COVID-19 Pneumonia: Epidemiology, Clinical Characteristics and Outcomes from a Developing Country. A Single Center Experience from Pakistan

Background: The first case of COVID-19 pneumonia was reported in Pakistan at the end of February 2020. In this single center study we report epidemiology, clinical, laboratory, and radiology findings, treatment and outcome of patients with COVID-19 pneumonia. Methods: This retrospective study was undertaken between 21st March to 15th May 2020 where 6712 persons were screened for exposure and symptoms of COVID-19 and 2715 was test by RT-PCR. In all 317 patients with confirmed COVID-19 were admitted. Data were retrieved from hospital electronic health records and analysis performed using SPSSv.20. Findings: COVID-19 positivity rate in general public was 24·9% and 38.6% in in-patients. A total of 317 patients were admitted in corona wards. Their mean age was 47·1±14·8 and 66·5% were males. Exposure or contact history was given by 43·2%. Median duration of symptoms was six days (IQR 3-8·7) with fever in 75·4%, cough in 59·0% and dyspnea in 59%. Co-morbids were hypertension in 27·1%, diabetes in 27·4%, ischemic heart disease in 6·0%, and 63 (19·9%) had ESRD. Disease was severe in 40·4%of patients with significantly increased inflammatory markers, CRP-H, ferritin, D-Dimer, NLR in 81-97%, bilateral infiltrates and ground glass opacity in 73·9% and complication ARDS in 71%, secondary infection in 24·3%, and multi-organ failure in 8·7%. The overall death rate was 16·1%, 30·4% in severe and 7·9% in non-severe disease. Interpretation: The COVID-19 infected a quarter of the tested population where majority had non-severe disease. Severe disease was associated with old age, high co-morbids and mortality. Funding Statement: This study was funded from institutional resources. RT-PCR Kits for COVID-19 testing and were provided by provincial government. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the Ethical Review Committee of the institute, Ref No: SIUT-ERC 2020/A-217.