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© 2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Objectives

To establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.

Design

Hospital-based surveillance.

Setting

This study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.

Participants

In total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress.

Outcome measures

The outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson’s χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death.

Results

COVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30–50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in <2 days of symptom onset due to critical illness (AOR: 4.7; 95% CI: 1.2 to 17.8) and hospital admission (AOR: 3.4; 95% CI: 1.2 to 9.8).

Conclusions

COVID-19 positivity was observed in more than one-third of patients with suspected COVID-19 attending selected hospitals. While managing such patients, the risk factors identified for higher death rates should be considered.

Details

Title
Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings
Author
Das, Pritimoy 1   VIAFID ORCID Logo  ; Akhtar, Zubair 1   VIAFID ORCID Logo  ; Mah-E-Muneer, Syeda 1 ; Islam, Md Ariful 1 ; Mohammed Ziaur Rahman 1 ; Rahman, Mustafizur 1 ; Rahman, Mahmudur 1 ; Rahman, Mahbubur 2 ; Mallick Masum Billah 2 ; ASM Alamgir 2 ; Meerjady, Sabrina Flora 2 ; Tahmina Shirin 2 ; Sayera Banu 1 ; Chowdhury, Fahmida 1 

 Infectious Diseases Division (IDD), International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh 
 Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh 
First page
e055169
Section
Public health
Publication year
2021
Publication date
2021
Publisher
BMJ Publishing Group LTD
e-ISSN
20446055
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2605473597
Copyright
© 2021 Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.