First few cases of COVID-19 admitted in a teaching hospital of North Kerala – Insights gained on the clinico-epidemiological presentations, management and patient perceptions on transmission dynamics

Abstract

Introduction: The first case of COVID-19 in India was confirmed in Kerala on January 2020, with the state effectively crushing the epidemic curve. Objectives: This study aims to describe the clinico-epidemiological profile and transmission dynamics of confirmed COVID-19 cases admitted in our health care facility. Materials and Methods: A case series study of 19 laboratory-confirmed cases in the early pandemic phase was done (13th March–April 9th 2020). Information on sociodemographic variables, exposure histories, clinical symptoms, and treatment were collected from case records and in-depth telephonic interviews. Descriptive analysis of selected variables was done. Incubation periods and receipt of infection were estimated from patient histories. Results: About 78.9% were male, in the age group of 22–86 years (Median-42 years). 18/19 (94.7%) of laboratory-confirmed cases were imported, half of them from UAE. Fever and cough were the predominant symptoms, followed by sore throat, breathlessness, headache, muscle pain, and loose stools with majority (85%) reporting mild symptoms. Five patients were asymptomatic. Mean duration from symptom onset to reporting is 4 ± 4.47 days. Two patients developed complications, one requiring hemodialysis and ventilator support. About 42% of patients had at least one comorbidity. Mean duration of symptom clearance and hospital stay was 6.76 days and 19.41 ± 6.801 days, respectively. Virological clearance was noted in 13.06 ± 7.32 days. Conclusions: Epidemiological findings from these cases aided in prompt public health responses across the districts in Kerala.