- Clinical and epidemiological characteristics of COVID-19 mortality cases admitted to MSD hospitals, Kingdom of Saudi Arabia, between March and July 2020, stratified by cause of death from COVID-19 (N=224).
| Clinical characteristics | Direct (n=164) | Indirect (n=60) n (%) | Total (N=224) | P-value* |
|---|---|---|---|---|
| Age, mean±SD | 70.32±14.17 | 67.87±16.00 | 69.66±14.68 | 0.365‡ |
| DNR | 75 (45.7) | 33 (55.0) | 108 (48.2) | 0.219 |
| Full code | 89 (54.3) | 27 (45.0) | 116 (51.8) | |
| Resuscitated | 84 (51.2) | 25 (41.7) | 109 (48.7) | 0.205 |
| Intubated | 114 (69.5) | 42 (70.0) | 156 (69.6) | 0.944 |
| Any symptoms§ | 158 (97.5) | 52 (86.7) | 210 (94.6) | 0.001†† |
| Symptoms** | ||||
| Shortness of breath | 125 (76.2) | 40 (66.7) | 165 (73.7) | 0.151 |
| Fever | 120 (73.2) | 34 (56.7) | 154 (68.8) | 0.018†† |
| Cough | 113 (68.9) | 32 (53.3) | 145 (64.7) | 0.031†† |
| Confusion | 21 (12.8) | 11 (18.3) | 32 (14.3) | 0.295 |
| Diarrhea | 9 (5.5) | 8 (13.2) | 17 (7.6) | 0.050 |
| Chest pain | 11 (6.7) | 1 (1.7) | 12 (5.4) | 0.138 |
| Desaturation (SpO2<94%)** | 87 (53.0) | 26 (43.3) | 113 (50.4) | 0.198 |
| PPD/QuantiFERON test | ||||
| Positive | 16 (10.7) | 11 (19.6) | 27 (13.2) | 0.201 |
| Negative | 133 (89.3) | 45 (80.4) | 178 (86.8) | |
| Total | 149 (100.0) | 56 (100.0) | 205 (100.0) | |
| Chest X-ray§,** | ||||
| Normal | 12 (3.4) | 6 (4.5) | 18 (3.7) | 0.957 |
| Bilateral infiltration | 114 (32.5) | 42 (31.6) | 156 (32.2) | |
| Infiltrate/opacities | 122 (34.8) | 47 (35.3) | 169 (34.9) | |
| Pleural effusion | 103 (29.3) | 38 (28.6) | 141 (29.2) | |
| Total | 351 (100.0) | 133 (100.0) | 484 (100.0) | |
| Transfusion history | 37 (22.6) | 29 (48.3) | 66 (29.5) | <0.001†† |
| Type of transfusion history§ | ||||
| PRBCs | 32 (45.1) | 25 (45.5) | 57 (45.2) | 0.793 |
| FFP | 15 (21.1) | 15 (27.3) | 30 (23.8) | |
| Cryoprecipitate | 8 (11.3) | 3 (5.5) | 11 (8.7) | |
| Platelets | 10 (14.1) | 8 (14.5) | 18(14.3) | |
| Intravenous immunoglobulin | 6 (8.5) | 4 (7.3) | 10 (7.9) | |
| Total | 71 (100.0) | 55 (100.0) | 126 (100.0) | |
| Was death anticipated? | 146 (89.0) | 47 (78.3) | 193 (86.2) | 0.040†† |
| COVID-19 PCR at time of death | ||||
| Positive | 138 (89.6) | 41 (77.4) | 179 (86.5) | 0.032†† |
| Negative | 16 (10.4) | 12 (22.6) | 28 (13.5) | |
| Total | 179 (100.0) | 28 (100.0) | 207 (100.0) | |
| Co-morbidities | ||||
| Diabetes | 122 (74.4) | 43 (71.7) | 165 (73.7) | 0.682 |
| Hypertension | 117 (71.3) | 39 (65.0) | 156 (69.6) | 0.361 |
| Chronic kidney failure | 40 (24.4) | 16 (26.7) | 56 (25.0) | 0.728 |
| Coronary artery disease | 39 (23.8) | 13 (21.7) | 52 (23.2) | 0.740 |
| Heart failure | 16 (9.8) | 9 (15.0) | 25 (11.2) | 0.270 |
| Asthma | 19 (11.6) | 5 (8.3) | 24 (10.7) | 0.486 |
| Multiple sclerosis | 19 (11.6) | 4 (6.7) | 23 (10.3) | 0.283 |
| Atrial fibrillation | 14 (8.5) | 8 (13.3) | 22 (9.8) | 0.285 |
| On dialysis | 14 (8.5) | 3 (5.0) | 17 (7.6) | 0.376 |
| Ischemic stroke | 13 (7.9) | 3 (5.0) | 16 (7.1) | 0.451 |
| Thyroid dysfunction | 11 (6.7) | 5 (8.3) | 16 (7.1) | 0.676 |
| Dementia | 4 (2.4) | 8 (13.3) | 12 (5.4) | 0.001†† |
| COPD | 6 (3.7) | 1 (1.7) | 7 (3.1) | 0.448 |
| Obesity | 3 (1.8) | 2 (3.3) | 5 (2.2) | 0.500 |
| Co-infection | ||||
| Positive | 37 (23.1) | 27 (46.6) | 64 (29.4) | <0.001†† |
| Negative | 123 (76.9) | 31 (53.4) | 154 (70.6) | |
| Total | 160 (100.0) | 58 (100.0) | 218 (100.0) | |
| If co-infection positive§ | ||||
| Bacterial | 19 (47.5) | 17 (65.4) | 36 (54.5) | 0.186 |
| Fungal | 4 (10.0) | 3 (11.5) | 7 (10.6) | |
| Viral | 17 (42.5) | 6 (23.1) | 23 (34.8) | |
| Total | 40 (100.0) | 26 (100.0) | 66 (100.0) | |
| Complications§ | ||||
| ARDS | 116 (75.8) | 24 (64.2) | 150 (72.8) | 0.100 |
| Shock | 61 (39.9) | 32 (60.4) | 93 (45.1) | 0.010†† |
| Acute kidney injury | 67 (43.8) | 23 (43.4) | 90 (43.7) | 0.960 |
| Sepsis/septic shock | 54 (35.3) | 24 (45.3) | 78 (37.9) | 0.196 |
| Secondary infections | 20 (13.1) | 9 (17.0) | 29 (14.1) | 0.481 |
| Cardiogenic shock | 6 (3.9) | 8 (15.1) | 14 (6.8) | 0.005†† |
| Heart failure | 7 (4.6) | 6 (11.3) | 13 (6.3) | 0.082 |
| Acute cardiac injury | 11 (7.2) | 1 (1.9) | 12 (5.8) | 0.155 |
| Total | 153 (100.0) | 53 (100.0) | 206 (100.0) | |
COVID-19: coronavirus disease-19, MSD: Armed Forces Medial Services, DNR: do-not-resuscitate, PPD/QuantiFERON: Purified protein derivative/QuantiFERON, PRBCs: packed red blood cells, FFP: fresh frozen plasma, PCR: polymerase chain reaction, COPD: chronic obstructive pulmonary disease, ARDS: acute respiratory distress syndrome. *Chi-square test, ‡T-test. §Reported one or more co-infection, chest X-ray, type of transfusion history and complications, **at day of presentation. ††p<0.05 was considered significant