Clinical and Demographic Characteristics Including Comorbidities and Their Outcomes Among Patients Hospitalized With COVID-19 in Four Tertiary Care Hospitals Across Lahore

Abstract

Background The first case of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China, in 2019. By the first half of 2020, coronavirus disease 2019 (COVID-19) turned into a global pandemic. Objectives The aim of this study is to describe the clinical and demographic characteristics including comorbidities and their outcomes among patients hospitalized with COVID-19 in four tertiary care hospitals across Lahore . This retrospective study was conducted at Fatima Memorial Hospital, Sir Ganga Ram Hospital, Lahore General Hospital, and Jinnah Hospital, all in Lahore, Pakistan, from May 1, 2020, to June 30, 2020. The sample size was 445, which was derived using the convenient sampling method. Clinical outcomes during hospitalization included the requirement of invasive positive pressure ventilation, need for renal replacement therapy (RRT), and death. Data regarding demographics, baseline comorbidities, important vital signs on reporting, and initial workup with results were also collected. Results A total of 445 patients’ data were studied, of whom 291 (65.4%) were male patients and 154 (34.6%) female patients. The median age was 54 years (interquartile range [IQR]: 24). The most common comorbidities were hypertension (HTN) (195; 43.8%) followed by diabetes mellitus (DM) (168; 37.8%) and cardiovascular disease (CVD) (61; 13.7%). The median length of hospital stay was eight days (IQR: 3). Of the total patients, 137 (30.7%) were treated in intensive care unit settings, 40 (9%) received invasive mechanical ventilation, 40 (9%) patients had acute kidney injury, 38 (8.5%) received RRT, and 37 (8.3%) died. It was seen that more patients who were either diabetic or hypertensive received invasive mechanical ventilation as compared to those who did not have these comorbidities. The most common radiological finding on chest X-ray was the classical ground-glass appearance of COVID-19, which was found in 318 (71.4%) patients. Conclusions Patients with one or more underlying comorbidities had poor clinical outcomes compared to those with no comorbidities, with the most vulnerable group being patients with chronic kidney disease, DM, HTN, and CVD in descending order.

Clinical Variants, Characteristics, and Outcomes Among COVID-19 Patients: A Case Series Analysis at a Tertiary Care Hospital in Karachi, Pakistan

“…In contrast, Zhou et al reported high mortality and ICU admissions (28.3% and 26%, respectively) [28]. Surprisingly, a local study from Lahore reported 8.3% mortality; however, 30.7% of their patients required ICU care [29]. The differences in our study and one from Lahore may be explained by the availability of intensive care beds, as we were working in a relatively small private hospital as opposed to the pooling of data from four large public and private sector hospitals in Lahore.…”

COVID-19 severity: Studying the clinical and demographic risk factors for adverse outcomes

“…Previous studies provide limited evidence on the clinical characteristics of SARS-CoV-2 infection in Pakistan [31][32][33][34][35][36][37][38][39][40][41][42][43]. These studies had several limitations, including a small sample size or data collection at a single diagnostic center.…”

Characteristics, outcomes and global trends of respiratory support in patients hospitalized with COVID-19 pneumonia: a scoping review

“…95660 patients (33.3%) were hospitalized in ICUs (Supplementary Digital Material 1: Supplementary Table 1). The median age of the study population was 64 years (widest range 23-98 73 ), with the lowest mean age of 54 years reported by Khan Chachar and coworkers 36 and the highest (median 72 -IQR, 60-82) reported by Amit et al 57 . Distribution of comorbidities is reported in Supplementary Digital Material 1: Supplementary Figure 1.…”

“…PaCO2 at admission was available in nine studies 19,24,27,[29][30][31]33,35,42 (17%), and median PaCO2 values ranged from 33 mmHg 19,33 to 42 mmHg 30 (Supplementary Digital Material 1: Supplementary Table 2). Respiratory rate at admission was reported in 21 studies 19,23,25,27,28,30,32,33,35,36,39,40,45,47,[56][57][58]60,62,70 (40.4%), and generally ranged from 18-20 breaths/min 28,45,56,60 to 27-28 breaths/min 25,35 .…”

“…The median PaO2/FiO2 at admission ranged from 60 mmHg 44 to 442 mmHg 32 . Data on SpO2 and PaO2 were reported respectively in 14 19,23,27,28,[34][35][36]40,45,47,[56][57][58]61,70 (27%) and seven studies 7,19,27,29,30,35,42 (13%). PaCO2 at admission was available in nine studies 19,24,27,[29][30][31]33,35,42 (17%), and median PaCO2 values ranged from 33 mmHg 19,33 to 42 mmHg 30 (Supplementary Digital Material 1: Supplementary Table 2).…”