Predictors of Clinical Outcomes in Adult COVID-19 Patients Admitted to a Tertiary Care Hospital in India: an analytical cross-sectional study

Chauhan, Nishant Kumar; Shadrach, Benhur Joel; Garg, Mahendra Kumar; Bhatia, Pradeep; Bhardwaj, Pankaj; Gupta, Manoj Kumar; Dutt, Naveen; Jalandra, Ram Niwas; Garg, Pawan; Nag, Vijaya Lakshmi; Sharma, Praveen; Bohra, Gopal Krishna; Kumar, Deepak; Elhence, Poonam Abhay; Banerjee, Mithu; Mathur, Deepti; Purohit, Abhishek HL; Gadepalli, Ravisekhar; Sureka, Binit; Misra, Sanjeev

BACKGROUND: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in exponential rise in the number of patients getting hospitalised with corona virus disease 2019 (COVID-19). There is a paucity of data from South East Asian Region related to the predictors of clinical outcomes in these patients. This formed the basis of conducting our study. METHODS: This was an analytical cross-sectional study. Demographic, clinical, radiological and laboratory data of 125 patients was collected on admission. The study outcome was death or discharge after recovery. For univariate analysis, unpaired t-test, Chi-square and Fisher’s Exact test were used. Receiver operating characteristic (ROC) curves were plotted for Sequential Organ Failure Assessment (SOFA) score and few laboratory parameters. Logistic regression was applied for multivariate analysis. RESULTS: Elderly age, ischemic heart disease and smoking were significantly associated with mortality. Elevated levels of D-dimer and lactate dehydrogenase (LDH) and reduced lymphocyte counts were the predictors of mortality. The ROCs for SOFA score curve showed a cut-off value ≥ 3.5 (sensitivity- 91.7% and specificity- 87.5%), for IL-6 the cut-off value was ≥ 37.9 (sensitivity- 96% and specificity- 78%) and for lymphocyte counts, a cut off was calculated to be less than and equal to 1.46 x 10(9) per litre (sensitivity- 75.2% and specificity- 83.3%). CONCLUSION: Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised LDH and low lymphocyte counts at baseline are associated with COVID-19 mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19 patients. (www.actabiomedica.it)