CHARACTERISTICS AND COVID-19 INFECTION OUTCOME AMONG RURAL POPULATION IN NEGERI SEMBILAN, MALAYSIA.

Rahmat  Dapari; Mohd Hafizuddin  Mahfot; Mohd Safrin  Mohamad Bashaabidin; Nazri  Che Dom; Mohd Rohaizat  Hassan; Syed Sharizman  Syed Abdul Rahim

doi:10.37268/mjphm/vol.22/no.3/art.1825

Rahmat Dapari Faculty of Medicine and Health Sciences, UPM
Mohd Hafizuddin Mahfot Disease Control Division, Ministry of Health Malaysia.
Mohd Safrin Mohamad Bashaabidin Institute for Medical Research, Malaysia
Nazri Che Dom Faculty of Health Sciences, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia
Mohd Rohaizat Hassan Department of Community Health, Faculty of Medicine, National University of Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia.
Syed Sharizman Syed Abdul Rahim Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia.

DOI: https://doi.org/10.37268/mjphm/vol.22/no.3/art.1825

Keywords: COVID-19, Outcomes, Rural, Chronic diseases

Abstract

Coronavirus Disease 2019 (COVID-19) pandemic has still affected many countries around the world. While several studies have been published substantially regarding the risk factors of severe COVID-19 infection, less is known about the factors associated with COVID-19 infection among rural populations. This study aims to determine the characteristics and COVID-19 infection outcome in the rural population in Negeri Sembilan, Malaysia. Cross-sectional study was conducted in year 2021 among 3004 Laboratory-Confirmed COVID-19 cases in rural areas in Negeri Sembilan, Malaysia. The data was collected using proforma from list of COVID-19 cases in district health office and has been analyzed using SPSS version 25. Analysis shows that 884 (29.4%) out of 3004 Laboratory-Confirmed COVID-19 cases are classified as moderate-severe. The significant characteristics for moderate-severe COVID-19 infections were age (age 60 and above: aOR 2.00, 95% CI 1.474 – 2.715), gender (female: aOR 1.20, 95% CI 1.014-1.430), ethnicity (Chinese: aOR 3.09, 95% CI 1.746-5.454), employment status (employed: aOR 1.40, 95% CI 1.115-1.714), and chronic diseases (having chronic diseases: aOR 1.70, 95% CI 1.350-2.133). Early recognition of these characteristics among COVID-19 patients and prompt management of these cases might help to reduce COVID-19 severity in future.

References

WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int. [Accessed 3rd December 2021]

Shah AU M, Safri SNA, Thevadas R, Noordin NK, Rahman AA, Sekawi Z, Ideris A, Sultan MTH. COVID-19 outbreak in Malaysia: Actions taken by the Malaysian government. International Journal of Infectious Diseases 2020 97:108–116.

The official Malaysia government website for data and insights on COVID-19. https://covidnow.moh.gov.my. [Accessed 3rd December 2021]

Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential Effects of Coronaviruses on the Cardiovascular System: A Review. In JAMA Cardiology 2020 5(7):831–840.

Whittaker A, Anson M, Harky A. Neurological Manifestations of COVID-19: A systematic review and current update. In Acta Neurologica Scandinavica 2020 142(1): 14–22.

Paniz-Mondolfi A, Bryce C, Grimes Z, Gordon RE, Reidy J, Lednicky J, Sordillo EM, Fowkes M. Central nervous system involvement by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In Journal of Medical Virology 2020 92(7):699–702.

Pei G, Zhang Z, Peng J, Liu L, Zhang C, Yu C, Ma Z, Huang Y, Liu W, Yao Y, Zeng R, Xu G. Renal involvement and early prognosis in patients with COVID-19 pneumonia. In Journal of the American Society of Nephrology 2020 31(6):1157–1165.

Agarwal A, Chen A, Ravindran N, To C, Thuluvath PJ. Gastrointestinal and Liver Manifestations of COVID-19. In Journal of Clinical and Experimental Hepatology 2020 10(3):263–265.

Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Driggin, E, Nigoghossian CD, Ageno W, Madjid M, Guo Y, Tang LV, Hu Y, Giri J, Cushman M, Quéré I, Dimakakos EP, Gibson CM, Lippi G, Favaloro EJ, Lip GYH. COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. In Journal of the American College of Cardiology 2020 75 (23):2950–2973.

