clinical and biochemical predictors of developing hypoxia, deterioration during the hospital stay, and death.

Results: A total of 2080 patients were included. The case fatality rate was 19.5%. Among the survivors, the median duration of hospital stay was 8 (5-11) days. Out of 853 (42.3%%) of patients who had COVID-19 acute respiratory distress syndrome at presentation, 340 (39.9%) died. Patients aged >45 years had higher odds of death as compared to the 18-44 years age group. Vaccination reduced the odds of death by 40% (odds ratio [OR] [95% confidence interval [CI]]: 0.6 [0.4-0.9], P = 0.032). Patients with hyper inflammation at baseline as suggested by leukocytosis (OR [95% CI]: 2.1 [1.5-3.1], P < 0.001), raised d-dimer >500 mg/dL (OR [95% CI]: 3.2 [2.2-4.7], P < 0.001), and raised C-reactive peptide >0.5 mg/L (OR [95% CI]: 3.7 [2.2-13], P = 0.037) had higher odds of death. Patients who were admitted in the 2nd week had lower odds and those admitted in the 3rd week had higher odds of death.

Conclusion: This study shows that vaccination status and early admission during the inflammatory phase can change the course of illness of these patients. Improving vaccination rates and early admission of patients with moderate and severe COVID-19 can improve the outcomes.

Keywords: COVID-19; SARS-CoV-2; predictors of outcomes; vaccination.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Patient recruitment and outcomes
Figure 2
Figure 2
Kaplan–Meier survival estimates by COVID-19 baseline severity. Asymptomatic patients without symptoms of COVID-19. Mild patients with symptoms of COVID-19, but no breathlessness, SpO2 at baseline ≥94%. Moderate patients with COVID-19 pneumonia and breathlessness, SpO2 at baseline ≥94%. Severe patients with COVID-19 and severe hypoxia, SpO2 at baseline <94%
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