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
Clinical Epidemiology and Global Health, doi:10.1016/j.cegh.2021.100751
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 parameters 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 findings 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 mortality (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 pneumonia 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.
Declaration of competing interest Authors declare no conflict of interest for this article.
Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.cegh.2021.100751.
References
Chu, Cheng, Hung, Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings, Thorax
Cristelo, Azevedo, Marques, Nunes, Sarmento, SARS-CoV-2 and diabetes: new challenges for the disease, Diabetes Res Clin Pract
Hoffmann, Kleine-Weber, Schroeder, Krüger, Herrler et al., SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor, Cell
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Khan, Khan, Mustagir, Rana, Islam et al., Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: a systematic review and meta-analysis, J Glob Health
Kumar, Arora, Sharma, Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis, Diabetes Metab Syndr
Lu, Zhao, Li, Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding, Lancet
Manna, Wruble, Maron, COVID-19: a multimodality review of radiologic techniques, clinical utility, and imaging features, Radiol Cardiothorac Imaging
Mohan, Tiwari, Bhatnagar, Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India, Indian J Med Res
Murthy, Gomersall, Fowler, Care for critically ill patients with COVID-19, J Am Med Assoc
Osama, Pankhania, Majeed, Protecting older people from COVID-19: should the United Kingdom start at age 60?, J R Soc Med
Pascarella, Strumia, Piliego, COVID-19 diagnosis and management: a comprehensive review, J Intern Med
Rosenthal, Cao, Gundrum, Sianis, Safo, Risk factors associated with inhospital mortality in a US national sample of patients with COVID-19, JAMA Netw Open
Sami, Soltaninejad, Amra, A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: the Khorshid COVID Cohort (KCC) study, PloS One
Saqrane, Mhammedi, Review on the global epidemiological situation and the efficacy of chloroquine and hydroxychloroquine for the treatment of COVID-19, New Microbes New Infect
Sheahan, Sims, Leist, Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV, Nat Commun
Sohrabi, Alsafi, Neill, World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19), Int J Surg
Virendra, Shruti, Pranav, Blood gas analysis for bedside diagnosis, Natl J Maxillofac Surg
Yousefi, Valizadeh, Ghaffari, Vahedi, Karbalaei et al., A global treatments for coronaviruses including COVID-19, J Cell Physiol
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
Zhu, Huang, Tang, Nussler, Zheng, Increasing age, the existence of comorbidities, and corticosteroid treatment in combination with antiviral therapy prolongs the recovery of SARS-COV-2-infected patients, measured as the conversion from positive to negative rtPCR: a 239 patients' retrospective study, Front Med
DOI record:
{
"DOI": "10.1016/j.cegh.2021.100751",
"ISSN": [
"2213-3984"
],
"URL": "http://dx.doi.org/10.1016/j.cegh.2021.100751",
"alternative-id": [
"S2213398421000555"
],
"article-number": "100751",
"assertion": [
{
"label": "This article is maintained by",
"name": "publisher",
"value": "Elsevier"
},
{
"label": "Article Title",
"name": "articletitle",
"value": "Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study"
},
{
"label": "Journal Title",
"name": "journaltitle",
"value": "Clinical Epidemiology and Global Health"
},
{
"label": "CrossRef DOI link to publisher maintained version",
"name": "articlelink",
"value": "https://doi.org/10.1016/j.cegh.2021.100751"
},
{
"label": "Content Type",
"name": "content_type",
"value": "article"
},
{
"label": "Copyright",
"name": "copyright",
"value": "© 2021 The Author(s). Published by Elsevier B.V. on behalf of INDIACLEN."
