Clinical characteristics of coronavirus disease 2019 (COVID-19) patients in Kuwait

Abstract

This is a retrospective single-center study of 417 consecutive patients with coronavirus disease 2019 (COVID-19) admitted to Jaber Al-Ahmad Hospital in Kuwait between February 24, 2020 and May 24, 2020. In total, 39.3% of patients were asymptomatic, 41% were symptomatic with mild/moderate symptoms, 19.7% were admitted to the intensive care unit (ICU). Most common symptoms in cohort patients were fever (34.3%) and dry cough (32.6%) while shortness in breath was reported in (75.6%) of ICU admissions. Reported complications requiring ICU admission included Sepsis (68.3%), acute respiratory distress syndrome (95.1%) and heart failure (63.4%). ICU patients were more likely to have comorbidities, in comparison to non-ICU patients, including diabetes (35.4% vs 20.3%) and hypertension (40.2% vs 26.9%). Mortality rate of cohort was 14.4% and mean age of death was 54.20 years (± 11.09) and 90% of death cases were males. Chest high-resolution computed tomography for ICU cases reveled multifocal large patchy areas of ground glass opacification mixed with dense consolidation. Cases admitted to ICU showed abnormal levels of markers associated with infection, inflammation, abnormal blood clotting, heart problems and kidney problems. Mean hospital stay for asymptomatic cases was 20.69 days ±8.57 and for mild/moderate cases was 21.4 days ±8.28. Mean stay in ICU to outcome for survivors was 11.95 days ±8.96 and for death cases 13.15 days ±10.02. In this single-center case series of 417 hospitalized COVID-19 patients in Kuwait 39.3% were asymptomatic cases, 41% showed mild/moderate symptoms and 18.7% were admitted to ICU with a mortality rate of 14.4%.

Fig 1. Hospitalization dynamics.

Fig 2. Categorical age structures.

Each age group percentage is calculated by dividing the count by the total in each category. Highest ICU admissions were in the age groups (41–50 years) and (51–60 years) while highest numbers of death cases were recorded in the age group (51–60 years).

Fig 3. COVID-19 patients chest imaging.

A. Normal chest radiography of a patient with mild to moderate COVID-19. B. Diffuse bilateral airspace opacification with patches of consolidation in an ICU survivor. C. Diffuse bilateral airspace opacification with consolidation patches in an ICU death. D. Diffuse bilateral airspace opacification with near total white out of both lung fields in an ICU death. E and F. High Resolution CT chest showing multifocal large patchy areas of ground glass opacification mixed with dense consolidations in an ICU death.

Fig 4. Dynamic Profile of certain laboratory markers in COVID-19 ICU patients.

Laboratory tests were done on daily basis after disease onset. Dotted black lines indicate upper normal limit in A and B, and lower normal limit in C and F. (WBC: White blood cells, CRP: C-Reactive protein, PCT: Procalcitonin, eGFR: Estimated glomerular filtration rate).