key: cord-1055813-ejqjorq7
authors: Mallah, Saad I.; Abdulrahman, Abdulkarim; Alawadhi, Abdulla I.; AlQahtani, Manaf M.
title: Clinical and Epidemiological Characteristics of COVID-19 in a Multi-National Cohort in the Middle East
date: 2021-06-03
journal: J Epidemiol Glob Health
DOI: 10.2991/jegh.k.210306.001
sha: 2edc64584648cd76fd28096727f019f3494844e7
doc_id: 1055813
cord_uid: ejqjorq7

nan

The total number of positive cases identified was 83,811 ( Table 1 ). The total number of tests conducted in the same time period was 1.84 million tests (4.5% of which were positive). Mean age of the individuals was 32.76 years (±16.37), with a male majority (66.37%). Ninety-nine nationalities are reported in the cohort, with Bahrainis representing the majority (54.96%). In terms of WHO Regions, the Eastern Mediterranean Region forms 63.67% of cases, followed by South-East Asia Region (33.36%), Western Pacific Region (1.34%), African Region (1.10%), Region of the Americas (0.28%), and European Region (0.24%). Only 32.83% of the cohort was symptomatic. Children were more likely to present asymptomatically (70.5% vs 66.3%). 54.5% (n = 45,891) were admitted to hospital and isolation facilities. 0.7% (n = 623) required ICU admission. The overarching death rate is at 0.39% (n = 331), with 97.1% of cases recovered/discharged.

In the subset analysis, we identified a total of 1792 patients hospitalized in COVID-19 hospitals. The mean age was 46.2 (±16.7), with a male majority (59.0%). The majority (63.3%) of the admitted patients presented with symptoms. Most common symptom was cough (42%), followed by fever (22.4%), dyspnea (20.1%), myalgia (15.5%), and chest pain (8.9%). Other less commonly reported symptoms included diarrhea (5.8%), nausea/vomiting (5.2%), anosmia (3.1%), and ageusia (3.0%). The most common comorbidities which may be related to the intensive wide screening policies. In terms of disease presentation, our cohort corroborates global findings, ranking cough, fever, and dyspnea as most common, albeit at a lower prevalence [6] . With regards to prevalence of comorbidities, and in line with reports from Iran and Kuwait, diabetes is a significantly prevalent comorbidity, unlike Western and East Asian cohorts [6, 7, 9] . Additionally, we report a higher prevalence of G6PD, and sickle cell disease compared to other cohorts, which is in line with this region's disease epidemiology [10] .

The authors declare they have no conflicts of interest.

SIM drafted the manuscript. AA and AIA collected the data. SIM, AA and AIA analysed and interpreted the data. AA and MMA edited the manuscript. MMA supervised the project from conception and critically reviewed the manuscript. All authors contributed significantly to and approve of the final manuscript.

No financial support was provided.

The data collected for the study was approved by the National COVID-19 Research and Ethics Committee. 

Bahrain Population (LIVE)

World Health Organisation. WHO Coronavirus Disease (COVID-19) Dashboard. 2020

Oxford COVID-19 Government Response Tracker

Predictors of COVID-19 severity: a literature review

COVID-19 clinical characteristics, and sex-specific risk of mortality: systematic review and meta-analysis

Prevalence of comorbidities among individuals with COVID-19: a rapid review of current literature

Proportion of asymptomatic coronavirus disease 2019: a systematic review and meta-analysis

glucose-6-phosphate dehydrogenase (G6PD) deficiency (9.8%), asthma (4.5%), chronic kidney disease (CKD) (4.4%), obesity (3.24%), sickle cell disease (2.1%), and chronic obstructive pulmonary disease (COPD) (0.4%). 2.2% identified as current smokers

= 8) required non-invasive ventilation/highflow nasal cannula, and 0.17% (n = 3) required invasive ventilation. During hospital stay, we ventilated 8.31% of patients, and intubated 2.62%. The overall mean length of stay was 10.56 days

Logistic regression identified symptomatic status (p < 0.05), CKD, and hypertension (p < 0.01), as statistically significant predictors of severe respiratory disease (defined by ventilatory requirement)

Our study would be one of the largest cohorts from this region to confirm the association between certain comorbidities and disease severity, but that does not identify age as a risk factor

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