Clinical, laboratory and radiological features and outcomes of moderate to severe COVID-19 patients A descriptive retrospective study

• Published in: Journal of acute disease Vol. 10; no. 2; pp. 62 - 70
• Main Authors: Nehara, Hardeva, Agrawal, Sahaj, Chhimpa, Atma, IH, Sunil, Arakeri, Avadusidda, Sirohi, Pramendra
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.03.2021; Department of Medicine, SP Medical College, Bikaner, Rajasthan, India%Department of Geriatric Medicine, SP Medical College, Bikaner, Rajasthan, India; Wolters Kluwer Medknow Publications
• Subjects: Medical research; Medicine, Experimental; sars-cov-2; covid-19; moderate to severe; outcome; China; India; COVID-19; Moderate to severe; SARS-CoV-2; Outcome
• ISSN: 2221-6189; 2221-6189
• DOI: 10.4103/2221-6189.312154

Objective: To describe the clinical, laboratory and radiological characteristics and outcomes of moderate-to-severe coronvirus disease 2019 (COVID-19) patients. Methods: We retrospectively analyzed 43 RT-PCR confirmed moderate-to-severe COVID-19 patients who were admitted to a tertiary care center. The primary composite outcomes were admission to intensive care unit, requirement of mechanical ventilation, and death. Results: The median age of the patients was 50 years, and 62.8% of the patients were male. Out of 43 patients, 15 (34.88%) were categorized as severe. A total of 26 (60.47%) patients had 1 or more comorbidities [diabetes (34.88%) and hypertension (30.23%)]. The median duration from the onset of symptoms to admission was 3 days, and the most common symptoms were dyspnoea (90.7%), cough (79.07%), fever (69.77%), and body ache (46.51%). Leucopenia was presented in 14 (32.56%) patients, lymphopenia in 26 (60.47%) patients, and monocytosis in 7 (16.28%) patients. Besides, 40 (93.02%) patients had bilateral patchy nodular or interstitial infiltration on chest X-ray. The primary outcomes occurred in 20 patients (46.5%), among whom 8 required mechanical ventilation. The patients who had met the primary outcomes were older. They were prone to have at least 1 comorbidity ( P =0.004), diabetes ( P =0.01), hypertension, higher sequential organ failure assessment score, more tachycardia, lower SpO 2 , lower PaO 2 /FiO 2 , more thrombocytopenia, and more pancytopenia. Conclusions: This retrospective study identified several risk factors for poor outcomes in adults with COVID-19. In particular, older age, tachycardia, high SOFA score, low SpO 2 , low PaO 2 /FiO 2 , presence of comorbidities in form of diabetes and hypertension, thrombocytopenia, and pancytopenia at admission were associated with higher odds of ICU admission, a requirement of mechanical ventilation and in-hospital death.