Predictors of Clinical Outcomes in Adult COVID-19 Patients Admitted to a Tertiary Care Hospital in India: an analytical cross-sectional study Predictors of clinical outcomes in COVID-19

Main Article Content

Nishant Kumar Chauhan
Benhur Joel Shadrach
Mahendra Kumar Garg
Pradeep Bhatia
Pankaj Bhardwaj
Manoj Kumar Gupta
Naveen Dutt
Ram Niwas Jalandra
Pawan Garg
Vijaya Lakshmi Nag
Praveen Sharma
Gopal Krishna Bohra
Deepak Kumar
Poonam Abhay Elhence
Mithu Banerjee
Deepti Mathur
Abhishek HL Purohit
Ravisekhar Gadepalli
Binit Sureka
Sanjeev Misra

Keywords

Keywords: COVID-19; Predictors; Outcomes; SOFA score; D-dimer

Abstract

Background:The outbreak ofsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted inexponential rise in the number of patients getting hospitalised with corona virus disease 2019 (COVID-19). There is a paucity of data from South East Asian Region related to the predictors of clinical outcomes in these patients. This formed the basis of conducting our study.


Methods:This was an analytical cross-sectional study. Demographic, clinical, radiological and laboratory data of 125 patients was collected on admission. The study outcome was death or discharge after recovery. For univariate analysis, unpaired t-test, Chi-square and Fisher’s Exact test were used. Receiver operating characteristic (ROC) curves were plotted for Sequential Organ Failure Assessment (SOFA) score and few laboratory parameters. Logistic regression was applied for multivariate analysis.


Results:Elderly age, ischemic heart disease and smoking were significantly associated with mortality. Elevated levels of D-dimer and lactate dehydrogenase (LDH) and reduced lymphocyte counts were the predictors of mortality. The ROCs for SOFA score curve showed a cut-off value ≥ 3.5 (sensitivity- 91.7% and specificity- 87.5%), for IL-6 the cut-off value was ≥ 37.9 (sensitivity- 96% and specificity- 78%) and for lymphocyte counts, a cut off was calculated to be less than and equal to 1.46 x 109per litre (sensitivity-75.2%and specificity- 83.3%).


Conclusion:Older age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, LDH and low lymphocyte counts at baseline are associated with COVID-19 mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19 patients.

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