Clinical characteristic of first COVID-19 patients hospitalized at the multidisciplinary clinic of the Tashkent Medical Academy: A single-center retrospective study

Abstract

Background. Owing to the rapid spread of coronavirus disease (COVID-19) globally, and specifically in Uzbekistan, it has become important for the healthcare system to predict the course of the disease, its severity, and the possibility of admission into the intensive care unit (ICU). This study aimed to describe the epidemiological and clinical aspects of COVID-19 patients at the multidisciplinary clinic of the Tashkent Medical Academy, Uzbekistan, and identify the risk factors for admission into the (ICU). 

Methods. Medical records of 2500 discharged and deceased COVID-19 patients at the multidisciplinary clinic of the Tashkent Medical Academy between April 11 and August 8, 2020 were accessed and analyzed. Further, the demographics, symptoms, clinical outcomes, and laboratory and treatment data were collected through medical records of patients and the risk factors for ICU admission were identified.

Results. Out of the 2500 patients, 989 were asymptomatic, and 1511 had at least one symptom. The median age of the patients was 36 [26–51], ranging from 1-91 years. A total of 978 (39.1%) patients were women, including 31 (1.2%) who were pregnant. The symptomatic group was also divided into two groups: non-ICU and ICU patients. Of all the hospitalized patients, a total of 129 patients (5.16%) were admitted to the ICU. The clinical classification of COVID-19 was different in both groups. In the ICU group, severe (45, 34.9%) and critical (48, 37.2%) severity was dominant. The ICU group suffered from high temperatures in the range of 37.4 °C–38 ºC. The respiratory rate in the range of 25–30 was experienced by 67 (51.9%) patients, and 61 (47.3%) ICU patients suffered from <79 oxygen saturation. Comorbidities, such as hypertensive heart disease (41.1%), stable angina (39.5%), hypertension (35.6%), and diabetes mellitus (21.7%), were higher among the ICU group. Logistic regression analyses showed that higher odds of ICU admission were related to older age and comorbidities, such as ischemic heart disease and diabetes mellitus.

Conclusion. It is necessary to pay attention to family clusters and cases where the route of transmission of the disease is unknown. Additionally, special consideration should be given to men, elderly patients, and comorbidities, such as heart disease, diabetes mellitus, because they present a high probability of admission into the ICU. This study is useful as a basis for an accurate and rapid assessment of the COVID-19 situation in Uzbekistan and for the development of preventive healthcare policy in this direction.