Risk factors associated with morbidity and mortality outcomes of COVID-19 patients on the 14 th and 28 th day of the disease course: a retrospective cohort study in Bangladesh

  1. M.Z. Islam
  2. B.K. Riaz
  3. ANMS Islam
  4. F. Khanam
  5. J. Akhter
  6. R. Choudhury
  7. N. Farhana
  8. N.A. Jahan
  9. M.J. Uddin
  10. S.S. Efa

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Abstract

Diverse risk factors intercede the outcomes of COVID-19. We conducted this retrospective cohort study to identify the risk factors associated with morbidity and mortality outcomes with a cohort of 1016 COVID-19 patients diagnosed in May 2020. Data were collected by telephone-interview and reviewing records using a questionnaire and checklist. Morbidity (64.4% Vs. 6.0%) and mortality (2.3% Vs. 2.5%) outcomes varied between the 14 th and 28 th day. Morbidity risk factors included chronic obstructive pulmonary disease (COPD) (RR=1.19, RR=2.68) both on the 14th and 18 th day while elderly (AOR=2.56) and smokeless tobacco (SLT) (AOR=2.17) on the 28 th day. Mortality risk factors included elderly (AOR=10.14), COPD (RR=5.93), and SLT (AOR=2.25) on the 14 th day, and elderly (AOR=24.37) and COPD (RR=2.72) on the 28 th day. The morbidity risk was higher with chronic kidney disease (CKD) (RR=3.33) and chronic liver disease (CLD) (RR=3.99) on the 28 th day. The mortality risk was higher with coronary heart disease (RR=4.54) and CLD (RR=9.66) on the 14 th while with diabetes mellitus (RR=3.08, RR=2.08), hypertension (RR=3.14, RR=2.30), CKD (RR=8.97, RR=2.71), and malignant diseases (RR=10.29) on both 14 th and 28 th day. We must espouse program interventions considering the morbidity and mortality risk factors to condense the aggressive outcomes of COVID-19.

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    SciScore for 10.1101/2020.08.17.20176586: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Participation of the COVID-19 patients was voluntary and informed consent was obtained from each participant before data collection.
    IACUC: Ethical clearance was obtained from the Institutional Ethics Committee (IEC) of NIPSOM, Dhaka, Bangladesh.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analysed using SPSS STATISTICS (Version 25.0, IBM Statistical Product and Service Solutions, Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Despite a few limitations of recall bias that emerged through a telephone-interview and wrong telephone contact number, the study findings conserve irrefutable policy implications for prevention and control of the worst outcomes of the COVID-19 patients. Baseline characteristics: Though the males (64.1%) have a reasonably higher risk of being affected by COVID-19 than their counterpart females (35.9%), but no significant gender difference of outcomes was revealed in our study. Similar findings were also found by other studies [7–8, 12–13] where males were being affected more than females. It is evident that the males are more involved in outdoor activities in our context and thus they are more vulnerable than the females. Though the majority(89.9%) of the patients were aged ≥ 59 years, the adverse outcomes were more prevalent among elderly patients (≤ 60 years). Urban prevalence (69.3%) was higher than the rural; it could be argued that unplanned urbanization, higher population density, and industrialization in the urban areas increase disease transmission and prevalence. Moreover, more aware urban people undergo laboratory tests for COVID-19 more than the rural people. By occupation, lion shareholders were service holders (32.5%) and health workforce (18.6%). It is evident that the service holders including bankers, security forces, police, and community forces provide various emergency services and are exposed to COVID-19 infection. The health workforce including doctors, n...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

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  2. Version published to 10.1101/2020.08.17.20176586v1 on medRxiv
  3. Version published to 10.1017/s0950268820002630