Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study.
Identifieur interne : 000045 ( Main/Corpus ); précédent : 000044; suivant : 000046Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study.
Auteurs : Rosemarie De Souza ; Sharayu Mhatre ; Burhanuddin Qayyumi ; Garvit Chitkara ; Tushar Madke ; Mohan Joshi ; Ramesh Bharmal ; D S Asgaonkar ; Prem Lakhani ; Sudeep Gupta ; Pankaj Chaturvedi ; Rajesh Dikshit ; Rajendra BadweSource :
- BMJ open [ 2044-6055 ] ; 2021.
English descriptors
- KwdEn :
- MESH :
- chemical : Hydroxychloroquine.
- geographic , epidemiology : India.
- Adult, Aged, COVID-19, Comorbidity, Female, Hospital Mortality, Hospitalization, Humans, Male, SARS-CoV-2.
Abstract
OBJECTIVE
To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.
DESIGN
Observational study with follow-up.
SETTING
Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.
PARTICIPANTS
689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.
PRIMARY AND SECONDARY OUTCOME MEASURES
In-hospital mortality; joint effect of comorbidity and age on the risk of dying.
RESULTS
A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.
CONCLUSIONS
In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.
TRIAL REGISTRATION
Not applicable (observational study, not a clinical trial).
DOI: 10.1136/bmjopen-2020-042943
PubMed: 33958335
PubMed Central: PMC8103559
Links to Exploration step
pubmed:33958335Le document en format XML
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<author><name sortKey="Chaturvedi, Pankaj" sort="Chaturvedi, Pankaj" uniqKey="Chaturvedi P" first="Pankaj" last="Chaturvedi">Pankaj Chaturvedi</name>
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<term>Aged (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>Comorbidity (MeSH)</term>
<term>Female (MeSH)</term>
<term>Hospital Mortality (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (MeSH)</term>
<term>India (epidemiology)</term>
<term>Male (MeSH)</term>
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<front><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN</b>
</p>
<p>Observational study with follow-up.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>SETTING</b>
</p>
<p>Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b>
</p>
<p>689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PRIMARY AND SECONDARY OUTCOME MEASURES</b>
</p>
<p>In-hospital mortality; joint effect of comorbidity and age on the risk of dying.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b>
</p>
<p>Not applicable (observational study, not a clinical trial).</p>
</div>
</front>
</TEI>
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<DateCompleted><Year>2021</Year>
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<Title>BMJ open</Title>
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<ArticleTitle>Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study.</ArticleTitle>
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<Abstract><AbstractText Label="OBJECTIVE">To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.</AbstractText>
<AbstractText Label="DESIGN">Observational study with follow-up.</AbstractText>
<AbstractText Label="SETTING">Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.</AbstractText>
<AbstractText Label="PARTICIPANTS">689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.</AbstractText>
<AbstractText Label="PRIMARY AND SECONDARY OUTCOME MEASURES">In-hospital mortality; joint effect of comorbidity and age on the risk of dying.</AbstractText>
<AbstractText Label="RESULTS">A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.</AbstractText>
<AbstractText Label="CONCLUSIONS">In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.</AbstractText>
<AbstractText Label="TRIAL REGISTRATION">Not applicable (observational study, not a clinical trial).</AbstractText>
<CopyrightInformation>© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>de Souza</LastName>
<ForeName>Rosemarie</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India drrosemariedesouza@gmail.com.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mhatre</LastName>
<ForeName>Sharayu</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Qayyumi</LastName>
<ForeName>Burhanuddin</ForeName>
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</AffiliationInfo>
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</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Madke</LastName>
<ForeName>Tushar</ForeName>
<Initials>T</Initials>
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</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Joshi</LastName>
<ForeName>Mohan</ForeName>
<Initials>M</Initials>
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</AffiliationInfo>
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</AffiliationInfo>
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</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Gupta</LastName>
<ForeName>Sudeep</ForeName>
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<Identifier Source="ORCID">0000-0002-6742-6378</Identifier>
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</AffiliationInfo>
<AffiliationInfo><Affiliation>Medical Oncology, Homi Bhabha National Institute, Mumbai, India.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chaturvedi</LastName>
<ForeName>Pankaj</ForeName>
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<AffiliationInfo><Affiliation>Head and Neck Services, Tata Memorial Hospital, Mumbai, India.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dikshit</LastName>
<ForeName>Rajesh</ForeName>
<Initials>R</Initials>
<Identifier Source="ORCID">0000-0003-4830-0486</Identifier>
<AffiliationInfo><Affiliation>Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Badwe</LastName>
<ForeName>Rajendra</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Surgical Oncology, Tata Memorial Centre, Mumbai, India.</Affiliation>
</AffiliationInfo>
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<Language>eng</Language>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
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<CoiStatement>Competing interests: None declared.</CoiStatement>
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<ReferenceList><Reference><Citation>JAMA. 2020 Apr 28;323(16):1574-1581</Citation>
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