Clinical features and outcomes of COVID-19 patients admitted at a tertiary hospital in Cebu City, Philippines

Abstract

Introduction: The World Health Organization has categorized coronavirus disease 2019 (COVID-19) into mild, moderate, severe, and critical illness severities to guide clinical decision-making. This study aimed to describe the clinical characteristics, complications, and outcomes of COVID-19 patients by illness severity, at a tertiary healthcare center in Cebu City, Philippines.

Methodology: This was a retrospective, observational cohort study that examined clinical information of patients with confirmed COVID-19 infection admitted between March and September 2020.

Results: Data from 901 admitted patients were analyzed, with 185 (20.5%) classified as mild, 429 (47.6%) as moderate, 223 (24.7%) as severe, and 64 (7.1%) as critical. The frequency of male gender, advancing age, co-morbidities (hypertension and diabetes mellitus), inflammatory marker elevation (LDH, CRP, Ferritin, Procalcitonin), and elevated mean white blood cell counts with relative neutrophilia and lymphopenia increased with COVID severity. Severe and critical cases of COVID presented with more diffuse lung involvement in chest radiographs and abnormal electrocardiographic patterns such as ischemic changes, PVCs, PACs, and sinus tachycardia. The most common complications on admission were ARDS (10.9%), AKI (10.1%), shock (6.6%), and cardiac arrest (6.3%). Mortality rates were highest in critical cases (82.8%). Severe and critical COVID-19 cases were predominant on final disposition, rising to 62.5% of the study population from 32.1% on admission.

Conclusions: This study highlights key differences in clinical characteristics, complications, and outcomes between illness severities. Risk prediction models are needed for disease progression and poor outcomes.