Background: WHO has reported greater than 6.8 million deaths due to COVID-19. Identifying predictors of clinical deterioration and death would be useful in triaging and prioritizing such patients for early interventions.

Aims and objectives:To identify the sociodemographic, clinical, laboratory, and radiological predictors of deterioration among patients hospitalized with COVID-19.

Methods: Consecutive patients with COVID-19, hospitalized over one year at the P.D.Hinduja hospital,which is a tertiary care center in the city of Mumbai, were included.

Results: 1000 patients were included;62% were male.17% were transferred to intensive care. In the multivariable analysis, independent predictors for ICU transfer were underlying malignancy(OR 5.7 (95%CI 2.35-13.83), X-ray/CT involvement(OR 21.9 (95%CI 12.15-39.75), and elevated levels of serum creatinine(OR 1.8 (95% CI 1.04-2.93) at admission. 2% of patients expired during hospital stay; Chest X-ray/CT involvement and elevated creatinine were associated with mortality. 14.3% of patients had a prolonged hospital stay;age over 60(OR 1.6(95%CI 1.13-2.28),low total white blood cell count(OR 2.4 (95%CI 1.52-3.65), and low absolute neutrophil count(OR 1.04 (95%CI 0.68-1.58) were independent predictors. 9.5% of patients required oxygen at discharge; elevated D-dimer levels(OR 1.76,95%CI 1.13-2.74) and Chest X-ray/CT involvement were predictors.

Conclusion: An underlying malignancy was the strongest clinical predictor of deterioration, with radiological involvement and altered renal function being important predictors of poor outcomes. Such patients could benefit with early aggressive intervention with medications such as antivirals and monoclonal antibodies.