Case Fatality in COVID-19; a District Perspective

Main Article Content

Hamzullah Khan
Faridullah Shah
Khalid Khan
. Abuzar

Abstract

Objectives: To determine the case fatality rate of COVID-19 by evaluating the data of Patients died due to COVID-19.

Materials and Methods: A total of 243 patients with PCR done from the government designated Public health research laboratory of Khyber Medical University were included in a cross sectional comparative study. Chi-square test, risk analysis, probability testing and survival analysis using Kaplan Meir test was done on data sheet prepared in SPPS version 25 in accordance with the objectives of the study.

Results: Out of total 243 patients, 165 (67.90%) were negative by PCR testing and 78 (32.09%) were COVID-19 positive. The Mean age with SD was 36+17 years. Out of total 178 (73.3%) were males and 65 (26.7%) were females. 34 (13.99%) had age more than 55 years, where 4/5 (80%) of the deaths were recorded. The relationship of an increase in age with rate of mortality was statistically significant (p=0.001). The over all probability of death in our population in age more than 55 years is 24 times higher (OR=24,95CI: 2.6-221.24) with relative risk of 1.1 (rr=1.11, 95CI:1-1.24). Mortality rate was 6.41%. A significant correlation of mortality with case positivity (p=0.003) with relative risk of 1.06 (rr=1.06, 95CI: 1.008-1.13). Three out of 5 of the COVID-19 positive deceased had cardiac diseases and 2/5 had respiratory disease/viral pneumonia. Using Kaplan Meir test, the survival graphs of COVID positive vs COVID negative cases had similar pattern that shows the mortality rate in the positive cases was not solely due to COVID-19, but has aggravated the pre-existing illness to cause death.

Conclusion: The mortality rate was 6.41%, more in age>55 years (80%) and almost all the deceased had chronic co-morbid conditions like CAD, CCF and COPD at time of presentation. COVID-19 is not the sole killer, it contributes killing in immune-deficient patients.

Keywords:
COVID-19, mortality, PCR testing, age factor, co-morbidities.

Article Details

How to Cite
Khan, H., Shah, F., Khan, K., & Abuzar, . (2020). Case Fatality in COVID-19; a District Perspective. Microbiology Research Journal International, 30(8), 51-58. https://doi.org/10.9734/mrji/2020/v30i830250
Section
Original Research Article

References

Ahn DG, Shin HJ, Kim MH, Lee S, Im HS, Myoung J, Kim BT, Kim SJ. Current status of epidemiology, diagnosis, therapeutics, and vaccines for novel coronavirus disease 2019 (COVID-19). J Microbiol Biotechnol. 2020;30(3):313-324. DOI: 10.4014/jmb.2003.03011

Pakistan prepares to fight back as two coronavirus cases emerge in country. Arab News PK; 2020. Retrieved 4 March 2020.

Coronavirus in Pakistan - Confirmed Cases. Available:www.covid.gov.pk/ Retrieved 24 July 2020.

Backer JA, Klinkenberg D, Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020;25. [Google Scholar] [Ref list]

Meo SA, Al-Khlaiwi T, Usmani AM, Meo AS, Klonoff DC, Hoang TD. Biological and epidemiological trends in the prevalence and mortality due to outbreaks of novel coronavirus COVID-19 [published online ahead of print, 2020 Apr 9]. J King Saud Univ Sci; 2020. DOI:10.1016/j.jksus.2020.04.004

Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China [published online ahead of print, 2020 Mar 3] [published correction appears in Intensive Care Med. 2020 Apr 6;:]. Intensive Care Med. 2020;1‐3. DOI:10.1007/s00134-020-05991

Wang DW, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA; 2020. DOI:10.1001/jama.2020.1585

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395:507-13.

Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A novel coronavirus emerging in china - key questions for impact assessment. N Engl J Med. 2020;382:692-4.

Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients [published online ahead of print, 2020 Apr 13]. Int Immunopharmacol. 2020;84: 106504. DOI: 10.1016/j.intimp.2020.106504

Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B. Molecular and serological investigation of 2019-nCoV infected patients: Implication of multiple shedding routes. Emerg Microbes Infect. 2020;9: 386–389.

Fang Y, Zhang H, Xie J, Lin M, Ying L, Pang P. Sensitivity of chest CT for COVID-19: Comparison to RT-PCR. Radiology; 2020

Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection [published online ahead of print, 2020 Mar 12]. Lancet Infect Dis. 2020;S1473-3099(20)30195-X. DOI: 10.1016/S1473-3099(20)30195-X

CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343–346. DOI: 10.15585/mmwr.mm6912e2 Published 2020 Mar 27.

Mizumoto K, Chowell G. Estimating the risk of 2019 novel coronavirus death during the course of the outbreak in China, 2020. Med Rxiv.; 2020. DOI: 10.1101/2020.02.19.20025163

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.

Tan W, Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. Int J Cardiol. 2020;309: 70‐77. DOI: 10.1016/j.ijcard.2020.03.063

Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS. J. Virol; 2020. Available:https://jvi.asm.org/content/early/2020/01/23/JVI.00127-20