Clinical course and outcome of patients with COVID-19 in Mumbai City: an observational study

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.