BACKGROUND: Haiti's first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations. METHODS: We conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease. RESULTS: Of 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%), and myalgia (45.8%). The odds of having moderate-to-severe disease were highest among persons with hypertension (aOR = 1.72, 95% Confidence Interval [CI] (1.34, 2.20), chronic pulmonary disease (aOR = 3.93, 95% CI (1.93, 8.17)) and tuberculosis (aOR = 3.44, 95% CI (1.35, 9.14)) compared to persons without those conditions. The odds of having moderate-to-severe disease increased with age but was also seen among children aged 0-4 years (OR: 1.73, 95% CI (0.93, 3.08)), when using 30-39 years old as the reference group. All of the older age groups, 50-64 years, 65-74 years, 75-84 years, and 85+ years, had significantly higher odds of having moderate-to-severe COVID-19 compared with ages 30-39 years. Diabetes was associated with elevated odds of moderate-to-severe disease in bivariate analysis (OR = 2.17, 95% CI (1.58,2.98) but, this association did not hold in multivariable analyses (aOR = 1.22,95%CI (0.86,1.72)). CONCLUSION: These findings from a resource-constrained country highlight the importance of surveillance systems to track emerging infections and their risk factors. In addition to co-morbidities described elsewhere, tuberculosis was a risk factor for moderate-to-severe COVID-19 disease.
BACKGROUND: Haiti's first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations. METHODS: We conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease. RESULTS: Of 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%), and myalgia (45.8%). The odds of having moderate-to-severe disease were highest among persons with hypertension (aOR = 1.72, 95% Confidence Interval [CI] (1.34, 2.20), chronic pulmonary disease (aOR = 3.93, 95% CI (1.93, 8.17)) and tuberculosis (aOR = 3.44, 95% CI (1.35, 9.14)) compared to persons without those conditions. The odds of having moderate-to-severe disease increased with age but was also seen among children aged 0-4 years (OR: 1.73, 95% CI (0.93, 3.08)), when using 30-39 years old as the reference group. All of the older age groups, 50-64 years, 65-74 years, 75-84 years, and 85+ years, had significantly higher odds of having moderate-to-severe COVID-19 compared with ages 30-39 years. Diabetes was associated with elevated odds of moderate-to-severe disease in bivariate analysis (OR = 2.17, 95% CI (1.58,2.98) but, this association did not hold in multivariable analyses (aOR = 1.22,95%CI (0.86,1.72)). CONCLUSION: These findings from a resource-constrained country highlight the importance of surveillance systems to track emerging infections and their risk factors. In addition to co-morbidities described elsewhere, tuberculosis was a risk factor for moderate-to-severe COVID-19 disease.
Authors: Rebecca L Laws; Rebecca J Chancey; Elizabeth M Rabold; Victoria T Chu; Nathaniel M Lewis; Mark Fajans; Hannah E Reses; Lindsey M Duca; Patrick Dawson; Erin E Conners; Radhika Gharpure; Sherry Yin; Sean Buono; Mary Pomeroy; Anna R Yousaf; Daniel Owusu; Ashutosh Wadhwa; Eric Pevzner; Katherine A Battey; Henry Njuguna; Victoria L Fields; Phillip Salvatore; Michelle O'Hegarty; Jeni Vuong; Christopher J Gregory; Michelle Banks; Jared Rispens; Elizabeth Dietrich; Perrine Marcenac; Almea Matanock; Ian Pray; Ryan Westergaard; Trivikram Dasu; Sanjib Bhattacharyya; Ann Christiansen; Lindsey Page; Angela Dunn; Robyn Atkinson-Dunn; Kim Christensen; Tair Kiphibane; Sarah Willardson; Garrett Fox; Dongni Ye; Scott A Nabity; Alison Binder; Brandi D Freeman; Sandra Lester; Lisa Mills; Natalie Thornburg; Aron J Hall; Alicia M Fry; Jacqueline E Tate; Cuc H Tran; Hannah L Kirking Journal: Pediatrics Date: 2020-10-08 Impact factor: 7.124
Authors: Melissa M Arons; Kelly M Hatfield; Sujan C Reddy; Anne Kimball; Allison James; Jesica R Jacobs; Joanne Taylor; Kevin Spicer; Ana C Bardossy; Lisa P Oakley; Sukarma Tanwar; Jonathan W Dyal; Josh Harney; Zeshan Chisty; Jeneita M Bell; Mark Methner; Prabasaj Paul; Christina M Carlson; Heather P McLaughlin; Natalie Thornburg; Suxiang Tong; Azaibi Tamin; Ying Tao; Anna Uehara; Jennifer Harcourt; Shauna Clark; Claire Brostrom-Smith; Libby C Page; Meagan Kay; James Lewis; Patty Montgomery; Nimalie D Stone; Thomas A Clark; Margaret A Honein; Jeffrey S Duchin; John A Jernigan Journal: N Engl J Med Date: 2020-04-24 Impact factor: 91.245
Authors: Kimberly D Spencer; Christina L Chung; Alison Stargel; Alvin Shultz; Phoebe G Thorpe; Marion W Carter; Melanie M Taylor; Mary McFarlane; Dale Rose; Margaret A Honein; Henry Walke Journal: MMWR Morb Mortal Wkly Rep Date: 2021-01-22 Impact factor: 17.586