Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.12.28.20248920; this version posted January 2, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Title: Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan Samreen Sarfaraz1, Quratulain Shaikh2, Syed Ghazanfar Saleem3, Anum Rahim4 Fivzia Farooq Herekar5, Samina Junejo6, Aneela Hussain7 1-Samreen Sarfaraz, FRCP (Glasg) Infectious Disease Department, The Indus Hospital, Karachi 2- Quratulain Shaikh, FCPS, MSc Indus Hospital Research Centre, The Indus Hospital, Karachi 3-Syed Ghazanfar Saleem, FCPS Emergency Department, The Indus Hospital, Karachi 4-Anum Rahim, MBBS, MSc Indus Hospital Research Centre, The Indus Hospital Karachi 5- Fivzia Farooq Herekar, FCPS Internal Medicine Department, The Indus Hospital, Karachi 6-Samina Junejo, FCPS Paediatric infectious Diseases, The Indus Hospital, Karachi 7-Aneela Hussain, FCPS Infectious Disease Department, The Indus Hospital, Karachi Corresponding Author: Samreen Sarfaraz, Email: samreen.sarfaraz@tih.org.pk samreen2002@gmail.com Office Tel: +92(21)35112709-17, Office Fax no.: +92(21)35112718 Cell no.:+923232688200 Postal Address: The Indus Hospital, Plot C-76, Sector 3 1/5, Opposite Korangi Crossing, Karachi -75190. Word Count of summary: 199 Word count of the text: 2877 References: 40 Tables: 4 Figures: 2 Summary NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.12.28.20248920; this version posted January 2, 2021. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . A prospective cohort study was conducted at the Indus Hospital Karachi, Pakistan between March and June 2020 to describe the determinants of mortality among hospitalized COVID-19 patients. 186 adult patients were enrolled and all-cause mortality was found to be 36% (67/186). Those who died were older and more likely to be males (p<0.05). Temperature and respiratory rate were higher among non-survivors while Oxygen saturation was lower (p<0.05). Serum CRP, D-dimer and IL-6 were higher while SpO2 was lower on admission among non-survivors (p<0.05). Non-survivors had higher SOFA and CURB-65 scores while thrombocytopenia, lymphopenia and severe ARDS was more prevalent among them (p<0.05). Use of non-invasive ventilation in emergency room, ICU admission and invasive ventilation were associated with mortality in our cohort (p<0.05). Length of hospital stay and days of intubation were longer in non-survivors (p<0.05). Use of azithromycin, hydroxychloroquine, steroids, tocilizumab, antibiotics, IVIG or anticoagulation showed no mortality benefit (p>0.05). Multivariable logistic regression showed that age > 60 years, oxygen saturation <93% on admission, pro-calcitonin > 2 ng/ml, unit rise in temperature and SOFA score, ICU admission and sepsis during hospital stay were associated with higher odds of mortality. Larger prospective studies are needed to further strengthen these findings. Key Findings 1. Age greater than 60 years is..