Demographic and clinical factors associated with early hospital Coronovirus disease 2019 deaths in a low middle income setting: A record-based analysis of 20,641 deaths from India

Abstract

Understanding the demographic and clinical characteristics cases and deaths is essential for better clinical and public health management of coronavirus disease-2019 (COVID-19) in resource-limited settings. We analyzed the COVID-19 deaths reported from India, to describe the demographic and clinical characteristics and identify the factors associated with early hospital deaths (within one day of hospitalization) and survival duration. We conducted a record review of the publicly available data on COVID-19 deaths reported between January 30th and November 30th, 2020. After imputation for missing data, we calculated unadjusted and adjusted prevalence ratio, and regression coefficient for factors associated with early hospital death and survival duration. Of the 20,641 COVID-19 deaths analyzed, a) 14,684 (71.1%) were males; b) 10,134 (50.9%) were aged < 65 years; c) 9,722 (47.1%) treated at public hospitals and d) 5405 (27.1%) were early hospital deaths. Breathlessness was the most common presenting complaint. Diabetes (11,075,53.7%), hypertension (95,77,46.5%) and coronary artery disease (2,821,13.7%) were the common comorbidities. After adjustment, early hospital death was significantly higher among patients aged <65 years, without severe acute respiratory illness (SARI) at admission, non-diabetics, and cared at public hospitals compared to their counterparts. Similarly, the survival duration was at least one day higher among patients presented with SARI, chronic liver disease and cared at a private hospital. The analysis covered >10% of India's COVID-19 deaths, providing essential information regarding the COVID-19 epidemiology. The characteristics associated with early hospital death and survival duration among the COVID-19 fatalities may be deliberated as markers for prognosis and compared with survivors.

Mortalidade no primeiro ano da pandemia por COVID-19 na região metropolitana de Fortaleza: comparação em série histórica com outras causas de morte

“…É imprescindível compreender que o entendimento sobre as taxas de mortalidade específicas de uma população terá uma contribuição direta sobre a evitação de desperdícios de recursos e de tarefas, além de colaborar com o planejamento e a priorização de investimentos feitos na saúde. Nos casos de Covid-19, especificar as características clínicas e demográficas das fatalidades ajuda os especialistas em saúde pública a tornar prioritário a ação e direcionar a comunicação para conjuntos populacionais de maior risco (PERIYASAMY et al, 2022).…”

“…Ademais, ocorrem outras alterações fisiológicas em idosos, que aumentam essa vulnerabilidade a complicações importantes do quadro infeccioso causado pelo Sars-CoV-2, como diminuição da complacência e da força muscular respiratória, atenuação da produção de líquido surfactante, entre outras alterações(GANDRA et al, 2021).Além das supracitadas alterações fisiológicas em idosos, pode-se explicitar que estes apresentam, muitas vezes, doenças crônicas. Algumas dessas patologias são consideradas comorbidades, as quais agravam as fatalidades em quadros de Covid-19, como diabetes, hipertensão arterial, cardiopatias, doenças pulmonares e alterações cerebrovasculares(GANDRA et al, 2021;PERIYASAMY et al, 2022).Relativo ao sexo dos indivíduos que faleceram por Covid-19, é possível mencionar que a maioria pertencia ao sexo masculino. A gravidade dos casos dessa doença é maior, de forma significativa, em homens do que em mulheres.…”

Risk Perception and Knowledge, Attitudes, and Practices Against COVID-19 in a Hypertensive Population From a Semi-Urban City of Ecuador

“…A study conducted in Peru, for example, found the most common comorbidities associated with mortality due to COVID-19 were obesity, hypertension, and diabetes mellitus ( 13 ), while in Malaysia or India, most of the deaths due to COVID-19 occurred in individuals with diabetes and hypertension, and in those aged 70 years or older ( 14 , 15 ).…”