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Observational Study
. 2022 Jun 10;17(6):e0269026.
doi: 10.1371/journal.pone.0269026. eCollection 2022.

Clinical characteristics and outcomes of COVID-19 patients in Bali, Indonesia

Sri Masyeni  1 , Erni Juwita Nelwan  2   3 , Rois Muqsith Fatawy  2 , Surya Wibawa  4 , Putu Arya Nugraha  5 , Jarwa Antara  6 , Adi Suparta  7 , D G Wedha Asmara  1 , L G Sri Yenny  1 , A A G Budhitresna  1 , Dewi Arimas  8 , Dewi Indriani  9 , Kmg Parwata  9 , Ketut Sutarjana  10 , Eka Sugiartha  10 , Siska Kahari  6 , Clareza Arief Wardhana  11 , A A G Indraningrat  1 , Kadek Mulyantari  11 , Arya Widiyana Pasek  7 , Oka Putrawan  7 , Nyoman Trisna Yustiani  5 , Gede Wardana  12 , Made Indra Wijaya  1 , Suka Aryana  13 , Yuli Gayatri  13 , Dewi Dian Sukmawati  13 , Ketut Suastika  13 , Tuti Parwati Merati  13 , Made Bakta  13 , Raka Widiana  13
Affiliations
Observational Study

Clinical characteristics and outcomes of COVID-19 patients in Bali, Indonesia

Sri Masyeni et al. PLoS One. .

Abstract

Introduction: The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms.

Method: This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy.

Results: This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not.

Conclusion: A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Plotted map of hospitals in Bali where patients recruited.
Fig 2
Fig 2. Receiver operating characteristics curve.
Plotting clinical characteristics.
See this image and copyright information in PMC

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