Abstract
The outbreak of the novel corona virus disease 2019 (COVID-19) began in Wuhan, China in December 2019. Since then, it has rapidly spread around the world. The clinical spectrum of COVID-19 pneumonia ranges from mild to critically ill cases. In this study, we tried to present details of patients admitted to the COVID-19 dedicated Mugda Medical College and Hospital in Dhaka, Bangladesh with laboratory-confirmed COVID-19 and a definite clinical outcome (death or discharge) as of June 30, 2020. We conducted a retro-prospective study of 384 patients admitted with COVID-19. Epidemiological, demographic, clinical, treatment, and outcome data were obtained from patient charts and the hospitals’ admission records using a structured questionnaire. Among them 384 of the PCR confirmed COVID-19 cases had an outcome of death (25.5%), transfer to other facilities (3.1%), discharge through palliative purpose (1.6%) or live discharge (67.2%). Males accounted for 52.9% of the study subjects and 44.4% of the survivors. Survival was significantly higher in females than in males (p ≤0.001). The most common symptoms on admission were fever (21, 70.6%) and cough (229, 59.6%), followed by shortness of breath (200, 52.1%), fatigue (152, 39.6%) and sore throat (141, 36.7%). In-hospital death was higher in patients with diabetes or hypertension. Moving forward, we hope to continue to deliver early and optimal care, limit community transmission, and tying the case fatality to the lower end of the known range.
Keywords: Clinical Course, Risk Factors, Health Outcome, COVID-19 Pandemic
References
- Liang W, Liang H, Ou L, et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients with COVID-19. JAMA Intern Med. Published online May 12, 2020. doi:10.1001/jamainternmed.2020.2033
- Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229):1054-1062. doi:10.1016/S0140-6736(20)30566-3
- United Nations Department of Economic and Social Affairs Population Dynamics. World population prospects 2019. Accessed April 6, 2020. https://population.un.org/wpp/Graphs/DemographicProfiles/Pyramid/840
- Chen Z, Peto R, Zhou M, et al; China Kadoorie Biobank (CKB) collaborative group. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. 2015;386 (10002):1447-1456. doi:10.1016/S0140-6736(15)00340-2
- Hossain I, Mullick AR, Khan MH, Aktaruzzaman M, Rahman S, Tuhin SGN, et al. Impacts of Conventional Oxygen Therapy on COVID-19 Patient in Intensive Care Unit (ICU). J Med SciClin Res. 2020;08(08):183–9.
- Hossain I, Khan MH, Ahmad SA, Aktaruzzaman M, Tuhin SGN, Rahman S, et al. Characteristics of Inpatients’ Fatality Due to Covid -19 Pandemic: Experience fromMugda Medical College and Hospital,Dhaka, World J Adv Heal Care Res. 2020;4(5):11–5.
- Hossain I, Mullick AR, Khan MH, Ahmad SA, Rahman S, Aktaruzzaman M. Epidemiology of Coronavirus Disease:Past,Present, Future Prospects and Its Journey Towards Bangladesh. Int Med J. 2020;25(06):2517–29.
- Institute for Health Metrics and Evaluation. GBD Compare/Viz Hub. Accessed April 6, 2020. https://vizhub.healthdata.org/gbd-compare/
- Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized with COVID-19 in the New York City Area. 2020;323(20):2052–2059. doi:10.1001/jama.2020.6775
- Li Q Guan X Wu P et al., Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020; (published online Jan 29.) DOI:10.1056/NEJMoa20013168
- Li Q, Guan X, Wu P et al., Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020; (published online Jan 29.) DOI:10.1056/NEJMoa2001316
- Wang D Hu B Hu C et al., Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; (published online Feb 7.) DOI:10.1001/jama.2020.1585 10.
- Chen N Zhou M Dong X et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395: 507-513
- Kalil AC Metersky ML Klompas M et al., Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016; 63: e61-e111
- World Health Organization. Coronavirus disease (COVID-19) technical guidance: laboratory testing for 2019-nCoV in humans. [cited 2020 Jan 24]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/laboratory-guidance
- Docherty, A. B., Harrison, E. M., Green, C. A., Hardwick, H. E., Pius, R., Norman, L., Holden, K. A., Read, J. M., Dondelinger, F., Carson, G., Merson, L., Lee, J., Plotkin, D., Sigfrid, L., Halpin, S., Jackson, C., Gamble, C., Horby, P. W., Nguyen-Van-Tam, J. S., M. G. (2020). Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. The BMJ, 369. https://doi.org/10.1136/bmj.m1985
- Fei Zhou (2020) Clinical Course and Risk Factors for Mortality of Adult in Patients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. J Med Stud Res 3: 015.
- Guan W.J., Ni Z.Y., Hu Y., Liang W.-H., Ou C.-Q., He J.-X., et al.: Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; https://doi.org/10.1056/NEJMoa2002032
- Smits S.L., de Lang A., van den Brand J.M., Leijten L.M., van IJcken W.F., Eijkemans M.J.C., et al.: Exacerbated innate host response to SARS-CoV in aged non-human primates., PLoSPathog. 2010; 6e1000756
- Opal S.M., Girard T.D., Ely E.W.: The immune-pathogenesis of sepsis in elderly patients. Clin Infect Dis. 2005; 41: S504-S512
- Chen T, Wu D, Chen H, et al: Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091
- Cortes Garcia M, Sierra Moros MJ, Santa-Olalla Peralta P, Hernandez-Barrera V, Jimenez-Garcia R, Pachon I: Clinical characteristics and outcomes of diabetic patients who were hospitalised with 2009 pandemic influenza A H1N1 infection. J Infect 2012; 64:218–224
- Lippi G, Wong J, Henry BM: Hypertension and its severity or mortality in Coronavirus Disease 2019 (COVID-19): a pooled analysis. Pol Arch Intern Med 2020; 130:304–309
- Zhang H., Kang Z.J., Gong H.Y., Xu D., Wang J., Li Z. et al.: The digestive system is a potential route of 2019 nCoV infection: a bioinformatics analysis based on single-cell transcriptomes. (Preprint Posted Online January 31)2020 https://doi.org/10.1101/2020.01.30.927806
Corresponding Author
Dr Irin Hossain, Dr Ashekur Rahman Mullick
National Institute of Preventive and Social Medicine (NIPSOM), Dhaka, Bangladesh
DOI: https://dx.doi.org/10.18535/jmscr/v8i9.39
