Characteristics and factors associated with mortality of 200 COVID-19 patients at a Philippine COVID-19 tertiary referral center

Abstract

Objectives. To describe the clinical profile and factors associated with mortality among the first 200 patients confirmed to have COVID-19 infection admitted in the University of the Philippines – Philippine General Hospital (UP-PGH). Methodology. We conducted a review of adult patients with confirmed COVID-19 infection admitted to the UP-PGH, a designated COVID-19 referral center. Demographic, clinical data and clinical outcomes were extracted from medical records. Frequencies and distributions of various clinical characteristics were described, and factors associated with mortality were investigated. Results. Of the 200 patients in our cohort, most were male (55.5%), and the median age was 56 years old. Underlying comorbid illnesses were present in 67.5% of patients, which included hypertension (49.5%), diabetes mellitus (26.5%), and other cardiovascular diseases (20.5%). The most frequent presenting symptoms were cough (69.0%), fever (58.5%), or shortness of breath (53.0%). Most patients presented with mild (n=41, 20.5%) to moderate illness (n=99, 49.5%) and only 60 were considered severely (n=32, 16.0%) or critically ill (n=28, 14.0%). Many (61%) received empiric antibiotics, while 44.5% received either repurposed drugs or investigational therapies for COVID-19. Bacterial co-infection was documented in 11%, with Klebsiella pneumoniae commonly isolated. In-hospital mortality was 17.5%, which was highest for critical COVID-19 (71.4%). Mortality was observed to be higher among patients aged 60 and above, requiring oxygen, ventilatory support, and ICU admission, and those who developed acute kidney injury, acute stroke, sepsis, and nosocomial pneumonia. Conclusion. Our study confirmed that COVID-19 affects older individuals and those with underlying comorbid conditions. Empiric antimicrobial treatment was given for most patients, despite documentation of bacterial infection in only 11%. K. pneumoniae was commonly isolated, reflecting local epidemiology. The mortality rate during this early period of the pandemic was high and comparable with other institutions. Factors associated with mortality were related to critical COVID-19 and were similar to other studies.