Risk Factors for SARS-CoV-2 Infection Severity in Abu Dhabi
Latifa Mohammad, Baynouna Alketbi, Nico Nagelkerke, Hanan Abdelbaqi, Fatima Alblooshi, Mariam Alsaedi, Shamsa Almansoori, Ruqaya Alnuaimi, Amal Alkhoori, Aysha Alaryani, Mariam Alshamsi, Fatima Kayani, Noura Alblooshi, Shamma Alkhajeh, Jehan Alfalahi, Sumaya Alameri, Saeed Aldhahei
doi:10.1007/s44197-021-00006-4
Background Prediction models are essential for informing screening, assessing prognosis, and examining options for treatment. This study aimed to assess the risk of SARS-CoV-2 infection severity in the Abu Dhabi population. Methods This is a mixed retrospective cohort study and case-control study to explore the associated factors of receiving treatment in the community, being hospitalized, or requiring complex hospital care among patients with a diagnosis of SARS-CoV-2. Of 641 patients included, 266 were hospitalized; 135 were hospitalized and either died or required complex care, i.e., required ICU admission, intubation, or oxygen and 131 did not develop severe disease requiring complex care. The third group ("controls") were 375 patients who were not hospitalized. Logistic regression analyses were used to study predictors of disease severity. Results Among hospitalized patients older age and low oxygen saturation at admission were the consistent and strongest predictors of an adverse outcome. Risk factors for the death in addition to age and low oxygen saturation were elevated white blood count and low reported physical activity. Chronic kidney disease and diabetes were also associated with more severe disease in logistic regression. The mortality rate among those with less than 30 min per week of physical activity was 4.9%, while the mortality rate was 0.35% for those with physical activity > 30 min at least once a week. The interval from the onset of symptoms to admission and mortality was found to have a significant inverse relationship, with worse survival for shorter intervals. Conclusion Oxygen saturation is an important measure that should be introduced at screening sites and used in the risk assessment of patients with SARS-CoV-2. In addition, an older age was a consistent factor in all adverse outcomes, and other factors, such as low physical activity, elevated WBC, CKD, and DM, were also identified as risk factors.
Authors contributions All authors approved the manuscript. LBK conceptualization data analysis and writing the manuscript, NN review of data analysis and manuscript. HAB, FAB, MAS, SAM, RAN, AAK, AAA, MAS, FK, NAB, SAK, JAF, participated in data collection, SAD data management, and manuscript review.
Conflict of interest None.
Ethics approval and consent to participate This study was approved by the Abu Dhabi COVID19 Research IRB Committee, DOH/ CVDC/2020/833. Written informed consent was obtained from all participants which was at the start of the electronic survey. Consent for publication Abu Dhabi Health COVID19 Research Ethics Committee consented to publish this study. All authors consented to publish.
Availability of data and materials Available on request based on the Abu Dhabi Health COVID19 Research Ethics Committee approval. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by..
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'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n'
' <jats:title>Background</jats:title>\n'
' <jats:p>Prediction models are essential for informing screening, assessing '
'prognosis, and examining options for treatment. This study aimed to assess the risk of '
'SARS-CoV-2 infection severity in the Abu Dhabi population.</jats:p>\n'
' </jats:sec><jats:sec>\n'
' <jats:title>Methods</jats:title>\n'
' <jats:p>This is a mixed retrospective cohort study and case–control study to '
'explore the associated factors of receiving treatment in the community, being hospitalized, '
'or requiring complex hospital care among patients with a diagnosis of SARS-CoV-2. Of 641 '
'patients included, 266 were hospitalized; 135 were hospitalized and either died or required '
'complex care, i.e., required ICU admission, intubation, or oxygen and 131 did not develop '
'severe disease requiring complex care. The third group (“controls”) were 375 patients who '
'were not hospitalized. Logistic regression analyses were used to study predictors of disease '
'severity.</jats:p>\n'
' </jats:sec><jats:sec>\n'
' <jats:title>Results</jats:title>\n'
' <jats:p>Among hospitalized patients older age and low oxygen saturation at '
'admission were the consistent and strongest predictors of an adverse outcome. Risk factors '
'for the death in addition to age and low oxygen saturation were elevated white blood count '
'and low reported physical activity. Chronic kidney disease and diabetes were also associated '
'with more severe disease in logistic regression. The mortality rate among those with less '
'than 30\xa0min per week of physical activity was 4.9%, while the mortality rate was 0.35% for '
'those with physical activity\u2009>\u200930\xa0min at least once a week. The interval from '
'the onset of symptoms to admission and mortality was found to have a significant inverse '
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' </jats:sec><jats:sec>\n'
' <jats:title>Conclusion</jats:title>\n'
' <jats:p>Oxygen saturation is an important measure that should be introduced '
'at screening sites and used in the risk assessment of patients with SARS-CoV-2. In addition, '
'an older age was a consistent factor in all adverse outcomes, and other factors, such as low '
'physical activity, elevated WBC, CKD, and DM, were also identified as risk factors.</jats:p>\n'
' </jats:sec>',
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