Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study

Abstract

Background Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020. Methods This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality. Findings Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5–9; 2% (3/133) for 10–19; 2% (8/638) for 20–29; 3% (26/755) for 30–39; 7% (61/819) for 40–49; 17% (155/941) for 50–59; 22% (132/611) for 60–69; and 34% (96/284) for ≥70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28–10.52; 27% vs 3% mortality). Interpretation Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis

“…We identified 9937 potentially relevant records from the literature databases and registers, and 1575 records from the additional searches. After screening the titles, abstracts and full texts, 56 studies (22 cohort studies, 9 case-control studies, and 25 case series) with a total of 79,104 patients were included [ [10] , [11] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] ] ( Fig. 1 ).…”

Hyperactivated RAGE in Comorbidities as a Risk Factor for Severe COVID-19—The Role of RAGE-RAS Crosstalk

“…Infected AECs undergo pyroptosis and release DAMPs, including RAGE ligands (5), leading to excess RAGE expression and activation (6). In these conditions, RAGE activity increases AT1R expression (7), and might transactivate AT1R, reinforcing the deleterious effects of Ang II/AT1R in alveolar epithelial, immune, and endothelial cells, and in fibroblasts (8). Ang II/AT1R induce the further release of RAGE ligands (5), thus establishing a detrimental loop between AT1R and RAGE signaling.…”

“…Interestingly, overexpression and/or hyperstimulation of RAGE characterize COVID-19 comorbidities. The most common comorbidities observed in confirmed COVID-19 deceased patients in Italy (n = 34,142) as of 22 July 2020 [6]; New York State (NY) (n = 41,849) from 1 March 2020 to 26 April 2021 [7]; and Jakarta, Indonesia (n = 4265) from 2 March to 31 July 2020 [8]. (1) Percentages of COVID-19 deceased patients with one or more comorbidities.…”

Karakteristik Pasien COVID-19 Rawat Inap di RS Immanuel Bandung, Indonesia

“…Beberapa studi karakteristik klinis pasien COVID-19 di Kuwait, Wuhan, dan Jakarta menunjukkan mayoritas jenis kelamin pria dan rentang usia 50 -59 tahun. 5,9,10 Sebanyak 4 pasien (8,3%) pada studi ini berprofesi sebagai tenaga kesehatan, dan tercatat tidak ada mortalitas pada penderita dengan profesi tersebut. Studi sebelumnya di Wuhan mencatat COVID-19 menimpa 40 orang (29%) tenaga kesehatan, diduga 10 di antaranya berasal dari transmisi pasien yang masuk dengan gejala nyeri akut abdomen.…”

“…Gambaran gejala klinis ditemukan bervariasi pada berbagai studi, suatu studi di Wuhan mencatat gejala demam ditemukan pada 98% pasien, sementara studi multisenter di Jakarta menunjukkan mayoritas pasien dengan gejala batuk sebanyak 66%. 9,10 Dari studi ini didapatkan bahwa komorbid tersering pada penderita COVID-19 adalah hipertensi (56,3 %). Hal tersebut ditemukan pula pada studi di Wuhan (31,2 %), Kuwait (29,2 %), maupun Jakarta (19 %).…”