Characteristics and prognostic factors of COVID-19 among infected cases: A nationwide Tunisian analysis

Abstract

Background: The outbreak of coronavirus disease (COVID-19) continues to constitute an international public health concern. Few data are available on the duration and prognostic factors of the disease. We aimed to study the recovery time among a Tunisian cohort of COVID-19 confirmed patients and identify the prognostic factors.Methods: A retrospective, nationwide study was conducted from March 2 to May 8, 2020, recruiting all patients who were diagnosed with COVID-19, by RT-PCR methods, in Tunisia. Data were collected via phone call interview. Kaplan-Meir Methods and Cox proportional hazards regression models were, respectively, used to study the recovery time and estimate its prognostic factors.Results: One thousand thirty patients with COVID-19 (aged 43.2 ± 18.2 years, 526 female (51.1%)) were enrolled. Among them 141 (14.8%) were healthcare professionals. Out of 173 patients (17.8%) admitted to the hospital, 47 were admitted in an intensive care unit. Among 827 patients who didn’t require specialized care, 55.5% were self-isolated at home, while the rest were in specialized centers. Six hundred two patients were symptomatic. A total of 634 (61.6 %) patients have recovered and 45 (4.4 %) patients died. The median duration of illness was estimated to be 31 days (95% CI: [29 - 32]). Older age (HR=0.66, CI:[ 0.46-0.96], P=0.031) and symptoms (HR=0.61, CI:[ 0.43-0.81], P=0.021) were independently associated with a delay in recovery time. Being a healthcare professional (HR=1.52, CI :[1.10-2.08], P=0.011) and patients in home isolation compared to isolation centers (HR=2.99, CI :[1.85-4.83], P<10¯³) were independently associated with faster recovery time. Conclusion: The duration of illness was estimated to be one month. However, this long estimated duration of illness may not equate to infectiousness. A particular attention must to be paid to elderly and symptomatic patients with closer monitoring.

Validity and reliability of a modified short version of a stigma scale for use among Tunisian COVID‐19 patients after quarantine: A cross‐sectional study

“…In the literature, similar results were reported in several case series 9,16,17 . The proportion of healthcare professionals of 14.8% among participants was also similar to that in the Tunisian national survey 24 …”

“…The median age of participants in the current study was 40 years with 61.4% aged between 31 and 64 years. Similar young age range was reported by a national study about the characteristics of COVID‐19 patients and the prognosis of the infection in the Tunisian general population 24 . In the literature, similar results were reported in several case series 9,16,17 .…”

“…Nonetheless, a daily random sampling was performed using updated lists of the new declared cases in Sousse. Indeed, this predominance of females and home quarantined patients was observed at the national level 24. Further investigation on larger samples and different populations is required to confirm our stigma-related results.…”

“…In fact, regarding the lack of confinement centers in Tunisia, home quarantine was the only solution to isolate COVID-19 patients. 24 Highest scores were recorded on the following questions: "I am very careful about who I tell that I have COVID-19" and "Telling someone I have COVID-19 is risky". These results join those in Pakistan 16 and India 10 showing significantly higher levels of public attitude and disclosure concerns domains.…”

“…Most of cases did not require treatment in a hospital structure and were self‐isolated at home with family members (78.4%). In fact, regarding the lack of confinement centers in Tunisia, home quarantine was the only solution to isolate COVID‐19 patients 24 …”