Clinical Characteristics and Outcomes of First 100 Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-Cov-2) Patients: A Single Center Experience

Abstract

Since December 2019, the world has witnessed the Coronavirus disease caused by the Severe Acute Respiratory Syndrome Coronavirus-2, which has been declared a pandemic by the World Health Organization in March 2020. We share our initial experience at a center in Dubai, UAE, with a diverse ethnic population and present the clinical characteristics of the first 100 laboratory-confirmed coronavirus disease patients. In this retrospective, single center study, we included all adult (≥12 years old) laboratory-confirmed COVID-19 patients who presented at Al Kuwait Hospital, Dubai, UAE between 21 February 2020 and 15 April 2020. We extracted data on the demograhics, clinical presentation, laboratory and imaging results, treatment, complications and outcomes from the electronic medical records. Results are expressed as counts and percentages for categorical variables, and mean (with range) for continuous variables. A total of one hundred patients were studied. Mean age was 44 years (range 13-82 years); 16% were aged more than 60 years. 69% were males. Most of the patients (41%) belonged to South Asia, while 33% belonged to the Middle East. 21% were diabetics, 20% were hypertensives, 10% were active smokers and 6% were known cases of asthma/chronic obstructive lung disease. Upon admission, fever (46%) and dry cough (41%) were the most common symptoms, while 24% were asymptomatic on admission. Mean duration of symptoms before hospital admission was 5.1 days (range 1-14 days). Upon admission, 8% had low platelets, 7% had lymphopenia, 61% had high C-reactive protein, 48% had high ferritin, 37% had high lactate dehydrogenase, and 31% had high D-dimers. 63% had normal chest radiography upon presentation. Computed tomography chest showed ground glass opacification in 80%, consolidation in 21% while 14% had ill defined patchy opacities. All lesions were located peripherally and 79% had bilateral involvement with predominantly lower lobe disease. 8% had critical illness. Chloroquine/hydroxychloroquine (93%) and the protease inhibitor lopinavir-ritonavir (86%) were the most commonly prescribed treatment. 8% needed non-invasive ventilation and 7% were intubated and ventilated invasively. 7% developed acute repiratory distress syndrome, 5% went into septic shock and needed vasopressor support, 2% developed acute cardiac injury, 17% had acute kidney injury, 11% had acute liver injury and 2% developed disseminated intravascular coagulation. Almost half of the patients (49%) were declared recovered after having two negative COVID-19 PCR tests while 5% died. We concluded that the Coronavirus disease 2019 (COVID-19) presents with different clinical characteristics in the UAE with an ethnic diverse background. Majority affected were young, males and diabetic. One-fourth were asymptomatic on admission, while fever and dry cough were the most common symptoms. High C-reactive protein and ferritin on admission was common. Most of the patients had normal chest radiograph on admission, while computed tomography chest showed the characteristic findings in over two-thirds. Almost half of our patients recovered while 5% died. This is an intial experience only and increased patient cohort will provide further information.