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis. In Clinical Chemistry and Laboratory Medicine 2020 58(7):1021–1028.

Patrício A, Costa RS, Henriques R. Predictability of COVID-19 Hospitalizations, Intensive Care Unit Admissions, and Respiratory Assistance in Portugal: Longitudinal Cohort Study J Med Internet Res 2021 23(4)

Jin JM, Bai P, He W. et al. Gender Differences in Patients With COVID-19: Focus on Severity and Mortality. Frontiers in Public Health 2020 8.

Phelps M, Christensen DM, Gerds T. et al. Cardiovascular comorbidities as predictors for severe COVID-19 infection or death. European Heart Journal - Quality of Care and Clinical Outcomes 2021 7: 172–180.

McDaniel M, McDaniel JT. Examining the geographic distribution of six chronic disease risk factors for severe COVID-19: Veteran–nonveteran differences. Chronic Illness. September 2021 18(3):666-676

Laires PA, Dias S, Gama A, Moniz M, Pedro AR, Soares P, Aguiar P, Nunes C. The Association Between Chronic Disease and Serious COVID-19 Outcomes and Its Influence on Risk Perception: Survey Study and Database Analysis

JMIR Public Health Surveillance 2021 7(1).

Wang Q, Berger NA, Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol. 2020:1–8.

Kuderer NM, MD TKC, PhD DPS, PhD YS, MD SMR, PharmD DRR, et al. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. The Lancet. 2020 395(10241):1907–18

Sun Q, Qiu H, Huang M, Yang Y. Lower mortality of COVID-19 by early recognition and intervention: experience from Jiangsu Province. Ann Intensive Care [Internet]. 2020 10(1):2–5.

Department Of Statistics Malaysia, Official Portal. The Source of Malaysia's Official Statistics. https://www.dosm.gov.my/v1/index.php [Accessed 3rd December 2021].

Huang S, Wang J, Liu F, et al. COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study. Hypertens Res. 2020; 43(8):824-831.

MOH MALAYSIA. Annex 2e Clinical Management of Confirmed Covid-19 Case In Adult And Paediatric. A. Clinical Management of Confirmed COVID-19 Case in Adult. 2021; Available from: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/underlying-evidence-

Koff WC, Williams MA. Covid-19 and Immunity in Aging Populations - A New Research Agenda. New England Journal of Medicine, 2020 383(9): 804–805.

Bhargava A, Fukushima EA, Levine M, Zhao W, Tanveer F, Szpunar SM, Saravolatz L. Predictors for Severe COVID-19 Infection. Clinical Infectious Diseases, 2020 71(8):1962–1968.

Hasani WSR, Ganapathy SS, Lin CZ, Rifin HM, Bahari MN, Ghazali MH, Lodz NA, Ramli MHT, Majid NLA, Ling MYJ, Yusoff MFM, Ahmad NA, Suleiman A, Yusoff AF, Balan V, Ngadiman S. Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia. Western Pacific Surveillance and Response Journal: WPSAR, 2021 12(1), 46–52.

Shi Y, Yu X, Zhao H, Wang H, Zhao R, Sheng J. Host susceptibility to severe COVID-19 and establishment of a host risk score: Findings of 487 cases outside Wuhan. Critical Care, 2020 24(1).

Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y, Pan S, Zou X, Yuan S, Shang Y. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine, 2020 8(5), 475–481.

Both L, Botgros R, Cavaleri M. Analysis of licensed over-the-counter (OTC) antibiotics in the European Union and Norway, 2012. Eurosurveillance, 2015 20(34).

Zhang B, Zhou X, Qiu Y, Song Y, Feng F, Feng J, Song Q, Jia Q, Wang J. Clinical characteristics of 82 cases of death from COVID-19. PLoS ONE, 2020 15

Dhochak N, Singhal T, Kabra SK, Lodha R. Pathophysiology of COVID-19: Why Children Fare Better than Adults? Indian Journal of Pediatrics, 2020 87(7), 537–546.

Lee PI, Hu YL, Chen PY, Huang YC, Hsueh PR. Are children less susceptible to COVID-19? Journal of Microbiology, Immunology and Infection, 2020 53(3), 371–372.

