COVID-19 outcomes associated with clinical and demographic characteristics in patients hospitalized with severe and critical disease in Peshawar

Abstract

Background As a novel disease, understanding the relationship between the clinical and demographic characteristics of coronavirus disease 2019 (COVID-19) patients and their outcome is critical. We investigated this relationship in hospitalized patients in a tertiary healthcare setting. Aims/objectives To study COVID-19 severity and outcomes in relation to clinical and demographic characteristics of in admitted patients Methodology In this cross-sectional study, medical records for 1087 COVID-19 patients were reviewed to extract symptoms, comorbidities, demographic characteristics, and outcomes data. Statistical analyses included the post-stratification chi-square test, independent sample t-test, multivariate logistic regression, and time-to-event analysis. Results The majority of the study participants were >50 years old (67%) and male (59%) and had the following symptoms: fever (96%), cough (95%), shortness of breath (73%), loss of taste (77%), and loss of smell (77%). Regarding worst outcome, multivariate regression analysis showed that these characteristics were statistically significant: shortness of breath (adjusted odds ratio [aOR] 31.3; 95% CI, 11.87–82.53; p < 0.001), intensive care unit (ICU) admission (aOR 28.3; 95% CI,9.0–89.6; p < 0.001), diabetes mellitus (aOR 5.1; 95% CI;3.2–8.2; p < 0.001), ischemic heart disease (aOR 3.4; 95% CI,1.6–7; p = 0.001), nausea and vomiting (aOR 3.3; 95% CI, 1.7–6.6; p = 0.001), and prolonged hospital stay (aOR 1.04; 95% CI, 1.02–1.08; p = 0.001), while patients with rhinorrhea were significantly protected (aOR 0.3; 95% CI, 0.2–0.5; p < 0.001). A Kaplan–Meier curve showed that the symptoms of shortness of breath, ICU admission, fever, nausea and vomiting, and diarrhea increased the risk of mortality. Conclusion Increasing age, certain comorbidities and symptoms, and direct admission to the ICU increased the risk of worse outcomes. Further research is needed to determine risk factors that may increase disease severity and devise a proper risk-scoring system to initiate timely management.