Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan.
Though many studies on COVID have been published to date, data on COVID-19 epidemiology, symptoms, risk factors and severity in low- and middle-income countries (LMICS), such as Afghanistan are sparse. To describe clinical characteristics, severity, and outcomes of patients hospitalized in the MSF C...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0001687 |
| _version_ | 1797729830301597696 |
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| author | Ana Klein Mathieu Bastard Hamayoun Hemat Saschveen Singh Bruno Muniz Guyguy Manangama Amber Alayyan Abdul Hakim Tamanna Bashir Barakzaie Nargis Popal Mohammad Azeem Zmarial Kakar Elisabeth Poulet Flavio Finger |
| author_facet | Ana Klein Mathieu Bastard Hamayoun Hemat Saschveen Singh Bruno Muniz Guyguy Manangama Amber Alayyan Abdul Hakim Tamanna Bashir Barakzaie Nargis Popal Mohammad Azeem Zmarial Kakar Elisabeth Poulet Flavio Finger |
| author_sort | Ana Klein |
| collection | DOAJ |
| description | Though many studies on COVID have been published to date, data on COVID-19 epidemiology, symptoms, risk factors and severity in low- and middle-income countries (LMICS), such as Afghanistan are sparse. To describe clinical characteristics, severity, and outcomes of patients hospitalized in the MSF COVID-19 treatment center (CTC) in Herat, Afghanistan and to assess risk factors associated with severe outcomes. 1113 patients were included in this observational study between June 2020 and April 2022. Descriptive analysis was performed on clinical characteristics, complications, and outcomes of patients. Univariate description by Cox regression to identify risk factors for an adverse outcome was performed. Adverse outcome was defined as death or transfer to a level 3 intensive care located at another health facility. Finally, factors identified were included in a multivariate Cox survival analysis. A total of 165 patients (14.8%) suffered from a severe disease course, with a median time of 6 days (interquartile range: 2-11 days) from admission to adverse outcome. In our multivariate model, we identified male gender, age over 50, high O2 flow administered during admission, lymphopenia, anemia and O2 saturation < = 93% during the first three days of admission as predictors for a severe disease course (p<0.05). Our analysis concluded in a relatively low rate of adverse outcomes of 14.8%. This is possibly related to the fact that the resources at an MSF-led facility are higher, in terms of human resources as well as supply of drugs and biomedical equipment, including oxygen therapy devices, compared to local hospitals. Predictors for severe disease outcomes were found to be comparable to other settings. |
| first_indexed | 2024-03-12T11:35:22Z |
| format | Article |
| id | doaj.art-4ed86eaaa5704865be48bfb2b98092e8 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T11:35:22Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-4ed86eaaa5704865be48bfb2b98092e82023-09-01T06:16:57ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0138e000168710.1371/journal.pgph.0001687Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan.Ana KleinMathieu BastardHamayoun HematSaschveen SinghBruno MunizGuyguy ManangamaAmber AlayyanAbdul Hakim TamannaBashir BarakzaieNargis PopalMohammad Azeem Zmarial KakarElisabeth PouletFlavio FingerThough many studies on COVID have been published to date, data on COVID-19 epidemiology, symptoms, risk factors and severity in low- and middle-income countries (LMICS), such as Afghanistan are sparse. To describe clinical characteristics, severity, and outcomes of patients hospitalized in the MSF COVID-19 treatment center (CTC) in Herat, Afghanistan and to assess risk factors associated with severe outcomes. 1113 patients were included in this observational study between June 2020 and April 2022. Descriptive analysis was performed on clinical characteristics, complications, and outcomes of patients. Univariate description by Cox regression to identify risk factors for an adverse outcome was performed. Adverse outcome was defined as death or transfer to a level 3 intensive care located at another health facility. Finally, factors identified were included in a multivariate Cox survival analysis. A total of 165 patients (14.8%) suffered from a severe disease course, with a median time of 6 days (interquartile range: 2-11 days) from admission to adverse outcome. In our multivariate model, we identified male gender, age over 50, high O2 flow administered during admission, lymphopenia, anemia and O2 saturation < = 93% during the first three days of admission as predictors for a severe disease course (p<0.05). Our analysis concluded in a relatively low rate of adverse outcomes of 14.8%. This is possibly related to the fact that the resources at an MSF-led facility are higher, in terms of human resources as well as supply of drugs and biomedical equipment, including oxygen therapy devices, compared to local hospitals. Predictors for severe disease outcomes were found to be comparable to other settings.https://doi.org/10.1371/journal.pgph.0001687 |
| spellingShingle | Ana Klein Mathieu Bastard Hamayoun Hemat Saschveen Singh Bruno Muniz Guyguy Manangama Amber Alayyan Abdul Hakim Tamanna Bashir Barakzaie Nargis Popal Mohammad Azeem Zmarial Kakar Elisabeth Poulet Flavio Finger Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. PLOS Global Public Health |
| title | Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. |
| title_full | Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. |
| title_fullStr | Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. |
| title_full_unstemmed | Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. |
| title_short | Factors associated with adverse outcomes among patients hospitalized at a COVID-19 treatment center in Herat, Afghanistan. |
| title_sort | factors associated with adverse outcomes among patients hospitalized at a covid 19 treatment center in herat afghanistan |
| url | https://doi.org/10.1371/journal.pgph.0001687 |
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