Epidemiological and Clinical Features of COVID-19 in Hodeidah, Yemen

Abstract

Background: Understanding the epidemiological and clinical features of the disease in different settings can help health system better manage cases and mitigate transmission risks. Objective: The study aimed to describe the epidemiological and clinical features of Coronavirus disease 2019 (COVID-19) namely the socio-demographic features, symptoms, severity of cases, seasonality of infection and risk factors of morbidity and mortality rate among peoples in Hodeiadh, Yemen. Methodology: A descriptive study (a case series) included 505 patients were diagnosed clinically and epidemiologically with COVID-19 according to national case definition between 1st June and 31st   December 2020 at emergency department, Center of Tropical Medicine and Infectious Diseases (CTMID) in Al Thawara Public Hospital Authority, Hodeidah, Yemen. The patients, ranging in age from 3-80 years old, were triaged epidemiologically into suspected, probable and confirmed cases and clinically into mild, moderate, severe and critical cases. Epidemiological and clinical data were collected and described through calculations of medians, ranges, frequencies and percentages. Comparisons between qualitative variables were analyzed using Chi-squared test. Results: The results showed that 386/505 (76.43%) of suspected cases, and 70/505 (13.86%) of probable cases that were isolated and treated at home. A total of 49/505 cases (9.70 %) were confirmed and admitted in isolation department. On the other mean, 386 patients (76.43%) of mild and moderate cases, 70 patients (13.86%) of severe illness were treated at home. 21 patients of severe illness (4.16 %) and 28 patients (5.54%) of critical illness were treated at isolation department. 49 patients (9.7 %) needed admission in an intensive care unit (ICU). Most admitted cases had Acute Respiratory Distress Syndrome (ARDS) and the onset date of symptom were two weeks before hospitalization. Males were more exposed to COVID-19 namely 40/49 (81.63%) of cases. 33/49 (67.3%) of old age, 32/49 (65.3 %) had chronic diseases where the most prevalent were diabetes mellitus and diabetes mellitus associated with other chronic diseases  9/49 cases and  8/49 (18.36 % and 16.32 % respectively), followed by 6/49 (12.24%) of cardiac disorders and  hypertension, 5/49 cases (10.20%) of respiratory disorders, 2/49 cases (4.08 %) of cardiac disorders associated with respiratory disorder and  2/49 cases (4.08 %) of renal failure. 2/49 cases (4.08 % ) of co-infection. Seasonal variation of COVID-19 cases was observed; there was higher frequency during the spring season, which accounted for 34/49 cases (69.4%), and lower frequency during the summer 4/49 cases (8.16%) and autumn 5/49 cases (10.2%) seasons. The overall case fatality rate (CFR) of confirmed cases was 23/49 (46.93%). Of these fatal cases, 15/49 cases (30.6 %) had chronic diseases, 7/49 cases (14.2 %) did not have any chronic diseases, and 1/49 cases (2.0%) had co-infection. However 19/23 cases (82.6 %) of deaths was over the age of 50 years.  Conclusion: The research concluded that, old age, chronic diseases and co-infection were factors that contributed to excess morbidity and mortality among COVID-19 patients.