Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience

Abstract

ObjectiveTo describe the clinical profile and factors leading to increased mortality in coronavirus disease (COVID-19) patients admitted to a group of hospitals in India.DesignA records-based study of the first 1000 patients with a positive result on real-time reverse transcriptase-polymerase-chain-reaction assay for SARS-CoV-2 admitted to our facilities. Various factors such as demographics, presenting symptoms, co-morbidities, ICU admission, oxygen requirement and ventilator therapy were studied.ResultsOf the 1000 patients, 24 patients were excluded due to lack of sufficient data. Of the remaining 976 in the early phase of the epidemic, males were admitted twice as much as females (67.1% and 32.9%, respectively). Mortality in this initial phase was 10.6% and slightly higher for males and steeply higher for older patients. More than 8% reported no symptoms and the most common presenting symptoms were fever (78.3%), productive cough (37.2%), and dyspnea (30.64%). More than one-half (53.6%) had no co-morbidity. The major co-morbidities were hypertension (23.7%), diabetes without (15.4%), and with complications (9.6%). The co-morbidities were associated with higher ICU admissions, greater use of ventilators as well as higher mortality. A total of 29.9% were admitted to the ICU, with a mortality rate of 32.2%. Mortality was steeply higher in those requiring ventilator support (55.4%) versus those who never required ventilation (1.4%). The total duration of hospital stay was just a day longer in patients admitted to the ICU than those who remained in wards.ConclusionMale patients above the age of 60 and with co-morbidities faced the highest rates of mortality. They should be admitted to the hospital in early stage of the disease and given aggressive treatment to help reduce the morbidity and mortality associated with COVID-19.

Role of Ivermectin in Patients Hospitalized with COVID-19: A Systematic Review of Literature

“…The studies chosen in this review are specific to hospitalized COVID-19 patients, larger in quantity, and include RCTs. A recent case series also supported these findings as 34 subjects treated with ivermectin all survived and mortality was observed in the other group(s) [36]. This is particularly encouraging keeping in view the current situation of the pandemic.…”

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19

“…Studies of ivermectin amongst more severely ill hospitalized patients include 6 RCT's, 5 OCTs, and a database analysis study (Ahmed et al, 2020;Budhiraja et al, 2020;Chachar et al, 2020;Elgazzar et al, 2020;Gorial et al, 2020;Hashim et al, 2020;Khan et al, 2020;Niaee et al, 2020;Portmann-Baracco et al, 2020;Rajter et al, 2020;Soto-Becerra et al, 2020;Spoorthi V, 2020).…”

“…This study also reported a significant reduction in length of hospital stay (7.6 days vs. 13.2 days, p<.001) in the ivermectin group. In a study reporting on the first 1000 patients treated in a hospital in India, they found that in the 34 patients treated with ivermectin alone, all recovered and were discharged, while in the over 900 patients treated with other agents, there was an overall mortality of 11.1% (Budhiraja et al, 2020).…”

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19

“…In a study reporting on the first 1000 patients treated in a hospital in India, they found that in the 34 patients treated with ivermectin alone, all recovered and were discharged, whereas in more than 900 patients treated with other agents, there was an overall mortality of 11.1%. 70 …”