Mortality in patients with Coronavirus disease 2019 (COVID- 19) and its clinicoradiological and laboratory correlates: A retrospective study

Abstract

Aim: To delineate and analyze the mortality from COVID -19 in our institute during the devastating second wave of pandemic.

Settings and design: A retrospective cohort analysis.

Methods and materials: A comprehensive mortality analysis of 142 laboratory-confirmed severe acute respiratory syndrome coronavirus 2-infected deceased patients from our hospital's medical records was done. These patients presented with severe disease at the time of admission and were managed in intensive care units.

Statistical analysis used: Statistical Package for Social Sciences software, IBM manufacturer, Chicago, USA, version 21.0 was used.

Results: The number of deceased males (82, 62.6%) was higher than females (53, 37.3%). Median age of deceased patient was 57 (44.25-69.75) years. Most frequent comorbidities were diabetes mellitus (42, 29.6%) and hypertension (41, 28.9%). Most common symptoms being shortness of breath (137, 96.5%), fever (94, 66.2%) and cough (73, 51.4%). Median peripheral capillary oxygen saturation (SpO2) at time of admission was 86% (77.25-90). Median time interval from symptom onset to admission in hospital was 3 (2.25-5) days. Neutrophil lymphocyte ratio was more than 5 in 117 (90.7%) patients. Complications seen were acute respiratory distress syndrome in 82.3%, acute liver injury in 58.4%, acute kidney injury in 26.7%, sepsis in 13.3% and acute cardiac injury in 12% patients. The median high-resolution computed tomography score was 20 (17-22).

Conclusions: Male and elderly patients with underlying comorbidities had poorer outcome and involvement of multiple organ systems was common. A short time interval between symptom onset and admission/mortality, particularly encountered was worrisome.

Keywords: COVID-19; SARS-CoV-2; mortality.

Figure 1

Distribution of complications in study subjects

Figure 2

Association of SpO2 on admission with duration of stay (nonparametric variable, Box-whisker plot)

Figure 3

Axial and coronal images from the HRCT Chest of a 44-year-old male patient. There is moderate lung involvement with multiple, peripheral patchy areas of ground glass attenuation and septal thickening. The findings were more prominent in the lower lobes bilaterally. The CT severity score was 18/25

Figure 4

Axial and coronal images of HRCT chest of a 61–year-old male patient showing extensive, confluent areas of ground glass attenuation and consolidations diffusely involving both lungs interspersed with septal thickening. Reported as ARDS and the CT severity score was 24/25