Presentation of COVID-19 Disease and the Impact of Patient’s Comorbidities on Its Hospital Outcome: An Observational Study in a COVID-19 Dedicated Hospital
Authors: Bodiuzzaman M. M. , Hossain M. I. 
Published: May 2021

Background: Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that initially started in Wuhan, China, and spread exponentially across the globe infecting human being irrespective of age, sex and ethnicity. Given the nature of this virus, there is much still to be learned. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms (e.g., common cold) to more severe diseases such as bronchitis, pneumonia, severe acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. Comorbidity is an important factor in COVID-19 pandemic outcome often leading to rapid and severe progression of the disease process, even death.

Objective: This study was carried out to see the socio-demographic characteristics and presenting features of COVID-19 disease as well as to assess impact of comorbidities on its hospital outcome.

Methods: This observational study was carried out in the COVID-19 dedicated hospital of Faridpur from April 2020 to September 2020 for a period of 06 month. All clinically suspected patients confirmed by RT PCR were included as cases. Data were collected by detailed history from patients then those were checked, verified for consistency and edited for result. After editing and coding, the coded data were analyzed by using the SPSS\PC software package.

Results: A total of 627 patients were included in the study of which 552 were treated in COVID ward and 75 patients were treated in ICU. Among COVID ward admitted (552) patients 354 (64.13%) were male and 198 (35.86%) were female with a male to female ratio of 1:0.56; young adult patients (19 to 50 years) were more affected and admitted (62.86%) and people living in urban area were more affected (52.71%) than rural area (47.28%). Fever, cough and shortness of breath (63.04%, 45.47% and 42.39% respectively) were predominant symptoms. Regarding comorbidities, 44.20% patients have one or more comorbidities whereas 55.79% patients have no comorbidity. Hypertension (17.57%) was the predominant comorbid condition followed by Diabetes (15.94%), ischemic heart disease (05.61%), COAD (05.61%), CKD (2.3%), Stroke (1.44%), Heart failure (0.54%) and Cancer (0.36%). A total of 75 patients needed ICU support; most of them were elderly patients (64 out of 75). Regarding hospital outcome, 96.74% (534 out of 552) COVID ward patients and 45.34% (34 out of 75) of ICU admitted patients discharged uneventfully whereas 03.2% COVID ward patients and 54.66%of ICU admitted patients expired. Deaths were more in elderly patients (n=43; 72.88%). Common comorbidities found among the patients who expired were Hypertension, Diabetes and Ischemic heart diseases (42.37%, 37.28% and 16.94% respectively).

Conclusion: The predominant number of patients presented with fever, cough and shortness of breath in our setting. The percentage of COVID-19 hospitalizations resulting in death remains high among elderly patients and those with one or more comorbid conditions. Therefore, elderly patients and those with comorbidities should take all necessary precautions to avoid getting infected with SARS CoV-2.