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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Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Chitkara, Garvit" sort="Chitkara, Garvit" uniqKey="Chitkara G" first="Garvit" last="Chitkara">Garvit Chitkara</name><affiliation><nlm:affiliation>Department of Breast Oncology, Tata Memorial Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Madke, Tushar" sort="Madke, Tushar" uniqKey="Madke T" first="Tushar" last="Madke">Tushar Madke</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Joshi, Mohan" sort="Joshi, Mohan" uniqKey="Joshi M" first="Mohan" last="Joshi">Mohan Joshi</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Bharmal, Ramesh" sort="Bharmal, Ramesh" uniqKey="Bharmal R" first="Ramesh" last="Bharmal">Ramesh Bharmal</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Asgaonkar, D S" sort="Asgaonkar, D S" uniqKey="Asgaonkar D" first="D S" last="Asgaonkar">D S Asgaonkar</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Lakhani, Prem" sort="Lakhani, Prem" uniqKey="Lakhani P" first="Prem" last="Lakhani">Prem Lakhani</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Gupta, Sudeep" sort="Gupta, Sudeep" uniqKey="Gupta S" first="Sudeep" last="Gupta">Sudeep Gupta</name><affiliation><nlm:affiliation>Medical Oncology, Tata Memorial Centre, Mumbai, India.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Medical Oncology, Homi Bhabha National 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Memorial Centre, Navi Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Qayyumi, Burhanuddin" sort="Qayyumi, Burhanuddin" uniqKey="Qayyumi B" first="Burhanuddin" last="Qayyumi">Burhanuddin Qayyumi</name><affiliation><nlm:affiliation>Head and Neck Services, Tata Memorial Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Chitkara, Garvit" sort="Chitkara, Garvit" uniqKey="Chitkara G" first="Garvit" last="Chitkara">Garvit Chitkara</name><affiliation><nlm:affiliation>Department of Breast Oncology, Tata Memorial Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Madke, Tushar" sort="Madke, Tushar" uniqKey="Madke T" first="Tushar" last="Madke">Tushar Madke</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Joshi, Mohan" sort="Joshi, Mohan" uniqKey="Joshi M" first="Mohan" last="Joshi">Mohan Joshi</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Bharmal, Ramesh" sort="Bharmal, Ramesh" uniqKey="Bharmal R" first="Ramesh" last="Bharmal">Ramesh Bharmal</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Asgaonkar, D S" sort="Asgaonkar, D S" uniqKey="Asgaonkar D" first="D S" last="Asgaonkar">D S Asgaonkar</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Lakhani, Prem" sort="Lakhani, Prem" uniqKey="Lakhani P" first="Prem" last="Lakhani">Prem Lakhani</name><affiliation><nlm:affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Gupta, Sudeep" sort="Gupta, Sudeep" uniqKey="Gupta S" first="Sudeep" last="Gupta">Sudeep Gupta</name><affiliation><nlm:affiliation>Medical Oncology, Tata Memorial Centre, Mumbai, India.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Medical Oncology, Homi Bhabha National Institute, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Chaturvedi, Pankaj" sort="Chaturvedi, Pankaj" uniqKey="Chaturvedi P" first="Pankaj" last="Chaturvedi">Pankaj Chaturvedi</name><affiliation><nlm:affiliation>Head and Neck Services, Tata Memorial Hospital, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Dikshit, Rajesh" sort="Dikshit, Rajesh" uniqKey="Dikshit R" first="Rajesh" last="Dikshit">Rajesh Dikshit</name><affiliation><nlm:affiliation>Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India.</nlm:affiliation></affiliation></author><author><name sortKey="Badwe, Rajendra" sort="Badwe, Rajendra" uniqKey="Badwe R" first="Rajendra" last="Badwe">Rajendra Badwe</name><affiliation><nlm:affiliation>Surgical Oncology, Tata Memorial Centre, Mumbai, India.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMJ open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><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><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" xml:lang="en"><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>India</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>COVID-19</term><term>Comorbidity</term><term>Female</term><term>Hospital Mortality</term><term>Hospitalization</term><term>Humans</term><term>Male</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><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><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Automated" Owner="NLM"><PMID Version="1">33958335</PMID><DateCompleted><Year>2021</Year><Month>05</Month><Day>13</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2044-6055</ISSN><JournalIssue CitedMedium="Internet"><Volume>11</Volume><Issue>5</Issue><PubDate><Year>2021</Year><Month>05</Month><Day>06</Day></PubDate></JournalIssue><Title>BMJ open</Title><ISOAbbreviation>BMJ Open</ISOAbbreviation></Journal><ArticleTitle>Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study.</ArticleTitle><Pagination><MedlinePgn>e042943</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjopen-2020-042943</ELocationID><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><Initials>B</Initials><AffiliationInfo><Affiliation>Head and Neck Services, Tata Memorial Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chitkara</LastName><ForeName>Garvit</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Department of Breast Oncology, Tata Memorial Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Madke</LastName><ForeName>Tushar</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Joshi</LastName><ForeName>Mohan</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bharmal</LastName><ForeName>Ramesh</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Asgaonkar</LastName><ForeName>D S</ForeName><Initials>DS</Initials><AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lakhani</LastName><ForeName>Prem</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gupta</LastName><ForeName>Sudeep</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0002-6742-6378</Identifier><AffiliationInfo><Affiliation>Medical Oncology, Tata Memorial Centre, Mumbai, India.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Medical Oncology, Homi Bhabha National Institute, Mumbai, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chaturvedi</LastName><ForeName>Pankaj</ForeName><Initials>P</Initials><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></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>05</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Open</MedlineTA><NlmUniqueID>101552874</NlmUniqueID><ISSNLinking>2044-6055</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="Y">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007194" MajorTopicYN="N" Type="Geographic">India</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">epidemiology</Keyword><Keyword MajorTopicYN="Y">public health</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate 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