Risk factors associated with morbidity and mortality outcomes of COVID-19 patients on the 28th day of the disease course: a retrospective cohort study in Bangladesh

• Published in: Epidemiology & Infection Vol. 148; p. e263
• Main Authors: Islam, M. Z., Riaz, B. K., Islam, A. N. M. S., Khanam, F., Akhter, J., Choudhury, R., Farhana, N., Jahan, N. A., Uddin, M. J., Efa, S. S.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 29.10.2020
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Bangladesh - epidemiology; Betacoronavirus; Cardiovascular diseases; Child; Child, Preschool; Chronic obstructive pulmonary disease; Cohort analysis; Comorbidity; Coronary artery disease; Coronavirus Infections - mortality; Coronaviruses; COVID-19; Diabetes mellitus; End Stage Liver Disease - epidemiology; Female; Heart diseases; Humans; Hypertension; Infant; Kidney diseases; Liver diseases; Lung diseases; Male; Middle Aged; Morbidity; Mortality; Neoplasms - epidemiology; Obstructive lung disease; Older people; Original Paper; Pandemics; Pneumonia, Viral - mortality; Pulmonary Disease, Chronic Obstructive - epidemiology; Renal Insufficiency, Chronic - epidemiology; Retrospective Studies; Risk analysis; Risk Factors; SARS-CoV-2; Tobacco; Viral diseases; Young Adult; Bangladesh; China; COVID-19 patients; risk factors; Cohort; morbidity; mortality and outcomes
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268820002630

Diverse risk factors intercede the outcomes of coronavirus disease 2019 (COVID-19). We conducted this retrospective cohort study with a cohort of 1016 COVID-19 patients diagnosed in May 2020 to identify the risk factors associated with morbidity and mortality outcomes. Data were collected by telephone-interview and reviewing records using a questionnaire and checklist. The study identified morbidity and mortality risk factors on the 28th day of the disease course. The majority of the patients were male (64.1%) and belonged to the age group 25–39 years (39.4%). Urban patients were higher in proportion than rural (69.3% vs. 30.7%). Major comorbidities included 35.0% diabetes mellitus (DM), 28.4% hypertension (HTN), 16.6% chronic obstructive pulmonary disease (COPD), and 7.8% coronary heart disease (CHD). The morbidity rate (not-cured) was 6.0%, and the mortality rate (non-survivor) was 2.5%. Morbidity risk factors included elderly (AOR = 2.56, 95% CI = 1.31–4.99), having comorbidity (AOR = 1.43, 95% CI = 0.83–2.47), and smokeless tobacco use (AOR = 2.17, 95% CI = 0.84–5.61). The morbidity risk was higher with COPD (RR = 2.68), chronic kidney disease (CKD) (RR = 3.33) and chronic liver disease (CLD) (RR = 3.99). Mortality risk factors included elderly (AOR = 7.56, 95% CI = 3.19–17.92), having comorbidity (AOR = 5.27, 95% CI = 1.88–14.79) and SLT use (AOR = 1.93, 95% CI = 0.50–7.46). The mortality risk was higher with COPD (RR = 7.30), DM (RR = 2.63), CHD (RR = 4.65), HTN (RR = 3.38), CKD (RR = 9.03), CLD (RR = 10.52) and malignant diseases (RR = 9.73). We must espouse programme interventions considering the morbidity and mortality risk factors to condense the aggressive outcomes of COVID-19.