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 patients with coronavirus disease 2019 (COVID-19) and their outcomes is critical. We investigated this relationship in hospitalized patients in a tertiary healthcare setting.

Aims/objectives: To study the severity and outcomes of COVID-19 in relation to clinical and demographic characteristics of inpatients

Methodology: In this cross-sectional study, medical records of 1087 patients with COVID-19 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: Most study participants were >50 years old (67%) and men (59%) and had the following symptoms: fever (96%), cough (95%), shortness of breath (73%), loss of taste (77%), and loss of smell (77%). Regarding worse outcomes, multivariate regression analysis revealed that the following characteristics were significant: shortness of breath (adjusted odds ratio [aOR] 31.3; 95% confidence interval [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). Moreover, patients with rhinorrhea were significantly protected (aOR 0.3; 95% CI, 0.2–0.5; p < 0.001). Kaplan–Meier analysis revealed that the symptoms of shortness of breath, ICU admission, fever, nausea and vomiting, and diarrhea were associated with an increased risk of mortality.

Conclusion: Increasing age, certain comorbidities and symptoms, and direct admission to the ICU were associated with an increased risk of worse outcomes. Further research is needed to determine the risk factors that may increase disease severity and devise an appropriate risk-scoring system to initiate timely management.