Epidemiological determinants of COVID-19 infection and mortality: A study among patients presenting with severe acute respiratory illness during the pandemic in Bihar, India
Bijit Biswas, Neeraj Agarwal, Pallavi Lohani
Abstract
OBJECTIVES: The study was designed to explore epidemiological characteristics, determinants of COVID-19 infection development and mortality of patients presenting with severe acute respiratory illness (SARI) to a tertiary care health facility of Bihar. METHODS: July 2020 (16 weeks) were used for the study. RESULTS: Out of 281 study participants, 95 (33.8%) were detected to have COVID-19 and 42 (14.9%) died. Among COVID-positive study subject's death rate was 28.4%. In the multivariable logistic regression analysis; increasing age (adjusted odds ratio [AOR] = 1.02 [1.00-1.03]), gender (males) (AOR = 2.51 [1.27-4.96]), presenting symptom (cough) (AOR = 2.88 [1.46-5.70]), co-morbidity (hypothyroidism) (AOR = 4.59 [1.45-14.56]) and delay between symptom onset and admission (>2 days) (AOR = 2.46 [1.19-5.07]) were significant predictors of COVID-19 infection among study participants adjusted with other co-morbidities (diabetes and hypertension). Similarly, place of residence (outside Patna district) (AOR = 2.38 [1.03-5.50]), co-morbidity (diabetes) (AOR = 3.08 [1.12-8.50]), intensive care unit (ICU) requirement at admission (yes) (AOR = 9.47 [3.98-22.52]) and COVID status (positive) (AOR = 6.33 [2.68-14.96]) were significant predictors of death among the study participants whereas place of residence (outside Patna district) (AOR = 4.04 [1.33-12.28]) and ICU requirement at admission (yes) (AOR = 7.22 [2.54-20.52]) were attributes affecting death of COVID-positive study participants. CONCLUSION: Risk of COVID-19 infection among the study participants was high. Age, gender and co-morbidities increased the risk of infection. COVID-19 infection negatively impacted the treatment outcome of the study participants. Age, co-morbidity and ICU requirement were the other attributes affecting mortality.