PESHAWAR: Seven more succumbed to coronavirus in Khyber Pakhtunkhwa on Sunday as a new study showed that underlying health conditions, oxygen saturation and breathing difficulty among the Covid-19 patients at the hospitals were main reasons of high mortality rate in the province.

Other reason cited for the high case fatality rate (CFR) among the Covid-19 patients in the province is the late arrival and short stay of patients at health facilities.

The study conducted by a team, having Khyber Medical University Vice-chancellor Prof Ziaul Haq as principal author, says that demographic, clinical and laboratory characteristics could potentially help clinicians and policymakers before onset of second wave of the pandemic in the country.

The co-authors of the study included Mohammad Shahzad, Maria Ishaq Khattak, Sheraz Fazid, Naeemullah, Akhtar Sherin, Naeemul Haq, Asif Izhar, Umer Farooq, Nizam Mohammad Darwesh, Mohammad Asim, Miangul Ali Gohar, Ambar Ashraf, Saad Khattak, Sadia Ashraf, Shehzad Akbar, Fawadullah, Mohammad Ismail, Amir Amanullah and Azizul Hassan Amir.

Study cites oxygen saturation and breathing difficulty as other reasons

As a health department report said that the province’s death toll from the virus rose to 1,609 and incidence to 57,467 with 252 more patients, the study found that 60.9 per cent of the deceased persons had comorbidities with hypertension being the commonest ailment among those dying at the hospitals.

Two each coronavirus patients died in Peshawar, Swat, Abbottabad and one in Kohat. With 376 more recoveries, the province has so far sent home 51,928 patients back home after they recovered from the pandemic. The number of active cases is 3,930 in the province.

The first multicenter study of patients in the province provides new insights on Covid-19 pandemic which has evolved into consequent second wave in various regions of the globe.

Prof Ziaul Haq told Dawn that the information was gathered from 179 patients at the designated hospitals from the beginning of the pandemic till peak of its first wave.

The study suggests several risk factors associated with death among hospitalised patients including, old age, comorbidity, oxygen saturation and dyspnea on arrival and length of stay in hospital.

The study says that there are significantly higher odds of in-hospital death from Covid-19 among patients with multiple morbidities.

It is consistent with findings from other parts of the world. It recommends conducting stringent evaluation of the mortality associated risk factors and clinical follow-up of Covid-19 patients.

Prof Zia said that he was pleased the way the researchers, doctors and public health specialists came together quickly at the beginning of the pandemic and conducted the study.

This is the first ever large multi-centre study in KP, according to doctors.

These results are important because they show definitively that patients infected with the Covid-19 virus need to be closely monitored for oxygen saturation at home before hospitalisation. On arrival at hospitals, they need to be treated with extra care particularly in cases where comorbidities exist.

Prof Zia said that the patients received at hospitals with oxygen saturation below 90 are 9.6 times more were likely to die compared to those with higher oxygen saturation at arrival.

Patients with multi-morbidities were 3.2 times, and with dyspnoea (difficulty in breathing), are four times more likely to die as compared to the people having no comorbidities.

The patients with earlier admission to hospital are 20 per cent less likely to die than latecomers.

These evidence-based directions are necessary to inform the clinicians, public health workers and policymakers during the ongoing second wave of the pandemic.

Published in Dawn, December 28th, 2020