BACKGROUND: The COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to describe the clinical characteristics of COVID-19 patients admitted to Hospital Tengku Ampuan Afzan (HTAA), Pahang, Malaysia and to identify the clinical and laboratory markers for severe disease, complications and virologic clearance according to clinical staging .
METHODS: This was a single-centre, retrospective, descriptive study . All COVID-19 patients admitted to HTAA from March 9 to April 15, 2020, were included in the study . Patients were categorised according to clinical staging . Data obtained from the medical report includes baseline characteristics of patients, comorbidities, presenting symptoms, laboratory findings, treatments, complications, and outcomes .
RESULTS: Of the total of 247 patients hospitalised, the majority consisted at clinical-stage 1 (43 %) and stage 2 (39 %) disease . Older patients, diabetes mellitus, hypertension, cardiovascular diseases, and chronic kidney disease were found more common among patients with severe disease . Fever was uncommon and the majority had normal haemoglobin levels, white cell counts, and platelet counts . C-reactive protein (CRP) was found statistically significant to predict pneumonia or hypoxia at a cut-off value of 14mg/L (sensitivity 73.8%, specificity 91.3 %) and 50mg/L (sensitivity 100%, specificity 96.4 %) respectively . Pneumonia was mostly diagnosed radiologically using chest radiography, especially among clinical stage 3 . Acute kidney injury (AKI) was a significant complication, with 31% of clinical stage 3 and above developed AKI and 44% of them requiring haemodialysis . Median virologic clearance time was 15 days from onset of illness, and asymptomatic patients had longer clearance time .
CONCLUSION: COVID-19 presented with a wide spectrum of clinical patterns . CRP was a valuable predictor of severe disease . In this study risk and severity of acute kidney injury were found to be higher . A longer duration of virologic clearance was observed among the asymptomatic patients.