Title : Factors affecting the outcomes of patients with coronavirus disease (COVID-19) admitted in a tertiary hospital in Iloilo City: A retrospective cross-sectional study
Abstract:
Background: COVID-19 is a viral respiratory illness caused by SARS-CoV-2, confirmed with RTPCR testing. Considering the heterogeneity of clinical picture of COVID-19 disease, and the threats of its variants, the review of current clinical data and outcome of available management strategies will have an impact on future management and recommendations in the local setting.
Objective: This study generally aimed to determine the factors affecting the outcomes of COVID-19 patients admitted in a tertiary hospital in Iloilo City. Specifically, this study aimed to describe the clinicodemographic profile as to severity, outline the baseline diagnostic results, and describe the management strategies of COVID-19 confirmed cases, determine the distribution of the disease severity as to length of hospital stay, complications, discharge outcomes, and identify significant associations between variables.
Methodology: This retrospective cross-sectional study involved RT-PCR confirmed COVID- 19 cases aged 19 years old and above admitted in a tertiary hospital from January to December 2021. The data were obtained from chart review. Respective statistical tools were used to outline the variables of this study and to determine significant differences between variables, across different groups. A 5% level of significance was used.
Results: There were 229 patients enrolled in this study. Among variables, age, sex, day of illness, and presence of comorbidities, were significantly related to disease severity. Severe and critical cases administered with different management strategies tend to have longer hospital stay, > 10 days, compared with those who did not receive treatment. Mild (28%) and moderate (36%) COVID cases improved or recovered more than more severe cases. Patients with severe disease (50%) at baseline experienced more complications, which are primarily acute respiratory distress syndrome (14.4%), acute kidney injury, (6.1%) and steroid- induced hyperglycemia (3.5%). Patients with lower oxygen saturation (58.2%) and PF ratio (59.7%), higher values of inflammatory markers, and those with infiltrates on their chest X-ray (36.1%) upon admission, were significantly noted to have higher risk of acquiring complications.
Conclusion: Patients who belonged to the higher age group, males, with longer days of illness, and with comorbidities, with lower oxygen level and PF ratio, elevated levels of serum inflammatory markers with findings of infiltrates on chest X-ray, were likely to have a more severe disease, and experienced statistically significant complications. The number of days of illness, and disease severity were also found to be significantly related to the occurrence of complications, as well as administration of various management strategies. Severe and critical patients were significantly identified to have received several management strategies, hence, had higher average hospital stay. Lastly it has been found out that disease severity and occurrence of complications were significantly associated with discharge outcomes. Most patients, regardless of severity at baseline improved, and those with more severe disease on baseline developed complications.
