Tulara Neeraj, Mehta Swapnil, Pahuja Vimal, Suralkar Shalini, Dwivedy Arpita, Bhaskar Maheema, Babu Sajit, Chitnis Archana, Shetty Suvin, Setia Maninder S
Internal Medicine, Dr. LH Hiranandani Hospital, Mumbai, IND.
Pulmonology, Dr. LH Hiranandani Hospital, Mumbai, IND.
Cureus. 2025 May 8;17(5):e83711. doi: 10.7759/cureus.83711. eCollection 2025 May.
We conducted the present analysis to understand the clinical outcomes in patients with COVID-19 infection and the factors associated with mortality over the one-and-a-half years of the pandemic in Mumbai, India.
This is a retrospective cohort study of 3561 COVID-19 patients admitted to a private tertiary care hospital in Mumbai, India. The main outcome variable for analysis was death (yes/no). We compared the characteristics of COVID-19 patients who had died during their stay in the hospital with those who had not died. We used survival analysis to identify the factors associated with mortality.
The mortality rate was 0.71 per 100 person-days (95% CI: 0.61-0.81 per 100 person days (PD)); it was higher (2.03 (95% CI: 1.47, 2.82) per 100 PD) in those aged >= 80 years compared with 18-39 years (p<0.001). The hazard rate (HR) was significantly higher in those with chronic liver disease (HR: 5.12, 95% CI: 1.78, 14.71; p=0.002) and lower in those who were treated with injection enoxaparin (HR: 0.46, 95% CI: 0.31, 0.69; p<0.001). In patients without breathing difficulties, the hazard was significantly lower in those treated with doxycycline (HR: 0.41, 95% CI: 0.17, 0.99; p=0.05). In patients who presented with breathing difficulties, hazard was significantly lower in those who were treated with remdesivir (HR: 0.52, 95% CI: 0.31, 0.90; p=0.019). In patients who required ventilatory support (invasive and non-invasive), the hazard was significantly lower with injected tocilizumab (HR: 0.56, 95% CI: 0.36, 0.89; p=0.013).
The mortality was highest during the initial days of the pandemic and in patients with co-morbidities. Remdesivir and the tocilizumab injection were useful in the reduction of mortality in the severe form of COVID-19 infection. Doxycycline was useful in milder and less severe forms of infection. However, enoxaparin injection was associated with lower mortality in most of these cases.
我们进行了本次分析，以了解印度孟买新冠疫情爆发一年半期间新冠病毒感染患者的临床结局以及与死亡率相关的因素。
这是一项对印度孟买一家私立三级护理医院收治的3561例新冠患者的回顾性队列研究。分析的主要结局变量为死亡（是/否）。我们比较了住院期间死亡的新冠患者与未死亡患者的特征。我们使用生存分析来确定与死亡率相关的因素。
死亡率为每100人日0.71例（95%置信区间：每100人日0.61 - 0.81例）；80岁及以上患者的死亡率（每100人日2.03例（95%置信区间：1.47, 2.82））高于18 - 39岁患者（p<0.001）。慢性肝病患者的风险率（HR）显著更高（HR：5.12，95%置信区间：1.78, 14.71；p = 0.002），而接受依诺肝素注射治疗的患者风险率较低（HR：0.46，95%置信区间：0.31, 0.69；p<0.001）。在无呼吸困难的患者中，接受多西环素治疗的患者风险显著较低（HR：0.41，95%置信区间：0.17, 0.99；p = 0.05）。在出现呼吸困难的患者中，接受瑞德西韦治疗的患者风险显著较低（HR：0.52，95%置信区间：0.31, 0.90；p = 0.019）。在需要通气支持（有创和无创）的患者中，注射托珠单抗后风险显著较低（HR：0.56，95%置信区间：0.36, 0.89；p = 0.013）。
在疫情初期以及患有合并症的患者中死亡率最高。瑞德西韦和托珠单抗注射剂对降低重症新冠病毒感染的死亡率有用。多西环素对症状较轻和不太严重的感染形式有用。然而，在大多数此类病例中，依诺肝素注射与较低的死亡率相关。
