1. Determinants of severity among hospitalised COVID-19 patients: Hospital-based case-control study, India, 2020
- Author
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Sanjay P. Zodpey, Himanshu Negandhi, Vineet Kumar Kamal, Tarun Bhatnagar, Parasuraman Ganeshkumar, Arvind Athavale, Amiruddin Kadri, Amit Patel, A. Bhagyalaxmi, Deepak Khismatrao, E. Theranirajan, Getrude Banumathi, Krishna Singh, P. Parameshwari, Prasita Kshirsagar, Rita Saxena, Sanjay G. Deshpande, Kadloor Satyanand, Saurabh Hadke, Simmi Dube, Sudarshini Subramaniam, Surabhi Madan, Swapnali Kadam, Tanu Anand, Kathiresan Jeyashree, Manickam Ponnaiah, Manish Rana, Manoj V. Murhekar, and DCS Reddy
- Subjects
Male ,Viral Diseases ,Blood Pressure ,Severity of Illness Index ,Biochemistry ,Vascular Medicine ,Medical Conditions ,Endocrinology ,Risk Factors ,Chronic Kidney Disease ,Medicine and Health Sciences ,Virus Testing ,Multidisciplinary ,Age Factors ,Proteases ,Middle Aged ,C-Reactive Proteins ,Hospitals ,Enzymes ,Hospitalization ,C-Reactive Protein ,Infectious Diseases ,Nephrology ,Hypertension ,Medicine ,Female ,Anatomy ,Procalcitonin ,Research Article ,Adult ,Adolescent ,Endocrine Disorders ,Science ,India ,Fibrin Fibrinogen Degradation Products ,Young Adult ,Diagnostic Medicine ,Renal Diseases ,Diabetes Mellitus ,Humans ,L-Lactate Dehydrogenase ,Interleukin-6 ,SARS-CoV-2 ,COVID-19 ,Biology and Life Sciences ,Proteins ,Covid 19 ,Renal System ,Case-Control Studies ,Metabolic Disorders ,Enzymology ,Serine Proteases - Abstract
Background Risk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management. Methods We conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease. Findings We identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 μg/L, fibrin degradation products >5 μg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease. Interpretation We have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.
- Published
- 2021