Sociodemographic characteristics of first 70 Coronavirus Disease-2019 patients in teaching medical city

Saeb Jasim Al-Shuwaili; Wafaa Mohammed Zaki Hadi

doi:10.4103/IRJCM.IRJCM_2_21

ORIGINAL ARTICLE

Year : 2020 | Volume : 33 | Issue : 2 | Page : 57-60

Sociodemographic characteristics of first 70 Coronavirus Disease-2019 patients in teaching medical city

Saeb Jasim Al-Shuwaili, Wafaa Mohammed Zaki Hadi
Department of Public Health, Baghdad Teaching Hospital, Teaching Medical City, Baghdad, Iraq

Date of Submission	01-Oct-2020
Date of Decision	20-Oct-2020
Date of Acceptance	30-Oct-2020
Date of Web Publication	6-Jul-2023

Correspondence Address:
Dr. Saeb Jasim Al-Shuwaili
Department of Public Health, Baghdad Teaching Hospital, Teaching Medical City, Baghdad
Iraq

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IRJCM.IRJCM_2_21

Abstract

Background: New coronavirus has been isolated in China and is named by the World Health Organization (WHO) severe acute respiratory syndrome-coronavirus-2 as a cause of coronavirus disease-2019 (COVID-19) which progressed to the pandemic. The first COVID-19 case was reported in Iraq on February 24, 2020, which was Iranian student. Objective: This study was conducted to highlight the demographic characteristics of the first 70 COVID-19 patients in a Teaching Medical City in Baghdad. Patients and Methods: This descriptive study involved the first 70 COVID-19 confirmed cases by reverse transcriptase–polymerase chain reaction (RT-PCR) and treated in Al-Shafaa Center–Teaching Medical City from March 1 to April 17. Data were collected from investigation forms which include demographic data, risk factors, outcome, type of laboratory sample, and their result. The definition of a suspected, probable, and confirmed case is that explained by the WHO. Results: The total number of confirmed COVID-19 patients (RT-PCR-positive) was found to be 70 out of 537 suspected cases (13%). The case fatality rate was found to be 6% for those who died within more than 24 h. The recovery rate was 53%. The low rate of occurrence was among children below 14 years, females, and those with no risk factor. The high fatality rate was among those whose ages were more than 60 years, males, those with risk factors, and who delayed in seeking medical advice. The recovery rate was better among those <60 years of age, no risk factors, and early seeking medical advice. Females have high recovery rate and low case fatality rate than males. Conclusions: COVID-19 affects all ages but low occurrence in children <14 years of age and affects males more than females. Fatality increases with old age, male gender, presence of chronic disease, and delay in seeking medical advice.

Keywords: Baghdad, coronavirus disease-2019, demographic, teaching medical city

How to cite this article:
Al-Shuwaili SJ, Hadi WM. Sociodemographic characteristics of first 70 Coronavirus Disease-2019 patients in teaching medical city. IRAQI J COMMUNITY MED 2020;33:57-60

How to cite this URL:
Al-Shuwaili SJ, Hadi WM. Sociodemographic characteristics of first 70 Coronavirus Disease-2019 patients in teaching medical city. IRAQI J COMMUNITY MED [serial online] 2020 [cited 2023 Dec 4];33:57-60. Available from: http://www.journalijcm.org/text.asp?2020/33/2/57/380711

Introduction

Coronavirus disease-2019 (COVID-19) is mainly a respiratory tract disease caused by new coronavirus, that was first reported in Wuhan, China, in December 2019, which is a betacoronavirus closely linked to severe acute respiratory syndrome (SARS) virus.^[1],[2] The virus has been isolated in China in January and named 2019-nCoV by the World Health Organization (WHO).^[3]

SARS-coronavirus-2 causes COVID-19 which is an infectious outbreak that progressed rapidly to a global pandemic.^[4]

Although the infectious disease is gradually understood, still the difference in mortality rate between different countries remains obscure. Three leading factors are reported to strongly influence the risk of dying from COVID-19 which are: male sex, advanced age (above 60 years), and the presence of comorbidities such as diabetes, hypertension, chronic respiratory disease, cancer, and cardiovascular disease.^[5]

The first confirmed case of COVID-19 in Iraq was reported on February 24, 2020, which was of Iranian student traveled to Iraq.^[6]

This study was conducted to highlight the demographic characteristics of the first 70 COVID-19 patients in Teaching Medical City in Baghdad, and their influence on case fatality and recovery rate.

Patients and Method

The study is a descriptive study and was conducted from March 1, 2020, to April 17, 2020. All patients with confirmed COVID-19 by reverse transcriptase–polymerase chain reaction (RT-PCR) and treated in Al-Shafaa Center in Medical City in Baghdad were included in the study. Privacy and confidentiality were considered after verbal consent. Patients were given the right to withdraw from the study at any time.

Data collection was conducted from the investigation form suggested by the WHO and the Iraqi Ministry of Health which is filled by medical doctors for every suspected case of COVID-19 when nasopharyngeal and oropharyngeal swabs were taken to be sent to the Central Public Health Laboratory for RT-PCR. All patients were followed to report their outcomes during the study whether they recovered, died, or remain active.

The investigation form includes sociodemographic data of patients, clinical features, risk factors, source of infection, the prognosis of the patient, and type of laboratory samples and their results.

