Epidemiology and Comparative Treatment Outcomes of patients with COVID 19 infection in Phra Nakhon Si Ayutthaya Hospital: A single center retrospective cohort study

Abstract

Background: COVID-19 infection is still a national problem of pandemic disease in Thailand due to a lack of effective therapy and inadequate vaccination. There were many times of outbreaks. However there is still very little study about epidemiology and treatment outcomes of COVID-19 infection in Thailand and by far there has been no study in Phra Nakhon Si Ayutthaya Hospital before. Therefore this study was conducted to collect data and fine the percentage and factors  associated with mortality, length of stay, treatment and treatments outcome of COVID-19 infection in Phra Nakhon Si Ayutthaya Hospital.

Objective: To study the percentage of COVID-19 infection from all admitted patients in Phra Nakhon Si Ayutthaya in 4-month duration and compare treatment outcomes of COVID-19 pneumonia and non-pneumonia groups in patients with COVID-19 infection admitted in Phra Nakhon Si Ayutthaya Hospital between August to November 2021.

Method: This study is a retrospective cohort study that collected data from patients aged at least 18 years old who were admitted in Phra Nakhon Si Ayutthaya Hospital from August to November 2021, and diagnosed with COVID-19 infection by RT-PCR COVID-19 method. Epidemiologic and clinical data including gender, age, principal diagnosis, comorbidities, length of stay, treatments, outcome and related laboratory results were collected and analyzed using appropriate statistics to identify the percentage, mortality rate and compared treatment outcomes between pneumonia and non-pneumonia groups.

Result: Patients aged above 18 years old and diagnosed with COVID-19 infection who were admitted in Phra Nakhon Si Ayutthaya Hospital from August to November 2021 were 313 cases. After excluding patients who were not fit in inclusion criteria, a total of 273 patients were studied. There were 206 patients with COVID-19 pneumonia (75.5%), with mean age of 63 years. Of the total cases, there were 98 male cases (47.6%). The median length of stay is 15 days and the mortality rate is 30.1% (62 cases). There were 67 patients with non-pneumonia COVID-19 infection (24.5%), with mean age of 40 years, composed of 29 male cases (43.3%), a median length of stay of 15 days and a mortality rate of 1.5% (1 case). The study found that length of stay and mortality rate between pneumonia and non-pneumonia groups are statistical significantly difference.

          This study showed that factors associated with the mortality rate are elderly, diabetes mellitus, heart disease, chronic obstructive pulmonary disease, chronic kidney disease and cerebrovascular disease. Multivariate analysis showed that the mortality rate in pneumonia groups was higher than non-pneumonia group 15.45 times.

Conclusion: The percentage of COVID-19 infection in Phra Nakhon Si Ayutthaya Hospital in 4 months is 12.73 and a significant difference of treatment outcome between COVID-19 pneumonia and non-pneumonia groups was found, including mortality rate and length of stay. When considered factors: elderly and some comorbidities, it is found that mortality rate in pneumonia group was higher than non-pneumonia group 15.45 times.