Initial Presenting Symptoms, Comorbidities and Severity of COVID-19 Patients Attending Hmawbi and Indine Treatment Centers During the Second Wave of Epidemic in Myanmar: a Cross-sectional Study (preprint)

Background: Coronavirus disease (COVID-19) caused by a highly contagious virus called severe acute respiratory syndrome coronavirus 2 emerged in China at the end of 2019 and became a major threat to health around the world. The health experts are still learning more about the detailed knowledge of the natural course and the severity of COVID-19. The study aimed to assess the prevalence and association of severity with demographic characteristics, initial presenting symptoms, and comorbidities among COVID-19 patients in Treatment Centers, Myanmar. Methods: : A cross-sectional study was conducted at Hmawbi and Indine Treatment Centers from November to December 2020 and a total of 176 adult COVID-19 patients participated in this study. Data were collected by telephone surveys using structured questionnaires. The odds ratio with a 95% confidence interval was used as a measure of association and the independent associated factors for severity (pneumonia) were investigated using logistic regression analysis. Results: : In total, 76.7% were symptomatic patients and the most common presenting symptoms were fever 43.2%, loss of smell 42.0%, and cough 25.6%. The prevalence of comorbidity in COVID-19 patients was 35.8% and the most common comorbidities were hypertension 19.9%, heart diseases 9.7%, and diabetes mellitus 9.1%, respectively. As a severity, 23.3% of patients had signs of pneumonia. The associated factors of pneumonia were aged 60 years and older [Adjusted Odds Ratio (AOR) = 8.82, 95 % CI: 2.68-29.08] , overweight or obese (AOR: 3.33, 95% CI: 1.30-8.54), current smoking (AOR: 15.29, 95% CI: 2.91-80.37), and alcohol drinking (AOR: 7.04, 95% CI: 1.40-35.31). Thirty percent of symptomatic patients present with pneumonia. Conclusions: : Nearly one-fourth of the patients developed pneumonia. The COVID-19 patients who are aged 60 years and older, overweight or obese, current smokers, and alcohol drinkers should be monitored carefully during the course of treatment to reduce the disease severity.

Epidemiological characteristics of SARS-COV-2 in Myanmar (preprint)

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In Myanmar, first COVID-19 reported cases were identified on 23rd March 2020. There were 336 reported confirmed cases, 261 recovered and 6 deaths through 13th July 2020. The study was a retrospective case series and all COVID-19 confirmed cases from 23rd March to 13th July 2020 were included. The data series of COVID-19 cases were extracted from the daily official reports of the Ministry of Health and Sports (MOHS), Myanmar and Centers for Disease Control and Prevention (CDC), Myanmar. Among 336 confirmed cases, there were 169 cases with reported transmission events. The median serial interval was 4 days (IQR 3, 2-5) with the range of 0 - 26 days. The mean of the reproduction number was 1.44 with (95% CI = 1.30-1.60) by exponential growth method and 1.32 with (95% CI = 0.98-1.73) confident interval by maximum likelihood method. This study outlined the epidemiological characteristics and epidemic parameters of COVID-19 in Myanmar. The estimation parameters in this study can be comparable with other studies and variability of these parameters can be considered when implementing disease control strategy in Myanmar.