Factors associated with poor outcomes in patients with severe acute respiratory infections in Bahrain

Author:

Mohamed Afaf Merza1ORCID,Al Sayyad Adel2ORCID,Matar Ebrahim3ORCID,Isa Hasan M.4ORCID,Hasan Wafa Fawzi5ORCID,Hashim Nawra Sayed Jalal Yusuf6,Alajaimi Bayan Abduljalil7ORCID,Aldolabi Qatrmeer7

Affiliation:

1. Consultant Family Medicine & Public Health Ministry of Health Manama Bahrain

2. Consultant Family Medicine, Epidemiology & Public Health, Chief of Disease Control Section, Ministry of Health. Associate Prof. of Family and Community Medicine CMMS, AGU Manama Bahrain

3. Medical Intern, Eastern Health Cluster Dammam Saudi Arabia

4. Consultant Pediatric Gastroenterologist, Pediatric Department Salmaniya Medical Complex, Arabian Gulf University Manama Bahrain

5. Statistician, Salmaniya Medical Complex Manama Capital Bahrain

6. Clinical attachment, Salmaniya Medical Complex Ministry of Health Manama Bahrain

7. Public Health Specialist (PHS), Disease Control Section Ministry of Health Manama Bahrain

Abstract

AbstractBackgroundSevere acute respiratory tract infection (SARI) is a major global health threat. This study aimed to examine risk factors associated with poor outcomes in patients with SARI.MethodsAll patients who met World Health Organization's (WHO) SARI case definition and were admitted to Salmaniya Medical Complex from January 2018 to December 2021 were included. Epidemiological and virological data were obtained and analyzed.ResultsOf 1159 patients with SARI included, 731 (63.1%) patients were below 50 years, and 357 (30.8%) tested positive for viral pathogens. The most prevalent virus was Flu‐A (n = 134, 37.5%), SARS‐CoV2 (n = 118, 33%), RSV (n = 51, 14.3%), Flu B (n = 49,13.7%), other viruses (n = 3, 0.8%), and combined infection (n = 2, 0.6%). Six hundred fifty‐eight (56.8%) patients had comorbidities, mainly diabetes (n = 284, 43%) and heart disease (n = 217, 33%). 183 (16%) patients were admitted to ICU, 110 (9%) needed mechanical ventilation, and 80 (7%) patients died.The odds of ICU admission were higher for patients with hematological (OR 5.9, 95% CI 3.1–11.1) and lung diseases (OR 2.7, 95% CI 1.6–4.6). The odds of mechanical ventilation were higher among patients with lung disease (OR 3.1, 95% 1.7–5.5). The mortality odds were higher among patients above 50 (OR 2.4, 95% CI 1.4–4.1) and chronic kidney disease (OR 2.5, 95% CI 1.1–5.2).ConclusionsBeing 50 years or above or having kidney, lung, or heart diseases was associated with worse SARI outcomes. Efforts and actions in developing better strategies to vaccinate individuals at high risk and early diagnosis and treatment should help in reducing the burden of SARI.

Publisher

Wiley

Subject

Infectious Diseases,Public Health, Environmental and Occupational Health,Pulmonary and Respiratory Medicine,Epidemiology

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