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Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study
BACKGROUND: COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673715/ https://www.ncbi.nlm.nih.gov/pubmed/34710053 http://dx.doi.org/10.2196/32203 |
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author | Akhtar, Hashaam Khalid, Sundas Rahman, Fazal ur Umar, Muhammad Ali, Sabahat Afridi, Maham Hassan, Faheem Saleh Khader, Yousef Akhtar, Nasim Khan, Muhammad Mujeeb Ikram, Aamer |
author_facet | Akhtar, Hashaam Khalid, Sundas Rahman, Fazal ur Umar, Muhammad Ali, Sabahat Afridi, Maham Hassan, Faheem Saleh Khader, Yousef Akhtar, Nasim Khan, Muhammad Mujeeb Ikram, Aamer |
author_sort | Akhtar, Hashaam |
collection | PubMed |
description | BACKGROUND: COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan’s population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19. OBJECTIVE: COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups. METHODS: A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender. RESULTS: This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality. CONCLUSIONS: Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes. |
format | Online Article Text |
id | pubmed-8673715 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-86737152022-01-10 Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study Akhtar, Hashaam Khalid, Sundas Rahman, Fazal ur Umar, Muhammad Ali, Sabahat Afridi, Maham Hassan, Faheem Saleh Khader, Yousef Akhtar, Nasim Khan, Muhammad Mujeeb Ikram, Aamer JMIR Public Health Surveill Original Paper BACKGROUND: COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan’s population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19. OBJECTIVE: COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups. METHODS: A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender. RESULTS: This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality. CONCLUSIONS: Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes. JMIR Publications 2021-12-14 /pmc/articles/PMC8673715/ /pubmed/34710053 http://dx.doi.org/10.2196/32203 Text en ©Hashaam Akhtar, Sundas Khalid, Fazal ur Rahman, Muhammad Umar, Sabahat Ali, Maham Afridi, Faheem Hassan, Yousef Saleh Khader, Nasim Akhtar, Muhammad Mujeeb Khan, Aamer Ikram. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 14.12.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Akhtar, Hashaam Khalid, Sundas Rahman, Fazal ur Umar, Muhammad Ali, Sabahat Afridi, Maham Hassan, Faheem Saleh Khader, Yousef Akhtar, Nasim Khan, Muhammad Mujeeb Ikram, Aamer Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title | Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title_full | Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title_fullStr | Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title_full_unstemmed | Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title_short | Presenting Characteristics, Comorbidities, and Outcomes Among Patients With COVID-19 Hospitalized in Pakistan: Retrospective Observational Study |
title_sort | presenting characteristics, comorbidities, and outcomes among patients with covid-19 hospitalized in pakistan: retrospective observational study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8673715/ https://www.ncbi.nlm.nih.gov/pubmed/34710053 http://dx.doi.org/10.2196/32203 |
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