At 42%, AIIMS study finds highest ICU mortality among 18-50 age group

AIIMS, Covid-19, Sepsis

A study by the All India Institute of Medical Sciences (AIIMS), New Delhi, suggested that patients under the age of 50 succumbed to Covid-19 more than those above 65, while it found Sepsis with multi-organ dysfunction as the most common cause of death.

The recent study published in the Indian Journal of Critical Care Medicine, authored by Dr Randeep Guleria and Dr Rajesh Malhotra, is a retrospective research of ICU Covid deaths in AIIMS that occurred a year ago. It covered adult deceased patients admitted from April 4 to July 24, 2020.

The study area looked at comorbidities, complications and causes of death.

“Very few studies have documented similar features of the deceased. This study was aimed to describe the clinico-epidemiological features and the causes of mortality of patients admitted in a dedicated Covid-19 centre in India,” it read.

It was revealed in the research that the ICU mortality went as high as 38 per cent, while it was recorded highest, at 42 per cent among the 18-50 years age group.

654 adult patients were admitted to ICU during the study period. Of them, 247 died and mortality was 37.7 per cent. Adult patients were further divided into age groups of 18-50, 51-65 and above 65. The study shows 42.1 per cent were between 18-50, 34.8 per cent from 51-65 and 23.1 per cent above 65.

“Among the adult deceased, 65.9 per cent were males with a median age of 56 years (between 41.5-65) and 94.7 per cent had one or more comorbidities,” the study said. It was found that the most common cause of death was sepsis with multi-organ failure (55.1 per cent) followed by severe acute respiratory distress syndrome (ARDS) (25.5 per cent).

The research charted out underlying hypertension as the most frequent comorbidity in 107 (43.32 per cent) patients, followed by diabetes in 86 (34.82 per cent) and chronic kidney disease in 51 (20.6 per cent). Among patients with other ailments, 39 per cent had one comorbidity, 27.5 per cent had two, 21 per cent had three and 6 per cent had more than three comorbidities.

“Percentage of deceased having multiple comorbidities (two or more) was significantly higher in the age-group above 65 as compared to younger age-groups. Multiple comorbidities were seen in 68.4 per cent of patients above 65, as compared to 59.3 per cent in the age group of 51–65  and 44.2 per cent in patients between 18-50,” the study noted.

There were 46 pediatric admissions during this period, of which six died of Covid. ICU mortality in the pediatric group was 13 per cent. The age group of the deceased varied from 6 months to 16 years and all these patients had comorbidities including congenital heart disease, tubercular meningitis, endocrine disorders and hematologic malignancies.

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