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J Clin Virol Plus . A retrospective analysis of 902 hospitalized COVID-19 patients in Lebanon: clinical epidemiology and risk factors

tetano

Editor, Senior Moderator
J Clin Virol Plus


. 2021 Dec;1(4):100048.
doi: 10.1016/j.jcvp.2021.100048. Epub 2021 Oct 22.
A retrospective analysis of 902 hospitalized COVID-19 patients in Lebanon: clinical epidemiology and risk factors


Fatima Dakroub[SUP] 1 2 [/SUP], Suha Fakhredine[SUP] 1 3 [/SUP], Mohammad Yassine[SUP] 1 4 [/SUP], Alaa Dayekh[SUP] 1 5 [/SUP], Rachid Jaber[SUP] 6 [/SUP], Abbass Fadel[SUP] 3 [/SUP], Haidar Akl[SUP] 2 [/SUP], Ali Maatouk[SUP] 7 [/SUP]



Affiliations

Abstract

Background: The clinical epidemiology of hospitalized COVID-19 patients has never been described before in Lebanon. Moreover, the hospital admission and PCR positivity rates have not been assessed and compared yet.
Objectives: To describe the characteristics and outcomes of hospitalized patients with coronavirus induced disease 2019 (COVID-19) in Lebanon and identify risk factors for severe disease or death.
Study design: This is a retrospective mono-center cohort study in which we used patients' files to extract and analyse data on demographic and clinical characteristics, as well as mortality. Moreover, we tracked the pandemic by recording the daily total and ICU inpatient census and the PCR positivity rate for admitted and outpatients.
Results: Although the total admission rate increased from September to April, the ICU census switched this trend in December to stabilize at an average of around 10 patients/day until April. The case fatality rate was 19% for the 902 hospitalized patients, of which the majority (80%) had severe COVID-19. The severity odds ratio is significantly decreased in immunosuppressed cases (OR, 0.18; CI, 0.05-0.67; p=0.011). Additionally, the odds of COVID-19 related death are significantly greater if consolidations are found in the chest computed tomography (CT) scan (OR, 12; CI, 2.63-55.08; p=0.0013).
Conclusion: Consolidations in the lungs significantly increase the COVID-19 death risk. Risk factors identification is important to improve patients' management and vaccination strategies. In addition, hospital statistics are good indicators of a pandemic's track.

Keywords: 95% CI, 95 percent confidence interval; ACEI, Angiotensin-converting-enzyme inhibitors; ARB, Angiotensin receptor blockers; ARDS, Acute respiratory distress syndrome; BiPAP, Bi-level positive airway pressure; CFS, Clinical frailty scale; COPD, Chronic obstructive pulmonary disease; COVID-19; COVID-19, Coronavirus disease 2019; CRF, Chronic kidney failure; CT, Computed tomography; CVD, cardiovascular diseases; Case fatality rate; Clinical characteristics; DVT, Deep vein thrombosis; ECMO, Extracorporeal membrane oxygenation; ER, emergency room; Epidemiology; FM, Face mask; GGOs, Ground glass opacities; HFNC, High flow nasal cannula; ICU, Intensive care unit; Lebanon; MV, Mechanical ventilation; NC, Nasal cannula; NIV, Non-invasive ventilation; NRFM, Non-rebreathing face mask; OR, Odds ratio; PCR, polymerase chain reaction; PE, Pulmonary embolism; SARS CoV-2; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2; SD, Standard deviation; SGH, Saint Georges Hospital; URTI, Upper respiratory tract infection; VTE, Venous thromboembolism; WHO, World Health Organization.
 
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