Clinical Aspects and Predictors of Outcome for Hospitalized COVID-19 Patients in Hail, Saudi Arabia

Abstract

Background: As of December 2020, the documented Corona Virus Disease 2019 (COVID-19) cases have almost reached 360,000 with a case fatality of 1.7%. In this study, we aimed to identify common presentations and complications of the disease and to assess the mortality predicting factors in hospitalized COVID-19 patients. Patients and Methods:A retrospective study was conducted between 1st June and 31st August 2020 on the confirmed cases of COVID-19 (using RT-PCR) admitted to King Khalid Hospital, Hail, Saudi Arabia. Adult patients aged 18 years or older who were hospitalized for at least 24 hours with confirmed COVID-19 during the study period were included, while patients with an inadequate past medical history and who were still hospitalized were excluded. Data were collected, coded, and analyzed using SPSS software.Results: Out of 1466 patients tested by RT-PCR, 404 patients (27.55%) were positive for COVID-19. Out of these 404 patients, 131 (32%) were hospitalized and included in our study with a mean age of 57±16 years, and 74 patients (56.5%) were males. Out of 131 patients, there were 28 deaths (21.4%). The most frequent comorbidities were hypertension (80.9%), diabetes mellitus (67.9%), and chronic kidney disease (39.7%). Fever (95.4%), cough (80.9%), dyspnea (65.6%), and body aches & myalgia (35.9%) were the most common symptoms. The significant predictors of mortality were elevated levels of WBC (AOR= 24.2; p=0.06), BUN (AOR= 31.8; p=0.001), AST (AOR= 11.8; p=0.041), INR (AOR= 11.5; p=0.001), D-Dimer (AOR=10.7; 0.005), lactic acid (AOR= 38.3; p<0.001), and creatinine kinase (AOR=2.1; p<0.001). Decreased lymphocyte count and SPO 2 were associated with a high risk of mortality (AOR= 11.9; p=0.037 and AOR= 34.8; p=0.003), respectively. Similarly, patients with COPD were at high risk of mortality (AOR= 18.8; p=0.004). Conclusion:Among the included patients, the hospitalization mortality rate was 21.4%. Old age and male gender were associated with significant mortality. The independent predictors of COVID-19 mortality were COPD, SPO 2 <89, acute Liver Injury, leukocytosis, lymphopenia, and markers of inflammation (ESR, CRP, D-Dimer) and shock (lactate, and creatine Kinase). Further studies are needed to assess definite mortality predictors in hospitalized COVID-19 patients to identify and guide patients' management at risk.