4278413
doi
10.1016/j.lanwpc.2020.100055
oai:zenodo.org:4278413
user-crc_icr_nih
user-clinupcovid
Suresh Kumar Chidambaram
Infectious Disease Department, Sungai Buloh Hospital, Malaysia
Xin Ci Wong
Digital Health Research and Innovation Unit, Institute for Clinical Research, Malaysia
Mohan Dass Pathmanathan
Digital Health Research and Innovation Unit, Institute for Clinical Research, Malaysia
Kalaiarasu M. Peariasamy
Digital Health Research and Innovation Unit, Institute for Clinical Research, Malaysia
Chee Peng Hor
Clinical Research Centre, Seberang Jaya Hospital, Penang, Malaysia
Hiu Jian Chua
Infectious Disease Department, Sungai Buloh Hospital, Malaysia
Pik Pin Goh
Digital Health Research and Innovation Unit, Institute for Clinical Research, Malaysia
Clinical characteristics and risk factors for severe COVID-19 infections in Malaysia: A nationwide observational study
Benedict Lim Heng Sim
Infectious Disease Department, Sungai Buloh Hospital, Malaysia
info:eu-repo/semantics/openAccess
Creative Commons Attribution 4.0 International
https://creativecommons.org/licenses/by/4.0/legalcode
COVID-19
Coronavirus
Infections
Malaysia
Nationwide
Observational
Study
Clinical Characteristics
Factors
<p><strong>Background</strong> COVID-19 emerged as a major public health outbreak in late 2019. Malaysia reported its first imported case on 25th January 2020, and adopted a policy of extensive contact tracing and hospitalising of all cases. We describe the clinical characteristics of COVID-19 cases nationwide and determine the risk factors associated with disease severity.</p>
<p><strong>Method </strong>Clinical records of all RT-PCR confirmed COVID-19 cases aged ≥12 years admitted to 18 designated hospitals in Malaysia between 1st February and 30th May 2020 with complete outcomes were retrieved. Epidemiological history, co-morbidities, clinical features, investigations, management and complications were captured using REDCap database. Variables were compared between mild and severe diseases. Univariate and multivariate regression were used to identify determinants for disease severity.</p>
<p><strong>Findings</strong> The sample comprised of 5889 cases (median age 34 years, male 71.7%). Majority were mild (92%), and 3.3% required intensive care, with 80% admitted within the first five days. Older age (≥51 years), underlying chronic kidney disease and chronic pulmonary disease, fever, cough, diarrhoea, breathlessness, tachypnoea, abnormal chest radiographs and high serum CRP (≥5 mg/dL) on admission were significant determinants for severity (p<0.05). The case fatality rate was 1.2%, and the three commonest complications were liver injuries (6.7%), kidney injuries (4%), and acute respiratory distress syndrome (2.3%).</p>
<p><strong>Interpretations</strong> Lower case fatality rate was possibly contributed by young cases with mild diseases and early hospitalisation. Abnormal chest radiographic findings in elderly with tachypnoea require close monitoring in the first five days to detect early deterioration.</p>
Zenodo
2020-11-18
info:eu-repo/semantics/article
4278412
user-crc_icr_nih
user-clinupcovid
1605702428.263619
412208
md5:8c389fa54f33a0ac4cc3ade84204c8ba
https://zenodo.org/records/4278413/files/1-s2.0-S2666606520300559-main.pdf
public