Abstract
BackgroundThe relationship between COVID-19 patient’s clinical characteristics and disease manifestation remains incompletely understood. The impact of ethnicity on mortality of patients with COVID-19 infection is poorly addressed in the literature. Emerging evidence suggests that many risk factors are related to symptoms severity and mortality risk, emphasizing the necessity of fulfilling this knowledge gap that may help reducing mortality from COVID-19 infections through tackling the risk factors.AimsTo explore epidemiological and demographic characteristics of hospitalized COVID-19 patients from different ethnic origins living in the UAE, compare them to findings reported across the globe and determine the impact of these characteristics and ethnicity on mortality during hospitalization.MethodsA single center, retrospective chart review study of hospitalized COVID-19 patients was conducted in a large COVID-19 referral hospital in UAE. The following outcomes were assessed: patients’ clinical characteristics, disease symptoms and severity, and association of ethnicity and other risk factors on 30-day in hospital mortality.ResultsA total of 3296 patients were recruited in this study with an average age of 44.3±13.4 years old. Preliminary data analysis indicated that 78.3% (n = 2582) of cases were considered mild. Average duration of hospital stay was 6.0±7.3 days and 4.3% (n = 143) were admitted to ICU. The most frequently reported symptoms were cough (32.6%, n = 1075) and fever (22.2%, n = 731). The 30-day mortality rate during hospitalization was 2.7% (n = 90). Many risk factors were associated with mortality during hospitalization including: age, respiratory rate (RR), creatinine, and C-reactive protein, oxygen saturation (SaO2), hemoglobin, hematocrit, ferritin, creatinine, C-reactive protein, anemia, COPD, Chronic kidney disease, dyslipidemia, Vitamin-D Deficiency, and ethnic origin (p <0.05). Multiple logistic regression analysis showed that higher mortality rates during hospitalization was associated with anemia, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and Middle Eastern origin (p<0.05).ConclusionThe results indicated that most COVID-19 cases were mild and morality rate was low compared to worldwide reported mortality. Mortality rate during hospitalization was higher in patients from Middle East origin with preexisting comorbidities especially anemia, COPD, and chronic kidney disease. Due to the relatively small number of mortality cases, other identified risk factors from univariate analysis such as age, respiratory rate, and Vitamin-D (VitD) deficiency should also be taken into consideration. It is crucial to stratify patients on admission based on these risk factors to help decide intensity and type of treatment which, possibly, will reduce the risk of death.
Highlights
Since the early 2020, Corona virus (SARS-CoV-2) has rapidly spread over the world causing a communicable respiratory infection known as “COVID-19”, with symptoms varying from person to person
Many risk factors were associated with mortality during hospitalization including: age, respiratory rate (RR), creatinine, and C-reactive protein, oxygen saturation (SaO2), hemoglobin, hematocrit, ferritin, creatinine, C-reactive protein, anemia, chronic obstructive pulmonary disease (COPD), Chronic kidney disease, dyslipidemia, Vitamin-D Deficiency, and ethnic origin (p
Multiple logistic regression analysis showed that higher mortality rates during hospitalization was associated with anemia, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and Middle Eastern origin (p
Summary
Since the early 2020, Corona virus (SARS-CoV-2) has rapidly spread over the world causing a communicable respiratory infection known as “COVID-19”, with symptoms varying from person to person. Up to April 2021, 8,609,860 cases were confirmed with consequent 173,334 disease- related deaths in the Eastern Mediterranean region (including the Middle East). Despite the diversity of healthcare systems in the countries of Eastern Mediterranean region, their restriction of social, educational, and economic movements has limited the enormous prevalence of the infection [1]. In January 2021, a total of 370,425 cases were registered with 1,125 reported disease- related deaths. UAE is the central hub of national diversity with multi-ethnicity and cultural concepts, these numbers were much lower than numbers reported by many other countries due early implementation of governmental efforts in combating this crisis; including social distancing, lockdown, sterilization campaigns, restricted regulations in the tourism and entertainment destinations, cases isolation, and mandatory masking in all public places [2, 3]. Emerging evidence suggests that many risk factors are related to symptoms severity and mortality risk, emphasizing the necessity of fulfilling this knowledge gap that may help reducing mortality from COVID-19 infections through tackling the risk factors
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