Clinical and Laboratory Predictors of Mortality in Patients With SARS-CoV-2 Infection in A Tertiary Care Center of Central Kerala, India - A Case control Study

Background: Since various studies indicate differences in the case fatality rate of SARS-CoV-2 in different settings, it is vital to elucidate the clinical and laboratory parameters. This would be helpful in identifying individuals who are susceptible to adverse outcomes, thereby targeting essential health interventions to resource poor settings. This study aimed to determine the clinical and laboratory predictors of mortality due to COVID-19. Materials & Methods: In this case control study, we included 162 adult inpatients who died due to COVID-19 from May 2020 to February 2021, as cases (n=81) and those discharged as controls (n=81). Demographic, clinical, treatment, and laboratory data was extracted from medical records and electronic database and compared between survivors and non-survivors. Univariate analysis and multivariable logistic regression methods were used to identify the risk factors associated with in-hospital death. Results: Comorbidities were present among 82 (50.6%) participants. Hypertension was the most common comorbidity 99(61.1%) followed by diabetes mellitus 92 (56.8%) and coronary artery disease 55(34%). Multivariable logistic regression model showed that cardiovascular disease (OR=5.80, 95%CI: 1.09–47.55, P=0.011), decreased oxygen saturation (OR=33.68, 95%CI: 2.81–403.80, P=0.006), elevated CRP (OR=1.16, 95%CI: 1.01–1.32, P=0.026), and serum creatinine (OR=3.26, 95%CI: 1.02–11.55, P=0.047) were the significant predictors of mortality. Conclusion: This study found that comorbidities such as CAD, elevated serum creatinine, elevated inflammatory markers, and decreased O2 saturation were independent predictors of mortality among COVID-19 patients.