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Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study.
Surendra, Henry; Elyazar, Iqbal Rf; Djaafara, Bimandra A; Ekawati, Lenny L; Saraswati, Kartika; Adrian, Verry; Oktavia, Dwi; Salama, Ngabila; Lina, Rosa N; Andrianto, Adhi; Lestari, Karina D; Burhan, Erlina; Shankar, Anuraj H; Thwaites, Guy; Baird, J Kevin; Hamers, Raph L.
  • Surendra H; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Elyazar IR; Centre for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
  • Djaafara BA; Akademi Ilmuwan Muda Indonesia, Jakarta, Indonesia.
  • Ekawati LL; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Saraswati K; Akademi Ilmuwan Muda Indonesia, Jakarta, Indonesia.
  • Adrian V; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Widyastuti; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.
  • Oktavia D; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Salama N; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Lina RN; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Andrianto A; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
  • Lestari KD; Jakarta Provincial Health Office, Jakarta, Indonesia.
  • Burhan E; Jakarta Provincial Health Office, Jakarta, Indonesia.
  • Shankar AH; Jakarta Provincial Health Office, Jakarta, Indonesia.
  • Thwaites G; Jakarta Provincial Health Office, Jakarta, Indonesia.
  • Baird JK; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
  • Hamers RL; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
Lancet Reg Health West Pac ; 9: 100108, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1117263
Preprint
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ABSTRACT

BACKGROUND:

Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.

METHODS:

This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality.

FINDINGS:

Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32-57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5-9; 2% (3/133) for 10-19; 2% (8/638) for 20-29; 3% (26/755) for 30-39; 7% (61/819) for 40-49; 17% (155/941) for 50-59; 22% (132/611) for 60-69; and 34% (96/284) for ≥70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28-10.52; 27% vs 3% mortality).

INTERPRETATION:

Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Lancet Reg Health West Pac Year: 2021 Document Type: Article Affiliation country: J.lanwpc.2021.100108

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Lancet Reg Health West Pac Year: 2021 Document Type: Article Affiliation country: J.lanwpc.2021.100108