Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India

Monaldi Arch Chest Dis. 2020 Nov 9;90(4). doi: 10.4081/monaldi.2020.1507.

Abstract

COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a high modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India. *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmonary Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology).

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Anemia / blood
  • Aspartate Aminotransferases / blood
  • Betacoronavirus
  • COVID-19
  • Child
  • Child, Preschool
  • Comorbidity
  • Coronary Artery Disease / epidemiology
  • Coronavirus Infections / blood*
  • Coronavirus Infections / mortality
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / therapy
  • Cough / physiopathology
  • Creatinine / blood
  • Diabetes Mellitus / epidemiology
  • Female
  • Fever / physiopathology
  • Humans
  • Hypertension / epidemiology
  • Hypoxia / physiopathology
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Intensive Care Units
  • Length of Stay
  • Leukocyte Count
  • Leukocytosis / blood
  • Lymphopenia / blood
  • Lymphopenia / physiopathology
  • Male
  • Middle Aged
  • Myalgia / physiopathology
  • Organ Dysfunction Scores
  • Pandemics
  • Pharyngitis / physiopathology
  • Platelet Count
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / therapy
  • Prospective Studies
  • Respiration, Artificial
  • SARS-CoV-2
  • Tachypnea / physiopathology
  • Tertiary Care Centers
  • Time Factors
  • Tuberculosis / epidemiology
  • Young Adult

Substances

  • Creatinine
  • Aspartate Aminotransferases
  • Alanine Transaminase