Predictors of Outcome in Hospitalized Adult COVID-19 Patients Admitted to a Tertiary Hospital in Chattogram

R. Biswas, M. Karim, E. Ullah, Mahmud Hassan Arif, Moinuddin A. Chowdhury, Mohammad Abu Sayeed Chowdhury, Sabrina Yusuf, Fatema Tooj Johra
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Abstract

Background: The COVID-19 pandemic emerged as a major public health emergency affecting the healthcare services all over the world. It is essential to analyze the epidemiological and clinical characteristics of patients with COVID-19 in different parts of our country. This study highlights clinical experience in managing patients with COVID-19 at a tertiary care centre in southeastern Bangladesh. Materials and methods: Clinical characteristics and outcomes of consecutive 199 adult patients admitted to Chittagong Medical College Hospital, Chattogram, Bangladesh, from February 1 to March 31, 2021 were studied in this prospective observational study. The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) on throat and/or nasopharyngeal swabs. All patients were managed according to the hospital’s consensus protocol and in accordance with National Guidelines on clinical management of COVID-19. Results: The median age of the patients was 57 years (Range: 20-102 years) and 118 (59.3%) were male. One hundred and thirty two (67.3%) patients had associated comorbid condition and diabetes (44.7%) and hypertension (33.3%) were the most common. Majority (57.3%) was classified as having moderate severity and mortality of 10.1% (20 patients) was observed. Elderly age (>60 years), diabetes mellitus, elevated levels of D-dimer and neutrophillymphocyte ratio were the predictors of mortality. Conclusions: These findings suggest that the mortality rate in elderly COVID-19 patients with comorbidity is high and neutrophil-lymphocyte ratio could be a cost effective predictor of mortality in our context. JCMCTA 2022 ; 33 (1) : 138-143
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三级医院成人COVID-19住院患者的预后预测因素
背景:2019冠状病毒病大流行已成为影响全球卫生服务的重大突发公共卫生事件。分析我国不同地区COVID-19患者的流行病学和临床特征是必要的。本研究重点介绍了孟加拉国东南部一家三级保健中心在管理COVID-19患者方面的临床经验。材料与方法:本前瞻性观察研究对2021年2月1日至3月31日在孟加拉国吉大港医学院医院连续收治的199例成年患者的临床特征和结局进行了研究。咽喉和/或鼻咽拭子实时逆转录聚合酶链反应(RT-PCR)证实了SARS-CoV-2感染的诊断。所有患者均按照医院共识方案和《国家COVID-19临床管理指南》进行管理。结果:患者中位年龄为57岁(范围:20 ~ 102岁),男性118例(59.3%)。合并合并症132例(67.3%),以糖尿病(44.7%)和高血压(33.3%)最为常见。大多数(57.3%)为中度重症,死亡率为10.1%(20例)。老年(>60岁)、糖尿病、d -二聚体水平升高和中性淋巴细胞比例升高是死亡率的预测因素。结论:这些研究结果表明,合并合并症的老年COVID-19患者的死亡率很高,中性粒细胞-淋巴细胞比率可能是本研究中具有成本效益的死亡率预测指标。Jcmcta 2022;33 (1): 138-143
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