Clinical Characteristics of Deceased with COVID-19 Infection: Data from the Largest COVID-19 Dedicated Hospital in Bangladesh

Abstract

The death toll of the coronavirus disease 2019 (COVID-19) has been considerable. Several risk factors have been linked to mortality due to COVID-19 in hospitals. This study aimed to describe the clinical characteristics of patients who either died from COVID-19 at Dhaka Medical College Hospital in Bangladesh. In this retrospective study, we reviewed the hospital records of patients who died or recovered and tested positive for COVID-19 from May 3 to August 31, 2020. All patients who died during the study period were included in the analysis. A comparison group of patients who survived COVID-19 at the same hospital during the same period was systematically sampled. All available information was retrieved from the records, including demographic, clinical, and laboratory variables. Of the 3115 patients with confirmed COVID-19 during the study period, 282 died. The mean age of patients who died was higher than that of those who survived (56.7 vs 52.6 years). Approximately three-fourths of deceased patients were male. History of smoking (risk ratio 2.3; 95% confidence interval: 1.6–3.4), comorbidities (risk ratio: 1.5; 95% confidence interal:1.1–2.1), chronic kidney disease (risk ratio: 3.2; 95% confidence interval: 1.7–6.25), and ischemic heart disease (risk ratio:1.8; 95% confidence interval: 1.1–2.9) were higher among the deceased than among those who survived. Mean C-reactive protein and D-dimer levels [mean (interquartile range), 34 (21–56) vs. 24 (12–48); and D-dimer [1.43 (1–2.4) vs. 0.8 (0.44–1.55)] were higher among those who died than among those who recovered. Older age, male sex, rural residence, history of smoking, and chronic kidney disease were found to be important predictors of mortality. Early hospitalization should be considered for patients with COVID-19 who are older, male, and have chronic kidney disease. Rapid referral to tertiary care facilities is necessary for high-risk patients in rural settings J MEDICINE 2023; 24: 28-36