Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Journal article

Background
Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.
Methods
This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality.
Findings
Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5–9; 2% (3/133) for 10–19; 2% (8/638) for 20–29; 3% (26/755) for 30–39; 7% (61/819) for 40–49; 17% (155/941) for 50–59; 22% (132/611) for 60–69; and 34% (96/284) for ≥70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28–10.52; 27% vs 3% mortality).
Interpretation
Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

Authors: Surendra, H; Elyazar, IR; Djaafara, BA; Ekawati, LL; Saraswati, K

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: The Lancet Regional Health - Western Pacific
• Volume: 9
• Article number: 100108
• Publication date: 2021-03-02
• Acceptance date: 2021-02-01
• DOI: 10.1016/j.lanwpc.2021.100108
• EISSN: 2666-6065
• ISSN: 2666-6065
• Language: English
• Keywords: SARS-CoV-2; mortality; FFR; Indonesia; children; coronavirus; COVID-19