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

Abstract

Background: Pre-existing comorbidities are predictive of severe COVID-19 infection requiring intubation and mechanical ventilation. This study determined comorbidity and additional predictive factors for invasive ventilatory support among Malaysian COVID-19 patients.Method: Field data collected during COVID-19 outbreak in Selangor, Malaysia up to 13th April 2020 were used. It contained sociodemographic characteristics, comorbidities, and presenting symptoms of COVID-19 cases. Their medical records were traced for information on intensive care unit admission requiring intubation and mechanical ventilation.Results: A total of 1,287 COVID-19 positive cases were included in the analysis. The most common comorbidities among COVID-19 patients were hypertension (15.5%) and diabetes (11.0%). More than one third of symptomatic patients presented with fever (43.8) and cough (37.1%). Among all 25 intubated cases, 68.0% had hypertension, 88.0% had fever, 40.0% had dyspnoea and 44.0% was lethargic. Multivariable regression model showed that the odds of being intubated among COVID-19 patients were significantly higher among older person (aged ?60 years) [adjusted odd ratio (aOR=3.9)], those who had hypertension (aOR =5.7), presented with fever (aOR=9.8), dyspnoea (aOR=9.6), and lethargy (aOR = 7.9).Conclusion: Old age, hypertension, and several presenting symptoms were strong risk factors for invasive ventilatory support among COVID-19 patients. They must be diagnosed early and monitored closely to improve clinical outcome. 

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Published

2021-02-16

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Section

COVID-19: Original Research