Background
Methods
Study design and participants
Laboratory procedures
Viral nucleic acid extraction and rRT-PCR for SARS-CoV- 2
Epidemic wave
Statistical analysis
Results
Demographic status, comorbidity, and hospitalization of patients with suspected COVID-19
Characteristic | Total hospitalizations | p-value | SARS-CoV2 PCR Positive | p-value | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Wave 01 (%) | 4th (alpha) wave N (%) | 5th (delta) wave N (%) | 6th (omicron) wave N (%) | Wave 0 N (%) | 4th (alpha) wave N (%) | 5th (delta) wave N (%) | 6th (omicron) wave N (%) | |||
Overall | 3417 (25.5) | 2519 (18.9) | 5231 (39.3) | 2143 (16.1) | – | 644 (10) | 1402 (21.7) | 3573 (55.3) | 835 (12.9) | – |
Median age, yrs., (IQR) | 56 (39) | 56 (31) | 52 (28) | 62 (38) | < 0.001 | 55 (27) | 53 (24) | 52 (23) | 65 (34) | < 0.001 |
Mean ± SD, age, yrs | 49.66 ± 27.4 | 53.6 ± 21.82 | 49.5 ± 21.7 | 54.3 ± 27.5 | < 0.001 | 54.7 ± 19.3 | 53.5 ± 16.9 | 51.1 ± 17.4 | 58.6 ± 25.1 | < 0.001 |
Age group, yrs. | ||||||||||
< 18 (n = 1690; 12.8%) | 634 (18.8) | 185 (7.4) | 522 (10) | 349 (16.4) | < 0.001 | 23 (3.6) | 18 (1.3) | 121 (3.4) | 84 (10.1) | < 0.001 |
18–49 (n = 3721; 28.1%) | 776 (23) | 781 (31) | 1803 (34.6) | 361 (16.9) | 216 (33.6) | 567 (40.4) | 1445(40.5) | 160 (19.2) | ||
50–64 (n = 3443; 26%) | 737 (21.9) | 686 (27.3) | 1557 (29.9) | 463 (21.7) | 206 (32) | 444 (31.7) | 1215 (34) | 166 (19.9) | ||
65-79 (n = 2908; 22%) | 770 (22.9) | 588 (23.4) | 977 (18.7) | 573 (26.9) | 125 (19.4) | 276 (19.7) | 649 (18) | 246 (29.5) | ||
≥ 80 (n = 1468; 11.1%) | 451 (13.4) | 276 (11) | 353 (6.8) | 388 (18.2) | 73 (11.4) | 97 (6.9) | 149 (4.2) | 177 (21.2) | ||
Sex | ||||||||||
Men | 1754 (51.3) | 1188 (47.2) | 2392 (45.7) | 1005 (46.9) | < 0.001 | 309 (48) | 614 (43.8) | 1533(42.9) | 377 (45.1) | 0.097 |
Women | 1663 (48.7) | 1331 (52.8) | 2839 (54.3) | 1138 (53.1) | 335 (52) | 788 (56.2) | 2040(57.1) | 458 (54.9) | ||
Underlying diseases | ||||||||||
CVD2 | 824 (24.1) | 652 (25.9) | 857 (16.4) | 635 (29.6) | < 0.001 | 158 (24.5) | 298 (21.3) | 484 (13.5) | 243 (29.1) | < 0.001 |
Diabetics | 592 (17.3) | 433 (17.2) | 751 (14.4) | 397 (18.5) | < 0.001 | 116 (18) | 236 (16.8) | 520 (14.6) | 173 (20.7) | < 0.001 |
KD3 | 137 (4) | 72 (2.9) | 103 (2) | 80 (3.7) | < 0.001 | 17 (2.6) | 33 (2.4) | 53 (1.5) | 34 (4.1) | < 0.001 |
Hypertension | 444 (13) | 195 (7.7) | 372 (7.1) | 239 (11.2) | < 0.001 | 102 (15.8) | 101 (7.2) | 232 (6.5) | 92 (11) | < 0.001 |
