Clinical features, laboratory characteristics and risk factors for mortality of COVID-19 patients in a secondary hospital in Oman during the first wave of the SARS-CoV-2 pandemic

Abstract

Background The changing epidemiological profile of the COVID-19 pandemic and the uncertain clinical picture of patients characterise this ongoing and most challenging health event. Objectives To report clinical features, laboratory characteristics, and mortality risk factors among COVID-19 patients admitted to a secondary hospital in Oman. Methods A retrospective study for the first 455 patients admitted with COVID-19 to Rustaq hospital from 12th April, 2020 to 27th September, 2020. A predesigned questionnaire collected data from the hospital medical electronic system. Results The mean age was 42.84 (SD = 19.86) years, and the majority of patients were aged 30 to 59 and 60 or above; 207 (45.5%) and 189 (41.5%), respectively. Male patients constituted approximately two-thirds of the subjects. Fever, dyspnea and cough were the most common presenting symptoms (69%, 66%, and 62%, respectively), while comorbidities with diabetes mellitus and hypertension were 47% and 44%, respectively. Bacterial growth was identified at approximately 10%. Bivariate analysis turned out to be significant with a number of factors. However, multivariate analysis showed significance with patients aged over 60 (OR = 7.15, 95% CI 1.99–25.63), dyspnea (OR = 2.83, 95% CI 1.5–5.33), dyslipidemia (OR = 1.93, 95% CI 1.02–3.66) and being bed-ridden (OR = 5.01, 95% CI 1.73–14.44). Durations from onset of symptoms to admission and respiratory distress were lower among patients who died; p = 0.024 and p = 0.001, respectively. Urea, Troponin and LDH may act as potential diagnostic biomarkers for severity or mortality. Conclusions This study identified groups of patients with a higher risk of mortality, with severe disturbance in the laboratory markers while some could act as potential diagnostic biomarkers.

Epidemiological, Clinical, and Laboratory Findings of 235 Hospitalized COVID-19 Adult Patients (Survivors and Non-Survivors) at Sohar Hospital in Oman

“…This study showed that the most common alterations were increased values of CRP, ferritin, D-dimer, reduced amount of CO2 in serum, and reduced lymphocyte count, and these could be considered as significant biomarkers for COVID-19 prognosis. These findings agree with recent national [ 15 ] and international studies [ 6 , 26 ]. Similar to our findings, Wang et al reported that increased values of CRP, D-dimer, ferritin, and troponin T and reduced lymphocyte count were the most frequent laboratory alterations that were highly associated with mortality [ 27 ].…”

“…Other uncommon symptoms were myalgia, difficulty in breathing, and sore throat. These findings agree with previous national [ 13 , 15 , 22 , 25 ] and an international study [ 2 ].…”

“…In line with another study [ 6 ], the current study found that the rate of in-hospital mortality was 14%, while other national [ 15 ] and international studies reported that the mortality rate ranged from 11.9% to 28% [ 16 , 17 ]. These differences are also seen in other international studies of hospital-admitted COVID-19 patients.…”

“…Furthermore, a significant number of patients show abnormal values of other blood tests even in the early stages of the disease [ 27 ]. These alterations were seen with the following parameters: WBC, neutrophil, ALP, creatinine, hemoglobin, and albumin [ 6 , 17 ] Unfortunately, the current study could not investigate the blood levels of procalcitonin and lactate dehydrogenase (LDH), which were found to be good biomarkers and involved in the prognosis of COVID-19 [ 6 , 15 , 17 , 18 ]. This suggests that these two markers may play a role in determining the outcome of the disease.…”

Assessment of the hematological profiles among COVID-19 patients during the first and second waves in Ethiopia: A multicenter retrospective cohort study

“… 13 Many types of research have proven that comorbidities, age, and abnormalities of numerous scientific biomarkers may be essential to apprehending the sickness severity. 14 , 15 Even though the clinical characteristics of the COVID-19 pandemic have been widely reported, the summary of changes in the common hematological variables that are observed in patients with various waves of COVID-19 infection is still not well investigated, the published laboratory findings of COVID-19 infection are collected from hospital-admitted patients at a single time point which limits our understanding of the dynamic hematological changes during the disease, clinical symptoms and severity of the disease is differing across a wave. 16 The consistency and difference of the hematological profiles of COVID-19 patients across waves remain largely unknown.…”