Priya S, Selva Meena M, Sangumani J, Rathinam Prabhakaran, Brinda Priyadharshini C, Vijay Anand V
Institute of Community Medicine, Madurai Medical College, India.
Government RajajiHospital(GRH) and Madurai Medical College, India.
Clin Epidemiol Glob Health. 2021 Apr-Jun;10:100705. doi: 10.1016/j.cegh.2021.100705. Epub 2021 Feb 10.
COVID19* is a new disease with significant mortality risk. Because of the scarcity of the study on factors associated with the mortality in Tamil Nadu present study was done to determine the factors associated with the outcome of the COVID19 patients admitted in a tertiary care hospital, Madurai.
4530 lab confirmed COVID19 patients admitted from March to August 31st 2020; excluding the non-responders or who gave incomplete information were included in the study. Data retrieved from Case Investigation Forms *filled through telephonic interview. Chi -square test, Univariate and multivariate logistic regression were used to find out the association between the factors and risk of death(outcome).
Out of 4530 COVID19 positive patients 381(8.4%) died and 4149(91.6%) were discharged. Using multivariate logistic regression* following were the factors predicted to be associated with mortality:Age group <17yrs(PR = 4.12),30-44yrs(PR = 2.28),45-59(PR = 3.12),60-69(PR = 4.26) and ≥ 70(PR = 7.05); male gender(PR = 1.26); breathlessness at the time of admission(PR = 7.05); with 1symptom (PR = 2.58), 2symptoms(PR = 3.16) and ≥ 3 symptoms(PR = 2.45); chronic kidney disease(PR = 3.07), malignancy(PR = 2.39); other chronic diseases(PR = 1.89); having only diabetes(PR = 1.58); diabetes with hypertension (PR = 1.70); diabetes with heart disease(PR = 1.94); Hypertension with heart disease(PR = 2.30); diabetes with hypertension and heart disease(PR = 1.58). Survival probability* was more than 90% when patient gets admitted within a week after symptom onset,<80% for between 7 and 10 days and declines thereafter.
Early insights into factors associated with COVID-19 deaths have been generated in the context of a global health emergency *which may help the treating physician.
新型冠状病毒肺炎*是一种具有重大死亡风险的新疾病。由于泰米尔纳德邦关于与死亡相关因素的研究较少,因此开展了本研究,以确定在马杜赖一家三级护理医院收治的新型冠状病毒肺炎患者的预后相关因素。
纳入2020年3月至8月31日收治的4530例实验室确诊的新型冠状病毒肺炎患者;排除无应答者或提供信息不完整者。数据从通过电话访谈填写的病例调查表*中获取。采用卡方检验、单因素和多因素逻辑回归分析来找出这些因素与死亡风险(预后)之间的关联。
在4530例新型冠状病毒肺炎阳性患者中,381例(8.4%)死亡,4149例(91.6%)出院。采用多因素逻辑回归分析*,以下因素被预测与死亡率相关:年龄组<17岁(PR = 4.12)、30 - 44岁(PR = 2.28)、45 - 59岁(PR = 3.12)、60 - 69岁(PR = 4.26)和≥70岁(PR = 7.05);男性(PR = 1.26);入院时呼吸困难(PR = 7.05);有1种症状(PR = 2.58)、2种症状(PR = 3.16)和≥3种症状(PR = 2.45);慢性肾脏病(PR = 3.07)、恶性肿瘤(PR = 2.39);其他慢性病(PR = 1.89);仅患有糖尿病(PR = 1.58);糖尿病合并高血压(PR = 1.70);糖尿病合并心脏病(PR = 1.94);高血压合并心脏病(PR = 2.30);糖尿病合并高血压和心脏病(PR = 1.58)。症状出现后一周内入院的患者生存概率*超过90%,7至10天之间入院的患者生存概率<80%,此后逐渐下降。
在全球卫生紧急情况*背景下,已对新型冠状病毒肺炎死亡相关因素有了早期认识,这可能有助于治疗医生。