LAUSR

We read with immense interest the article published in this journal by A. Di Stadio et al1. The authors described in detail the characteristics of COVID-19 patients based on age, sex and comorbidities differences. In this report, we also investigated the sex age, and comorbidities-related differences in deceased COVID-19 patients in Balochistan (Pakistan) and we would like to report some data as follows. Since the outbreak of COVID-19, over 263 million cases including over 5 million deaths have been reported across the globe (as of December 1, 2021). In addition, the number of confirmed COVID-19 cases in Pakistan reached 12,85,254 including 28,737 deaths since February 26, 20202. Balochistan is one of the fourth provinces of Pakistan located at the eastern edge of the Iranian plateau. It is geographically the largest province of Pakistan. Balochistan represents the 42% of the total land area of the country. In this province, the population density is very low due to the mountainous terrain. As of December 1, 2021, a total of 33,484 confirmed COVID-19 cases, including 360 deaths, have been reported from Balochistan3. Analysis of age, sex, and comorbidities-related data are essential to understand the risk factors of COVID-19 infection and mortality. The present study was designed to compare sex, age and comorbidities in patients who died due to COVID-19 infection. Data collection was carried out from 13 March 2020 to 25 October 2021. The confirmed diagnosis of COVID-19 was defined as a positive result by using real-time RT-PCR on the throat or nasopharyngeal swabs. The study was approved by the Internal Review Board of the National Institute of Health (NIH) Islamabad, Pakistan. The NIH Research Committee waived the requirement of written informed consent. Complete epidemiological and clinical data were collected from the hospitals’ medical records. From 13 March 2020 to 25 October 2021, the total of 326 COVID-19 patients died in Balochistan. All patients with a diagnosis of laboratory-confirmed COVID-19 infection were included in the present study. Out of total 326 deceased COVID-19 patients, the greatest proportion 62.8% (205/326) were male compared to 37.1% (121/326) were female individuals. The mean age of deceased COVID-19 patients at the time of death was 60.1 ± 14.4 years. The majority [83% (270/326)] of deceased COVID-19 patients belonged to the >50 years of age. On the other hand, 17% (56/326) of patients belonged to <50 years of age group. Fever was noted in 96.6% (315/326) of deceased COVID-19 patients at the time of hospital admission with a significant difference (p<0.0001) in the <50 and >50 years of age group. An increased level of neutrophils was found in 74% of COVID-19 patients with a significant difference (p<0.0001) between both groups. An increased level of C-reactive protein was found in almost 100% of patients in both age groups. No significant differences were observed for comorbidities, such as cardiovascular disease, hypertension, coronary artery diseases, asthma, pneumonia, tuberculosis, liver disease and diabetes mellitus between both age groups. Demographic, clinical and laboratory characteristics of deceased COVID-19 patients are presented in Table I. The risk of death from COVID-19 strongly depends on age, gender and underlying medical conditions. Older patients with chronic comorbidities are much more prone to critical and even fatal disease outcomes. European Review for Medical and Pharmacological Sciences 2022; 26: 740-742