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Public health
Original research
Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study
  1. Rosemarie de Souza1,
  2. Sharayu Mhatre2,
  3. Burhanuddin Qayyumi3,
  4. Garvit Chitkara4,
  5. Tushar Madke1,
  6. Mohan Joshi1,
  7. Ramesh Bharmal1,
  8. D S Asgaonkar1,
  9. Prem Lakhani1,
  10. Sudeep Gupta5,6,
  11. Pankaj Chaturvedi3,
  12. Rajesh Dikshit7,
  13. Rajendra Badwe8
  1. 1Department of Medicine, BYL Nair Charitable Hospital, Mumbai, India
  2. 2Centre for Cancer Epidemiology, Tata Memorial Centre, Navi Mumbai, India
  3. 3Head and Neck Services, Tata Memorial Hospital, Mumbai, India
  4. 4Department of Breast Oncology, Tata Memorial Hospital, Mumbai, India
  5. 5Medical Oncology, Tata Memorial Centre, Mumbai, India
  6. 6Medical Oncology, Homi Bhabha National Institute, Mumbai, India
  7. 7Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
  8. 8Surgical Oncology, Tata Memorial Centre, Mumbai, India
  1. Correspondence to Dr Rosemarie de Souza; drrosemariedesouza{at}gmail.com

Abstract

Objective To understand the outcome of hospitalised patients from Mumbai City, which had the highest number of COVID-19 cases in India.

Design Observational study with follow-up.

Setting Data extraction from medical records of patients with COVID-19 admitted to Nair Hospital & TN Medical College, Mumbai, India.

Participants 689 patients with COVID-19 were admitted in the hospital from 26 March 2020 to 11 May 2020.

Primary and secondary outcome measures In-hospital mortality; joint effect of comorbidity and age on the risk of dying.

Results A total of 689 patients (median age 44 years) admitted with RT-PCR-confirmed COVID-19 were included in the study. Of these, 77.36% of patients were discharged alive while 22.64% died. 11.61% required some kind of oxygen support while 2.8% of patients required intensive care unit admissions. Older age (HR 2.88, 95% CI 2.09 to 3.98), presence of comorbidities (HR 2.56, 95% CI 1.84 to 3.55), history of hypertension (HR 3.19, 95% CI 1.67 to 6.08), and presence of symptoms at the time of admission (HR 3.21, 95% CI 1.41 to 7.26) were associated with increased risk of in-hospital mortality. Treatment with a combination of azithromycin with hydroxychloroquine, antiviral or steroid compared with no treatment did not alter the disease course and in-hospital mortality. The combined effect of old age and presence of comorbid conditions was more pronounced in women than men.

Conclusions In-hospital patients were younger, less symptomatic with lesser need of ventilators and oxygen support as compared with many western countries.

Trial registration Not applicable (observational study, not a clinical trial).

  • epidemiology
  • public health

Data availability statement

Data are available upon reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2020-042943

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors RdS, PC, SG, RD, RB, GC and SM were involved in the conceptualisation of the study, RdS, BQ, PL and TM were involved in the acquisition of the data and conduct of the study. SM performed the statistical analysis. RdS, PC, SG, RD, RB, GC, SM, MJ and DSA were involved in the interpretation of the data. All authors contributed to drafting this manuscript, with RdS taking a lead role; she is also the guarantor of the manuscript. All authors gave intellectual input to improve the manuscript, and have read and approved the final version.

    • Funding Tata Memorial Centre, Mumbai.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.