Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia
10.5365/wpsar.2020.11.3.007
- Author:
Wan Shakira Rodzlan Hasani
1
;
Shubash Shander Ganapathy
1
;
Chong Zhuo Lin
1
;
Halizah Mat Rifin
1
;
Mohammad Nazaruddin Bahari
2
;
Muhammad Haikal Ghazali
2
;
Noor Aliza Lodz
1
;
Muhammad Hafizuddin Taufik Ramli
1
;
Nur Liana Ab Majid
1
;
Jane Ling Miaw Yn
1
;
Muhammad Fadhli Mohd Yusoff
1
;
Noor Ani Ahmad
1
;
Anita Suleiman
3
;
Ahmad Faudzi Yusoff
4
;
Venugopalan Balan
2
;
Sha’ari Ngadiman
2
Author Information
1. Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
2. Selangor State Health Department (JKNS), Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
3. Disease Control Division, Ministry of Health Malaysia, WP Putrajaya, Malaysia
4. Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
- Publication Type:Journal Article
- From:
Western Pacific Surveillance and Response
2021;12(1):46-52
- CountryWHO-WPRO
- Language:English
-
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.
- Full text:wpsar.2020.11.3.007 Hasani - FINAL.pdf
