Clinical characteristics and factors associated with COVID-19-related mortality and hospital admission during the first two epidemic waves in 5 rural provinces in Indonesia: A retrospective cohort study
Data on coronavirus disease 2019 (COVID-19) clinical characteristics and severity from resource-limited settings are limited. This study examined clinical characteristics and factors associated with COVID-19 mortality and hospitalisation in rural settings of Indonesia, from 1 January to 31 July, 202...
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| Veröffentlicht in: | PloS one 2023-03, Vol.18 (3), p.e0283805 |
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| creator | Surendra, Henry Praptiningsih, C Yekti Ersanti, Arina M Rahmat, Mariati Noviyanti, Widia Harmani, Joshua A D Mansur, Erni N A Suleman, Yana Y Sudrani, Sitti Rosalina, Rosalina Mukhtar, Ismen Rosadi, Dian Fauzi, Lukman Elyazar, Iqbal R F Hawley, William A Wibisono, Hariadi |
| description | Data on coronavirus disease 2019 (COVID-19) clinical characteristics and severity from resource-limited settings are limited. This study examined clinical characteristics and factors associated with COVID-19 mortality and hospitalisation in rural settings of Indonesia, from 1 January to 31 July, 2021.
This retrospective cohort included individuals diagnosed with COVID-19 based on polymerase chain reaction or rapid antigen diagnostic test, from five rural provinces in Indonesia. We extracted demographic and clinical data, including hospitalisation and mortality from a new piloted COVID-19 information system named Sistem Informasi Surveilans Epidemiologi (SISUGI). We used mixed-effect logistic regression to examine factors associated with COVID-19-related mortality and hospitalisation.
Of 6,583 confirmed cases, 205 (3.1%) died and 1,727 (26.2%) were hospitalised. The median age was 37 years (Interquartile range 26-51), with 825 (12.6%) under 20 years, and 3,371 (51.2%) females. Most cases were symptomatic (4,533; 68.9%); 319 (4.9%) had a clinical diagnosis of pneumonia and 945 (14.3%) presented with at least one pre-existing comorbidity. Age-specific mortality rates were 0.9% (2/215) for 0-4 years; 0% (0/112) for 5-9 years; 0% (1/498) for 10-19 years; 0.8% (11/1,385) for 20-29 years; 0.9% (12/1,382) for 30-39 years; 2.1% (23/1,095) for 40-49 years; 5.4% (57/1,064) for 50-59 years; 10.8% (62/576) for 60-69 years; 15.9% (37/232) for ≥70 years. Older age, pre-existing diabetes, chronic kidney disease, liver diseases, malignancy, and pneumonia were associated with higher risk of mortality and hospitalisation. Pre-existing hypertension, cardiac diseases, COPD, and immunocompromised condition were associated with risk of hospitalisation but not with mortality. There was no association between province-level density of healthcare workers with mortality and hospitalisation.
The risk of COVID-19-related mortality and hospitalisation was associated with higher age, pre-existing chronic comorbidities, and clinical pneumonia. The findings highlight the need for prioritising enhanced context-specific public health action to reduce mortality and hospitalisation risk among older and comorbid rural populations. |
| doi_str_mv | 10.1371/journal.pone.0283805 |
| format | Article |
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This retrospective cohort included individuals diagnosed with COVID-19 based on polymerase chain reaction or rapid antigen diagnostic test, from five rural provinces in Indonesia. We extracted demographic and clinical data, including hospitalisation and mortality from a new piloted COVID-19 information system named Sistem Informasi Surveilans Epidemiologi (SISUGI). We used mixed-effect logistic regression to examine factors associated with COVID-19-related mortality and hospitalisation.