The suspected case definition for surveillance by the WHO^[7] is:

A patient with acute respiratory illness (fever and at least one sign/symptom of respiratory disease such as cough and shortness of breath), and with no other etiology that fully explains the clinical presentation and a history of travel to or residence in a country/area or territory reporting local transmission or
A patient with an acute respiratory illness and has been in contact with a confirmed or probable COVID-19 case in the past 14 days before the onset of symptoms or
A patient with a severe acute respiratory infection (fever and at least one sign/symptom of respiratory disease e.g., cough and shortness of breath) requiring hospitalization and with no other etiology that fully explains the clinical presentation.

A probable case is a suspected case for whom testing for COVID-19 is inconclusive.^[7] A confirmed case is a person with laboratory confirmation of COVID-19, irrespective of clinical signs and symptoms.^[7]

Statistical analysis was done using appropriate standard techniques such as ranges, numbers, and percentages.

Results

[Table 1] shows that only 70 patients out of 537 suspected cases have a positive result for COVID-19 by RT-PCR with a positivity rate of 13%, the case fatality rate (CFR) was found to be 13%, 7% died within <24 h or reached died, and 6% more than 24 h. The recovery rate was found to be 53.

Table 1: The distribution of coronavirus disease-2019 cases in Teaching Medical City till April 17, 2020

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It is reported that the frequency of COVID-19 is the lowest among children <14 years of age (3%) and it affects all age groups and males are affected more than females (71% vs. 29%, respectively). The rate in Rusafa side of Baghdad (70%) is higher than Karkh side (24%). Most of the patients seek medical advice within <3 days of the appearance of clinical features (61%) and about 43% of the patients had risk factors such as diabetes, hypertension, and chronic respiratory, cardiovascular, or renal diseases [Table 2].

Table 2: Sociodemographic characteristics and risk factors among coronavirus disease-2019 confirmed patients in Teaching Medical City till April 17, 2020, Baghdad

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[Table 3] shows that the CFR was lowest among children <14 years of age (0%) and the highest among old ages more than 60 years (23.5%). It was more among males than females (16% vs. 5%, respectively). In addition, it was higher in Rusafa than Karkh (16.3% vs. 5.9%, respectively). Those who delayed in seeking medical advice have a higher CFR than those who earlier seeking medical device (18.5% vs. 9.3%, respectively). Moreover, the death rate among patients who had risk factors was higher (26.7%) than those without risk factors (2.5%).

Table 3: The distribution of the coronavirus disease-2019 died patients according to the case fatality rate by sociodemographic characteristics in Teaching Medical City till April 17, 2020, Baghdad

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It was found that the recovery rate was the lowest among elderly patients (more than 60 years of age), those who seek medical advice later (more than 3 days), and those with risk factors (47%, 37%, and 43.3%), respectively [Table 4].

Table 4: The distribution of the coronavirus disease-2019 recovered patients according to the recovery rate by sociodemographic characteristics in Teaching Medical City till April 17, 2020, Baghdad

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[Table 5] shows that females have high recovery rate and low CFR than males.

Table 5: The distribution of the sample (n=70) according to the case fatality rate and recovery rate by gender

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Discussion

About 13% of all suspected cases (537) were found to be positive for COVID-19 which indicates a good selection of suspected cases to be tested by RT-PCR for COVID-19 according to the criteria of the WHO. The recovery rate was found to be 53% which is nearly similar to that reported by the Iraqi Ministry of Health,^[8] which increased later to 90% as the health-care workers became well experienced.

The total CFR was 13% if excluding those who died within 24 h (7%), then CFR was 6% which is in agreement with^[8] and,^[6] CFR decreased later on to 2% as health-care workers became well-trained to deal with such cases and hospital well equipped.

All the age groups have been infected including those younger than 14 years and older than 60 years, and males are affected more than females which are in accordance with Alsofayan et al., in Saudi Arabia.^[9] The study reported that low rate of the disease among children <14 years which is inconsistent with Khan in Pakistan (2020).^[10]

A high rate was reported in Rusafa side of Baghdad which might be due to the location of the Medical City in Rusafa side of Baghdad. Most of the patients seek medical advice early during the course of the disease which indicates good awareness of people toward the disease.

The CFR was the lowest among children <14 years which is inconsistent with Khan in Pakistan (2020),^[10] but it was higher in those with risk factors and old people more than 60 years of age which is in agreement with findings from other countries as comorbid conditions increase with age.^[8] In addition, the CFR was higher among males than females which is in agreement with^[10] which needs a further analytic study to discover the relationship between gender and COVID-19 mortality.

Although the high death rate was reported in Rusafa side of Baghdad, this might be due to the high number of cases reported on that side and most people regard it as a stigmatic disease so they are delayed in seeking medical advice until the last stages of the disease so the prognosis became poor. Moreover, the study reported a high recovery rate among those who their ages <60 years, females, those who early seeking medical advice, and patients without risk factors which is similar to the findings reported by.^[11]

Conclusion

We can conclude from this study that COVID-19 affects all ages but low incidence in children <14 years of age, males affected more than females, and most of the patients seeking medical advice within a period of <3 days from the appearance of clinical features which indicate good awareness of disease. Fatality rate increases with old age, male gender, presence of chronic diseases, and delay in seeking medical advice, whereas recovery rate increases with younger age, among females, early seeking of medical advice, and absence of chronic diseases. Health education of people is necessary to seek medical advice as early as possible to increase recovery rate and decrease mortality.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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