Epidemiological Analysis of COVID-19 Patients detected by Real-Time Reverse Transcription - Polymerase Chain reaction in a Tertiary Care Biosafety Level III Laboratory, Rawalpindi

  • Rabia Anjum Bbh,RMU
  • Nadeem Ikram
  • Asma Nafisa
  • Naeem Akhtar
Keywords: COVID-19, RT-PCR, Epidemiological analysis.

Abstract

Introduction: Unexpected eruption and global dissemination of Coronavirus disease (COVID-19) has tested the healthcare systems of both developed and developing countries.
Objective: To analyze the spectrum of novel coronavirus infection in a tertiary care setup.
Materials and Methods: All oropharyngeal and nasopharyngeal samples (n=7057) were collected in a viral transport medium (VTM) for qualitative analysis by a real-time reverse transcription-polymerase chain reaction (RT-PCR) machine. Positive and negative controls were applied with each batch. Positive cases were stratified into mild, moderate, severe, and asymptomatic, according to the guidelines of the National Institute of Health, Pakistan. Descriptive statistical tests were applied including percentage, chi-square tests, mean, median, and mode. P < 0.05 was counted as statistically significant.
Results: Average positive test rate was 18.97% (n=1339). The maximum positivity rate (26%) of COVID-19 infection was observed in June 2020. Most of the cases (60%) belonged to Rawalpindi District, were male (n=844, 63.03%), and belonged to age group (20-40 years) and mean of 36 and age range from 2-85 years. Forty-nine percent of COVID-19 infected patients were asymptomatic and only 9.8% progressed to severe disease. Overall, the mortality rate was 159(11.87%) in RT-PCR confirmed cases.
Conclusion: Average positive test rate was 18.97%. The majority of the participants belonged to the young age group (20-40 yrs.) with a range from 2 to 85 years. Forty-nine percent positive COVID-19 infected patients were asymptomatic while 9.8% had severe disease.