Malignancies | 243 (7.1) | 123 (4.9) | 160 (3.1) | 122 (5.7) | < 0.001 | 18 (2.8) | 29 (2.1) | 47 (1.3) | 40 (4.8) | < 0.001 |
RD4 | 136 (4) | 82 (3.3) | 100 (1.9) | 73 (3.4) | < 0.001 | 15 (2.3) | 49 (3.5) | 54 (1.5) | 29 (3.5) | < 0.001 |
GID5 | 34 (1) | 24 (0.95) | 31 (0.62) | 12 (0.54) | 0.061 | 5 (0.8) | 13 (0.9) | 11 (0.33) | 8 (0.9) | 0.005 |
BND6 | 230 (6.7) | 132 (5.2) | 119 (3.4) | 160 (7.5) | < 0.001 | 35 (5.4) | 48 (3.4) | 84 (2.4) | 75 (9) | < 0.001 |
BD7 | 23 (0.7) | 18 (0.7) | 14 (0.3) | 13 (0.6) | 0.016 | 2 (0.3) | 10 (0.7) | 9 (0.3) | 3 (0.4) | 0.118 |
Pregnancy | 57 (1.7) | 19 (0.8) | 73 (1.4) | 30 (1.4) | 0.024 | 25 (3) | 8 (0.6) | 54 (1.5) | 25 (3) | 0.001 |
Others8 | 25 (0.7) | 31 (1.2) | 29 (0.6) | 21 (1) | 0.012 | 3 (0.5) | 19 (1.4) | 12 (0.4) | 11 (1.3) | < 0.001 |
Comorbidities | ||||||||||
No Comorbidities | 1570 (45.9) | 1219 (48.4) | 3346 (64) | 967 (45.1) | < 0.001 | 307 (47.7) | 767 (57.7) | 2458(68.8) | 344 (41.2) | < 0.001 |
One | 1187 (34.7) | 917 (36.4) | 1258 (24) | 725 (33.8) | 222 (34.5) | 455 (32.5) | 749 (21) | 301 (36) | ||
> = Two | 660 (19.3) | 383 (15.2) | 627 (12) | 451 (21) | 115 (17.9) | 180 (12.8) | 366 (10.2) | 190 (22.8) | ||
Hospitalization outcome | ||||||||||
Length of stay, days, median (IQR) | 5 (4) | 5 (4) | 5 (3) | 5 (5) | < 0.001 | 5 (3) | 5 (3) | 5 (3) | 5 (4) | 0.066 |
Length of stay, days, Mean ± SD | 7.6 ± 9.0 | 7.5 ± 11.3 | 7.1 ± 8.6 | 6.6 ± 6.0 | < 0.001 | 7.03 ± 10.9 | 6.6 ± 9.4 | 6.7 ± 7.5 | 6.3 ± 5.7 | 0.744 |
ICU admission | 139 (4.1) | 97 (3.9) | 176 (3.4) | 75 (3.5) | 0.344 | 49 (7.6) | 62 (4.4) | 138 (3.9) | 42 (5) | < 0.001 |
In-hospital death | 72 (2.1) | 167 (6.6) | 139 (2.7) | 43 (2) | < 0.001 | 17 (2.6) | 95 (6.8) | 96 (2.7) | 29 (3.5) | < 0.001 |
Demographic status, comorbidity and hospitalization outcomes of SARS-CoV2 PCR-positive patients
Characteristic | Total hospitalizations | SARS-CoV-2 PCR Positive | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total | ICU | p-value | Death | p-value | Total | ICU | p-value | Death | p-value | |
Overall | 13,312 | 487 | – | 422 | – | 6459 | 291 | – | 238 | – |
Median age, yrs., (IQR) | 55 (32) | 62 (28) | < 0.001 | 66 (28) | < 0.001 | 54 (26) | 62 (26) | < 0.001 | 65 (28) | < 0.001 |
Mean ± SD age, yrs | 51.9 ± 24.4 | 57.9 ± 23.2 | < 0.001 | 63.0 ± 20.8 | < 0.001 | 52.9 ± 18.8 | 56.0 ± 21.0 | < 0.001 | 52.5 ± 18.7 | 0.002 |
Age group, yrs | ||||||||||
