Clinical Characteristics and Factors Associated with Mortality of Patients with COVID-19 at Bussarakham Field Hospital: Thailand

Authors

  • Kittisak Agsornwong Preventive Medicine (Public Health), Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi 11000, Thailand.
  • Thotsaporn Morasert Pulmonary and Critical Care Medicine, Department of Internal Medicine, Surat Thani Hospital, Surat Thani 84000, Thailand.
  • Kornkrit Limsommut Public Health Medicine, Health Administration Division, Nonthaburi 11000, Thailand.
  • Phongsak Nitikaroon Critical Care Medicine, Department of Anesthesiology, Prapokklao Hospital, Chanthaburi 22000, Thailand.
  • Osaree Akaraborworn Critical Care Medicine, Department of Surgery, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
  • Jintana Srisompong Infectious Medicine, Department of Internal Medicine, Surat Thani Hospital, Surat Thani 84000, Thailand.
  • Direk Deesiri Preventive Medicine (Public Health), Department of Orthopedics, Pranangklao Hospital, Nonthaburi 11000, Thailand.
  • Kavalin Chuencharoensuk Health Administration Division, Nonthaburi 11000, Thailand.
  • Kanchanat Sangnak Health Administration Division, Nonthaburi 11000, Thailand.
  • Nitipatana Chierakul Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
  • Sopon Iamsirithaworn Department of Disease Control, Ministry of Public Health, Nonthaburi 11000, Thailand.

DOI:

https://doi.org/10.31584/jhsmr.2023975

Keywords:

COVID-19, factors, field hospital, mortality, Thailand

Abstract

Objective: During the third and fourth wave of the coronavirus disease 2019 (COVID-19); from April to September 2021 all hospitals in Bangkok Metropolitan Region reached surge capacity. Hence, Bussarakham Field Hospital (BH) was established to address this crisis. This study aimed to identify factors associated with in-hospital mortality in BH, Thailand’s largest field hospital for COVID-19.
Material and Methods: This was a retrospective study among all adult COVID-19 patients, confirmed by Reverse transcription-polymerase chain reaction (RT-PCR), admitted to BH from May to September 2021. The data on potential factors associated with treatment outcome (survived or deceased) were retrieved from the standard admission records for COVID-19 and discharge summaries. A multivariable logistic regression model was performed to explore factors associated with in-hospital mortality.
Results: A total of 18,173 patients were enrolled with death occurring in 224 patients during hospitalization. The mortality rate was 1.23%. The adjusted odds ratios (95% CIs) of male gender, aged >65 years, having diabetes mellitus, pregnancy, lower respiratory tract (LRT) symptoms at initial presentation, pneumonia with hypoxemia at initial presentation were: 1.91 (1.35, 2.70), 5.37 (3.75, 7.69), 2.55 (1.75, 3.71), 6.40 (2.15, 19.08), 2.81 (1.88, 4.19) and 3.11 (1.35, 7.15) respectively.
Conclusion: The pre-existing factors that increased mortality risk consisted of elderly age, diabetes mellitus and pregnancy. In addition, patients who presented with LRT symptoms or pneumonia with hypoxemia also had a higher mortality risk. Therefore, clinical triage should be carefully performed in field hospitals during any pandemic.

References

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-33.

WHO. WHO Director-General’s opening remarks at the media briefing on COVID-19-11 March 2020. [homepage on the Internet]. Geneva: WHO; 2020 [cited 30 April 2022]; Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-mediabriefing-on-covid-19---11-march-2020.

Rajatanavin N, Tuangratananon T, Suphanchaimat R, Tangcharoensathien V. Responding to the COVID-19 second wave in Thailand by diversifying and adapting lessons from the first wave. BMJ Glob Health 2021;6:e006178.

Ong SWX, Chiew CJ, Ang LW, Mak TM, Cui L, Toh M, et al. Clinical and virological features of SARS-CoV-2 variants of concern: a retrospective cohort study comparing B.1.1.7 (Alpha), B.1.315 (Beta), and B.1.617.2 (Delta). Clin Infect Dis 2022;75:e1128-e36.

Theerawit P, Morasert T, Sutherasan Y. Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis. J Crit Care 2016;36:246-51.

Hasan MN, Haider N, Stigler FL, Khan RA, McCoy D, Zumla A, et al. The global case-fatality rate of COVID-19 has been declining since May 2020. Am J Trop Med Hyg 2021;104:2176-84.

Berenguer J, Ryan P, Rodríguez-Baño J, Jarrín I, Carratalà J, Pachón J, et al. Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain. Clin Microbiol Infect 2020;26:1525-36.

Chilimuri S, Sun H, Alemam A, Mantri N, Shehi E, Tejada JSDLHD, et al. Predictors of mortality in adults admitted with COVID-19: Retrospective Cohort Study from New York City. West J Emerg Med 2020;21:779-84.

Lee LY, Cazier JB, Angelis V, Arnold R, Bisht V, Campton NA, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet 2020;395:1919-26.

Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis 2021;21:855.

Liang W, Liang H, Ou L, Chen B, Chen A, Li C, et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Intern Med 2020;180:1081-9.

Bertsimas D, Lukin G, Mingardi L, Nohadani O, Orfanoudaki A, Stellato B, et al. COVID-19 mortality risk assessment: an international multi-center study. PLoS One 2020;15:e0243262.

Minnai F, De Bellis G, Dragani TA, Colombo F. COVID-19 mortality in Italy varies by patient age, sex and pandemic wave. Sci Rep 2022;12:4604.

Klang E, Kassim G, Soffer S, Freeman R, Levin MA, Reich DL. Severe obesity as an independent risk factor for COVID-19 mortality in hospitalized patients younger than 50. Obesity (Silver Spring) 2020;28:1595-9.

