An Epidemiological Analysis of COVID-19 cases from Jan to July 2020 in Kelantan, Malaysia
DOI:
https://doi.org/10.33102/uij.vol33no1.293Keywords:
epidemiology, COVID-19, ICU Admission, MalaysiaAbstract
As the global battle against COVID-19 rages on, Malaysia’s concerted effort in stemming the spread is commendable. This study characterized the epidemiology of COVID-19 aiming towards understanding the disease in a local setting for better preparation and management. A nation-based e-COVID reporting system was used to collect data on laboratory-confirmed COVID-19 cases in Kelantan from January to July 2020. Information from investigation reports was also reviewed. Analyses comprised of the estimation of incidence and case-fatality rate, summary of demographic and clinical characteristics including the age and sex distributions, construction of the epidemiological curve and choropleth map, and appraisal of healthcare usage. Multiple logistic regression was used to determine the risk factors for Intensive Care Unit (ICU) admission. A total of 166 cases reported in Kelantan until July 2020. Cases peaked during March before steadily declining and were concentrated in the capital. The age-adjusted incidence rate was 9.4/100,000 populations with a case-fatality rate of 2.4%. The median age was 37 years and 78% were male. The predominant symptoms were fever and cough while 25% of cases were asymptomatic. About 57% of cases were identified by active case detection and 97% had exposure risk. Potentially infected cases were isolated within a median of 7 days after exposure, even before the diagnosis. All cases were hospitalized with a median of 14 bed days, while 12% admitted to ICU, and 3% required mechanical ventilators. Significant factors for ICU admission were older age (AOR: 1.05, 95% CI: 1.02, 1.09, P = 0.001) and diabetes mellitus (AOR 4.55, 95% CI: 1.36, 15.25, P = 0.014). Although all ages appeared susceptible to COVID-19, older age and diabetic patients were more vulnerable. Kelantan’s targeted approaches of prompt identification and isolation of potentially infected individuals have been effective in limiting the transmission, allowing sufficient healthcare capacity in managing the pandemic.
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References
Bhagavathula, A. S., Rahmani, J., Aldhaleei, W. A., Kumar, P., & Rovetta, A. (2020). Global, Regional and National Incidence and Case-fatality rates of Novel Coronavirus (COVID-19) across 154 countries and territories: A systematic assessment of cases reported from January to March 16, 2020. medRxiv, 2020.2003.2026.20044743. doi:10.1101/2020.03.26.20044743
Boehmer, T. K., DeVies, J., Caruso, E., van Santen, K. L., Tang, S., Black, C. L., . . . Lozier, M. (2020). Changing age distribution of the COVID-19 pandemic—United States, May–August 2020. Morbidity and Mortality Weekly Report, 69(39), 1404.
CDC. (2020, 10 July 2020). Coronavirus Disease 2019: COVID-19 Pandemic Planning Scenarios. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html
Che Mat, N. F., Edinur, H. A., Abdul Razab, M. K. A., & Safuan, S. (2020). A single mass gathering resulted in massive transmission of COVID-19 infections in Malaysia with further international spread. Journal of Travel Medicine, 27(3). doi:10.1093/jtm/taaa059
Cummings, M. J., Baldwin, M. R., Abrams, D., Jacobson, S. D., Meyer, B. J., Balough, E. M., . . . Hastie, J. (2020). Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. The Lancet.
De Wit, E., Van Doremalen, N., Falzarano, D., & Munster, V. J. (2016). SARS and MERS: recent insights into emerging coronaviruses. Nature Reviews Microbiology, 14(8), 523.
Dong, Y., Mo, X., Hu, Y., Qi, X., Jiang, F., Jiang, Z., & Tong, S. (2020). Epidemiology of COVID-19 among Children in China. Pediatrics, 145(6), e20200702. doi:10.1542/peds.2020-0702
DOSM. (2019). Current Population Estimates, Malaysia, 2018-2019. Retrieved from https://www.dosm.gov.my/v1/index.php?r=column/cone&menu_id=RU84WGQxYkVPeVpodUZtTkpPdnBmZz09
Feng, Z., Li, Q., Zhang, Y., Wu, Z., Dong, X., Ma, H., . . . Wang, D. (2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Weekly, 2(8), 113-122.