Of 6,583 confirmed cases, 205 (3.1%) died and 1,727 (26.2%) were hospitalised. The median age was 37 years (Interquartile range 26-51), with 825 (12.6%) under 20 years, and 3,371 (51.2%) females. Most cases were symptomatic (4,533; 68.9%); 319 (4.9%) had a clinical diagnosis of pneumonia and 945 (14.3%) presented with at least one pre-existing comorbidity. Age-specific mortality rates were 0.9% (2/215) for 0-4 years; 0% (0/112) for 5-9 years; 0% (1/498) for 10-19 years; 0.8% (11/1,385) for 20-29 years; 0.9% (12/1,382) for 30-39 years; 2.1% (23/1,095) for 40-49 years; 5.4% (57/1,064) for 50-59 years; 10.8% (62/576) for 60-69 years; 15.9% (37/232) for ≥70 years. Older age, pre-existing diabetes, chronic kidney disease, liver diseases, malignancy, and pneumonia were associated with higher risk of mortality and hospitalisation. Pre-existing hypertension, cardiac diseases, COPD, and immunocompromised condition were associated with risk of hospitalisation but not with mortality. There was no association between province-level density of healthcare workers with mortality and hospitalisation.
The risk of COVID-19-related mortality and hospitalisation was associated with higher age, pre-existing chronic comorbidities, and clinical pneumonia. The findings highlight the need for prioritising enhanced context-specific public health action to reduce mortality and hospitalisation risk among older and comorbid rural populations.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0283805</identifier><identifier>PMID: 36996045</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Admission and discharge ; Adult ; Age ; Antigens ; Bacterial pneumonia ; Biology and Life Sciences ; Child, Preschool ; Chronic illnesses ; Chronic kidney failure ; Chronic obstructive pulmonary disease ; Cohort analysis ; Collaboration ; Comorbidity ; Coronary artery disease ; Coronaviruses ; COVID-19 ; COVID-19 - epidemiology ; COVID-19 vaccines ; Data collection ; Diabetes ; Diabetes mellitus ; Epidemics ; Epidemiology ; Fatalities ; Female ; Health aspects ; Health surveillance ; Heart diseases ; Hospitalization ; Hospitals ; Humans ; Hypertension ; Indonesia ; Indonesia - epidemiology ; Infant ; Infant, Newborn ; Information systems ; Kidney diseases ; Liver diseases ; Male ; Malignancy ; Medical personnel ; Medicine and Health Sciences ; Midwifery ; Mortality ; Mortality risk ; People and Places ; Pneumonia ; Polymerase chain reaction ; Population ; Provinces ; Public health ; Regression analysis ; Retrospective Studies ; Risk ; Risk Factors ; Rural areas ; Rural Population ; Rural populations ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Variables ; Viral diseases</subject><ispartof>PloS one, 2023-03, Vol.18 (3), p.e0283805</ispartof><rights>Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication: https://creativecommons.org/publicdomain/zero/1.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c693t-5a2e0b1b08db80e0dca122220367817d29bc5994baf1b4b9507248c5adcd1dd43</citedby><cites>FETCH-LOGICAL-c693t-5a2e0b1b08db80e0dca122220367817d29bc5994baf1b4b9507248c5adcd1dd43</cites><orcidid>0000-0002-6029-0623</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062642/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10062642/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36996045$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Harapan, Harapan</contributor><creatorcontrib>Surendra, Henry</creatorcontrib><creatorcontrib>Praptiningsih, C Yekti</creatorcontrib><creatorcontrib>Ersanti, Arina M</creatorcontrib><creatorcontrib>Rahmat, Mariati</creatorcontrib><creatorcontrib>Noviyanti, Widia</creatorcontrib><creatorcontrib>Harmani, Joshua A D</creatorcontrib><creatorcontrib>Mansur, Erni N A</creatorcontrib><creatorcontrib>Suleman, Yana Y</creatorcontrib><creatorcontrib>Sudrani, Sitti</creatorcontrib><creatorcontrib>Rosalina, Rosalina</creatorcontrib><creatorcontrib>Mukhtar, Ismen</creatorcontrib><creatorcontrib>Rosadi, Dian</creatorcontrib><creatorcontrib>Fauzi, Lukman</creatorcontrib><creatorcontrib>Elyazar, Iqbal R F</creatorcontrib><creatorcontrib>Hawley, William A</creatorcontrib><creatorcontrib>Wibisono, Hariadi</creatorcontrib><title>Clinical characteristics and factors associated with COVID-19-related mortality and hospital admission during the first two epidemic waves in 5 rural provinces in Indonesia: A retrospective cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Data on coronavirus disease 2019 (COVID-19) clinical characteristics and severity from resource-limited settings are limited. This study examined clinical characteristics and factors associated with COVID-19 mortality and hospitalisation in rural settings of Indonesia, from 1 January to 31 July, 2021.