}
],
"author": [
{
"affiliation": [],
"family": "Mohandas",
"given": "Prithvi",
"sequence": "first"
},
{
"affiliation": [],
"family": "Periasamy",
"given": "Sathya",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0002-2636-1766",
"affiliation": [],
"authenticated-orcid": false,
"family": "Marappan",
"given": "Manimaran",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0003-3926-8752",
"affiliation": [],
"authenticated-orcid": false,
"family": "Sampath",
"given": "Arun",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Garfin Sundaram",
"given": "Vanaja Kate",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Cherian",
"given": "Vijit Koshy",
"sequence": "additional"
}
],
"container-title": "Clinical Epidemiology and Global Health",
"container-title-short": "Clinical Epidemiology and Global Health",
"content-domain": {
"crossmark-restriction": true,
"domain": [
"cegh.net",
"elsevier.com",
"sciencedirect.com"
]
},
"created": {
"date-parts": [
[
2021,
4,
26
]
],
"date-time": "2021-04-26T17:46:43Z",
"timestamp": 1619459203000
},
"deposited": {
"date-parts": [
[
2022,
8,
22
]
],
"date-time": "2022-08-22T07:37:50Z",
"timestamp": 1661153870000
},
"indexed": {
"date-parts": [
[
2024,
4,
18
]
],
"date-time": "2024-04-18T10:36:10Z",
"timestamp": 1713436570868
},
"is-referenced-by-count": 11,
"issued": {
"date-parts": [
[
2021,
7
]
]
},
"language": "en",
"license": [
{
"URL": "https://www.elsevier.com/tdm/userlicense/1.0/",
"content-version": "tdm",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2021,
7,
1
]
],
"date-time": "2021-07-01T00:00:00Z",
"timestamp": 1625097600000
}
},
{
"URL": "http://creativecommons.org/licenses/by-nc-nd/4.0/",
"content-version": "vor",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2021,
4,
14
]
],
"date-time": "2021-04-14T00:00:00Z",
"timestamp": 1618358400000
}
}
],
"link": [
{
"URL": "https://api.elsevier.com/content/article/PII:S2213398421000555?httpAccept=text/xml",
"content-type": "text/xml",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://api.elsevier.com/content/article/PII:S2213398421000555?httpAccept=text/plain",
"content-type": "text/plain",
"content-version": "vor",
"intended-application": "text-mining"
}
],
"member": "78",
"original-title": [],
"page": "100751",
"prefix": "10.1016",
"published": {
"date-parts": [
[
2021,
7
]
]
},
"published-print": {
"date-parts": [
[
2021,
7
]
]
},
"publisher": "Elsevier BV",
"reference": [
{
"DOI": "10.1111/joim.13091",
"article-title": "COVID-19 diagnosis and management: a comprehensive review",
"author": "Pascarella",
"doi-asserted-by": "crossref",
"first-page": "192",
"issue": "2",
"journal-title": "J Intern Med",
"key": "10.1016/j.cegh.2021.100751_bib1",
"volume": "288",
"year": "2020"
},
{
"key": "10.1016/j.cegh.2021.100751_bib2",
"unstructured": "Statement on the Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus 2019 (N-CoV) on 23 January 2020 (who.Int) [Last accessed December 2020]."
},
{
"DOI": "10.1016/j.ijsu.2020.02.034",
"article-title": "World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19)",
"author": "Sohrabi",
"doi-asserted-by": "crossref",
"first-page": "71",
"journal-title": "Int J Surg",
"key": "10.1016/j.cegh.2021.100751_bib3",
"volume": "76",
"year": "2020"
},
{
"key": "10.1016/j.cegh.2021.100751_bib5",
"unstructured": "Release of District Level Factsheets for Nfhs-5(2019-20) Phase-I States/uts. Available at: MoHFW | Home [Last accessed December 2020]."
},
{
"DOI": "10.1002/jcp.29785",
"article-title": "A global treatments for coronaviruses including COVID-19",
"author": "Yousefi",
"doi-asserted-by": "crossref",
"first-page": "9133",
"issue": "12",
"journal-title": "J Cell Physiol",
"key": "10.1016/j.cegh.2021.100751_bib6",
"volume": "235",
"year": "2020"
},
{
"DOI": "10.4103/0975-5950.127641",
"article-title": "Blood gas analysis for bedside diagnosis",
"author": "Singh",
"doi-asserted-by": "crossref",
"first-page": "136",
"issue": "2",
"journal-title": "Natl J Maxillofac Surg",
"key": "10.1016/j.cegh.2021.100751_bib7",
"volume": "4",
"year": "2013"
},
{
"DOI": "10.1148/ryct.2020200210",
"article-title": "COVID-19: a multimodality review of radiologic techniques, clinical utility, and imaging features",
"author": "Manna",
"doi-asserted-by": "crossref",
"issue": "3",
"journal-title": "Radiol Cardiothorac Imaging",
"key": "10.1016/j.cegh.2021.100751_bib8",
"volume": "2",
"year": "2020"
},
{
"key": "10.1016/j.cegh.2021.100751_bib9",
"unstructured": "Overview of COVID-19 Section_43 (nih.Gov). [Last accessed January 2021]."
