Determinants of Disease Progression in Bangladeshi COVID-19 Patients: A Cross-sectional Survey

Ridwana Maher Manna, S. Hasan, Rifat Hannan, Tahamina Akter, Md. Masum Mrida, Mohammad Delwer Hossain Hawlader
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Abstract

Background Coronavirus disease 2019 (COVID-19) shows a wide range of clinical manifestations, including asymptomatic presentation to severe pneumonia, acute respiratory distress syndrome, and respiratory failure. Although COVID-19 disease progression was studied elsewhere, it is largely unknown in Bangladesh. Methods We conducted this cross-sectional study in November 2020 to January 2021 on patients diagnosed with COVID-19 confirmed by Reverse Transcription-Polymerase Chain Reaction (RT-PCR). Pearson chi-square tests were used to assess the disease progressions across selected variables. A logistic regression model was used to assess the associated factors of COVID-19 infection for explanatory variables. All statistics were performed using the Stata software version 14.0 (Stata corporation, college station, Texas, USA). Results A total of 384 of respondents were involved in the survey. Of participants, most males (73%), unmarried (69%), aged 18 to 35 years during survey, and lived in urban community (73%). Overall, 41% of patients were in asymptotic condition, 44% were in mild condition, while 17% were moderate to severe conditions. Male patients and patients over 50 years had severe symptoms, accounting for 52% and 50%, respectively. Nearly half of business persons and office employees had severe symptoms. Almost all married patients (98%) had severe symptoms. The severity of symptoms was also higher for patients living in urban areas (79%), smoking (95%), and not physically active (52%). Patients with diabetes, asthma/COPD, and cancer were significantly associated with severe stage of COVID-19 (p≤0.05). Patient’s age, gender, smoking status, diabetics, working conditions significantly affect Covid-19 disease progression. Conclusion The study found that 7.03% of patients had severe, 9.11% had moderate and 40.36% had asymptomatic conditions. The heterogenic association between the disease progressions with age, sex, residence, marital status, smoking habits, diabetes, physical exercise, working conditions, sedentary lifestyles. Findings highlight the idea of using vulnerability ratings for each risk factor related to disease progression.
孟加拉 COVID-19 患者疾病进展的决定因素:横断面调查
背景 2019 年冠状病毒病(COVID-19)的临床表现多种多样,包括无症状、重症肺炎、急性呼吸窘迫综合征和呼吸衰竭。虽然 COVID-19 疾病的进展在其他地方也有研究,但在孟加拉国却鲜为人知。方法 我们于 2020 年 11 月至 2021 年 1 月对经逆转录聚合酶链反应(RT-PCR)确诊的 COVID-19 患者进行了横断面研究。采用皮尔逊卡方检验评估选定变量的疾病进展情况。使用逻辑回归模型评估解释变量中与COVID-19感染相关的因素。所有统计均使用 Stata 14.0 版软件(Stata Corporation,college station,Texas,USA)进行。结果 共有 384 名受访者参与了调查。参与者中,男性居多(73%),未婚(69%),调查期间年龄在 18 至 35 岁之间,居住在城市社区(73%)。总体而言,41%的患者无症状,44%的患者病情较轻,17%的患者病情为中度至重度。男性患者和 50 岁以上的患者症状严重,分别占 52% 和 50%。近一半的商务人士和办公室职员症状严重。几乎所有已婚患者(98%)都有严重症状。居住在城市地区(79%)、吸烟(95%)和不爱运动(52%)的患者症状严重程度也较高。糖尿病、哮喘/慢性阻塞性肺病和癌症患者与 COVID-19 的严重阶段显著相关(P≤0.05)。患者的年龄、性别、吸烟状况、糖尿病患者、工作条件都会明显影响 COVID-19 的病情发展。结论 研究发现,7.03%的患者病情严重,9.11%的患者病情中等,40.36%的患者无症状。疾病进展与年龄、性别、居住地、婚姻状况、吸烟习惯、糖尿病、体育锻炼、工作条件、久坐不动的生活方式之间存在异质性关联。研究结果强调了对与疾病进展相关的每个风险因素进行脆弱性评级的想法。
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