Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan
Muhammad Zeeshan Munir, Amer Hayat Khan, Tahir Mehmood Khan
doi:10.3390/healthcare11081192
Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is essential to comprehend the relationship between disease characteristics, medications used, and mortality for better patient outcomes. Methods: The medical records of confirmed cases in the Lahore and Sargodha districts were examined using a two-stage cluster sampling from March 2021 to March 2022. Demographics, signs and symptoms, laboratory findings, and pharmacological medications as mortality indicators were noted and analyzed. Results: A total of 288 deaths occurred out of the 1000 cases. Death rates were higher for males and people over 40. Most of those who were mechanically ventilated perished (OR: 124.2). Dyspnea, fever, and cough were common symptoms, with a significant association amid SpO2 < 95% (OR: 3.2), RR > 20 breaths/min (OR: 2.5), and mortality. Patients with renal (OR: 2.3) or liver failure (OR: 1.5) were at risk. Raised C-reactive protein (OR: 2.9) and D-dimer levels were the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), corticosteroids (54.8%), anticoagulants (34%), tocilizumab (20.3%), and ivermectin (9.2%). Conclusions: Older males having breathing difficulties or signs of organ failure with raised C-reactive protein or D-dimer levels had high mortality. Antivirals, corticosteroids, tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower mortality risk.
Author Contributions: Elements of this work including the conception of ideas, literature search, study designs, clinical data collections, statistical data analysis, data interpretation, manuscript drafting, and paper writing were done by M.Z.M., T.M.K. and A.H.K. Supervised and performed project administration, critical revisions of the paper, final editing, agreed to submit the manuscript to this journal, gave the final approval for the submitted version, and agreed to be accountable for all aspects of the work. All authors have read and agreed to the published version of the manuscript.
Conflicts of Interest: The authors declare no conflict of interest.
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'abstract': '<jats:p>Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is '
'essential to comprehend the relationship between disease characteristics, medications used, '
'and mortality for better patient outcomes. Methods: The medical records of confirmed cases in '
'the Lahore and Sargodha districts were examined using a two-stage cluster sampling from March '
'2021 to March 2022. Demographics, signs and symptoms, laboratory findings, and '
'pharmacological medications as mortality indicators were noted and analyzed. Results: A total '
'of 288 deaths occurred out of the 1000 cases. Death rates were higher for males and people '
'over 40. Most of those who were mechanically ventilated perished (OR: 124.2). Dyspnea, fever, '
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'the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), '
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'Conclusions: Older males having breathing difficulties or signs of organ failure with raised '
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'tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower '
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