},
{
"DOI": "10.4103/ijmr.IJMR_1788_20",
"article-title": "Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India",
"author": "Mohan",
"doi-asserted-by": "crossref",
"first-page": "61",
"issue": "1 & 2",
"journal-title": "Indian J Med Res",
"key": "10.1016/j.cegh.2021.100751_bib10",
"volume": "152",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)30183-5",
"article-title": "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China",
"author": "Huang",
"doi-asserted-by": "crossref",
"first-page": "497",
"issue": "10223",
"journal-title": "Lancet",
"key": "10.1016/j.cegh.2021.100751_bib11",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1177/0141076820921107",
"article-title": "Protecting older people from COVID-19: should the United Kingdom start at age 60?",
"author": "Osama",
"doi-asserted-by": "crossref",
"first-page": "169",
"issue": "5",
"journal-title": "J R Soc Med",
"key": "10.1016/j.cegh.2021.100751_bib12",
"volume": "113",
"year": "2020"
},
{
"DOI": "10.1001/jama.2020.3633",
"article-title": "Care for critically ill patients with COVID-19",
"author": "Murthy",
"doi-asserted-by": "crossref",
"first-page": "1499",
"issue": "15",
"journal-title": "J Am Med Assoc",
"key": "10.1016/j.cegh.2021.100751_bib13",
"volume": "323",
"year": "2020"
},
{
"DOI": "10.3389/fmed.2020.575439",
"author": "Zhu",
"doi-asserted-by": "crossref",
"first-page": "575439",
"journal-title": "Front Med",
"key": "10.1016/j.cegh.2021.100751_bib14",
"volume": "7",
"year": "2020"
},
{
"DOI": "10.7189/jogh.10.020503",
"article-title": "Effects of underlying morbidities on the occurrence of deaths in COVID-19 patients: a systematic review and meta-analysis",
"author": "Khan",
"doi-asserted-by": "crossref",
"issue": "2",
"journal-title": "J Glob Health",
"key": "10.1016/j.cegh.2021.100751_bib15",
"volume": "10",
"year": "2020"
},
{
"DOI": "10.1016/j.dsx.2020.04.044",
"article-title": "Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis",
"author": "Kumar",
"doi-asserted-by": "crossref",
"first-page": "535",
"issue": "4",
"journal-title": "Diabetes Metab Syndr",
"key": "10.1016/j.cegh.2021.100751_bib16",
"volume": "14",
"year": "2020"
},
{
"DOI": "10.1016/j.diabres.2020.108228",
"article-title": "SARS-CoV-2 and diabetes: new challenges for the disease",
"author": "Cristelo",
"doi-asserted-by": "crossref",
"first-page": "108228",
"journal-title": "Diabetes Res Clin Pract",
"key": "10.1016/j.cegh.2021.100751_bib17",
"volume": "164",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)30566-3",
"article-title": "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study",
"author": "Zhou",
"doi-asserted-by": "crossref",
"first-page": "1054",
"issue": "10229",
"journal-title": "Lancet",
"key": "10.1016/j.cegh.2021.100751_bib18",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)30251-8",
"article-title": "Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding",
"author": "Lu",
"doi-asserted-by": "crossref",
"first-page": "565",
"issue": "10224",
"journal-title": "Lancet",
"key": "10.1016/j.cegh.2021.100751_bib19",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1016/j.cell.2020.02.052",
"article-title": "SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor",
"author": "Hoffmann",
"doi-asserted-by": "crossref",
"first-page": "271",
"issue": "2",
"journal-title": "Cell",
"key": "10.1016/j.cegh.2021.100751_bib20",
"volume": "181",
"year": "2020"
},
{
"DOI": "10.1016/j.nmni.2020.100680",
"article-title": "Review on the global epidemiological situation and the efficacy of chloroquine and hydroxychloroquine for the treatment of COVID-19",
"author": "Saqrane",
"doi-asserted-by": "crossref",
"first-page": "100680",
"journal-title": "New Microbes New Infect",
"key": "10.1016/j.cegh.2021.100751_bib21",
"volume": "35",
"year": "2020"
},
{
"DOI": "10.1136/thorax.2003.012658",
"article-title": "Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings",
"author": "Chu",
"doi-asserted-by": "crossref",
"first-page": "252",
"issue": "3",
"journal-title": "Thorax",
"key": "10.1016/j.cegh.2021.100751_bib22",
"volume": "59",
"year": "2004"
},
{
"DOI": "10.1038/s41467-019-13940-6",
"article-title": "Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV",
"author": "Sheahan",
"doi-asserted-by": "crossref",
"first-page": "222",
"issue": "1",
"journal-title": "Nat Commun",
"key": "10.1016/j.cegh.2021.100751_bib23",
"volume": "11",
"year": "2020"
},
{
"DOI": "10.1371/journal.pone.0241537",
"article-title": "A one-year hospital-based prospective COVID-19 open-cohort in the Eastern Mediterranean region: the Khorshid COVID Cohort (KCC) study",
"author": "Sami",
"doi-asserted-by": "crossref",
"issue": "11",
"journal-title": "PloS One",
"key": "10.1016/j.cegh.2021.100751_bib24",
"volume": "15",
"year": "2020"
},
{
"DOI": "10.1001/jamanetworkopen.2020.29058",
"article-title": "Risk factors associated with in-hospital mortality in a US national sample of patients with COVID-19",
"author": "Rosenthal",
"doi-asserted-by": "crossref",
"issue": "12",
"journal-title": "JAMA Netw Open",
"key": "10.1016/j.cegh.2021.100751_bib25",
"volume": "3",
"year": "2020"
}
],
"reference-count": 24,
"references-count": 24,
"relation": {},
"resource": {
"primary": {
"URL": "https://linkinghub.elsevier.com/retrieve/pii/S2213398421000555"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [],
"subtitle": [],
"title": "Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study",
"type": "journal-article",
"update-policy": "http://dx.doi.org/10.1016/elsevier_cm_policy",
"volume": "11"
}
