Nishant Kumar Chauhan1, Benhur Joel Shadrach2, Mahendra Kumar Garg3, Pradeep Bhatia4, Pankaj Bhardwaj5, Manoj Kumar Gupta6, Naveen Dutt7, Ram Niwas Jalandra8, Pawan Garg9, Vijaya Lakshmi Nag10, Praveen Sharma11, Gopal Krishna Bohra12, Deepak Kumar13, Poonam Abhay Elhence14, Mithu Banerjee15, Deepti Mathur16, Abhishek Hl Purohit17, Ravisekhar Gadepalli18, Binit Sureka19, Sanjeev Misra20. 1. a:1:{s:5:"en_US";s:47:"All India Institute of Medical Sciences Jodhpur";}. nishant97@gmail.com. 2. Department of Pulmonary Medicine,All India Institute of Medical Sciences, Jodhpur. benjoe6326@gmail.com. 3. Department of General Medicine, All India Institute of Medical Sciences, Jodhpur. mkgargs@gmail.com. 4. Department of Anaesthesiology and Critical care, All India Institute of Medical Sciences, Jodhpur. pk_bhatia@yahoo.com. 5. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur. pankajbhardwajdr@gmail.com. 6. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur. drmkgbhu@gmail.com. 7. Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur. drnaveendutt@yahoo.co.in. 8. Department of Pulmonary Medicine, All India Institute of Medical Sciences, Jodhpur. drriniwas@gmail.com. 9. Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur. drgargpawan@gmail.com. 10. Department of Microbiology, All India Institute of Medical Sciences, Jodhpur. vijayalakshmi005@gmail.com. 11. Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur. praveensharma55@gmail.com. 12. Department of General Medicine, All India Institute of Medical Sciences, Jodhpur. gopalbohra17@gmail.com. 13. Department of General Medicine, All India Institute of Medical Sciences, Jodhpur. deepak1007sharma@gmail.com. 14. Department of Pathology, All India Institute of Medical Sciences, Jodhpur. poonamelhence@gmail.com. 15. Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur. mithu.banerjee.3@gmail.com. 16. Research assistant, All India Institute of Medical Sciences, Jodhpur. dr.deeptimathur84@gmail.com. 17. Department of Pathology, All India Institute of Medical Sciences, Jodhpur. purohitabhi80@gmail.com. 18. Department of Microbiology, All India Institute of Medical Sciences, Jodhpur. gadepallirs@gmail.com. 19. Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur. binitsurekapgi@gmail.com. 20. Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur. misralko@gmail.com.
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: Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised 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.
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: Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised LDH and low lymphocyte counts at baseline are associated with COVID-19mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19patients.