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