An Epidemiological Analysis of COVID-19 cases from Jan to July 2020 in Kelantan, Malaysia

Abstract

As the global battle against COVID-19 rages on, Malaysia’s concerted effort in stemming the spread is commendable. This study characterized the epidemiology of COVID-19 aiming towards understanding the disease in a local setting for better preparation and management. A nation-based e-COVID reporting system was used to collect data on laboratory-confirmed COVID-19 cases in Kelantan from January to July 2020. Information from investigation reports was also reviewed. Analyses comprised of the estimation of incidence and case-fatality rate, summary of demographic and clinical characteristics including the age and sex distributions, construction of the epidemiological curve and choropleth map, and appraisal of healthcare usage. Multiple logistic regression was used to determine the risk factors for Intensive Care Unit (ICU) admission. A total of 166 cases reported in Kelantan until July 2020. Cases peaked during March before steadily declining and were concentrated in the capital. The age-adjusted incidence rate was 9.4/100,000 populations with a case-fatality rate of 2.4%. The median age was 37 years and 78% were male. The predominant symptoms were fever and cough while 25% of cases were asymptomatic. About 57% of cases were identified by active case detection and 97% had exposure risk. Potentially infected cases were isolated within a median of 7 days after exposure, even before the diagnosis. All cases were hospitalized with a median of 14 bed days, while 12% admitted to ICU, and 3% required mechanical ventilators. Significant factors for ICU admission were older age (AOR: 1.05, 95% CI: 1.02, 1.09, P = 0.001) and diabetes mellitus (AOR 4.55, 95% CI: 1.36, 15.25, P = 0.014). Although all ages appeared susceptible to COVID-19, older age and diabetic patients were more vulnerable. Kelantan’s targeted approaches of prompt identification and isolation of potentially infected individuals have been effective in limiting the transmission, allowing sufficient healthcare capacity in managing the pandemic.