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Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital

BACKGROUND: Most COVID-19 studies conclude old age and coexisting illnesses as mortality determinants owing to different populations or methodologies, or omitting factors affecting outcomes. METHODS: We analyzed COVID-19 patients' data (N = 391) of Dubai Hospital between January 1, 2020 and Jun...

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Autores principales: Nadeem, Rashid, Aijazi, Ishma, Elhoufi, Ashraf, Danthi, Crystal, Azaza, Nouha, Khan, Mohd Kafeel, Alheraki, Mohannad, Jamshaid, Muhammed, Nawazani, Asadullah, Tariq, Sadia, Siddiq, Sobia, Hafeez, Muzammil, Kumar, Mukesh, Bon, Islam, Elsousi, Ahmed, Salama, Lamiaa, Kamat, Sahish, Abdalla, Rami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247811/
http://dx.doi.org/10.1159/000516591
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author Nadeem, Rashid
Aijazi, Ishma
Elhoufi, Ashraf
Danthi, Crystal
Azaza, Nouha
Khan, Mohd Kafeel
Alheraki, Mohannad
Jamshaid, Muhammed
Nawazani, Asadullah
Tariq, Sadia
Siddiq, Sobia
Hafeez, Muzammil
Kumar, Mukesh
Bon, Islam
Elsousi, Ahmed
Salama, Lamiaa
Kamat, Sahish
Abdalla, Rami
author_facet Nadeem, Rashid
Aijazi, Ishma
Elhoufi, Ashraf
Danthi, Crystal
Azaza, Nouha
Khan, Mohd Kafeel
Alheraki, Mohannad
Jamshaid, Muhammed
Nawazani, Asadullah
Tariq, Sadia
Siddiq, Sobia
Hafeez, Muzammil
Kumar, Mukesh
Bon, Islam
Elsousi, Ahmed
Salama, Lamiaa
Kamat, Sahish
Abdalla, Rami
author_sort Nadeem, Rashid
collection PubMed
description BACKGROUND: Most COVID-19 studies conclude old age and coexisting illnesses as mortality determinants owing to different populations or methodologies, or omitting factors affecting outcomes. METHODS: We analyzed COVID-19 patients' data (N = 391) of Dubai Hospital between January 1, 2020 and June 30, 2020. RESULTS: Only 19 patients (4.8%) were UAE nationals, while 372 (95.2%) were expatriates. Median age was 48 (interquartile range, 40–56) years; 22% were <40 years, and only 16.6% were female. Cough was the most common symptom (78.7%), fever was 77.4%, and gastrointestinal symptoms were least common (13.8%). Approximately 95% had elevated C-reactive protein (CRP) and D-dimers (79%), lymphocytopenia 47.3%, and thrombocytopenia 13.8%. Mortality was 30% for the total sample and 50% in ICU patients. ICU patients were older than non-ICU (age; 49.6 ± 10.9 vs. 46.7 ± 12.7 years, p = 0.04). Eighty-five percent of ICU patients required invasive mechanical ventilation, 78% vasopressors, 88% sedation, 84% muscle paralysis, while none require any of these in the medical group. Survivors had fewer patients with sedatives (p = 0.01). The median length of stay in the hospital was 19 days, ICU stays 14 days, and ventilator 11 days. The Mann-Whitney test showed that survivors spent more days in the ICU (median [IQR] 18 [6.5–29.5] vs. 11 [4–18], p value 0.003) and the hospital (32 [14.5–49.5] vs. 14 [7–21], p value 0.001) than nonsurvivors. Ferritin and D-dimers were higher in nonsurvivors, but CRP was lower in nonsurvivors (ferritin (ng/mL) median (IQR) 1,434 (661.5–2206.5) versus 1,362 (630–2,094), p value = 0.017, CRP (mg/L) 118.7 (53.4–184) versus 134.9 (66.5–203.2), p value 0.001 and D-dimer (µg/mL) 1.54 (0–3.13) versus 1.09 (0–2.51), p value = 0.001). Multiple logistic regression analysis determined age, fever on admission, use of oxygen, mechanical ventilation, and steroids as predictors of survival. CONCLUSIONS: COVID-19 patients were young males with pre-existing conditions. Ferritin, CRP, and D-dimers were higher in nonsurvivors. Treatment with chloroquine, antivirals, and anticoagulation was not different between survivors and nonsurvivors. Steroid use was a survival predictor.
