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Presenting characteristics, comorbidities, and outcomes among COVID-19 patients hospitalized in twin cities of Pakistan.

BACKGROUND
COVID-19 converted into a pandemic rapidly after its emergence in December of 2019. It belongs to the Corona family of viruses which have struck a few times before in history. Data based on previous research helped building relationships, which played a vital role in preventions and precautions during initial stages of this pandemic. Since, data related to COVID-19 in Pakistan has not been documented on a large scale initially and due to weak healthcare system and low economic conditions, Pakistan population in general already suffers from many comorbidities, which can affect the outcome of the COVID-19 infected patients severely.


OBJECTIVE
COVID-19 infections are coupled by manifestation of various notable outcomes that can be documented and characterized clinically. These clinical manifestations can serve as indicators for early detection as well as severity prognosis for COVID-19 infections especially in high-risk groups.


METHODS
A retrospective observational study involving abstraction of demographic features, presenting symptoms and adverse clinical outcomes for 1,812 COVID-19 patients admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan was conducted in the period February-August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, ICU admission, ventilator-aid and mortality. The study not only relate COVID-19 infection with comorbidities but also underlines other related factors like age and gender.


RESULTS
The current study depicts fever (87.9%), cough (79.1%) and shortness of breath (55.1%) at the time of admission as the most prevalent symptoms for COVID-19 patients. These symptoms were common but not conclusive of the outcome of infection. Out of all the patients, 24% required ICU admission and 21.5% required ventilator-aid at some point of disease progression during their stay at the hospital and 25.9 % patients died. Further analysis revealed the relationship of the symptoms presented, comorbidities and the progression of severity in these patients. Elderly patients with comorbidities like hypertension, diabetes, chronic kidney disease and asthma were significantly affected in higher proportions, resulting in requirement of intensive care unit (ICU) and ventilator-aid in some cases and even mortality in many cased.


CONCLUSIONS
Elderly patients with comorbidities such as hypertension, diabetes, asthma, COPD, and chronic kidney disease are at increased risk of developing severity in COVID-19 infections with an increased likelihood of adverse clinical outcomes.


CLINICALTRIAL