Assessing COVID-19 Prognostic Indicators in the Kingdom of Bahrain

Background: Assessing the COVID-19 prognostic indicators is crucial to identify high risk group and is vital in order to establish admission ground basis and identify the level of care required as well as prevention of rapid progression and deterioration by providing the proper care level at the time of presentation. This study has been designed to assess the outcome of hospitalized COVID-19 patients across government medical institutions in the Kingdom of Bahrain to delineate any bad clinical representations based on demographic prognostic indicators and laboratory parameters.

Method: A prospective observational analysis of all patients that were admitted with confirmed COVID-19 disease at different COVID governmental treating institutions throughout the Kingdom of Bahrain over a period of nine (9) consecutive months (February to October 2020).

Results: During the months of February and October 2020, it was estimated that 490 patients were admitted at the governmental COVID-19 isolation and treatment centers. Male predominance as well as old age was the most common risk factors. However, the latter was noticed to show no significant difference between ICU and non-ICU group. Among the comorbidities, diabetes was the commonest, although immuno-compromised state; respiratory diseases and hypertension were associated with higher risk of ICU admissions. Added to that, the clinical presentation had an impact on the outcome, as higher rates of ICU admissions were reported with fever, cough, and shortness of breath. (p value of 0.003, 0.001 and 0.001 respectively). Moreover, high inflammatory markers reflecting the presence of a cytokine storm were noticed among ICU patients.

Conclusion: It was found out that both the male gender as well as the comorbidities such as immuno-compromised status of admitted patients, respiratory diseases and/or hypertension reflected an independent risk factor for the severity of COVID-19 disease amidst adults. That, while clinical and laboratory indicators for the disease progression to a severe one included fever, cough and shortness of breath with presence of leukocytosis and elevated inflammatory markers such as D-Dimer, LDH, Ferritin and ESR..

Author(s): J Al-Salman, S Al-Khawaja AA Hadi , A Farookh , A Madan , A Nasser , F Majeed , H Ali , M Al-Alawi , M Fouad , R A. Nabi , H Jahrami.

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