Predictors Associated with In-hospital Mortality among COVID-19 Patients during the Second Wave in a Tertiary Care Hospital, Gujarat, India: A Retrospective Observational Study

Abstract

Background: Fatalities due to coronavirus disease 2019 (COVID-19) have already crossed to more than 5 million globally so far. Hence, it is crucial for us to identify the risk factors associated with hospital deaths starting from first contact which can help to give timely treatment to the targeted population. Objectives: This retrospective cohort study was conducted to identify various factors related to in-hospital mortality related to COVID-19 in our region. Materials and methods: The present study was a single-center, retrospective cohort study of 675 adult patients, admitted with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between 1st April and 25th May 2021 in our tertiary care hospital. Baseline demographic profile, comorbidities, clinical characteristics, and investigatory findings were analyzed for increased odds of mortality. Results: A total of 181 (26.8%) patients died and 494 (73.2%) survived. There were 65.4% of males and no difference was found between genders in terms of mortality. Comorbidities associated with in-hospital death in our cohort were age group ≥50 years (p< 0.001), diabetes (p< 0.0007), and renal injury (p< 0.0001). More than half of the patients died during the first week of admission. Breathlessness (83%) was the most common symptom in non-survivors. Neutrophil-to-lymphocyte ratio (NLR), S. creatinine, D-dimer, ferritin, and C-reactive protein (CRP) were increased significantly among the patients who died. Multivariate logistic regression revealed age ≥50 years [adjusted odds ratio (AOR) 2.30, 95% confidence interval (CI) 1.45-3.64] and oxygen (O2) saturation <94% at the time of admission (AOR 2.62, 95% CI 1.75-3.93) were associated with mortality. Conclusion: Overall in-hospital mortality was 26.8%. Higher age and low O2 saturation were the major risk factors associated with in-hospital mortality.