Profil mortaliteta povezanih sa COVID-19 u centru za tercijarnu njegu: opisna studija

  • Sudhir Bhandari Sr. Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Raman Sharma Sr. Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Ajit Singh Shaktawat Sr. Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Subrata Banerjee Sr. Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Bhoopendra Patel Assistant Professor, Department of Physiology, Government Medical College, Barmer (Rajasthan) https://orcid.org/0000-0002-1475-5119
  • Amit Tak Senior Resident, Department of Physiology, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan) https://orcid.org/0000-0003-2509-2311
  • Deepa Meena State Epidemiologist, Department of Medical and Health, Government of Rajasthan
  • Abhishek Agarwal Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Vishal Gupta Associate Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Shrikant Sharma Assistant Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Sunil Mahavar Associate Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Radhey Shyam Chejara Associate Professor, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Govind Rankawat Senior Resident, Department of Medicine, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Kapil Gupta Associate Professor, Department of Physiology, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Jitendra Gupta Associate Professor, Department of Physiology, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Amitabh Dube Sr. Professor, Department of Physiology, S.M.S. Medical College & Attached Hospitals, Jaipur (Rajasthan)
  • Shivankan Kakkar Assistant Professor, Department of Pharmacology, Government Medical College, Barmer (Rajasthan)

Sažetak


Background/Aim: The recent pandemic of Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) is yet another scourge from the coronaviridae family that causes illnesses ranging from common cold to more severe diseases such as Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). The numbers are still on the rise, despite a country wide lockdown and yet no definitive drugs and or/vaccines are available to manage the active COVID-19 cases.

Methods: The present research design was a hospital based observational descriptive study conducted at S. M. S. Medical College and Attached hospitals, Jaipur, that analysed data of all the patients with COVID-19 related mortality, admitted between 1 April to 4 May 2020. Patients included in this study were RT-PCR confirmed cases of SARS-CoV-2 using nasopharyngeal and oropharyngeal swab samples.

Results: The mean age of patients with COVID-19 related mortality was 53.41 ± 18.42 year with majority of patients belonging to age group of more than 60 years (41.18 %) followed closely by COVID-19 positive patients in age range of 45 to 60 years (33.33 %). The male to female ratio was 1.68: 1. Mean time lag between hospitalization and death reported was 6.18 days. Majority of the patients admitted (72.5 %) succumbed within 3 days of hospitalization. Eleven patients (21 %) were brought dead to the hospital who were tested COVID-19 positive after death. Most common comorbidity reported in patients with COVID-19 related mortality was hypertension (30 %) followed by diabetes mellitus (27.5 %).

Conclusion: Hypertension and diabetes mellitus might be independent risk factors making an individual susceptible to COVID-19 related death. Elderly patients also have a greater risk of mortality. The non-availability of definitive management protocol and/or vaccine against COVID-19 makes public health preventive measures of social distancing, use of masks and frequent handwashing an important modality in the fight against COVID-19.

Reference

World Health Organization. Coronavirus disease (COVID-19) pandemic. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed on 8th May 2020.

World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-theinternational-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-ofnovel-coronavirus-(2019-ncov). Accessed on 8th May 2020.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497 – 506.

Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of basic reproduction number of novel coronavirus (20192-nCov) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak. Int J Infect Dis 2020; 92:214-7.

COVID-19 India. Available from: https://www.mohfw.gov.in/. Accessed on 10th May 2020.

Hui DS, Azhar E, Madani TA, Ntoumi F, Kock R, Dar O, et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan, China. Int J Infect Dis 2019;91:264–6.

Murthy S, Gomersall CD, Fowler RA. Care for critically ill patients with COVID-19. JAMA 2020;323(15):1499-500.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020;323(13):1239-42.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507-13.

Liu Y, Mao B, Liang S, Yang JW, Lu HW, Chai YH, et al. Association between age and clinical characteristics and outcomes of COVID-19. Eur Respir J 2020 May 27;55(5):2001112. doi: 10.1183/13993003.01112-2020.

Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020;8(5):475–81.

Zhou F, Yu T, Du R, Fan G, Ying L, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395(10229):1054–62.

Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu Sha, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020 Mar 13;e200994. doi: 10.1001/jamainternmed.2020.0994.

Miller EJ, Linge HM. Age-related changes in immunological and physiological responses following pulmonary challenge. Int J Mol Sci 2017 Jun; 18(6):1294. doi:10.3390/ijms18061294.

Guan W-jie, Liang W-hua, Zhao Y, Liang H, Chen Z, Li Y, et al. Comorbidity and its impact on 1590 patients with Covid-19 in China: a nationwide analysis. Eur Respir J 2020 May 14;55(5):2000547. doi: 10.1183/13993003.00547-2020.

Jin J-M, Bai P, He W, Wu F, Liu X-F, Han D-M, et al. Gender differences in patients with COVID-19: focus on severity and mortality. Front Public Health 2020 Apr 29;8:152. doi: 10.3389/fpubh.2020.00152.

Itelman E, Wasserstrum Y, Segev A, Avaky C, Negru L, Cohen D, et al. Clinical characterization of 162 patients in Israel: preliminary report from a large tertiary center. Isr Med Assoc J 2020; 22: 271-4.

Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020 Mar 26;368:m1091. doi: 10.1136/bmj.m1091.

Ferrario CM, VonCannon, J, Jiao Y, Ahmad S, Bader M, Dell'Italia LJ, et al. Cardiac angiotensin-(1-12) expression and systemic hypertension in rats expressing the human angiotensinogen gene. Am J Physiol Heart Circ Physiol 2016 Apr 15;310(8):H995–1002.

Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020 Apr 16;181(2):271–80.

Zhang HA, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med 2020 Apr;46(4):586–90.

Tikellis C, Thomas MC. Angiotensin-converting enzyme 2 (ACE2) is a key modulator of the renin angiotensin system in health and disease. Int J Pept 2012;2012:256294. doi: 10.1155/2012/256294.

Zangrillo A, Beretta L, Scandroglio AM, Monti G, Fominskiy E, Colombo S, et al. Characteristics, treatment, outcomes and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy. Crit Care Resusc 2020 Apr 23. Online ahead of [published online ahead of print]. Available from: https://pubmed.ncbi.nlm.nih.gov/32353223/. Accessed on 27 June 2020.

Diamond M, Peniston Feliciano HL, Sanghavi D, Mahapatra S, et al. Acute Respiratory Distress Syndrome (ARDS) [Updated 2020 Jan 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK436002/. Accessed on: 20 June 2020.

Chen L, Li X, Chen M, Feng Yi, Xiong C. The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res 2020 May 1;116(6):1097-100.

Guo J, Huang Z, Lin L, Lv J. Coronavirus Disease 2019 (COVID-19) and cardiovascular disease: a viewpoint on the potential influence of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers on onset and severity of severe acute respiratory syndrome coronavirus 2 infection. J Am Heart Assoc 2020 Apr 7;9(7):e016219. doi: 10.1161/JAHA.120.016219.

Wang D, Hu B, Hu C, Zhu F, Li X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323(11):1061-9.

Ruan, Q, Yang, K, Wang, W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020 May;46(5):846-8.

Objavljeno
2020/06/30
Broj časopisa
Rubrika
Originalni naučni članak