tetano
Editor, Senior Moderator
Lancet Reg Health West Pac
. 2021 Apr;9:100108.
doi: 10.1016/j.lanwpc.2021.100108. Epub 2021 Mar 2.
Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study
Henry Surendra[SUP] 1 2 3 [/SUP], Iqbal Rf Elyazar[SUP] 1 3 [/SUP], Bimandra A Djaafara[SUP] 1 4 [/SUP], Lenny L Ekawati[SUP] 1 5 [/SUP], Kartika Saraswati[SUP] 1 5 [/SUP], Verry Adrian[SUP] 6 [/SUP], Widyastuti[SUP] 6 [/SUP], Dwi Oktavia[SUP] 6 [/SUP], Ngabila Salama[SUP] 6 [/SUP], Rosa N Lina[SUP] 1 [/SUP], Adhi Andrianto[SUP] 1 [/SUP], Karina D Lestari[SUP] 1 [/SUP], Erlina Burhan[SUP] 7 [/SUP], Anuraj H Shankar[SUP] 1 5 [/SUP], Guy Thwaites[SUP] 5 8 [/SUP], J Kevin Baird[SUP] 1 5 [/SUP], Raph L Hamers[SUP] 1 5 7 [/SUP]
Affiliations
Abstract
Background: Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.
Methods: This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality.
Findings: Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32-57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5-9; 2% (3/133) for 10-19; 2% (8/638) for 20-29; 3% (26/755) for 30-39; 7% (61/819) for 40-49; 17% (155/941) for 50-59; 22% (132/611) for 60-69; and 34% (96/284) for ?70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28-10.52; 27% vs 3% mortality).
Interpretation: Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.
Keywords: COVID-19; Indonesia; Mortality; SARS-CoV-2; children; coronavirus.
. 2021 Apr;9:100108.
doi: 10.1016/j.lanwpc.2021.100108. Epub 2021 Mar 2.
Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study
Henry Surendra[SUP] 1 2 3 [/SUP], Iqbal Rf Elyazar[SUP] 1 3 [/SUP], Bimandra A Djaafara[SUP] 1 4 [/SUP], Lenny L Ekawati[SUP] 1 5 [/SUP], Kartika Saraswati[SUP] 1 5 [/SUP], Verry Adrian[SUP] 6 [/SUP], Widyastuti[SUP] 6 [/SUP], Dwi Oktavia[SUP] 6 [/SUP], Ngabila Salama[SUP] 6 [/SUP], Rosa N Lina[SUP] 1 [/SUP], Adhi Andrianto[SUP] 1 [/SUP], Karina D Lestari[SUP] 1 [/SUP], Erlina Burhan[SUP] 7 [/SUP], Anuraj H Shankar[SUP] 1 5 [/SUP], Guy Thwaites[SUP] 5 8 [/SUP], J Kevin Baird[SUP] 1 5 [/SUP], Raph L Hamers[SUP] 1 5 7 [/SUP]
Affiliations
- PMID: 33681830
- PMCID: PMC7924904
- DOI: 10.1016/j.lanwpc.2021.100108
Abstract
Background: Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.
Methods: This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality.
Findings: Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32-57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5-9; 2% (3/133) for 10-19; 2% (8/638) for 20-29; 3% (26/755) for 30-39; 7% (61/819) for 40-49; 17% (155/941) for 50-59; 22% (132/611) for 60-69; and 34% (96/284) for ?70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28-10.52; 27% vs 3% mortality).
Interpretation: Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.
Keywords: COVID-19; Indonesia; Mortality; SARS-CoV-2; children; coronavirus.