Retrospective 3,345 hospitalized patients in India, 11.5% treated with HCQ, showing unadjusted higher mortality with treatment. Confounding by indication and time based confounding (due to declining use over the period when overall treatment protocols improved dramatically) are likely.
This study is excluded in the after exclusion results of meta
analysis:
substantial unadjusted confounding by indication likely; unadjusted results with no group details; substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically.
Abstract: Clinical Epidemiology and Global Health 11 (2021) 100751
Contents lists available at ScienceDirect
Clinical Epidemiology and Global Health
journal homepage: www.elsevier.com/locate/cegh
Original article
Clinical review of COVID-19 patients presenting to a quaternary care
private hospital in South India: A retrospective study
Prithvi Mohandas *, Sathya Periasamy, Manimaran Marappan, Arun Sampath,
Vanaja Kate Garfin Sundaram, Vijit Koshy Cherian
MIOT International Hospital, Chennai, Tamil Nadu, 600089, India
A R T I C L E I N F O
A B S T R A C T
Keywords:
COVID-19
Epidemiology
Risk factors
SARS-CoV-2
South India
Background: Coronavirus disease 2019 (COVID-19) has been declared a global public-health crisis due to its
impact on health, economy, and mental well-being. Here, we evaluated the clinical and epidemiological pa
rameters associated with COVID-19 in South India.
Methods: A retrospective, quaternary care hospital-based study that included COVID-19 positive patients
admitted to MIOT International Hospital, Chennai between 8 April–7 August 2020. Cases were identified by
reverse transcriptase-polymerase chain reaction. Epidemiological, demographic, clinical, and radiological find
ings were recorded and analyzed. The primary endpoint was stable discharge from hospital/patient recovery or
death. Associations between risk factors and comorbidities were analyzed using Chi-Square/Fisher’s exact test.
Results: Of the 5264 cases reviewed, 3345 cases were included. The mean (standard deviation, SD) age of the
patients was 47.58 (16.69) years with a median and range hospital stay of 5 (2–41) days. 69.20% of patients were
male. The most frequent comorbidities were diabetes (37.10%) and hypertension (29.10%). Contact history was
available for 58% of patients. The most common symptoms were cough (36.60%), fever (28.30%), and myalgia
(15.40%). Abnormal chest radiography was reported in 16.9% of patients. Phase of admission, age ≥50 years,
hypertension, diabetes, coronary artery disease, chronic kidney disease was significantly associated with mor
tality (p < 0.05). There were 142 (4.2%) deaths in this study.
Conclusion: In this single centre hospital-based study, late presentation and more severe form of COVID pneu
monia lead to higher mortality although it had lower mortality rate for COVID-19 in comparison. Late phase of
the pandemic showed better outcomes vs. the early group.
Late treatment is less effective
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