EVALUATION OF MORTALITY IN COVID-19, BASED ON CBC CHANGES IN COMORBID VS. NON-COMORBID PATIENTS OF KHOST PROVINCE OF AFGHANISTAN

Abstract

Introduction: The COVID-19 pandemic has resulted in more than 248 million confirmed cases and in excess of 5 million deaths globally until November 2021. Many countries are continuing to experience epidemic waves of COVID-19. The first reported case of COVID-19 in Afghanistan was in Herat province on 24 February 2020; as of 20 July 2021, Afghanistan has reported 156 363 confirmed cases of COVID-19 and 7284 deaths from the disease. We investigated the mortality rate on COVID-19 in the basis of CBC changes, correlation and impact of comorbid vs noncomorbid on incidence of COVID-19 patients of Khost province of Afghanistan. Objective: This study aimed to determine and evaluate the mortality rate in COVID-19 in the basis of CBC changes, correlation and impact of comorbid vs. non-comorbid on incidence of COVID-19 patients in Khost province of Afghanistan.

Method and Materials: It is a prospective descriptive cross sectional study on 165 COVID-19 patients of Khost province from 2024/May/17 to 2024/Aug/18. The including parameters were age categories, gender, address, comorbidities, CBC changes and mortality rate of all 165 participants under study that recorded in computer special format. COVID-19 investigation, comorbidities and CBC changes are done by special regents, micro lab, cardiac monitor and other technology for the investigation of comorbidities. Recorded findings processing, comparison and evaluation results have been identified by IBM SPSS-23 version.

Results and Discussion: The study was conducted during (3) months on 165 COVID-19 patients in SZU and KPH hospitals of Khost province. Initially we described all participants according to age. At the current study, all participants were with (mean age: 59.48 ± 21.37; range: 15-108 years). Statistical description of all participants, according to age categories, gender, address, comorbidities, CBC changes and mortality rate shows that 1-Category: Children (0-12 years): was no incidence. 2-Category: Adolescence (13-18 years): was 9(5.45). 3-Category: Adult (19-59 years): was prevalent 61(36.97), but the 4-Category: Senior adult (60 and above years); was more prevalent 95(57.58). Statistic description of all participants, according to gender shows that male was 83(50.3) and female was 82 (49.7). Statistic description of all participants, according to address shows that rural was more prevalent 137(83.0) than urban 28 (17.0). Statistic description of all participants, according to comorbidities shows that incidence of COVID-19 in comorbidities was prevalent 118(71.52) than non-morbid 47 (28.48). Statistical description of all participants, according to CBC changes shows that WBC were leukocytosis (2.50-43.30; mean: 13.74 ± 7.07). Normal range of CBC (=4.5-11.0 x109 /L) was 67(40.61); Low range of CBC (˂4.5 x x109 /L) was 4 (2.42); High range of CBC (>11.0 x109 /L) was 94(56.97). Statistical description of lymphocytes shows that lymphopenia was prevalent (0.90-20.70; mean: 9.06 ± 4.79). Normal range of lymphocytes (20-40%) was 3(1.82); Low range of lymphocytes (˂ 20%) was 162(98.18); High range of lymphocytes (>40%) was 0(0). Statistic description of granulocytes shows that granulocytosis was prevalent (69.10-96.80; mean: 86.66 ± 5.83). Normal range of granulocytes (50-70%) was 1(0.61); Low range of granulocytes (˂ 50%) was 0(0); High range of granulocytes (>70%) was 164(99.39). Statistic description of all participants, according to mortality rate shows 18(10.91). Hypotheses summarized by One-Simple Chi-Square test show that incidence of COVID19 in urban population is low. (p˂ 0.000) is significant. One-Simple Binomial- test show that COVID-19 has mortality. (p˂ 0.000) is significant. One-Simple Kolmogorov- Simonov test show that between COVID-19 incidence and high age category have positive relationship. (p˂ 0.001) is significant. One-Simple Kolmogorov- Simonov test show that in COVID-19 TLC is high. (p˂ 0.000) is significant. One-Simple Chi-Square test show that COVID-19 does not have relationship with gender, (p >0.05) and not significant. One-Simple Kolmogorov- Simonov test show that in COVID-19, there is lymphopenia, but (p >0.05) and not significant. One-Simple Kolmogorov-Simonov test show that in COVID-19, granulocytosis is present, but (p >0.05) and not significant.

Conclusion: Overall, findings of our study indicated that adult and senior adult categories of age, comorbidities and CBC changes have a positive relationship with COVID-19 mortality and COVID-19 incidence, which is higher in rural populations than urban. However, this issue needs to further investigations to confirm these findings.