References

1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet. 2020 Feb 15;395(10223):507-13. https://doi.org/10.1016/ S0140-6736(20)30211-7
2. World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific brief, 27 March 2020. World Health Organization; 2020.
3. Tahir S, Tahir SA, Arif TB, Majid B, Majid Z, Malik F, et al. Epidemiological and Clinical Features of SARS-CoV-2: A Retrospective Study from East Karachi, Pakistan. Cureus. 2020 Jun;12(6).
4. Jin JM, Bai P, He W, Liu S, Wu F, Liu XF, et al. Higher severity and mortality in male patients with COVID-19 independent of age and susceptibility. medRxiv. 2020 Jan 1. DOI: 10.3389/fpubh.2020.00152
5. Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Annals of internal medicine. 2020 May 5;172(9):577-82.DOI: 10.7326/M20-0504
6. World Health Organization. Considerations for quarantine of individuals in the context of containment for coronavirus disease (‎‎ COVID-19)‎‎: interim guidance, 19 March 2020. World Health Organization; 2020.
7. Gupta N, Agrawal S, Ish P, Mishra S, Gaind R, Usha G, et al.Safdarjung Hospital COVID 2019 working group. Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India. Monaldi archives for chest disease. 2020 Apr 10;90(1).
8. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of hospital infection. 2020 Mar 1;104(3):246-51. DOI: 10.1016/j.jhin.2020.01.022.
9. Dong L, Tian J, He S, Zhu C, Wang J, Liu C, et al. Possible vertical transmission of SARS-CoV-2 from an infected mother to her newborn. Jama. 2020 May 12;323(18):1846-8. DOI: 10.1001/jama.2020.4621
10. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. Radiology. 2020 Aug;296(2): E15-25. https://doi.org/10.1148/radiol.2020200490
11. Cao W. Clinical features and laboratory inspection of novel coronavirus pneumonia (COVID-19) in Xiangyang, Hubei. medRxiv. 2020 Jan 1. DOI: https://doi.org/10.1101/2020.02.23.20026963
12. World Health Organization: coronavirus disease (COVID-19) advice for the public. (2020). Accessed: May 20, 2020: https://www.who.int/emergencies/diseases/novel-coronavirus2019/advice-for-public
13. Liu R, Han H, Liu F, Lv Z, Wu K, Liu Y, et al. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clinica Chimica Acta. 2020 Jun 1;505: 172-5. DOI: 10.1016/j.cca.2020.03.009
14. The organization, W.H, 2020b. Coronavirus Disease 2019 (COVID-19): Situation Report, 70.
15. Badar N, Ikram A, Mirza HA, Ahad A, Alam MM, Arshad Y,et al.Laboratory-based surveillance of SARS-CoV-2 in Pakistan. medRxiv. 2020 Jan DOI: https://doi.org/10.1101/2020.06.10.20126847
16. National Institute of Health: COVID-19. (2020). Accessed: May 20, 2020: https://www.nih.org.pk/novel-coranavirus-2019-ncov/.
17. Raza H, Wahid B, Rubi G, Gulzar A. Molecular epidemiology of SARS-CoV-2 in Faisalabad, Pakistan: A real-world clinical experience. Infection, Genetics, and Evolution. 2020 Oct 1; 84:104374 DOI: 10.1016/j.meegid.2020.104374
18. Pan Y, Zhang D, Yang P, Poon LL, Wang Q. Viral load of SARS-CoV-2 in clinical samples. The Lancet infectious diseases. 2020 Apr 1;20(4):411-2. DOI: 10.1016/S1473-3099(20)30113-4
19. Qiu F., Wang H., Zhang Z., et al. Laboratory testing techniques for SARS-CoV-2. 2020 Feb 29;40(2):164-167. DOI: 10.12122/j.issn.1673-4254.2020.02.04.
20. Lau LT, Fung YW, Wong FP, Lin SS, Wang CR, Li HL,et al. A real-time PCR for SARS-coronavirus incorporating target gene pre-amplification. Biochemical and Biophysical Research Communications. 2003 Dec 26;312(4):1290-6. DOI: 10.1016/j.bbrc.2003.11.064.
21. Bai Y, Yao L, Wei T, Tian F, Jin DY, Chen L, et al. Presumed asymptomatic carrier transmission of COVID-19. Jama. 2020 Apr 14;323(14):1406-7. doi:10.1001/jama.2020.2565
22. Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England journal of medicine. 2020 Apr 16;382(16):1564-7.doi: 10.1056/NEJMc2004973
23. Ikram N, Nafisa A, Anjum R. Predictive Efficacy of Haematological Biomarkers in COVID-19 infection. Journal of Rawalpindi Medical College. 2020 Dec 30;24(4):423-9. DOI: https://doi.org/10.37939/jrmc.v24i4.1517
24. Dehingia N, Raj A. Sex differences in COVID-19 case fatality: do we know enough? The Lancet Global Health. 2021 Jan 1;9(1): e14-5. DOI: 10.1016/S2214-109X(20)30464-2
25. Peckham H, de Gruijter NM, Raine C, Radziszewska A, Ciurtin C, Wedderburn LR, et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nature communications. 2020 Dec 9;11(1):1-0. DOI: 10.1038/s41467-020-19741-6
26. Zheng Y, Xiong C, Liu Y, Qian X, Tang Y, Liu L, et al. Epidemiological and clinical characteristics analysis of COVID-19 in the surrounding areas of Wuhan, Hubei Province in 2020. Pharmacological research. 2020 Jul 1;157: 104821. DOI: 10.1016/j.phrs.2020.104821.
Published
2021-03-30
How to Cite
1.
Anjum R, Ikram N, Nafisa A, Akhtar N. Epidemiological Analysis of COVID-19 Patients detected by Real-Time Reverse Transcription - Polymerase Chain reaction in a Tertiary Care Biosafety Level III Laboratory, Rawalpindi. JRMC [Internet]. 30Mar.2021 [cited 5Aug.2021];25(1):128-33. Available from: https://journalrmc.com/index.php/JRMC/article/view/1576