Estimation of emerging diagnostic parameters for Coronavirus Disease 2019 patients severity and fatality

Abstract

Objective: To identify various emerging diagnostics parameters of coronavirus disease 2019 related to disease progression and fatality. Method: The cross-sectional study was conducted at Mardan Medical Complex, Khyber Pakhtunkhwah, Pakistan, from February 9, 2021, to April 21, 2021, and comprised patients of either gender aged >18 years diagnosed with coronavirus disease 2019 on the basis of polymerase chain reaction testing and who were admitted to the hospital using the World health Organisation interim guidelines. Disease progression was categorised as mild, moderate, severe and critical, and they were monitored closely till the final outcome. Data was analysed using SPSS 26. Result: Of the 408 patients, 215(52.69%) were male and 193(47.30%) were female. The overall median age of the sample was 55 years (interquartile range: 18-84 years).  Symptoms included cough 92(22.54%), fever 80(19.60%), shortness of breath 78(19.60%), fatigue 60(14.70%) and loss of smell and test 52(12.74%), while 46(11.27%) were asymptomatic. Azithromycin was the most used drug 304(74.50%), while antiviral Remdesivir was given to 279(68.38%) patients and hydrocortisone to 143(35.04%). Plasma treatment was given to 55(13.48) patients and mechanical ventilation to 87(21.32). Compared to baseline, disease progression was mild in 72(17.64) patients, moderate 96(23.52), severe 98(24.01) and critical in 89(21.81), while no change was seen 53(12.99) cases. Severity level was significantly associated with liver and renal function parameters (p<0.05). Overall, 47(11.51%) patients died. Conclusions: Different severity levels during hospitalisation among patients of coronavirus disease 2019 were noted, and severity level was significantly associated with liver and renal function parameters.