Epidemiological study of COVID-19 mortality in a tertiary care center of South India

Jayakrishnan Thayyil; Aparna Padmanabhan; Alan Gangadharan; Navya Annikady

doi:10.18203/2394-6040.ijcmph20222640

Authors

Jayakrishnan Thayyil Department of Community Medicine, KMCT Medical College, Calicut, Kerala, India
Aparna Padmanabhan Department of Community Medicine, Govt Medical College, Calicut, Kerala, India
Alan Gangadharan Directorate of Health Service, Govt of Kerala, Kerala, India
Navya Annikady Department of Community Medicine, Govt Medical College, Calicut, Kerala, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20222640

Keywords:

COVID-19, Mortality associated factors, Co-morbidities, Interval of death

Abstract

Background: COVID-19 infection have taken a huge death toll across the globe since its emergence in 2019 in Wuhan, China. There have been inconsistencies related to many of the epidemiological features, which vary from country to country or are not known or explained properly. Therefore, there is an urgent need to generate epidemiological evidence of COVID-19 at the state level based on the data. Also, very limited published studies from India have analyzed the factors associated with death due to COVID-19. The objective of this study was to identify the epidemiological factors involved in COVID deaths in a tertiary care center of north Kerala, South India and to compare the trend of these factors affecting COVID-19 mortality in the consecutive years.

Methods: Descriptive study was conducted prospectively using secondary data extracted from the electronic surveillance records of the tertiary care center were analyzed using suitable software and presented.

Results: During the study period 1747 deaths due to COVID-19 was reported. The duration of hospital stay was 6.5+ 6.3 days. The median age was 67.5 years (IQR14) and males constitute 67.5% (95% CI: 64.8-69.3%). Among them 88.3% (95% CI:86.7-89.7%) have any of reported co morbidities which mainly diabetes and hypertension. Immediate cause of mortality mainly (73.6%) ARDS. Epidemiological factors related to mortality was similar during years.

Conclusions: Since COVID-19 deaths affect older age groups, and those with comorbidities, reverse isolation needs to be given more importance wherever possible and its high time to consider targeted COVID-19 vaccination among them.

Metrics

Metrics Loading ...

Author Biography

Jayakrishnan Thayyil, Department of Community Medicine, KMCT Medical College, Calicut, Kerala, India

Professsor & Head UNESCO Bioethics Chair

Department Of Community Medicine
Government Medical College.

References

World Health Organization. Novel coronavirus (2019-nCoV): situation report, 10. Available at: https://apps.who.int/iris/handle/10665/330775. Accessed on July 17 2021.

Iuliano AD, Chang HH, Patel NN, Threlkel R, Kniss K, Reich J et al. Estimating Under-recognized COVID-19 Deaths, United States, March 2020-May 2021 using an Excess Mortality Modelling Approach. Lancet Regional Heal-Am. 2021;100019.

Dhama K, Khan S, Tiwari R, Sircar S, Bhat S, Malik YS et al. Coronavirus Disease 2019-COVID-19. Clin Microbiol Rev. 2020;33(4):e00028-20.

Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207.

Carbone M, Lednicky J, Xiao SY, Venditti M, Bucci E. Coronavirus 2019 Infectious Disease Epidemic: Where We Are, What Can Be Done and Hope For. J Thorac Oncol. 2021;16(4):546-71.

John Hopkins University. Mortality analyses. Available at: https://coronavirus.jhu.edu/data/ mortality. Accessed on December 14 2020.

World Health Organization. International Guidelines for certification and classification (coding) of COVID 19 as cause of death based on ICD, International statistical classification of diseases. 2020. Available at: https://www.who.int/ classifications/icd/Guidelines_Cause_of_Death_COVID-19.pdf. Accessed on September 14, 2022.

Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, Felix SE et al. Coronavirus disease 2019 case surveillance-United States, January 22-May 30, 2020. Morbidity and Mortality Weekly Report. 2020;69(24):759.

Levin AT, Hanage WP, Owusu-Boaitey N, Cochran KB, Walsh SP, Meyerowitz-Katz G. Assessing the age specificity of infection fatality rates for COVID-19: systematic review, meta-analysis, and public policy implications. Eur J Epidemiol. 2020;35(12):1123-38.

Ward H. Antibody prevalence for SARS-CoV-2 following the peak of the pandemic in England: REACT2 study in 100,000 adults. Medrxiv. 2020.

Kansara N, Nandapurkar AB, Maniyar R, Yadav AK. Prediction of mortality by age andmulti-morbidities among confirmed COVID-19 patients: Secondary analysis of surveillance data in Pune, Maharashtra, India. Indian J Public Health. 2021;65(1):64-6.

Laxminarayan R, Wahl B, Dudala SR. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science. 2020:abd7672.

Smriti M. The corona virus is most deadly if you are old and male. Nature. 2020;585(9):16-7.

Jain VK, Iyengar KP, Vaishya R. Differences between First wave and Second wave of COVID-19 in India. Diabetes Metab Syndr. 2021;15(3):1047-8.

Asirvatham ES, Sarman CJ, Saravanamurthy SP, Mahalingam P, Maduraipandian S, Lakshmanan J. Who is dying from COVID-19 and when? An Analysis of fatalities in Tamil Nadu, India. Clin Epidemiol Glob Health. 2021;9:275-9.

Anand VV, Yogaraj GA, Raj PP. A Cross-sectional Study on Coronavirus Disease-19 Deaths Without Any Known Comorbidities In Tamil Nadu, 2020. Ann Community Health. 2021;9(2):34-9.

Wenham C, Smith J, Morgan R. COVID19: The gendered impacts of the outbreak. Lancet Publ Group. 2020;395:8468.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. lancet. 2020;395(10229):1054-62.

Public Health England. Seasonal influenza vaccine uptake in GP patients: winter season 2018 to 2019. Available at: https://www.gov.uk/government/ statistics/seasonal-flu-vaccine-uptake-in-gp-patients-winter-2018-to-2019.

Elezkurtaj S, Greuel S, Ihlow J. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep. 2021;11:4263.

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE et al. Factors associated with COVID-19-related death using Open SAFELY. Nature. 2020;584(7821):430-6.

Lewnard JA, Liu VX, Jackson ML, Schmidt MA, Jewell BL, Flores JP et al. Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study. BMJ. 2020;369.

“Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)” (World Health Organization, 2020. Available at: www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Accessed on September 14, 2022.

Veeranna CH, Rani S. Cause of Death Certification in COVID-19 Deaths. Indian J Crit Care Med. 2020;24(9):863-7.

Charles O, Hixenbaugh M. A spike in people dying at home suggests coronavirus deaths in Houston may Be higher than reported. NBC News. 2020.

Shi S, Qin M, Shen B. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5:802-10.

Baldi E, Sechi GM, Mare C, Canevari F, Brancagilone A. Out-of-hospital cardiac arrest during the COVID-19 outbreak in Italy. N Engl J Med. 2020;383:496-8.