Characteristics, risk factors and outcomes among the first consecutive 1096 patients diagnosed with COVID-19 in Kuwait

Abstract

Background: In Kuwait, prior to the first case of COVID-19 being reported in the country, mass screening of incoming travelers from countries with known outbreaks was performed and resulted in the first identified cases in the country. All COVID-19 cases at the time and subsequently after, were transferred to a single center, Jaber Al-Ahmad Al-Sabah Hospital, where the patients received standardized investigations and treatments. The objective of this study was to characterize the demographics, clinical manifestations, and outcomes in this unique patient population. Methods: This retrospective cohort study was conducted between 24th February 2020 and 20th April 2020. All consecutive patients in the entire State of Kuwait diagnosed with COVID-19 according to WHO guidelines and admitted to Jaber Al-Ahmad Al-Sabah Hospital were included. Patients received standardized investigations and treatments. Multivariable analysis was used to determine the associations between risk factors and outcomes (admission to intensive care and/or mortality). Findings: Of 1096 patients, the median age was 41 years and 81% of patients were male. Most patients were asymptomatic on admission (46.3%), of whom 35 later developed symptoms, and 59.7% had no signs of infection. Only 3.6% of patients required an ICU admission and 1.7% were dead at the study's cutoff date. On multivariable analysis, the risk factors found to be significantly associated with admission to intensive care were age above 50 years old, a qSOFA score above 0, smoking, elevated CRP and elevated procalcitonin levels. Asthma, smoking and elevated procalcitonin levels correlated significantly with mortality in our cohort.

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

“…Compared to European and American countries, the case fatality rate was low in Asian countries. The mortality rate among COVID-19 patients in Bangladesh was 10% [69] followed by Iran and Kuwait 8.06% and 1.73% respectively [73,74]. Among the Asian region, the highest mortality was found in China and South Korea [47,66].…”

“…The history of smoking among COVID-19 patients increased the risk of mortality. From a study, it was found that smokers had a 767% higher risk of mortality as non-smoker [32,33,74].…”

Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic: Systematic Review and Meta-analysis

“…For example, the incidence rate ratios between male and female were 1 Table 2. Besides, studies pointed out that most patients had more than one symptom [68,70,71]. Additionally, there were 20.9% of patients without viral pneumonia symptoms [16], which was opposite to previous studies [69,70].…”

“…Additionally, there were 20.9% of patients without viral pneumonia symptoms [16], which was opposite to previous studies [69,70]. The asymptomatic cases varied from 21.9%-49.5% [66,68,93,94]. The top 3 common symptoms among mild and severe patients are summarized and displayed in a figure (Figure 3) [12,16,61,70,[95][96][97][98].…”

Using Machine Learning to Unveil Demographic and Clinical Features of COVID-19 Symptomatic and Asymptomatic Patients

“…Data comprised 3 995 admitted patients between the 24th of February and the 27th of May 2020, and was an extension of a population described earlier elsewhere [17]. All patients, included in the study, tested positive for the SARS-CoV-2 virus using real-time polymerase chain reaction (RT-PCR).…”