Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia

Authors

  • Wan Shakira Rodzlan Hasani Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Shubash Shander Ganapathy Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Chong Zhuo Lin Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Halizah Mat Rifin Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Mohammad Nazaruddin Bahari Selangor State Health Department (JKNS), Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
  • Muhammad Haikal Ghazali Selangor State Health Department (JKNS), Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
  • Noor Aliza Lodz Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Muhammad Hafizuddin Taufik Ramli Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Nur Liana Ab Majid Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Jane Ling Miaw Yn Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Muhammad Fadhli Mohd Yusoff Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Noor Ani Ahmad Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Anita Suleiman Disease Control Division, Ministry of Health Malaysia, WP Putrajaya, Malaysia
  • Ahmad Faudzi Yusoff Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
  • Venugopalan Balan Selangor State Health Department (JKNS), Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
  • Sha’ari Ngadiman Selangor State Health Department (JKNS), Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia

DOI:

https://doi.org/10.5365/wpsar.2020.11.3.007

Abstract

Background: Pre-existing comorbidities can predict severe disease requiring intensive care unit (ICU) admission among COVID-19 cases. We compared comorbidities, clinical features and other predictive factors between COVID-19 patients requiring ICU admission for intubation/mechanical ventilation and all other COVID-19 cases in Selangor, Malaysia.

Methods: Field data collected during the COVID-19 outbreak in Selangor, Malaysia, up to 13 April 2020 were used, comprising socio-demographic characteristics, comorbidities and presenting symptoms of COVID-19 cases. ICU admission was determined from medical records. Multiple logistic regression analysis was performed to identify factors associated with ICU admission requiring intubation/mechanical ventilation among COVID-19 cases.

Results: A total of 1287 COVID-19-positive cases were included for analysis. The most common comorbidities were hypertension (15.5%) and diabetes (11.0%). More than one third of cases presented with fever (43.8%) or cough (37.1%). Of the 25 cases that required intubation/mechanical ventilation, 68.0% had hypertension, 88.0% had fever, 40.0% had dyspnoea and 44.0% were lethargic. Multivariate regression showed that cases that required intubation/mechanical ventilation had significantly higher odds of being older (aged 360 years) [adjusted odds ratio (aOR) = 3.9] and having hypertension (aOR = 5.7), fever (aOR = 9.8), dyspnoea (aOR = 9.6) or lethargy (aOR = 7.9) than cases that did not require intubation/mechanical ventilation.

Conclusion: The COVID-19 cases in Selangor, Malaysia requiring intubation/mechanical ventilation were significantly older, with a higher proportion of hypertension and symptoms of fever, dyspnoea and lethargy. These risk factors have been reported previously for severe COVID-19 cases, and highlight the role that ageing and underlying comorbidities play in severe outcomes to respiratory disease.

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Published

16-02-2021

How to Cite

1.
Rodzlan Hasani WS, Ganapathy SS, Zhuo Lin C, Mat Rifin H, Bahari MN, Ghazali MH, Lodz NA, Ramli MHT, Ab Majid NL, Miaw Yn JL, Mohd Yusoff MF, Ahmad NA, Suleiman A, Yusoff AF, Balan V, Ngadiman S. Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia. Western Pac Surveill Response J [Internet]. 2021 Feb. 16 [cited 2024 Nov. 21];12(1):7. Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/784

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COVID-19: Original Research

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