Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan

Sarfaraz, Samreen; Shaikh, Quratulain; Saleem, Syed Ghazanfar; Rahim, Anum; Herekar, Fivzia; Junejo, Samina; Hussain, Aneela

doi:10.1371/journal.pone.0251754

Cited by 46 publications

(48 citation statements)

References 38 publications

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“…We conducted this small-scale, retrospective study and analyzed risk factors among these patients. Nonsurvivors had a higher mean age compared to survivors, similar to other studies from Wuhan and Pakistan [7][8]. More than half of the patients had some underlying chronic illness, commonly hypertension followed by diabetes and hypothyroidism, similar to studies on Chinese and Italian patients [7,9].…”

Section: Discussionsupporting

confidence: 82%

“…The various other parameters were, however, almost similar in both groups. This is in conjunction with most other studies, thus signifying the role of these laboratory parameters in determining the severity of COVID-19 disease and the high rates of mortality [8,13,[17][18]. C-reactive protein and serum ferritin were elevated among non-survivors thus stressing the role of the inflammatory cytokine storm in the disease severity and poor prognosis [13].…”

Section: Discussionsupporting

confidence: 70%

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Epidemiology and Risk Factors of COVID-19-Related Mortality

Roy¹,

Gupta²,

Tomar³

et al. 2021

Cureus

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IntroductionDuring the coronavirus disease 2019 (COVID-19) pandemic in India, several characteristics of hospitalized COVID-19 patients, based on demographics, mortality predictors, and presence of comorbidities, were found to be associated with poor outcomes. The objective of this study was to identify such epidemiological and clinical characteristics among the patients admitted at a tertiary-care center in India that may have predisposed them to COVID-19-related mortality.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 70%

Epidemiology and Risk Factors of COVID-19-Related Mortality

Roy¹,

Gupta²,

Tomar³

et al. 2021

Cureus

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“…Our findings revealed that elevated procalcitonin was most strongly associated with both mortality and ICU acceptance, thereby contributing to the growing body of evidence for the utility of procalcitonin in the context of COVID-19 infection [14,15]. Calcitonin is normally expressed in neuroendocrine cells, but its precursor, procalcitonin (PCT), has been identified as a unique biomarker specific for bacterial sepsis [16].…”

Section: Discussionmentioning

confidence: 56%

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

et al. 2021

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Background and Objectives: This study aimed to identify demographic and clinical factors at the time of critical care consultation associated with mortality or intensive care unit acceptance in a predominantly Afro-Caribbean population during the first wave of the COVID19 pandemic. Materials and Methods: This retrospective, single-center observational cohort study included 271 COVID19 patients who received a critical care consult between March 11 and April 30, 2020 during the first wave of the COVID19 pandemic at State University of New York Downstate Health Sciences University. Results: Of the 271 patients with critical care consults, 33% survived and 67% expired. At the bivariate level, age, blood urea nitrogen, and blood neutrophil percentage were significantly associated with mortality (mean age: survivors, 61.62 ± 1.50 vs. non-survivors, 68.98 ± 0.85, p < 0.001). There was also a significant association between neutrophil% and mortality in the univariate logistic regression model (quartile 4 vs. quartile 1: odd ratio 2.73, 95% confidence interval (1.28–5.82), p trend = 0.044). In the multivariate analyses, increasing levels of procalcitonin and C-reactive protein were significantly associated with mortality, adjusting for age, sex, and race/ethnicity (for procalcitonin quartile 4 vs. quartile 1: odds ratio 5.65, 95% confidence interval (2.14–14.9), p trend < 0.001). In contrast, higher platelet levels correlated with significantly decreased odds of mortality (quartile 4 vs. quartile 1, odds ratio 0.47, 95% CI (0.22–0.998), p trend = 0.010). Of these factors, only elevated procalcitonin levels were associated with intensive care unit acceptance. Conclusions: Procalcitonin showed the greatest magnitude of association with both death and likelihood of intensive care unit acceptance at the bivariate level. Our data suggests that procalcitonin reflects pneumonia severity during COVID-19 infection. Thus, it may help the intensivist identify those COVID19 patients who require intensive care unit level care.

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“…However, the overall mortality reported from another one of our recently published papers from this cohort was 39% which was not very different from the Remdesivir group here. 13 One important difference to highlight in our data is that Remdesivir was being administered to people at a median 10th day (IQR=8-11) of illness during the first wave of COVID-19. Later, published data indicated that this was probably already late.…”

Section: Discussionmentioning

confidence: 91%

Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study

Shaikh

Sarfaraz²,

Rahim³

et al. 2021

Pak J Med Sci

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Objectives: To see the difference in mortality among hospitalized COVID-19 patients given Remdesivir (RDV) with those who were not given RDV. Methods: A prospective cohort study was conducted on patients who were admitted to the COVID-19 isolation unit at The Indus Hospital, Korangi Campus Karachi between March and June 2020. Results: Groups were similar in age and gender distribution. RDV group was more hypoxic, had severe ARDS and needed higher Oxygen support compared to non-RDV group (p=0.000). Median SOFA score was 2 in RDV vs 5 in non-RDV (p=0.000). More than moderate COVID pneumonia was found in 92% of the RDV group while 89% of non-RDV group (p value=0.001). Median day of illness to administer Remdesivir was 10. There was no difference in mortality (45.5% in RDV vs 40.4% in non-RDV; p=0.4) between the two groups. Median length of hospital stay was 12 days (IQR=7.5-14.5) in RDV group compared to 10 days (IQR=6-14) in non-RDV group (p=0.009). Conclusion: RDV did not show any difference in in-hospital mortality in our patients. More patients had severe ARDS in the RDV group while patients in the non-RDV group had higher SOFA score and multi-organ failure. Length of stay was longer in patients receiving Remdesivir. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779 How to cite this:Shaikh Q, Sarfaraz S, Rahim A, Hussain M, Shah R, Soomro S. Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study. Pak J Med Sci. 2022;38(2):405-410. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan

Cited by 46 publications

References 38 publications

Epidemiology and Risk Factors of COVID-19-Related Mortality

Epidemiology and Risk Factors of COVID-19-Related Mortality

Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population

Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study

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