670 Factors Associated With Mortality in Multi-Ethnic Hospitalised Covid Patients

Abstract

Introduction Whilst most patients during the COVID pandemic made an uneventful recovery, there was a significant minority in whom the disease was severe and unfortunately fatal. This survey aims to evaluate independent risk factors for those who died of COVID compared to survivors and to identify any markers for improvement in future management. Methods Medical records of all COVID patients admitted to two multi-ethnic, inner city acute district general hospitals over a 6-week period in 2020 were examined. Data collected included demographic details, medical comorbidities, and type of ward where they received care. Multivariable analysis using stepwise backward logistic regression was conducted to examine independent risk factors for those who died from COVID compared to survivors. Results Of 951 patients admitted with COVID, 284 died[30%]. Compared to survivors(n = 667), univariate analyses revealed COVID deaths were associated with increasing age[mean(CI): 79.3(77.9–80.7)vs64.7(63.4–66.0);P < 0.001], Black African [16.2%vs11.7%;p < 0.001] & South-Asian [12%vs9.1%;p < 0.001] ethnicity, Hypertension [64.4%vs49.5%;p < 0.001], Chronic Heart Disease(CHD)[40.1%vs20.7%;p < 0.001], Chronic Respiratory Disease [17.6%vs12.0%;p = 0.02] Chronic Kidney Disease [18%vs11.1%;p = 0.004], Chronic Neurological Disease 43.3%vs23.7%;p < 0.001]. Gender, Diabetes, asthma, obesity, Chronic Liver Disease and immunosuppression (disease or treatment related) were not associated with increasing mortality. Death rates between those in general wards vs intensive care were comparable[4.7%vs2.5%;p = 0.1]. Multivariable analyses showed age 60–70 [OR 2.3], age > 70 [OR 6.5], Black Caribbean [OR 1.6], and CHD [1.5] were independent risk factors for COVID deaths. Discussion This large multi-ethnic study showed that age > 60, Black Caribbean, and chronic heart disease were independent risk factors for COVID deaths. This study provides valuable information on independent prognostic implications for COVID, which can be used in future interventional studies aiming to improve COVID outcomes or in audits of clinical practice.

Demographic and Clinical Presentation of Hospitalised Patients with SARS-CoV-2 During the First Omicron Wave

“…Compared with previous studies from the same hospitals trust, this study showed that mortality rate post-COVID-19 was significantly lower than the previous two surges within this trust. 19,20 Compared with 29.5% and 18.5% during the first two surges, respectively, Article Speculative reasons for improved outcomes in this study include the fact that the Omicron variant may be less virulent and aggressive in its effects compared to previous variants, including less endothilialitis; 21 higher vaccination rates, which would reduce the impact of COVID-19 infections on the body; availability of better medical treatments, including steroids, antiviral therapy, and neutralising monoclonal antibodies; and more structured and faster processes for infection prevention and isolation, which meant fewer vulnerable patients may have been exposed to the risk. These results are in accordance with recent results published by the Office for National Statistics (ONS), which showed that the risk of death due to Omicron variant was 67% lower compared to the Delta variant in December 2021.…”