Clinical and Laboratory Characteristics of COVID- 19 and Their Relationship with Mortality in Patients at Wardha District: A Cross-Sectional Analysis

Abstract

Background: The highly contagious infectious disease COVID-19, caused by the SARS-CoV-2 virus, leads to acute respiratory distress syndrome. This study examines the clinical and laboratory characteristics of COVID-19 patients and explores how these factors correlate with mortality rates in individuals admitted to hospitals in Wardha District. This study also aims to investigate the relationship between the severity and fatality of hospitalized COVID-19 patients and their initial laboratory data. Utilizing a cross-sectional methodology, the research aims to provide insights into the key determinants of patient outcomes during the pandemic.

Methods: Demographic data (age, gender, comorbidities), symptomatology, clinical signs, and pulse oximetry were collected, and routine biochemical, hematological investigations, and chest X-ray findings of hospitalized COVID-19 patients who were RT-PCR positive were noted. This study was conducted from March 2020 to May 2023 at a tertiary care hospital in the Wardha district of central India. A univariate and bivariate analysis was done of this data, and the significant factors were derived and compared in survivors and non-survivors. A P-value of < 0.05 was considered to be statistically significant. SPSS software version. 21 was used for analysis.

Results: Among 1736 study subjects, 153 (8.8%) did not survive. The subjects with age >65 years had higher mortality, 12.9 % OR 2.41 (95% CI 1.50-3.88), as compared to those with younger ages 18-44 years

(5.8%). 34.16% were asymptomatic in the age group of 18-44 years, and they had a substantial correlation with death [P-value <0.001]. Among the symptoms, fever (39.05%), cough (31.62%), and breathlessness (23.32%) were the most common. The common non-respiratory symptoms were myalgia 17.74%, fatigue 11.23% and diarrhea 3.51%. The subjects with SPO2 of 88 to 92% on admission classified as moderate ARDS had the highest mortality, 31.05% OR of 8.70 (5.77, 13.12), compared to those with SPO2 of >92%.

Hematological parameters, neutrophil-lymphocyte ratio, absolute leukocyte count, and thrombocytopenia were significantly associated with mortality P value <0.001.

Conclusion: To objectively prioritize patients who are critically sick and in need of critical care management, the predictors of mortality are a helpful screening tool. It will assist in providing limited resources, such as ventilators, in rural India's resource-constrained environment.

Categories: Public Health, Internal Medicine, Infectious Disease