Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital

Background: Most COVID-19 studies conclude old age and coexisting illnesses as mortality determinants owing to different populations or methodologies, or omitting factors affecting outcomes. Methods: We analyzed COVID-19 patients’ data (N = 391) of Dubai Hospital between January 1, 2020 and June 30,...

Full description

Bibliographic Details
Main Authors: Rashid Nadeem, Ishma Aijazi, Ashraf Elhoufi, Crystal Danthi, Nouha Azaza, Mohd Kafeel Khan, Mohannad Alheraki, Muhammed Jamshaid, Asadullah Nawazani, Sadia Tariq, Sobia Siddiq, Muzammil Hafeez, Mukesh Kumar, Islam Bon, Ahmed Elsousi, Lamiaa Salama, Sahish Kamat, Rami Abdalla
Format: Article
Language:English
Published: Karger Publishers 2021-06-01
Series:Dubai Medical Journal
Subjects:
Online Access:https://www.karger.com/Article/FullText/516591
Description
Summary:Background: Most COVID-19 studies conclude old age and coexisting illnesses as mortality determinants owing to different populations or methodologies, or omitting factors affecting outcomes. Methods: We analyzed COVID-19 patients’ data (N = 391) of Dubai Hospital between January 1, 2020 and June 30, 2020. Results: Only 19 patients (4.8%) were UAE nationals, while 372 (95.2%) were expatriates. Median age was 48 (interquartile range, 40–56) years; 22% were <40 years, and only 16.6% were female. Cough was the most common symptom (78.7%), fever was 77.4%, and gastrointestinal symptoms were least common (13.8%). Approximately 95% had elevated C-reactive protein (CRP) and D-dimers (79%), lymphocytopenia 47.3%, and thrombocytopenia 13.8%. Mortality was 30% for the total sample and 50% in ICU patients. ICU patients were older than non-ICU (age; 49.6 ± 10.9 vs. 46.7 ± 12.7 years, p = 0.04). Eighty-five percent of ICU patients required invasive mechanical ventilation, 78% vasopressors, 88% sedation, 84% muscle paralysis, while none require any of these in the medical group. Survivors had fewer patients with sedatives (p = 0.01). The median length of stay in the hospital was 19 days, ICU stays 14 days, and ventilator 11 days. The Mann-Whitney test showed that survivors spent more days in the ICU (median [IQR] 18 [6.5–29.5] vs. 11 [4–18], p value 0.003) and the hospital (32 [14.5–49.5] vs. 14 [7–21], p value 0.001) than nonsurvivors. Ferritin and D-dimers were higher in nonsurvivors, but CRP was lower in nonsurvivors (ferritin (ng/mL) median (IQR) 1,434 (661.5–2206.5) versus 1,362 (630–2,094), p value = 0.017, CRP (mg/L) 118.7 (53.4–184) versus 134.9 (66.5–203.2), p value 0.001 and D-dimer (µg/mL) 1.54 (0–3.13) versus 1.09 (0–2.51), p value = 0.001). Multiple logistic regression analysis determined age, fever on admission, use of oxygen, mechanical ventilation, and steroids as predictors of survival. Conclusions: COVID-19 patients were young males with pre-existing conditions. Ferritin, CRP, and D-dimers were higher in nonsurvivors. Treatment with chloroquine, antivirals, and anticoagulation was not different between survivors and nonsurvivors. Steroid use was a survival predictor.
ISSN:2571-726X