Muscat: With the registration of the first case of COVID-19 in the Sultanate on February 24, 2020 as a travel-related case followed by the spread of the pandemic across the Sultanate in line with the widespread of the pandemic worldwide, an increase in the number of cases and deaths has been observed in the Sultanate. Therefore, there was a need to conduct a study in order to identify hospital admissions, intensive care units (ICUs) admissions and deaths related to the disease.
The study aims to facilitate the classification of risks for infected patients, especially the elderly, before and when they enter the hospital. By this means, it would help in improving the acceptance protocols for patients who require admission, in addition to improving the efficiency of epidemiological surveillance of Covid-19 patients.
It is hoped that the results of this study, conducted by the Ministry of Health’s (MOH) Directorate General of Disease Surveillance and Control, will enable the country's health sector to better manage the pandemic highlighting the most vulnerable groups, in addition to employing the results of this study in the classification of vaccine target groups.
To achieve these objectives, this study was conducted through data obtained from the National Surveillance Database of Covid-19. In this study, 68,967 laboratory-confirmed cases of Covid-19 were included, diagnosed from February 24 to July19, 2020.
Factors including gender, age groups, nationality and location, as well as symptoms of fever, cough and sore throat were studied. Furthermore, the study included the effect of the following chronic conditions: diabetes, hypertension, asthma, BMI >40, nervous system diseases, chronic lung diseases, patients using immunosuppressive drugs, chronic kidney disease, chronic blood cell disease and chronic liver disease. Pregnancy was among the factors included in the study.
The study revealed that (74%) of the patients were males in the age group between 15 and 60 years. Half of the cases were registered in Muscat Governorate; the capital city of Oman; similar to the spread of the pandemic in some countries.
This was also reflected in the high number of admissions and ICUs admissions, as well as deaths in Muscat. It was noted that the majority of recorded cases (81%) were mild to moderate category in terms of severity of the disease while (14%) were classified as severe and (5%) as critical conditions. During the study period, the rate of admission in general wards was (4%) whereas (0.4%) were admitted in ICUs, COVID-19 has been recorded as a cause of death in (0.5%) of the cases, with an estimated mortality rate of 8.2 per 100,000 population out of the total population of the Sultanate (4.49 million).
With regard to symptoms, 40% of these cases suffered from fever, 38% had coughs, 37% had sore throats, 34% did not suffer from any of the symptoms studied and 12% reported the presence of the three mentioned symptoms together. The symptom of fever and cough was statistically associated with a higher rate of admission in general wards and admission in the ICUs while people who suffered sore throat were found to be the least admitted in the hospital, indicating that sore throat could not be used as a risk factor. The most affected chronic diseases in admissions in general wards and ICUs, as well as deaths were diabetes (2.9%), high blood pressure (0.7%).
It was observed that patients over 60 years of age had a higher risk of admission (eight times), ICU admission (11 times) and mortality (4 times higher) than those aged 15 to 60. In addition, the results showed an increased risk of death among patients with certain chronic diseases including chronic lung diseases (4 times), as well as a BMI >40 and chronic kidney disease (3 times) each.
While this study has clarified the most vulnerable groups and the high-risk rates associated with them, it may be possible for some to think that they are safe from danger as long as they are not belonging to these groups. However, the study stresses to all other people among the low risk groups the importance of taking preventive measures to spare the high-risk groups whom are living among us, the risk of infection transmission, which may lead to possible admission or death. Consequently, the results of this study can be invested in the best way to curb the pandemic and prevent individuals and institutions from its short and long-term effects. --ONA
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