Survival and 30-days hospital outcome in hospitalized COVID-19 patients in Upper Egypt: Multi-center study

  1. Aliae AR Mohamed Hussein
  2. Islam Galal
  3. Mohammed Mustafa Abdel Rasik Mohamed
  4. Mohamed Eltaher AA Ibrahim
  5. Shazly B Ahmed

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Background

Defining the clinical features and associated outcomes of patients diagnosed with corona virus disease (COVID-19) is fundamental to improving our understanding and adequate management of this illness. The aim of this study was to identify the demographic data, underlying comorbidities and the mortality related factors of hospitalized patients with COVID-19 in Upper Egypt.

Patients and methods

1064 cases consecutively admitted to isolation hospitals in Upper Egypt. All cases had confirmed COVID-19 infection. The electronic records of the patients were retrospectively revised and the demographic data, clinical manifestations, qSOFA score on admission and 30 days-outcome (ICU admission, death, recovery, referral or still in hospital) were analyzed. Overall cumulative survival in all patients and those > or < 50 years were calculated.

Results

49.2% of the study population were males and 50.8% were females with mean age 49.4±17.8 years-old. On admission, 83.9% were stable with qSOFA score <1, 3% required non-invasive mechanical ventilation, and 2.1% required O2 therapy. Within 30 days, 203 cases (19.1%) required admission to ICU. Death was recorded in 11.7% of cases, 28.7% recovered, 40.5% referred and 19.2% were still under treatment. Determinants of ICU admission and survival in the current study were age > 50, respiratory rate > 24/minute, SaO2 < 89%, qSOFA >1 and need for O2 therapy or NIV. The cumulative survival was 75.3% with the mean survival was 28.1, and 95.2% overall survival was recorded in those aged ≤50 years.

Conclusions

Age older than 50 years old, those with pre-existing DM, initial qSOFA score, requirement for O 2 therapy and NIV from the first day of hospital admission may be associated with unfavorable 30 days- in hospital outcome of COVID-19.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.08.26.20180992: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIACUC: Ethical consideration: the study was approved by ethical committee of Assiut faculty of medicine and Ministry of Population and Health Egypt.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    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:
    Most of the limitations in this study are due to its retrospective character, for instance possible loss of data owing to omissions. In addition, we were not able to obtain the patients’ previous medical data and co-morbidities from the electronic medical records, they were recorded based on patient self-reporting and/or diagnosed using laboratory results during their admission. Moreover, during the course of pandemic, the guidelines for diagnosis, management and discharge criteria rapidly evolved ultimately, which may have implications on our results. At the end of the study, some patients remained hospitalized (19.2%) and their clinical course is still unclear. This study is, to our knowledge, the first comprehensive study to provide data on the initial 1064 consecutive hospitalized COVID-19 cases in Upper Egypt, all admitted to isolation hospitals, undergoing the same investigations and treatment protocols. We believe it gives a different perception on the nature and clinical course of this novel disease, compared to other large retrospective cohort studies, as it included patients with a wide variety of disease severity. Future studies, directed at further characterizing risk factors for disease severity and outcomes, principally predictive scoring systems, are desired.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04488588CompletedSurvival and 30-days Hospital Outcome in COVID-19 Patients i…

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.08.26.20180992v1 on medRxiv