Profiles and Characteristics of Patients with Mild to Moderate COVID -19 Disease Phenotypes in a Teaching Hospital in Kano, Northern Nigeria

Abstract

Background and Introduction: COVID-19 has affected almost 180 million people around the world, causing the death of about 5 million persons, as of November 16, 2021. The disease presents with a plethora of pulmonary and extrapulmonary symptoms of varying severity. After an exhaustive review of the literature, we found no data on the mild and moderate COVID-19 disease phenotypes in Northern Nigeria. Our objective is to describe the clinical characteristics of non-severe COVID -19 disease phenotypes in Kano State. Methods: This is a retrospective cohort study at the COVID-19 Isolation Center of Muhammad Buhari Specialist Hospital Kano, Nigeria. We included all patients admitted from May 2020 to December 2020. Patients’ medical records were assessed and evaluated to describe the clinical characteristics at presentation. We explored time to discharge between patients aged ≤ 50 years old versus those >50. We applied the Kaplan-Meier product-limit estimator to generate cumulative probabilities of discharge over time and used the Log-rank test to determine differences between the two age groups. We applied Cox Proportional Hazards to identify predictors of time to discharge among the patients in the study. The study variables comprised of time of viral clearance and time to discharge as outcome variables, while main exposure variables included, age, sex, occupation, mode of exposure, presence of co-morbidity, and duration of hospitalization. Results: A total of 187 COVID-19 patients were reviewed. The commonest symptoms were fever, breathing difficulty, and dry cough. There was no recorded death. Contact with a confirmed COVID-19 positive person was the source of infection in 167(89.3%) of patients. We noted faster time to viral clearance in patients on lopinavir compared to those on chloroquine (Log-rank test p-value = 0.048). There were no significant differences in time to discharge between younger (< 50 years) versus older patients (≥ 50 years) [24 days vs. 26 days respectively; Log-rank test p-value = 0.082]. Age, sex, and source of infection did not appear to be predictors of infection phenotype. Conclusion and Implications for Translation: The findings of this study have a bearing on the surveillance and diagnosis of COVID-19 in Nigeria. While the plethora of clinical features may not be limited to infection with the SARS-CoV-2 virus, healthcare practitioners should consider these symptom clusters in addition to cognate contact and travel history when confronted with a suspected COVID-19 infection.