COVID-19 severity: Studying the clinical and demographic risk factors for adverse outcomes

PLoS One. 2021 Aug 11;16(8):e0255999. doi: 10.1371/journal.pone.0255999. eCollection 2021.

Abstract

Background: The primary goal of the presented cross-sectional observational study was to determine the clinical and demographic risk factors for adverse coronavirus disease 2019 (COVID-19) outcomes in the Pakistani population.

Methods: We examined the individuals (n = 6331) that consulted two private diagnostic centers in Lahore, Pakistan, for COVID-19 testing between May 1, 2020, and November 30, 2020. The attending nurse collected clinical and demographic information. A confirmed case of COVID-19 was defined as having a positive result through real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens.

Results: RT-PCR testing was positive in 1094 cases. Out of which, 5.2% had severe, and 20.8% had mild symptoms. We observed a strong association of COVID-19 severity with the number and type of comorbidities. The severity of the disease intensified as the number of comorbidities increased. The most vulnerable groups for the poor outcome are patients with diabetes and hypertension. Increasing age was also associated with PCR positivity and the severity of the disease.

Conclusions: Most cases of COVID-19 included in this study developed mild symptoms or were asymptomatic. Risk factors for adverse outcomes included older age and the simultaneous presence of comorbidities.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • COVID-19 / pathology
  • COVID-19 / virology
  • Comorbidity
  • Demography
  • Diabetes Complications / pathology
  • Humans
  • Hypertension / complications
  • Pakistan / epidemiology
  • RNA, Viral / analysis
  • Real-Time Polymerase Chain Reaction
  • Risk Factors
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification
  • Severity of Illness Index

Substances

  • RNA, Viral

Grants and funding

This work was financially supported by the Social Science Research Council under Rapid-Response Grants on Covid-19 and University of the Punjab, Lahore, Pakistan. Grant recipient: NZ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.