##plugins.themes.bootstrap3.article.main##

Background: COVID-19 mortality is a public health issue in Malaysia and its contributing factors need to be addressed thoroughly. This study aimed to determine the risk factors for COVID-19 mortality in Besut region of Malaysia.

Materials and Methods: A 1:5 case-control study between deceased and survived groups among COVID-19 patients was conducted in Besut district, Terengganu state from 1st October 2020 until 16th September 2021 based on retrospective record review. The inclusion criteria for cases were individuals with laboratory RT-PCR confirmed positive test for COVID-19 and died during COVID-19 care period. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis.

Result: There were 6464 COVID-19 cases in Besut district during the studied period. The proportion of COVID-19 mortality was 0.84%. Among the deceased group, majority of them were male (51.9%), symptomatic (87.0%), unvaccinated (94.4%); had COVID-19 of category 5 (31.5%) and comorbidity (81.5%). Multiple logistic regression revealed older age, stage 4 COVID-19, stage 5 COVID-19, symptomatic, cases with comorbidity and unvaccinated cases as the significant associated factors for COVID-19 mortality with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.01, 1.10), p<0.001; AOR 92.61 (95%CI: 7.07, 1212.02), p=0.001; AOR 274.97 (95%CI: 25.27, 2991.74), p<0.001; AOR 8.83 (95%CI: 3.21, 24.28), p<0.001; AOR 46.72 (95%CI: 15.29, 142.70), p<0.001; and AOR 16.94 (95%CI: 6.34, 121.22), p=0.001, respectively.

Conclusion: Advanced age, severe stages of COVID-19, symptomatic cases, cases with comorbidity and unvaccinated cases were the risk factors for COVID-19 mortality. Emphasis should be given to these factors to ensure timely control and treatment strategies.

Downloads

Download data is not yet available.

