Laboratory based Retrospective Study to determine the start of SARS-CoV-2 in Patients with Severe Acute Respiratory Illness in Egypt at El-Demerdash tertiary hospitals

Abstract

Subject Area: SARS-CoV-2Purpose: COVID-19 is the most recent pandemic causing morbidity and mortality. Although a part of the pathogens causing SARI, it is unique in causing pulmonary thrombosis and lung fibrosis. Thus different management is needed. We aimed o explore the start of SARS-CoV-2 in preserved SARI samples to know the exact time of its emergence in our hospital, to conduct whole-genome sequencing in positive SARS-CoV-2 samples to define its strain. To assess the clinical characteristics of the severe respiratory infection admitted to El-Demerdash hospitals in that same period from our own file reports.Methods: We conducted a retrospective cohort study among SARI patients who were admitted to Ain Shams university hospitals. preserved nasopharyngeal& oropharyngeal swabs from 333 SARI patients were used in SARS-CoV-2 detection by RT-Real time PCR. Moreover, whole-genome sequencing of SARS-CoV-2 positive samples was performed. Clinical characteristics of the SARI patients were analyzed in the same period to show the relation to morbidity and mortality.Results: The first case of SARS-CoV-2 was detected in a 6months aged female patient on mid-April 2020, B.1.1.7, clade GR. Co-infection (with both bacterial and viral) was most prevalent in pediatrics than adults, but mortality was higher in adults than pediatrics (18.1% versus 7.1%). ICU admission was higher in adults than in the pediatric group (65% versus 12.8%). Co-morbidities were associated with higher mortality and more severe infection. The most common bacterial infection in both adults and pediatrics was Klebsiella pneumoniae, followed by Staphylococcus aureus and Streptococcus pneumoniae. Conclusion: COVID-19 didn’t start till mid-April in the Egyptian hospitals as remarked by this tertiary hospital’s data. Co-infection is the most prevalent in children and further research is needed in this area.