Comorbidity of COVID-19 related Fatalities in Tertiary Care Hospitals of Rawalpindi, Pakistan

  • Rizwana Shahid Rawalpindi Medical University
  • Muhammad Umar
  • Raja Bilal Zafar
  • Shazia Zeb
  • Saima Ambreen
  • Muhammad Omar Akram
Keywords: COVID-19, tertiary care hospitals, ventilator, diabetes, hypertension, comorbidity, Ischemic Heart Disease


Objectives: To assess the COVID-19 associated fatalities with respect to demographics, comorbidity, critical illness, and length of hospital stay in tertiary care hospitals.

Subjects & Methods: A retrospective hospital data-based research was done among 216 COVID-19 associated mortalities registered in 4 tertiary care hospitals Holy Family Hospital (HFH), Benazir Bhutto Hospital (BBH), District Head Quarters Hospital (DHQ) and Rawalpindi Institute of Urology & Transplantation (RIU & T) affiliated with Rawalpindi Medical University from 29th March-15th June 2020. The data was gathered by consecutive sampling pertinent to demographics, hospital stay, comorbidity, critical illness, and ventilator or oxygen support. The length of hospital stay among fatalities with and without comorbidity was compared by an independent sample z-test. Data were analyzed by using SPSS version 25.0.

Results: Of the total 216 COVID-19 related mortalities, 150(69.4%) were males and 66(30.6%) were females. The mean age of fatalities was 55.66 ± 13.97 years. About 76.7% of dying males were 41-70 years old while 56.1% of females dying of COVID-19 were 41-60 years old. Most (60.8%) of study subjects had hypertension followed by diabetes (53.8%), Ischemic Heart Disease (17.5%), and respiratory disorders (12.3%). About 75% of the critically ill patients needed a ventilator for respiratory support. Length of hospital stay was determined to have a statistically insignificant association (P > 0.10) with the presence or absence of comorbidity among COVID-19 patients. Critical illness had a highly significant association (P < 0.000) with ventilator support among COVID-19 related mortalities.

Conclusion: People 41-70 years should preferably adopt stringent precautions for protection against COVID-19. Comorbid states chiefly hypertension, diabetes, cardiac and respiratory diseases need special consideration amid COVID-19 pandemic to abstain from adverse health outcomes.


1. Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science 2020; 368(6490): 489-493.
2. Wilson ME, Chen LH. Travelers give wings to novel Coronavirus (2019-nCoV). J Travel Med 2020; 27:01. doi: 10.1093/jtm/taaa015.
3. Wu JT, K. L, Leung GM. Now casting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet 2020: 10.1016/S0140-6736(20)30260-9.
4. Du R-H, Liang L-R, Yang C-Q, Wang W, Cao T-Z, Li M, et al. Predictors of Mortality for patients with COVID-19 pneumonia caused by SARS-COV-2: A prospective cohort study. Eur Respir J 2020. (
5. Javed B, Sarwer A, Soto EB, Mashwani Z. Is Pakistan’s response to Coronavirus (SARS CoV-2) adequate to prevent an outbreak? Front. Med 21 April 2020.
6. Countries where COVID-19 has spread. Available at:
7. Waris A, Atta UK, Ali M, Asmat A, Baset A. COVID-19 Outbreak: Current Scenario of Pakistan. New Microbe and New Infect 2020; 35: 1-6.
8. COVID-19 cases in Pakistan latest. Available at:
9. Rodriguez-Morales, A.J., Cardona-Ospina, J.A., Guti_errez-Ocampo, E., Villamizar-Pena, R., Holguin-Rivera, Y., et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Medicine and Infectious Disease, 101623 (2020). doi:10.1016/j.tmaid.2020.101623
10. .Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). Journal of General Internal Medicine 2020. doi:10.1007/s11606-020-05762-w.
11. Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA 2020; 323(13): 1239-1242. doi:10.1001/jama.2020.2648.
12. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo, Q, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. International Journal of Infectious Diseases 94, 91-95 (2020). doi:10.1016/j.ijid.2020.03.017.
13. World Health Organization. Rolling Updates on coronavirus disease (COVID-19). Available at:
14. Coronavirus (COVID-19) Mortality Rate. Available at:
15. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059. doi:10.1001/jama.2020.6775.
16. Jin JM, Bai P, He W, Wu F, Liu XF, Han DM, et al. Gender differences in patients with COVID-19: Focus on severity and mortality. Front. Public Health 2020; 8:152.doi: 10.3389/fpubh.2020.00152.
17. Onder G, Rezza G, Brusaferro S. Case-Fatality Rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA 2020: E1-E2.
18. Shim E, Tariq A, Choi W, Lee Y, Chowell G. Transmission potential and severity of COVID-19 in South Korea. International Journal of Infectious Diseases 2020; 93: 339-344.
19. Rees EM, Nightingale ES, Jafari Y, Waterlow NR, Clifford S, Pearson CAB. COVID-19 length of hospital stay: a systematic review and data synthesis. doi:
20. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. The Lancet 2020; 395: 1054-1062.
21. Auld SC, Caridi-Scheible M, Blum JM, Robichaux C, Kraft C, Jacob JT, et al. ICU and ventilator mortality among critically ill adults with coronavirus disease 2019. Critical Care Medicine 2020. XX (XXX): 1-6. DOI: 10.1097/CCM.0000000000004457.
How to Cite
Shahid R, Umar M, Zafar R, Zeb S, Ambreen S, Akram M. Comorbidity of COVID-19 related Fatalities in Tertiary Care Hospitals of Rawalpindi, Pakistan. JRMC [Internet]. 17Jul.2020 [cited 2Oct.2022];24(Supp-1):32-6. Available from:

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