Risk Factors of Symptomatic COVID-19 in Samtse District, Bhutan

Abstract

IntroductionAll Coronavirus disease 2019 (COVID-19) positive cases in Samtse District, Bhutan were isolated in the isolation facilities managed by the government hospitals. This study aimed to identify the socio-demographic risk factors for developing COVID-19 symptoms amongst these patients.Methods and MaterialsA secondary data of the COVID-19 positive cases from isolation facilities of Samtse District from 5 May to 7 September 2021 was used for this study. Survival analysis was carried out to estimate the cumulative probability of symptom onset time by each risk factor. Kaplan–Meier curves were used to estimate the probabilities for the onset of symptoms at different time points and a log-rank test was employed to assess the differences between covariates.ResultsA total of 449 patients were included, of which 55.2% were males and 73.3% (328) were aged >18 years. The mean age was 42 years with a range of 3 months to 83 years. Forty-seven percent (213) reported at least one symptom. Common symptoms were fever (32.3%, 145), headache (31.6%, 142), and cough (30.1%, 135), respectively. Males were 64% less likely to be symptomatic than females [adjusted hazard ratio (aHR) = 0.36, 95% confidence interval (CI) 0.183–0.917]. Farmers (aHR = 3.17, 95% CI 1.119–8.953), and drivers and loaders (aHR = 3.18, 95% CI 1.029–9.834) were 3 times more likely to be symptomatic compared to housewives. Residents of Samtse sub-districts were 5 times more likely to be symptomatic than those living in other sub-districts (aHR = 5.16, 95% CI 2.362–11.254).ConclusionThe risk of developing COVID-19 symptoms was being fe male, farmers, drivers and loaders, and residents of the Samtse sub-district. These high-risk groups should be provided additional care when in isolation facilities.

Characterizing Risk Factors for Hospitalization and Clinical Characteristics in a Cohort of COVID-19 Patients Enrolled in the GENCOV Study

“…Female sex was associated with greater odds of developing many of the symptoms examined, which is supported by previous studies. For example, Lhendup et al found that males were 64% less likely to be symptomatic compared to females [ 20 ]. Similarly, our findings provide supporting evidence that individuals with comorbidities, individuals with higher BMI (specifically those who are clinically overweight or obese), and those who are non-White or non-European are more likely to develop symptomatic illness and experience a greater number of symptoms over the course of their illness.…”

“…When examining patient characteristics as risk factors for hospitalization, the following were controlled for as covariates based on previous evidence of being associated with COVID-19 severity and mortality [ 8 , 9 , 10 , 19 ]: sex (male vs. female), age, BMI, ethnicity (White/European vs. non-White/European), and underlying health conditions including hypertension, diabetes, and cardiovascular and pulmonary conditions. The following characteristics were analyzed as potential risk factors for developing and having persistent COVID-19 symptoms based on prior evidence of being predictive of symptomatic illness [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]: sex (male vs. female), age, BMI, ethnicity (White/European vs. non-White/European), viral strain (wild-type vs. variant), vaccination status (unvaccinated vs. vaccinated), and having any underlying health conditions.…”

Aetiologies and Risk Factors of Prolonged Fever Admission in Samtse Hospital, Bhutan, 2020

“…Although the notification of respiratory tract infection decreased in Bhutan due to COVID-19 restrictions, it is still a leading cause of infectious disease in the country [28]. The first case of COVID-19 in the Samtse District was reported on 9 May 2021 [29]. There are a number of plausible reasons for this finding.…”

Knowledge, Attitude, and Practice towards COVID-19 among Patients Attending Phuentsholing Hospital, Bhutan: A Cross-Sectional Study

“…There have been two national lockdowns and several local/regional lockdowns in response to community transmission. The towns and districts along the Indian border have been identified as "red zones," and a 7-day quarantine was required for people traveling out of these red zone areas [22].…”