Frequency of COVID-19 Complications and Their Outcomes in Patients Admitted to a Tertiary Care Hospital in Karachi
Abstract
The end of 2019 was marked by the emergence of a new coronavirus. Now it is named severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), which was declared a pandemic by the World Health Organization in March 2020. This study aims to highlight the variety of complications due to COVID-19 infection and their outcomes in hospitalized patients infected with this deadly virus. An observational cohort descriptive study was conducted from April 2020 till July 2020 at Dr. Ziauddin University Hospital, Karachi. All patients with confirmed features of COVID-19 pneumonia and age above 18 years were included. Pulmonary and extrapulmonary complications were labeled as primary outcomes. The association of these complications with the need for mechanical ventilation, length of hospital stays, and mortality was labeled as the secondary outcomes. Out of 244 patients enrolled for this study, 199 (81.5%) were COVID-19 PCR positive while 45 (18.5%) were negative. The mean age of patients was 58.1 (± 2.14) years with male predominance (68.4%). Acute respiratory distress syndrome (ARDS) was the most common complication in our study (51.6%), followed by acute liver injury [N=202 (58.9%)], and acute kidney injury [N=233 (24.4%)]. The outcomes were observed only in 219 patients, as 25 patients left against medical advice. Mortality was significantly higher in the ARDS group (41.9%, p<0.05) than in the non-ARDS group (0.01%). Mechanical ventilation requirement was also higher in the ARDS group than in the non-ARDS group (65.8% vs. 0.8%). As a whole, 69.67% of patients recovered and were successfully discharged, while 20.08% of patients died. The complications like ARDS, cardiomyopathy, renal impairment, and shock had a poor outcome in terms of morbidity and mortality.
Keywords: COVID-19, complications, acute respiratory distress syndrome, outcome, pandemic, ventilatory support.
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