Gao YD, Ding M, Dong X, Zhang J. jin, Kursat Azkur A, Azkur D, Gan H, Sun YL, Fu W, Li W, Liang HL, Cao YY, Yan Q, Cao C, Gao HY, Brüggen MC, van de Veen W, Sokolowska M, Akdis M, & Akdis CA. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy: European Journal of Allergy and Clinical Immunology, 2021 76(2), 428–455.

Hu J, Wang Y. The Clinical Characteristics and Risk Factors of Severe COVID-19. Gerontology, 2021 67(3), 255–266.

Patanavanich R, Glantz SA. Smoking is associated with COVID-19 progression: A meta-analysis. Nicotine and Tobacco Research, 2020 22(9):1653–1656.

Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tobacco Induced Diseases, 2020 18:1–4.

Lim KH, Teh CH, Pan S, Ling MY, Yusoff MFM, Ghazali SM, Kee CC, Lim KK, Chong KH, Lim HL. Prevalence and factors associated with smoking among adults in Malaysia: Findings from the National Health and Morbidity Survey (NHMS) 2015. Tobacco Induced Diseases, 2018 16:1–12.

Sim BLH, Chidambaram SK, Wong XC, Pathmanathan MD, Peariasamy KM, Hor CP, Chua HJ, Goh PP. Clinical characteristics and risk factors for severe COVID-19 infections in Malaysia: A nationwide observational study. Lancet Reg Health West Pac. 2020 4:100055.

Hasani WSR, Ganapathy SS, Lin CZ, Rifin HM, Bahari MN, Ghazali MH, Lodz NA, Ramli MHT, Majid NLA, Ling MYJ, Yusoff MFM, Ahmad NA, Suleiman A, Yusoff AF, Balan V, Ngadiman S. Comorbidities and clinical features related to severe outcomes among COVID-19 cases in Selangor, Malaysia. Western Pacific Surveillance and Response Journal: WPSAR, 2021 12(1): 46–52.

Kopel J, Perisetti A, Roghani A, Aziz M, Gajendran M, Goyal H. Racial and Gender-Based Differences in COVID-19. In Frontiers in Public Health 2020 8.

Sim BLH, Chidambaram SK, Wong XC, Pathmanathan MD, Peariasamy KM, Hor CP, Chua HJ, Goh PP. Clinical characteristics and risk factors for severe COVID-19 infections in Malaysia: A nationwide observational study. Lancet Reg Health West Pac. 2020 4:100055.

Sze S, Pan D, Nevill CR, Gray LJ, Martin CA, Nazareth J, Minhas JS, Divall P, Khunti K, Abrams KR, Nellums LB, Pareek M. Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis. EClinicalMedicine, 2020 29–30.

Mathur R, Rentsch CT, Morton CE, Hulme WJ, Schultze A, MacKenna B, Eggo RM, Bhaskaran K, Wong AYS, Williamson EJ, Forbes H, Wing K, McDonald HI, Bates C, Bacon S, Walker AJ, Evans D, Inglesby P, Mehrkar A, Goldacre B. Ethnic differences in SARS-CoV-2 infection and COVID-19-related hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform. The Lancet, 2021 397(10286):1711–1724.

El-Khatib Z, Jacobs GB, Ikomey GM, Neogi U. The disproportionate effect of COVID-19 mortality on ethnic minorities: Genetics or health inequalities? EClinicalMedicine, 2020 23, 100430.

Raifman MA, Raifman JR. Disparities in the Population at Risk of Severe Illness From COVID-19 by Race/Ethnicity and Income. American Journal of Preventive Medicine, 2020 59(1):137–139.

Gao YD, Ding M, Dong X, Zhang J. jin, Kursat Azkur A, Azkur D, Gan H, Sun YL, Fu W, Li W, Liang HL, Cao YY, Yan Q, Cao C, Gao HY, Brüggen MC, van de Veen W, Sokolowska M, Akdis M, & Akdis CA. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy: European Journal of Allergy and Clinical Immunology, 2021 76(2), 428–455.

Marin BG, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, Salazar-Mather TP, Dumenco L, Savaria MC, Aung SN, Flanigan T, Michelow IC. Predictors of COVID-19 severity: A literature review. Reviews in Medical Virology, 2021 31(1):1–10.