Clinical Features and Outcomes of COVID-19 at a Teaching Hospital in Kingston, Jamaica

Abstract

ObjectiveWe examined the demographic, clinical characteristics and indicators of poor outcomes among hospitalized adults with COVID-19 at the University Hospital of the West Indies, Jamaica.MethodsA retrospective medical record review between March 10 and December 31, 2020 analyzed data for 362 participants.ResultsThere were 218 males (mean age 59.5 years) and 144 females (mean age 55.7 years). Hypertension, diabetes mellitus, cardiovascular disease, obesity and chronic kidney disease were the most common comorbidities. Cough, shortness of breath, fever and malaise were the most common presenting complaints. Fifty-one percent of patients were moderately to severely ill on admission; 11% were critically ill; 18% were admitted to the Intensive Care Unit (ICU). Death occurred in 62 (17%) patients (95% CI 13.6-21.4%). Among obese participants, there were increased odds of developing respiratory failure (OR 5.2, p < 0.001), acute kidney injury (OR 4.7, p < 0.001), sepsis (OR 2.9, p =0.013) and the need for ICU care (OR 3.7, p < 0.001). Factors independently associated with increased odds of death were age (OR 1.03 per year, p = 0.013) and obesity (OR 2.26, p = 0.017). Mortality also correlated significantly with D-dimer > 1000 ng/ml (OR 2.78; p = 0.03), serum albumin < 40 g/L (OR 3.54; p = 0.03) and serum LDH > 485 U/L OR 1.92, p = 0.11).ConclusionsTargeted interventions among these high-risk patient subgroups may reduce in-patient morbidity and mortality.

Risk factors associated with severe COVID-19 outcomes in Jamaica: a cross-sectional study of national surveillance data

“…Although there are numerous scientific epidemiologic studies of COVID-19 risk factors and disease outcomes in high-income countries, publications from the Caribbean region have been limited. Those available include situation reports (4,14), case series of hospitalized patients (15)(16)(17), surveillance of COVID-19 deaths (18), and oral presentations (19). In Latin America, pre-existing economic and social disparities produced poor outcomes for the most vulnerable persons (20).…”