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

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Section

COVID-19: Original Research