An Analysis of First 100 Deaths Among COVID-19 Confirmed Cases in Pakistan

Abstract

Introduction: COVID-19, a novel coronavirus disease, appeared in December 2019 in China and rapidly spread across the world. Till second week of April 2020, high incidence (2.9/100,000) and cases fatality rates (1.7%) has been observed. During an epidemic, CFR is considered as an important indicator of disease severity. This study was conducted to estimate the temporal and spatial distribution of first 100 deaths attributed to COVID-19 in Pakistan and to determine the associated demographic factors Method: We conducted an epidemiological analysis of first 100 deaths reported among RT-PCR confirmed COVID-19 cases. Demographic, epidemiological and risk factors information was obtained along with history of travel. The overall case fatality rate was calculated and spatial and temporal trends of CFR were determined. Associated comorbidities and clinical signs and symptoms were recorded and frequencies were determined. Results: A total of 100 mortalities with overall Case Fatality Rate 1.67% (CFR) were analysed. Median age of patients was 64.5 years (IQR: 54-70) with 75% (n=75) Males. Among all deaths reported, 71 (71%) cases had one or more documented comorbidities at the time of diagnosis. Most frequently reported co-morbidities were; hypertension (67 %), followed by Diabetes Mellitus 945%) and Ischemic Heart Diseases (27%). First death was reported on 18 March 2020 and the most frequent presenting symptoms were shortness of breath (87%) and fever (79%). Median duration of illness was eight days (IQR: 4-11 days), median delay reaching hospital to seek health care was three days (IQR: 0-6 days) while median duration of hospital stay was also three days (IQR: 1-7 days). Among all reported deaths, 62% were attributed to local transmission as these cases had no history of international travel. The most affected age group was 60-69 years while no death reported in age group below 20 years. Highest case fatality rate was observed in Khyber Pakhtoon Khwa (KP) province (4.39%) and no deaths reported from Azad Jammu and Kashmir region. Conclusion: High CFR among old age group and its association with co-morbidities (chronic disease) suggests targeted interventions such as social distancing and strict quarantine measure for elderly and morbid people. Comparative studies among deaths and recovered patients are recommended to explore further disease dynamics. Funding Statement: This study was not funded by any organization. Declaration of Interests: Authors declare no competing interests. Ethics Approval Statement: Study was approved by the National Institute of health’s ethical review board and was exempted from written informed consent by the same.