Clinical Characteristics and Risk Factors Associated with COVID-19 Mortality: A Retrospective Study

Abstract

Background: COVID-19 originating in the end of Dec 2019, linked to the SARS-CoV-2 has presented major health challenges for people around the globe, with over 773 million cases and 6.91 million mortality recorded as of December 2023. In India, a total of 44.9 million confirmed positive COVID-19 cases, resulting in the 533,392 deaths. The COVID-19, which caused widespread mortality globally, necessitates a focused and thorough analysis of inpatient fatalities. Aim: This study aimed to investigate the risk factors and clinical characteristics associated with mortality in COVID-19 patients. Material and Methods: This observational analytical study was conducted at the Integral Institute of Medical Sciences and Research, Integral University, Lucknow, between December 2020 and June 2021. Out of 1,196 confirmed positive  cases, 107 adult mortality cases were thoroughly examined. The data analysis included the use of frequencies, mean values with standard deviations, as well as bivariate and multivariate statistical techniques. Results: The study revealed an overall mortality rate of 1.57% among admitted COVID-19 patients, with a case fatality rate of 8.9%. This study shows outmost number of COVID-19-related deaths occurred in April 2021, representing 61% of total fatalities. Males accounted for 67.37% of the deaths, while females comprised 33%. The age group of 41-60 years shows the highest mortality rate, contributing to 44.85% of the total deaths. Among the patients, 69 (64%) and 38 (35%) were from rural areas and urban areas simultaneously. Fever (91.5%) and breathlessness (84.1%) were the most commonly reported symptoms, with hypertension being the most prevalent comorbidity, affecting 34.58% of deceased patients. Increased inflammatory markers, such as increased CRP levels and WBC counts, were strongly linked to severe disease progression. Additionally, male patients showed higher levels of urea, creatinine, D-dimer, and blood glucose, indicating more severe systemic inflammation. Conclusions: A mortality rate of 1.57% was observed in the study population. Despite the shorter duration of the second wave, it resulted in a higher number of deaths, potentially due to more virulent strains or overwhelmed healthcare systems. These findings underscore the vitality of early identification and approaches for Addressing the needs of high risk Groups, emphasizing the importance of the biochemical markers in prognosticating the severity in COVID-19 Patients.