Guan, W.-j., Ni, Z.-y., Hu, Y., Liang, W.-h., Ou, C.-q., He, J.-x., . . . Hui, D. S. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England Journal of Medicine, 382(18), 1708-1720.
Hajikhani, B., Calcagno, T., Nasiri, M. J., Jamshidi, P., Dadashi, M., Goudarzi, M., . . . Mirsaeidi, M. (2020). Olfactory and gustatory dysfunction in COVID-19 patients: A meta-analysis study. Physiological Reports, 8(18), e14578. doi:https://doi.org/10.14814/phy2.14578
Hanaei, S., & Rezaei, N. (2020). COVID-19: Developing from an Outbreak to A Pandemic. Archives of medical research, 51(6), 582-584. doi:10.1016/j.arcmed.2020.04.021
Huang, X., Wei, F., Hu, L., Wen, L., & Chen, K. (2020). Epidemiology and Clinical Characteristics of COVID-19. Arch Iran Med March, 23(4), 268-271. doi:10.34172/aim.2020.09
Jiang, X., Niu, Y., Li, X., Li, L., Cai, W., Chen, Y., . . . Wang, E. (2020). Is a 14-day quarantine period optimal for effectively controlling coronavirus disease 2019 (COVID-19)? medRxiv, 2020.2003.2015.20036533. doi:10.1101/2020.03.15.20036533
Kim, J., Thomsen, T., Sell, N., & Goldsmith, A. J. (2020). Abdominal and testicular pain: An atypical presentation of COVID-19. The American Journal of Emergency Medicine, 38(7), 1542.e1541-1542.e1543. doi:10.1016/j.ajem.2020.03.052
Kim, L., Garg, S., O’Halloran, A., Whitaker, M., Pham, H., Anderson, E. J., . . . Langley, G. E. (2020). Risk Factors for Intensive Care Unit Admission and In-hospital Mortality among Hospitalized Adults Identified through the U.S. Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET). Clinical Infectious Diseases. doi:10.1093/cid/ciaa1012
Klein, S. L., Dhakal, S., Ursin, R. L., Deshpande, S., Sandberg, K., & Mauvais-Jarvis, F. (2020). Biological sex impacts COVID-19 outcomes. PLoS pathogens, 16(6), e1008570.
Kopel, J., Perisetti, A., Roghani, A., Aziz, M., Gajendran, M., & Goyal, H. (2020). Racial and gender-based differences in COVID-19. Frontiers in public health, 8, 418.
Lai, C.-C., Wang, C.-Y., Wang, Y.-H., Hsueh, S.-C., Ko, W.-C., & Hsueh, P.-R. (2020). Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. International Journal of Antimicrobial Agents, 55(4), 105946. doi:https://doi.org/10.1016/j.ijantimicag.2020.105946
Lechien, J. R., Chiesa-Estomba, C. M., De Siati, D. R., Horoi, M., Le Bon, S. D., Rodriguez, A., . . . Saussez, S. (2020). Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 277(8), 2251-2261. doi:10.1007/s00405-020-05965-1
Lee, P.-I., & Hsueh, P.-R. (2020). Emerging threats from zoonotic coronaviruses-from SARS and MERS to 2019-nCoV. Journal of Microbiology, Immunology and Infection.
Mauvais-Jarvis, F. (2020). Aging, Male Sex, Obesity, and Metabolic Inflammation Create the Perfect Storm for COVID-19. Diabetes, 69(9), 1857. doi:10.2337/dbi19-0023
MOH. (2020a). Guideline COVID-19 Management; No.5/2020 update on 3 July 2020. Ministry of Health, Malaysia
MOH. (2020b). Guideline on COVID-19 Testing Using Antigen Rapid Test Kit For the Health Facilities, Ministry of Health Version 3.0. Ministry Of Health, Malaysia.
MOH. (2020c). Guideline on COVID-19 Testing Using Antigen Rapid Test Kit For the Health Facilities, Ministry of Health Version 4.0. Ministry of Health, Malaysia.