This retrospective cohort included individuals diagnosed with COVID-19 based on polymerase chain reaction or rapid antigen diagnostic test, from five rural provinces in Indonesia. We extracted demographic and clinical data, including hospitalisation and mortality from a new piloted COVID-19 information system named Sistem Informasi Surveilans Epidemiologi (SISUGI). We used mixed-effect logistic regression to examine factors associated with COVID-19-related mortality and hospitalisation.
Of 6,583 confirmed cases, 205 (3.1%) died and 1,727 (26.2%) were hospitalised. The median age was 37 years (Interquartile range 26-51), with 825 (12.6%) under 20 years, and 3,371 (51.2%) females. Most cases were symptomatic (4,533; 68.9%); 319 (4.9%) had a clinical diagnosis of pneumonia and 945 (14.3%) presented with at least one pre-existing comorbidity. Age-specific mortality rates were 0.9% (2/215) for 0-4 years; 0% (0/112) for 5-9 years; 0% (1/498) for 10-19 years; 0.8% (11/1,385) for 20-29 years; 0.9% (12/1,382) for 30-39 years; 2.1% (23/1,095) for 40-49 years; 5.4% (57/1,064) for 50-59 years; 10.8% (62/576) for 60-69 years; 15.9% (37/232) for ≥70 years. Older age, pre-existing diabetes, chronic kidney disease, liver diseases, malignancy, and pneumonia were associated with higher risk of mortality and hospitalisation. Pre-existing hypertension, cardiac diseases, COPD, and immunocompromised condition were associated with risk of hospitalisation but not with mortality. There was no association between province-level density of healthcare workers with mortality and hospitalisation.
The risk of COVID-19-related mortality and hospitalisation was associated with higher age, pre-existing chronic comorbidities, and clinical pneumonia. The findings highlight the need for prioritising enhanced context-specific public health action to reduce mortality and hospitalisation risk among older and comorbid rural populations.</description><subject>Admission and discharge</subject><subject>Adult</subject><subject>Age</subject><subject>Antigens</subject><subject>Bacterial pneumonia</subject><subject>Biology and Life Sciences</subject><subject>Child, Preschool</subject><subject>Chronic illnesses</subject><subject>Chronic kidney failure</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Collaboration</subject><subject>Comorbidity</subject><subject>Coronary artery disease</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 vaccines</subject><subject>Data collection</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Fatalities</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health surveillance</subject><subject>Heart diseases</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Indonesia</subject><subject>Indonesia - epidemiology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Information systems</subject><subject>Kidney diseases</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Midwifery</subject><subject>Mortality</subject><subject>Mortality risk</subject><subject>People and Places</subject><subject>Pneumonia</subject><subject>Polymerase chain reaction</subject><subject>Population</subject><subject>Provinces</subject><subject>Public health</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Rural areas</subject><subject>Rural Population</subject><subject>Rural populations</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Variables</subject><subject>Viral 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characteristics and factors associated with COVID-19-related mortality and hospital admission during the first two epidemic waves in 5 rural provinces in Indonesia: A retrospective cohort study</title><author>Surendra, Henry ; Praptiningsih, C Yekti ; Ersanti, Arina M ; Rahmat, Mariati ; Noviyanti, Widia ; Harmani, Joshua A D ; Mansur, Erni N A ; Suleman, Yana Y ; Sudrani, Sitti ; Rosalina, Rosalina ; Mukhtar, Ismen ; Rosadi, Dian ; Fauzi, Lukman ; Elyazar, Iqbal R F ; Hawley, William A ; Wibisono, Hariadi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c693t-5a2e0b1b08db80e0dca122220367817d29bc5994baf1b4b9507248c5adcd1dd43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Admission and discharge</topic><topic>Adult</topic><topic>Age</topic><topic>Antigens</topic><topic>Bacterial pneumonia</topic><topic>Biology and Life Sciences</topic><topic>Child, 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Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Surendra, Henry</au><au>Praptiningsih, C Yekti</au><au>Ersanti, Arina M</au><au>Rahmat, Mariati</au><au>Noviyanti, Widia</au><au>Harmani, Joshua A D</au><au>Mansur, Erni N A</au><au>Suleman, Yana Y</au><au>Sudrani, Sitti</au><au>Rosalina, Rosalina</au><au>Mukhtar, Ismen</au><au>Rosadi, Dian</au><au>Fauzi, Lukman</au><au>Elyazar, Iqbal R F</au><au>Hawley, William A</au><au>Wibisono, Hariadi</au><au>Harapan, Harapan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical characteristics and factors associated with COVID-19-related mortality and hospital admission during the first two epidemic waves in 5 rural provinces in Indonesia: A retrospective cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-03-30</date><risdate>2023</risdate><volume>18</volume><issue>3</issue><spage>e0283805</spage><pages>e0283805-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Data on coronavirus disease 2019 (COVID-19) clinical characteristics and severity from resource-limited settings are limited. This study examined clinical characteristics and factors associated with COVID-19 mortality and hospitalisation in rural settings of Indonesia, from 1 January to 31 July, 2021.
