A Retrospective Study of Predictors of Mortality in Patients With Covid-19 Admitted at a Tertiary Care Hospital.

Abstract

Background: COVID-19 is associated with huge morbidity and mortality in India. Identication of factors associated with mortality would make a difference in the management of COVID-19 infection-related illness. To eval Objective: uate the risk factors which can predict the outcome in covid 19 survivors and non survivors including patient characteristics, comorbidities, laboratory abnormalities and modes of oxygenation and ventilation among 200 patients with COVID-19 infection admitted to a tertiary care hospital fullling inclusion and exclusion criteria. All the data collected were coded and entered in Microsoft Excel sheet which was re-checked and analyzed using SPSS statistical software version 25. Results: Out of 200 cases, 126(63%) patients were male while 74(37%) patients were female. The overall case-fatality rate among admitted cases was 24(12%) [In non -survivors males (12.7%) and females (0.8%)]. The Univariate analysis showed that more patients in the deceased group had respiratory rate of >30 cycles/min(p<0.001) spo2 75 +/- 13 (p<0.001), Patient who had pulse rate 96+/-19 (p=0.003) found to be signicantly associated. The Mean ± SD of white blood cell count, NLR, SGOT, APTT, S.Bilirubin , Total protein ,Albumin, Creatinine ,RBS, Trop I. CRP, D dimer, LDH ,Ferritin, IL6 ,PCT were statistically signicant and affecting mortality. In non-survived patients needed higher mode of oxygenation .out of 13 patients who required NIV on admission ,15 patients survived and 8 patient non-survived(P=0.002). out of 13 patients who required invasive ventilation, 5 patients survived and 8 patients non survived (p=0.001). Those who received more days of oxygenation they are not survived (6.25±4.19 P=0.001) and those who had prolonged ventilatory days also not survived (4.46±3.50 P=<0.001). Those who had admitted in ICU for mean days of 5±3.60 (p= <0.001) also not survived. All above differences were found to be statistically signicant. There was no signicant difference in the age, gender, clinical features, preexisting comorbidities between the two groups (p>0.05). Multivariate analysis using binary logistic regression was done to nd out independent factors associated with mortality. Logistic regression performed for signicant variables found in the univariate analysis showed higher HRCT CT severity score associated higher odds of death. Conclusion: The higher HRCT CT severity score associated higher odds of death. Lab markers such as raised TLC, NLR, CRP, LDH, ferritin, Ddimer, SGOT, APTT, Sodium, Creatinine, IL6, PCT and low albumin were associated with worse outcomes in COVID-19 illness.