Background: Corona virus disease (Covid -19) is the most contagious form of the disease of present time. Therefore, the risk factors which proliferate the spread and hinders the better outcome should be identified. There is gross difference in the spread and outcome of covid 19 in different region of the world. There is need to identify these factors in different communities of the globe.
Material and method: This is a retrospective observational cohort study of Covid -19 patients admitted during the study period. Institutional and ethical review board permission was taken prior to the study. Univariate and multivariate binary logistic regression was run and odds ratio with 95% confidence intervals were obtained. P value of ≤ 0.05 was considered significant. Outcome variables were recovery and death.
Results: There were 840 patients admitted between the study duration, while 704 (83.8%) were included in our study. There were 491(69.7%) males and 213(30.3%) females. The mean age of the population was 54.6±15.5 years. All continuous variables were categorized according to binary outcome (recovered and death) of patients. In Logistic regression analysis we found that patients in age group of 51-65 years died 2.5 time more than patients of age ≤ 50 years. Similarly, the patients within age group of > 65 died 4.5 times higher than ≤ 50 years of age (p<0.001). Male patients died 1.5 times more than females. Among all comorbid conditions HTN had significant effect on death, they died 1.5 times more than normotensive patients. In multivariate logistic regression analysis, the age groups had same significant effect on death when adjusted with other parameters, while effect of gender vanished. Similarly, the effect of HTN was also abolished when other factors were included in analysis.
Conclusion: We concluded that there is an urgent need of reevaluation of the traditional risk factors associated with viral epidemic and understanding the changing paradigm of epidemiology emerging out from this epidemic in both developed and developing counties. There is need of more data from developing world to elucidate the risk factors.
WHO. Coronavirus disease 2019: Situation report.93.2020.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet. 2020 Mar 28;395(10229):1054-62.
Ho FK, Celis-Morales CA, Gray SR, Katikireddi SV, Niedzwiedz CL, Hastie C, Lyall DM, Ferguson LD, Berry C, Mackay DF, Gill JM. Modifiable and non-modifiable risk factors for COVID-19: results from UK Biobank. MedRxiv. 2020 Jan 1.
Ahrenfeldt LJ, Nielsen CR, Möller S, Christensen K, Lindahl-Jacobsen R. Burden and prevalence of risk factors for severe COVID-19 disease in the ageing European population–A SHARE-based analysis.
Wang J, Guo S, Zhang Y, Gao K, Zuo J, Tan N, Du K, Ma Y, Hou Y, Li Q, Xu H. Clinical features and risk factors for severe inpatients with COVID-19: A retrospective study in China. PloS one. 2020 Dec 17;15(12):e0244125.
Anwar S, Nasrullah M, Hosen MJ. COVID-19 and Bangladesh: Challenges and how to address them. Frontiers in public health. 2020;8.
Laxminarayan R, Wahl B, Dudala SR, Gopal K, Neelima S, Reddy KJ, Radhakrishnan J, Lewnard JA. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science. 2020 Nov 6;370(6517):691-7.
WHO corona disease dashboard visited on 7 Jan 2021.
Sorci G, Faivre B, Morand S. Explaining among-country variation in COVID-19 case fatality rate. Scientific reports. 2020 Nov 3;10(1):1-1.
Atif M, Malik I. Why is Pakistan vulnerable to COVID‐19 associated morbidity and mortality? A scoping review. The International journal of health planning and management. 2020 Sep;35(5):1041-54.
Shah S. Why Youthful, Conservative Pakistan Is a Coronavirus Bright Spot. The Wall Street Journal. 2020;1.
Morand S, Walther BA. Individualistic values are related to an increase in the outbreaks of infectious diseases and zoonotic diseases. Scientific reports. 2018 Mar 1;8(1):1-9.
Bashford A. Imperial hygiene: a critical history of colonialism, nationalism and public health. Springer; 2003 Nov 11.
Illich I. Medical nemesis. Australian Broadcasting Commission, Science Programmes Unit; 1975.
Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Risk factors for severe illness and death in COVID-19: a systematic review and meta-analysis. medRxiv. 2020 Jan 1.
Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, Rosser EC, Webb K, Deakin CT. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nature communications. 2020 Dec 9;11(1):1-0.
Women's health - WHO | World Health Organization www.who.int › Health topics › Women's health.
Judah G, Aunger R, Schmidt WP, Michie S, Granger S, Curtis V. Experimental pretesting of hand-washing interventions in a natural setting. American journal of public health. 2009 Oct;99(S2):S405-11.
Allegranzi B, Memish ZA, Donaldson L, Pittet D, Safety WH, on Religious CT. Religion and culture: potential undercurrents influencing hand hygiene promotion in health care. American journal of infection control. 2009 Feb 1;37(1):28-34.
Katme AM. Muslim teaching gives rules for when hands must be washed. BMJ. 1999 Aug 21;319(7208):518.
Fisher M, Neugarten J, Bellin E, Yunes M, Stahl L, Johns TS, Abramowitz MK, Levy R, Kumar N, Mokrzycki MH, Coco M. AKI in Hospitalized Patients with and without COVID-19: A Comparison Study. Journal of the American Society of Nephrology. 2020 Sep 1;31(9):2145-57.
Chan L, Chaudhary K, Saha A, Chauhan K, Vaid A, Zhao S, Paranjpe I, Somani S, Richter F, Miotto R, Lala A. AKI in hospitalized patients with COVID-19. Journal of the American Society of Nephrology. 2021 Jan 1;32(1):151-60.
WHO Solidarity Trial Consortium. Repurposed antiviral drugs for Covid-19 — interim WHO Solidarity trial results. N Engl J Med 2021;384:497-511.
Bai T, Tu S, Wei Y, Xiao L, Jin Y, Zhang L, Song J, Liu W, Zhu Q, Yang L, Chen H. Clinical and laboratory factors predicting the prognosis of patients with COVID-19: an analysis of 127 patients in Wuhan, China. China (2/26/2020). 2020 Feb 26.