This retrospective cohort included individuals diagnosed with COVID-19 based on polymerase chain reaction or rapid antigen diagnostic test, from five rural provinces in Indonesia. We extracted demographic and clinical data, including hospitalisation and mortality from a new piloted COVID-19 information system named Sistem Informasi Surveilans Epidemiologi (SISUGI). We used mixed-effect logistic regression to examine factors associated with COVID-19-related mortality and hospitalisation.
Of 6,583 confirmed cases, 205 (3.1%) died and 1,727 (26.2%) were hospitalised. The median age was 37 years (Interquartile range 26-51), with 825 (12.6%) under 20 years, and 3,371 (51.2%) females. Most cases were symptomatic (4,533; 68.9%); 319 (4.9%) had a clinical diagnosis of pneumonia and 945 (14.3%) presented with at least one pre-existing comorbidity. Age-specific mortality rates were 0.9% (2/215) for 0-4 years; 0% (0/112) for 5-9 years; 0% (1/498) for 10-19 years; 0.8% (11/1,385) for 20-29 years; 0.9% (12/1,382) for 30-39 years; 2.1% (23/1,095) for 40-49 years; 5.4% (57/1,064) for 50-59 years; 10.8% (62/576) for 60-69 years; 15.9% (37/232) for ≥70 years. Older age, pre-existing diabetes, chronic kidney disease, liver diseases, malignancy, and pneumonia were associated with higher risk of mortality and hospitalisation. Pre-existing hypertension, cardiac diseases, COPD, and immunocompromised condition were associated with risk of hospitalisation but not with mortality. There was no association between province-level density of healthcare workers with mortality and hospitalisation.
The risk of COVID-19-related mortality and hospitalisation was associated with higher age, pre-existing chronic comorbidities, and clinical pneumonia. The findings highlight the need for prioritising enhanced context-specific public health action to reduce mortality and hospitalisation risk among older and comorbid rural populations.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>36996045</pmid><doi>10.1371/journal.pone.0283805</doi><tpages>e0283805</tpages><orcidid>https://orcid.org/0000-0002-6029-0623</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2023-03, Vol.18 (3), p.e0283805 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2792882747 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Admission and discharge Adult Age Antigens Bacterial pneumonia Biology and Life Sciences Child, Preschool Chronic illnesses Chronic kidney failure Chronic obstructive pulmonary disease Cohort analysis Collaboration Comorbidity Coronary artery disease Coronaviruses COVID-19 COVID-19 - epidemiology COVID-19 vaccines Data collection Diabetes Diabetes mellitus Epidemics Epidemiology Fatalities Female Health aspects Health surveillance Heart diseases Hospitalization Hospitals Humans Hypertension Indonesia Indonesia - epidemiology Infant Infant, Newborn Information systems Kidney diseases Liver diseases Male Malignancy Medical personnel Medicine and Health Sciences Midwifery Mortality Mortality risk People and Places Pneumonia Polymerase chain reaction Population Provinces Public health Regression analysis Retrospective Studies Risk Risk Factors Rural areas Rural Population Rural populations SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Variables Viral diseases |
| title | Clinical characteristics and factors associated with COVID-19-related mortality and hospital admission during the first two epidemic waves in 5 rural provinces in Indonesia: A retrospective cohort study |
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