Hernández-Galdamez DR, González-Block M, Romo-Dueñas DK, Lima-Morales R, Hernández-Vicente IA, Lumbreras-Guzmán M, et al. Increased risk of hospitalization and death in patients with COVID-19 and pre-existing noncommunicable diseases and modifiable risk factors in Mexico. Arch Med Res 2020;51:683-9.

Yan L, Zhang H-T, Goncalves J, Xiao Y, Wang M, Guo Y, et al. An interpretable mortality prediction model for COVID-19 patients. Nat Mach Intell 2020;2:283-8.

Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform 2019;95:103208.

Department of Medical Services of Thailand. Clinical Practice Guidelines for the Diagnosis, Management and Infectious Control of COVID-19, Updated version: 6 May 2021. [homepage on the Internet]. Nonthaburi: Department of Medical Services of Thailand; 2021 [cited 4 May 2022]. Available from: https://covid19.dms.go.th/Content/Select_Landding_page?contentId=129.

Small E, Clements CM. Defining fever: likelihood of infection diagnosis as a function of body temperature in the emergency department. Crit Care 2014;18(Suppl 2):P42.

Johnston R, Jones K, Manley D. Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual Quant 2018;52:1957-76.

Department of Disease Control Thailand. COVID-19, Thailand Situation 20 September 2021. [homepage on the Internet] Nonthaburi: Department of Disease Control Thailand; 2021 [cited 20 Apr 2022]. Available from: https://ddc.moph.go.th/viralpneumonia/file/situation/situation-no626-200964.pdf.

Wang W, Xin C, Xiong Z, Yan X, Cai Y, Zhou K, et al. Clinical characteristics and outcomes of 421 patients with coronavirus disease 2019 treated in a mobile cabin hospital. Chest 2020;158:939-46.

Aumpan N, Vilaichone RK, Ratana-Amornpin S, Teerakapibal S, Toochinda P, Witoonchart G, et al. Antiviral treatment could not provide clinical benefit in management of mild COVID-19: A Retrospective Experience from Field hospital. J Infect Public Health 2021;14:1206-11.

Magro B, Zuccaro V, Novelli L, Zileri L, Celsa C, Raimondi F, et al. Predicting in-hospital mortality from coronavirus disease 2019: a simple validated app for clinical use. PLoS One 2021;16:e0245281.

Rossman H, Meir T, Somer J, Shilo S, Gutman R, Ben Arie A, et al. Hospital load and increased COVID-19 related mortality in Israel. Nat Commun 2021;1:1904.

Corona G, Pizzocaro A, Vena W, Rastrelli G, Semeraro F, Isidori AM, et al. Diabetes is most important cause for mortality in COVID-19 hospitalized patients: Systematic review and metaanalysis. Rev Endocr Metab Disord 2021;22:275-96.

Caruso P, Longo M, Esposito K, Maiorino MI. Type 1 diabetes triggered by covid-19 pandemic: a potential outbreak? Diabetes Res Clin Pract 2020;164:108219.

RECOVERY Collaborative Group HP, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, et al. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med 2021;384:693-704.

Muhammad A, Hakim M, Afaq S, Khattak FA, Shakireen N, Jawad M, et al. Diabetic ketoacidosis amongst patients with COVID-19: A retrospective chart review of 220 patients in Pakistan. Endocrinol Diabetes Metab 2022;5:e00331.

Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: characteristics of symptomatic women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status-United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641-7.

Koçak Tufan Z, Kayaaslan B, Mer M. COVID-19 and Sepsis. Turk J Med Sci 2021;51(SI-1):3301-11.

Buetti N, Wicky PH, Le Hingrat Q, Ruckly S, Mazzuchelli T, Loiodice A, et al. SARS-CoV-2 detection in the lower respiratory tract of invasively ventilated ARDS patients. Crit Care 2020;24:610.

Fang D, Pan S, Li Z, Yuan T, Jiang B, Gan D, et al. Large-scale public venues as medical emergency sites in disasters: lessons from COVID-19 and the use of Fangcang shelter hospitals in Wuhan, China. BMJ Glob Health 2020;5:e002815.

Chen S, Zhang Z, Yang J, Wang J, Zhai X, Bärnighausen T, et al. Fangcang shelter hospitals: a novel concept for responding to public health emergencies. Lancet 2020;395:1305-14.

Quanjel MJR, van Holten TC, Gunst-van der Vliet PC, Wielaard J, Karakaya B, Söhne M, et al. Replication of a mortality prediction model in Dutch patients with COVID-19. Nat Mach Intell 2021;3:23-4.

Dupuis C, De Montmollin E, Neuville M, Mourvillier B, Ruckly S, Timsit JF. Limited applicability of a COVID-19 specific mortality prediction rule to the intensive care setting. Nat Mach Intell 2021;3:20-2.

Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis 2022;22:1293-302.

Downloads

Published

2023-11-20

How to Cite

1.
Agsornwong K, Morasert T, Limsommut K, Nitikaroon P, Akaraborworn O, Srisompong J, Deesiri D, Chuencharoensuk K, Sangnak K, Chierakul N, Iamsirithaworn S. Clinical Characteristics and Factors Associated with Mortality of Patients with COVID-19 at Bussarakham Field Hospital: Thailand. J Health Sci Med Res [Internet]. 2023 Nov. 20 [cited 2024 Nov. 22];42(1):e2023975. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/267172

Issue

Vol. 42 No. 1 (2024): Jan-Feb

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Crossref
Scopus
Google Scholar
Europe PMC