Clinical Features and Outcomes of COVID-19 at a Teaching Hospital in Kingston, Jamaica

  1. Tamara Thompson
  2. Yvonne Dawkins
  3. Swane Rowe-Gardener
  4. Lisa Chin-Harty
  5. Kyaw Kyaw Hoe
  6. Trevor S. Ferguson
  7. Kelvin Ehikhametalor
  8. Kelly Ann Gordon-Johnson
  9. Varough Deyde

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Abstract

Objective

We examined the demographic, clinical characteristics and indicators of poor outcomes among hospitalized adults with COVID-19 at the University Hospital of the West Indies, Jamaica.

Methods

A retrospective medical record review between March 10 and December 31, 2020 analyzed data for 362 participants.

Results

There were 218 males (mean age 59.5 years) and 144 females (mean age 55.7 years). Hypertension, diabetes mellitus, cardiovascular disease, obesity and chronic kidney disease were the most common comorbidities. Cough, shortness of breath, fever and malaise were the most common presenting complaints. Fifty-one percent of patients were moderately to severely ill on admission; 11% were critically ill; 18% were admitted to the Intensive Care Unit (ICU). Death occurred in 62 (17%) patients (95% CI 13.6-21.4%). Among obese participants, there were increased odds of developing respiratory failure (OR 5.2, p < 0.001), acute kidney injury (OR 4.7, p < 0.001), sepsis (OR 2.9, p =0.013) and the need for ICU care (OR 3.7, p < 0.001). Factors independently associated with increased odds of death were age (OR 1.03 per year, p = 0.013) and obesity (OR 2.26, p = 0.017). Mortality also correlated significantly with D-dimer > 1000 ng/ml (OR 2.78; p = 0.03), serum albumin < 40 g/L (OR 3.54; p = 0.03) and serum LDH > 485 U/L OR 1.92, p = 0.11).

Conclusions

Targeted interventions among these high-risk patient subgroups may reduce in-patient morbidity and mortality.

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  1. ScreenIT

    SciScore for 10.1101/2022.04.27.22274270: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethical approval was obtained from the University of the West Indies Mona Campus Research Ethics Committee: ECP 46 20/21 and the Centers for Disease Control and Prevention (CDC) before starting the study.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All statistical analyses were done using Stata version 16 and/or IBM SPSS version 21.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: This study is to be interpreted in the context of a number of limitations. This study was conducted during a time period when the ancestral and later Alpha SARS-CoV-2 variants were circulating in Jamaica. These findings therefore may not be representative of subsequent variants, particularly Delta and Omicron. Only patients diagnosed via SARS-CoV-2 PCR testing were included in the study. Excluded were hospitalized patients with a COVID-19-like illness who had a negative PCR, positive antigen or antibody test and any other adjunctive diagnostics consistent with COVID-19 such as specific radiographic findings. Not all patients had data for the laboratory investigations assessed or the full range of investigations, limiting a more fulsome review of all the laboratory data which could correlate with clinical outcomes. There was no consistent documentation of weight and height of study participants in the electronic patient records, hence documentation of obesity was based on the attending clinician’s subjective assessment of the patient’s body mass index. The study site is a major referral hospital in Jamaica, accepting severe and critically ill patients for specialist care. The population of COVID-19 patients sampled for this study therefore may include a bias towards the more severely and critically affected. Mortality thus could be excessive in this population. With limitations in ICU bed capacity, and the surge of patients on the hospitals, many critically ill CO...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.04.27.22274270v1 on medRxiv