References

  1. Elengoe A. COVID-19 outbreak in Malaysia. Osong public health research perspectives. 2020; 11(3): 93.
    DOI  |   Google Scholar
  2. Ministry of Health. COVIDNOW in Malaysia. Malaysia: Ministry of Health Malaysia. [Internet] 2021 Available from: https://covidnow.moh.gov.my/
     Google Scholar
  3. Awang H, Yaacob EL, Syed Aluawi SN, Mahmood MF, Hamzah FH, Wahab A, et al. A case–control study of determinants for COVID-19 infection based on contact tracing in Dungun district, Terengganu state of Malaysia. Infectious Diseases. 2021; 53(3): 222-5.
    DOI  |   Google Scholar
  4. Awang H, Hamzah FH, Ahmad MH, Mahmood MF, Wahab A, Embong K, et al. Polymerase chain reaction cycle threshold value as prerequisite for reporting of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection. Infectious Diseases. 2021; 53(5): 390-2.
    DOI  |   Google Scholar
  5. Awang H, Mohamed KA, Ahmad MH, Ning GS, Zakaria Z, Mizam NAN, et al. COVID-19 Outbreak In A Religious Secondary School In Setiu District, Terengganu State Of Malaysia: Incidence And Associated Factors. International Journal of Public Health and Clinical Sciences. 2021; 8(4): 78-86.
     Google Scholar
  6. Ning GS, Awang H, Omar AF, Muda F, Ahmad MH, Embong K, et al. Coronavirus Disease (COVID-19) Outbreak among Islamic Missionaries in Terengganu state of Malaysia in 2020. International Journal of Human and Health Sciences. 2021; 5(4): 491-8.
    DOI  |   Google Scholar
  7. Terengganu State Health Department. Current COVID-19 Situation in Terengganu Terengganu: Terengganu State Health Department. [Internet] 2021 Available from: https://www.facebook.com/jkntrg/photos/a.511556245562164/4640185389365875/?type=3
     Google Scholar
  8. Sepandi M, Taghdir M, Alimohamadi Y, Afrashteh S, Hosamirudsari H. Factors associated with mortality in COVID-19 patients: a systematic review and meta-analysis. Iranian journal of public health. 2020; 49(7): 1211.
    DOI  |   Google Scholar
  9. Albitar O, Ballouze R, Ooi JP, Ghadzi SMS. Risk factors for mortality among COVID-19 patients. Diabetes Research and Clinical Practice. 2020; 166: 108293.
    DOI  |   Google Scholar
  10. Parohan M, Yaghoubi S, Seraji A, Javanbakht MH, Sarraf P, Djalali M. Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies. The Aging Male. 2020; 23(5): 1416-24.
    DOI  |   Google Scholar
  11. Shi Q, Zhang X, Jiang F, Zhang X, Hu N, Bimu C, et al. Clinical characteristics and risk factors for mortality of COVID-19 patients with diabetes in Wuhan, China: a two-center, retrospective study. Diabetes care. 2020; 43(7): 1382-91.
    DOI  |   Google Scholar
  12. Cook T, Roberts JJA. Impact of vaccination by priority group on UK deaths, hospital admissions and intensive care admissions from COVID‐19. 2021; 76(5): 608-16.
    DOI  |   Google Scholar
  13. Moghadas SM, Vilches TN, Zhang K, Wells CR, Shoukat A, Singer BH, et al. The impact of vaccination on COVID-19 outbreaks in the United States. 2021.
    DOI  |   Google Scholar
  14. Ministry of Health. Classification of COVID-19 Death for National COVID-19 Death Statistics Ministry of Health Malaysia. Malaysia: Ministry of Health Malaysia. [Internet] 2021 Available from: https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm/Annex_20_Forensic_Guidelines_02122020.pdf
     Google Scholar
  15. Dupont WD, Plummer Jr WD. Power and sample size calculations: a review and computer program. Controlled Clinical Trials. 1990; 11(2): 116-28.
    DOI  |   Google Scholar
  16. Ministry of Health. COVID-19 Case Definition Malaysia: Ministry of Health Malaysia. [Internet] 2021 Available from: https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm/ANNEX_1_Case_definition_30082021.pdf
     Google Scholar
  17. Ministry of Health. Clinical Management of Confirmed COVID-19 Case in Adult and Paediatric Malaysia: Ministry of Health Malaysia. [Internet] 2021 Available from: https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm/ANNEX_2e_CLINICAL_MANAGEMENT_OF_CONFIRMED_COVID-19_CASE_IN_ADULT_AND_PAEDIATRIC_13082021.pdf
     Google Scholar
  18. Sim BLH, Chidambaram SK, Wong XC, Pathmanathan MD, Peariasamy KM, Hor CP, et al. Clinical characteristics and risk factors for severe COVID-19 infections in Malaysia: a nationwide observational study. The Lancet Regional Health-Western Pacific. 2020; 4: 100055.
    DOI  |   Google Scholar
  19. Din HM, Adnan RNER, Akahbar SAN, Ahmad SA. Characteristics of COVID-19-Related Deaths Among Older Adults in Malaysia. The Malaysian Journal of Medical Sciences. 2021; 28(4): 138.
    DOI  |   Google Scholar
  20. Wahil MSA, Jaafar MH, Ismail R, Chua SP, Jeevananthan C, Sandhu RS, et al. Preliminary Study on Associated Risk Factors of Mortality Due to COVID-19 Pandemic in Malaysia. Medical Sciences Forum. 2021; 4(1): 8.
    DOI  |   Google Scholar
  21. Klein SL, Dhakal S, Ursin RL, Deshpande S, Sandberg K, Mauvais-Jarvis F. Biological sex impacts COVID-19 outcomes. PLoS pathogens. 2020; 16(6): e1008570.
    DOI  |   Google Scholar
  22. Shahid Z, Kalayanamitra R, McClafferty B, Kepko D, Ramgobin D, Patel R, et al. COVID‐19 and older adults: what we know. Journal of the American Geriatrics Society. 2020; 68(5): 926-9.
    DOI  |   Google Scholar
  23. Smith R. Immunity, trauma and the elderly. Injury. 2007; 38(12): 1401-4.
    DOI  |   Google Scholar
  24. Krishnasamy N, Natarajan M, Ramachandran A, Thangaraj JWV, Etherajan T, Rengarajan J, et al. Clinical outcomes among asymptomatic or mildly symptomatic COVID-19 patients in an isolation facility in Chennai, India. The American Journal of Tropical Medicine and Hygiene. 2021; 104(1): 85.
    DOI  |   Google Scholar
  25. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020; 368.
    DOI  |   Google Scholar
  26. Gul MH, Htun ZM, Inayat A. Role of fever and ambient temperature in COVID-19. Expert Review of Respiratory Medicine. 2021; 15(2): 171-3.
    DOI  |   Google Scholar
  27. Li K, Wu J, Wu F, Guo D, Chen L, Fang Z, et al. The clinical and chest CT features associated with severe and critical COVID-19 pneumonia. Investigative radiology. 2020.
    DOI  |   Google Scholar
  28. Ministry of Health. RECoVaM study Malaysia: Ministry of Health Malaysia. [Internet] 2021 Available from: https://covid-19.moh.gov.my/semasa-kkm/2021/09/kajian-keberkesanan-vaksin-di-malaysia-oleh-icr
     Google Scholar
  29. Muthukrishnan J, Vardhan V, Mangalesh S, Koley M, Shankar S, Yadav AK, et al. Vaccination status and COVID-19 related mortality: A hospital based cross sectional study. Medical Journal Armed Forces India. 2021; 77: S278-S82.
    DOI  |   Google Scholar
  30. Dyer O. Covid-19: Unvaccinated face 11 times risk of death from delta variant, CDC data show. BMJ. 2021: 374.
    DOI  |   Google Scholar


Most read articles by the same author(s)