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spelling pubmed-82478112021-07-08 Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital Nadeem, Rashid Aijazi, Ishma Elhoufi, Ashraf Danthi, Crystal Azaza, Nouha Khan, Mohd Kafeel Alheraki, Mohannad Jamshaid, Muhammed Nawazani, Asadullah Tariq, Sadia Siddiq, Sobia Hafeez, Muzammil Kumar, Mukesh Bon, Islam Elsousi, Ahmed Salama, Lamiaa Kamat, Sahish Abdalla, Rami Dubai Medical Journal Educational Corner − Research Article BACKGROUND: Most COVID-19 studies conclude old age and coexisting illnesses as mortality determinants owing to different populations or methodologies, or omitting factors affecting outcomes. METHODS: We analyzed COVID-19 patients' data (N = 391) of Dubai Hospital between January 1, 2020 and June 30, 2020. RESULTS: Only 19 patients (4.8%) were UAE nationals, while 372 (95.2%) were expatriates. Median age was 48 (interquartile range, 40–56) years; 22% were <40 years, and only 16.6% were female. Cough was the most common symptom (78.7%), fever was 77.4%, and gastrointestinal symptoms were least common (13.8%). Approximately 95% had elevated C-reactive protein (CRP) and D-dimers (79%), lymphocytopenia 47.3%, and thrombocytopenia 13.8%. Mortality was 30% for the total sample and 50% in ICU patients. ICU patients were older than non-ICU (age; 49.6 ± 10.9 vs. 46.7 ± 12.7 years, p = 0.04). Eighty-five percent of ICU patients required invasive mechanical ventilation, 78% vasopressors, 88% sedation, 84% muscle paralysis, while none require any of these in the medical group. Survivors had fewer patients with sedatives (p = 0.01). The median length of stay in the hospital was 19 days, ICU stays 14 days, and ventilator 11 days. The Mann-Whitney test showed that survivors spent more days in the ICU (median [IQR] 18 [6.5–29.5] vs. 11 [4–18], p value 0.003) and the hospital (32 [14.5–49.5] vs. 14 [7–21], p value 0.001) than nonsurvivors. Ferritin and D-dimers were higher in nonsurvivors, but CRP was lower in nonsurvivors (ferritin (ng/mL) median (IQR) 1,434 (661.5–2206.5) versus 1,362 (630–2,094), p value = 0.017, CRP (mg/L) 118.7 (53.4–184) versus 134.9 (66.5–203.2), p value 0.001 and D-dimer (µg/mL) 1.54 (0–3.13) versus 1.09 (0–2.51), p value = 0.001). Multiple logistic regression analysis determined age, fever on admission, use of oxygen, mechanical ventilation, and steroids as predictors of survival. CONCLUSIONS: COVID-19 patients were young males with pre-existing conditions. Ferritin, CRP, and D-dimers were higher in nonsurvivors. Treatment with chloroquine, antivirals, and anticoagulation was not different between survivors and nonsurvivors. Steroid use was a survival predictor. S. Karger AG 2021-06-03 /pmc/articles/PMC8247811/ http://dx.doi.org/10.1159/000516591 Text en Copyright © 2021 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
spellingShingle Educational Corner − Research Article
Nadeem, Rashid
Aijazi, Ishma
Elhoufi, Ashraf
Danthi, Crystal
Azaza, Nouha
Khan, Mohd Kafeel
Alheraki, Mohannad
Jamshaid, Muhammed
Nawazani, Asadullah
Tariq, Sadia
Siddiq, Sobia
Hafeez, Muzammil
Kumar, Mukesh
Bon, Islam
Elsousi, Ahmed
Salama, Lamiaa
Kamat, Sahish
Abdalla, Rami
Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title_full Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title_fullStr Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title_full_unstemmed Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title_short Clinical Profile of Mortality and Treatment Profile of Survival in Patients with COVID-19 Pneumonia Admitted to Dubai Hospital
title_sort clinical profile of mortality and treatment profile of survival in patients with covid-19 pneumonia admitted to dubai hospital
topic Educational Corner − Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8247811/
http://dx.doi.org/10.1159/000516591
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