Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan
Sarfaraz et al.,
Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan,
medRxiv, doi:10.1101/2020.12.28.20248920 (Preprint)
Retrospective 186 hospitalized patients in Pakistan showing unadjusted HCQ mortality RR 1.45,
p = 0.07.
Confounding by indication is likely.
This study is excluded in the after exclusion results of meta
analysis:
substantial unadjusted
confounding by indication likely; significant unadjusted confounding possible; unadjusted results with no group details.
risk of death, 45.0% higher, RR 1.45, p = 0.07, treatment 40 of 94 (42.6%), control 27 of 92 (29.3%).
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Sarfaraz et al., 2 Jan 2021, retrospective, Pakistan, preprint, 7 authors, average treatment delay 7.0 days.
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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.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..
Late treatment
is less effective
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