Case Fatality in COVID-19; a District Perspective

Objectives: To determine the case fatality rate of COVID-19 by evaluating the data of Patients died due to COVID-19.

Materials and Methods: A total of 243 patients with PCR done from the government designated Public health research laboratory of Khyber Medical University were included in a cross sectional comparative study. Chi-square test, risk analysis, probability testing and survival analysis using Kaplan Meir test was done on data sheet prepared in SPPS version 25 in accordance with the objectives of the study.

Results: Out of total 243 patients, 165 (67.90%) were negative by PCR testing and 78 (32.09%) were COVID-19 positive. The Mean age with SD was 36+17 years. Out of total 178 (73.3%) were males and 65 (26.7%) were females. 34 (13.99%) had age more than 55 years, where 4/5 (80%) of the deaths were recorded. The relationship of an increase in age with rate of mortality was statistically significant (p=0.001). The over all probability of death in our population in age more than 55 years is 24 times higher (OR=24,95CI: 2.6-221.24) with relative risk of 1.1 (rr=1.11, 95CI:1-1.24). Mortality rate was 6.41%. A significant correlation of mortality with case positivity (p=0.003) with relative risk of 1.06 (rr=1.06, 95CI: 1.008-1.13). Three out of 5 of the COVID-19 positive deceased had cardiac diseases and 2/5 had respiratory disease/viral pneumonia. Using Kaplan Meir test, the survival graphs of COVID positive vs COVID negative cases had similar pattern that shows the mortality rate in the positive cases was not solely due to COVID-19, but has aggravated the pre-existing illness to cause death.

Conclusion: The mortality rate was 6.41%, more in age>55 years (80%) and almost all the deceased had chronic co-morbid conditions like CAD, CCF and COPD at time of presentation. COVID-19 is not the sole killer, it contributes killing in immune-deficient patients.