‘COVID-19 led to cardiac arrest in elderly, co-morbid patients’

What were the clinical characteristics of the cohort?

A majority of Covid-19 patients at the hospital were male (129) while 71 were female. Sixty per cent of the cohort was aged below 60 years old and 43 per cent (86) of the cohort had an underlying co-morbid condition, with hypertension being the dominant co-morbid condition (in 61 of the 200) followed by diabetes mellitus (40 of the 200). Twenty-three of the 86 high-risk patients had more than one co-morbidity. Only 35 patients of the 200 did not require any oxygen support.

What are the death-related characteristics observed?

Altogether 27 deceased patients complained of shortness of breath, comprising nearly 80 per cent of case fatalities. A total of 93 patients complained of shortness of breath among the 166 who survived, which is around 56 per cent of the survivor cohort. ICU admission, too, was seen to be higher — 17 among the 34 who died compared to seven among the 166 who lived. Clinical markers such as median C-reactive protein, D-Dimer and neutrophil-lymphocyte ratio were significantly higher among the deceased patients compared to the survivors.

Among the 34 Covid-19 patients who died, cardiac arrest was the leading cause of death in 24 (70.58 per cent), followed by severe ADRS (35 per cent), sepsis with multi-organ dysfunction and pulmonary embolism.

What have previous studies established with respect to second wave patient characteristics?

The Kheda hospital study is more or less in line with a largescale pan-India study conducted by ICMR last year, comparing first and second wave patient profiles based on data collected under the National Clinical Registry for Covid-19 (NCRC). The mortality is slightly higher in the Kheda hospital compared to the ICMR study for the second wave (17 per cent in the Gujarat hospital in the cohort, compared to 13 per cent in the ICMR study).