MOH. (2020d). Kenyataan Akhbar Ketua Pengarah Kesihatan 9 Julai 2020 – Situasi Semasa Jangkitan Penyakit Coronavirus 2019 (COVID-19) di Malaysia. Retrieved 9 July 2020, from Ministry of Health, Malaysia https://kpkesihatan.com/2020/07/09/kenyataan-akhbar-kpk-9-julai-2020-situasi-semasa-jangkitan-penyakit-coronavirus-2019-covid-19-di-malaysia/
MOH. (2020e). Updates on The Coronavirus Disease 2019 (COVID-19) Situation In Malaysia: 31 July 2020 [Press release]. Retrieved from https://kpkesihatan.com/2020/07/31/kenyataan-akhbar-kpk-31-julai-2020-situasi-semasa-jangkitan-penyakit-coronavirus-2019-covid-19-di-malaysia/
Munster, V. J., Koopmans, M., van Doremalen, N., van Riel, D., & de Wit, E. (2020). A Novel Coronavirus Emerging in China — Key Questions for Impact Assessment. New England Journal of Medicine, 382(8), 692-694. doi:10.1056/NEJMp2000929
NIH. (2019). Non-Communicable Diseases: Risk Factors and Other Health Problem. National Health and Morbidity Survey, Technical Report - Volume I.
Peck, K. R. (2020). Early diagnosis and rapid isolation: response to COVID-19 outbreak in Korea. Clinical Microbiology and Infection, 26(7), 805-807. doi:10.1016/j.cmi.2020.04.025
Petrosillo, N., Viceconte, G., Ergonul, O., Ippolito, G., & Petersen, E. (2020). COVID-19, SARS and MERS: are they closely related? Clinical Microbiology and Infection, 26(6), 729-734. doi:10.1016/j.cmi.2020.03.026
Postigo, J. A. R. (2011). Active Screening for Cutaneous Leihmaniasis: Diagnosis, Detection And Surveillance. Retrieved from https://www.who.int/leishmaniasis/surveillance/en/
Roncon, L., Zuin, M., Rigatelli, G., & Zuliani, G. (2020). Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome. Journal of Clinical Virology, 127, 104354. doi:https://doi.org/10.1016/j.jcv.2020.104354
Stokes, E. K., Zambrano, L. D., Anderson, K. N., Marder, E. P., Raz, K. M., Felix, S. E. B., . . . Fullerton, K. E. (2020). Coronavirus Disease 2019 Case Surveillance—United States, January 22–May 30, 2020. Morbidity and Mortality Weekly Report, 69(24), 759.
Sun, J., He, W.-T., Wang, L., Lai, A., Ji, X., Zhai, X., . . . Su, S. (2020). COVID-19: Epidemiology, Evolution, and Cross-Disciplinary Perspectives. Trends in Molecular Medicine, 26(5), 483-495. doi:https://doi.org/10.1016/j.molmed.2020.02.008
Tian, Y., Rong, L., Nian, W., & He, Y. (2020). Review article: gastrointestinal features in COVID-19 and the possibility of faecal transmission. Alimentary Pharmacology & Therapeutics, 51(9), 843-851. doi:https://doi.org/10.1111/apt.15731
WHO. (2019). PHEIC Global research and innovation forum: towards a research roadmap.
WHO. (2020a). Coronavirus disease (COVID-2019) situation reports-171.
WHO. (2020b). Tracking Public Health and Social Measures: A Global Dataset. World Health Organization.
WHO. (2020c). Transmission of SARS-CoV-2: implications for infection prevention precautions: scientific brief, 9 July 2020.
Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239-1242. doi:10.1001/jama.2020.2648
Zeng, F., Dai, C., Cai, P., Wang, J., Xu, L., Li, J., . . . Wang, L. (2020). A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: A possible reason underlying different outcome between sex. Journal of Medical Virology, 92(10), 2050-2054. doi:https://doi.org/10.1002/jmv.25989
Zimmermann, P., & Curtis, N. (2020). Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. The Pediatric infectious disease journal, 39(5), 355-368. doi:10.1097/INF.0000000000002660
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Copyright (c) 2021 Hazlienor Mohd Hatta, Nik Mohd Hafiz Mohd Fuzi, Nur Dalilah Mohd Zin, Afiq Izzudin A Rahim, Najihah Mahfuzah Zakria, Suhaiza Sulaiman, Abdul Haris Muhammad, Zaini Hussin
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