Parhad Priyanka, Galhotra Abhiruchi, Jindal Atul, Nagarkar Nitin M, Behera Ajoy K
Department of Public Health, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2022 Jul 16;14(7):e26909. doi: 10.7759/cureus.26909. eCollection 2022 Jul.
Background Coronavirus disease 2019 (COVID-19) is the largest pandemic that has affected people around the globe. Various researches have been conducted worldwide, but there is a scarcity of data from Central India on the relationship between several risk factors for infection and mortality. Our study assessed the predictors and patient profiles of those with COVID-19, which will aid in prioritizing patient treatment and preventive measures. Methods A retrospective study was done between March and December 2020. The study included 5,552 COVID-19 patients admitted to the All India Institute of Medical Sciences (AIIMS), Raipur. A validated questionnaire form provided by the WHO was used. Data for multiple clinical and nonclinical parameters were collected, and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY, USA) and STATA version 12 (StataCorp LLC, College Station, TX, USA). Mortality and risk assessment of patients was done using multivariate logistic regression. Result In our study cohort of 5,552 COVID-19 patients, the median age was found to be 47 years (interquartile range (IQR): 31-60 years; range: 14-100 years), and 3,557 (64%) were male. Predominantly, patients presented with fever (41.30%), cough (40.20%), and dyspnea (29.29%). The major comorbidities were hypertension (29.70%), diabetes (25.40%), and chronic cardiac disease (5.79%). The common complications were liver dysfunction (26.83%), viral pneumonitis (23.66%), acute renal injury (15.25%), and acute respiratory distress syndrome (ARDS) (13.41%). In multivariate analysis, age (more than 40 years) (odds ratio (OR): 2.63; 95% confidence interval (CI): 1.531-4.512; p<0.001), diabetes (OR: 1.61; 95% CI: 1.088-2.399; p=0.017), obesity (OR: 6.88; 95% CI: 2.188-12.153; p=0.004), leukocytosis (OR: 1.74; 95% CI: 1.422-2.422; p<0.001), lymphocytopenia (OR: 2.54, 95% CI: 1.718-3.826; p<0.001), thrombocytopenia (OR: 1.15; 95% CI: 1.777-8.700; p=0.001), and ferritin concentration > 1,000 ng/mL (OR: 4.67; 95% CI: 1.991-10.975; p<0.001) were the independent predictors of mortality among COVID-19 patients. Conclusion The leading comorbidities in our study were hypertension, followed by diabetes. Patients who were 40 years or older, obese patients, and diabetic patients have a higher mortality risk. The poor prognostic predictors in COVID-19 patients were high ferritin levels (>1,000 ng/mL), leukocytosis, lymphocytopenia, and thrombocytopenia.
背景 2019 冠状病毒病（COVID - 19）是影响全球人口的最大规模的大流行病。全球已开展了各种研究，但印度中部缺乏关于多种感染风险因素与死亡率之间关系的数据。我们的研究评估了 COVID - 19 患者的预测因素和患者特征，这将有助于确定患者治疗和预防措施的优先级。方法 于 2020 年 3 月至 12 月进行了一项回顾性研究。该研究纳入了 5552 名入住赖布尔全印度医学科学研究所（AIIMS）的 COVID - 19 患者。使用了世界卫生组织提供的经过验证的问卷形式。收集了多个临床和非临床参数的数据，并使用 SPSS 26 版（美国纽约州阿蒙克市 IBM 公司）和 STATA 12 版（美国德克萨斯州大学城 StataCorp 有限责任公司）进行分析。使用多因素逻辑回归对患者的死亡率和风险进行评估。结果 在我们 5552 名 COVID - 19 患者的研究队列中，发现中位年龄为 47 岁（四分位间距（IQR）：31 - 60 岁；范围：14 - 100 岁），3557 名（64%）为男性。主要症状为发热（41.30%）、咳嗽（40.20%）和呼吸困难（29.29%）。主要合并症为高血压（29.70%）、糖尿病（25.40%）和慢性心脏病（5.79%）。常见并发症为肝功能障碍（26.83%）、病毒性肺炎（23.66%）、急性肾损伤（15.25%）和急性呼吸窘迫综合征（ARDS）（13.41%）。在多因素分析中，年龄（超过 40 岁）（比值比（OR）：2.63；95%置信区间（CI）：1.531 - 4.512；p < 0.001）、糖尿病（OR：1.61；95% CI：1.088 - 2.399；p = 0.017）、肥胖（OR：6.88；95% CI：2.188 - 12.153；p = 0.004）、白细胞增多（OR：1.74；95% CI：1.422 - 2.422；p < 0.001）、淋巴细胞减少（OR：2.54，95% CI：1.718 - 3.826；p < 0.001）、血小板减少（OR：1.15；95% CI：1.777 - 8.700；p = 0.001）以及铁蛋白浓度 > 1000 ng/mL（OR：4.67；95% CI：1.991 - 10.975；p < 0.001）是 COVID - 19 患者死亡率的独立预测因素。结论 我们研究中的主要合并症为高血压，其次是糖尿病。40 岁及以上的患者、肥胖患者和糖尿病患者有较高的死亡风险。COVID - 19 患者预后不良的预测因素为高铁蛋白水平（>1000 ng/mL）、白细胞增多、淋巴细胞减少和血小板减少。
