PLoS ONE (Jan 2022)

Clinical characteristics and outcomes of COVID-19 patients in Bali, Indonesia

  • Sri Masyeni,
  • Erni Juwita Nelwan,
  • Rois Muqsith Fatawy,
  • Surya Wibawa,
  • Putu Arya Nugraha,
  • Jarwa Antara,
  • Adi Suparta,
  • D. G. Wedha Asmara,
  • L. G. Sri Yenny,
  • A. A. G. Budhitresna,
  • Dewi Arimas,
  • Dewi Indriani,
  • Kmg Parwata,
  • Ketut Sutarjana,
  • Eka Sugiartha,
  • Siska Kahari,
  • Clareza Arief Wardhana,
  • A. A. G. Indraningrat,
  • Kadek Mulyantari,
  • Arya Widiyana Pasek,
  • Oka Putrawan,
  • Nyoman Trisna Yustiani,
  • Gede Wardana,
  • Made Indra Wijaya,
  • Suka Aryana,
  • Yuli Gayatri,
  • Dewi Dian Sukmawati,
  • Ketut Suastika,
  • Tuti Parwati Merati,
  • Made Bakta,
  • Raka Widiana

Journal volume & issue
Vol. 17, no. 6

Abstract

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Introduction The spectrum of illness and outcomes of coronavirus disease 2019 (COVID-19) patients may vary. This study reports the characteristics of COVID-19 patients in Bali, Indonesia, and evaluates the diagnostic value of their clinical symptoms. Method This observational study was conducted in eight hospitals. The patients were classified as non-severe COVID-19, severe COVID-19, and non-COVID-19. Demographics, clinical, laboratory, and radiologic characteristics, and outcomes of COVID-19 patients were collected. Factors associated with the severity and outcomes were assessed using the chi-squared test or ANOVA when appropriate. We also compared the clinical features of non-severe COVID-19 and non-COVID-19 patients to evaluate the diagnostic accuracy. Results This study included 92 patients: 41 non-COVID-19 and 51 COVID-19 patients, comprising 45 non-severe and six severe cases. The most common symptoms of COVID-19 were cough (47.1%), fever (31.0%), and dyspnea (25.3%). Cough, fatigue, and anosmia have high accuracy, and combining these complaints in clinical diagnostics offered a higher accuracy in predicting COVID-19 patients (60.1%). We found lower lymphocyte counts and interleukin-1R levels and higher levels of C-reactive protein, interleukin-6, and interleukin-8 in severe compared than in non-severe COVID-19 patients. Lactate dehydrogenase was associated with intensive care unit admission and ventilator use, while other markers such as neutrophil-lymphocyte ratio, C-reactive protein, and interleukin-6 were not. Conclusion A battery of symptoms, including cough, fatigue, and anosmia, is likely associated with COVID-19 in Bali. Clinicians should be aware of these symptoms to ensure a prompt diagnostic test for COVID-19, beyond other causes of acute febrile illnesses.