< 18 | 1690 (12.8) | 40 (8.2) | < 0.001 | 17 (4.1) | < 0.001 | 246 (3.8) | 16 (5.5) | < 0.001 | 5 (2.1) | < 0.001 |
18–49 | 3723 (28.1) | 100 (20.6) | 74 (17.7) | 2390 (37) | 70 (24.1) | 51 (21.4) | ||||
50–64 | 3443 (26) | 130 (26.7) | 105 (25.2) | 2032 (31.5) | 82 (28.2) | 62 (26.1) | ||||
65-79 | 2908 (22) | 143 (29.4) | 119 (28.5) | 1290 (20) | 82 (28.2) | 68 (28.6) | ||||
≥ 80 | 1468 (11.1) | 73 (15) | 102 (24.5) | 497 (7.7) | 41 (14.1) | 52 (21.8) | ||||
Sex | ||||||||||
Men | 6340 (47.6) | 241 (49.5) | 0.402 | 212 (50.2) | 0.275 | 2833 (43.9) | 135 (46.4) | 0.373 | 118 (49.6) | 0.07 |
Women | 6972 (52.5) | 246 (50.5) | 210 (49.8) | 3626 (56.1) | 156 (53.6) | 120 (50.4) | ||||
Underlying diseases | ||||||||||
CVD2 | 2968 (22.3) | 130 (26.7) | 0.018 | 133 (31.5) | < 0.001 | 1184 (18.3) | 79 (27.1) | < 0.001 | 61 (25.6) | 0.003 |
Diabetics | 2173 (16.3) | 111 (22.8) | < 0.001 | 86 (20.4) | 0.022 | 1046 (16.2) | 65 (22.3) | 0.004 | 51 (21.4) | 0.026 |
KD3 | 394 (3) | 22 (4.5) | 0.039 | 27 (6.4) | < 0.001 | 137 (2.1) | 13 (4.5) | 0.004 | 14 (5.9) | < 0.001 |
Hypertension | 1250 (9.4) | 61 (12.5) | 0.016 | 41 (9.7) | 0.816 | 528 (8.2) | 28 (9.6) | 0.356 | 18 (7.6) | 0.726 |
Malignancies | 649 (4.9) | 27 (5.5) | 0.485 | 27 (6.4) | 0.140 | 135 (2.1) | 9 (3.1) | 0.221 | 12 (5) | 0.001 |
RD4 | 391 (2.9) | 25 (5.1) | 0.003 | 22 (5.2) | 0.005 | 147 (2.3) | 9 (3.1) | 0.339 | 11 (4.6) | 0.013 |
GID5 | 100 (0.75) | 4 (0.82) | 0.855 | 5 (1.2) | 0.294 | 36 (0.55) | 2 (0.7) | 0.761 | 3 (1.3) | 0.138 |
BND6 | 701 (5.3) | 49 (10.1) | < 0.001 | 35 (8.3) | 0.005 | 242 (3.7) | 23 (7.9) | < 0.001 | 17 (7.1) | 0.005 |
BD7 | 68 (0.5) | 5 (1.02) | 0.104 | 4 (0.94) | 0.201 | 24 (0.4) | 2 (0.7) | 0.365 | 3 (1.3) | 0.022 |
Pregnancy | 179 (1.3) | 2 (0.4) | 0.680 | 1 (0.2) | 0.045 | 94 (1.5) | 2 (0.7) | 0.263 | 1 (0.4) | 0.174 |
Others8a | 106 (0.72) | 5 (1.02) | 0.560 | 4 (0.94) | 0.722 | 47 (0.72) | 5 (1.7) | 0.042 | 2 (0.8) | 0.835 |
Comorbidities | ||||||||||
No Comorbidities | 7103 (53.4) | 192 (39.4) | < 0.001 | 150 (35.5) | < 0.001 | 3878 (60) | 130 (44.7) | < 0.001 | 99 (41.6) | < 0.001 |
One | 4088 (30.7) | 185 (38) | 185 (43.8) | 1729 (26.8) | 100 (34.4) | 97 (40.8) | ||||
> =Two | 2121 (15.9) | 110 (22.9) | 87 (20.6) | 852 (13.2) | 61 (21) | 42 (17.6) | ||||
Waves of disease | ||||||||||
Wave 0 | 3417 (25.5) | 139 (28.5) | 0.344 | 72 (17.1) | < 0.001 | 646 (10) | 49 (16.8) | < 0.001 | 17 (7.2) | < 0.001 |
4th (alpha) wave | 2519 (18.9) | 97 (19.9) | 167 (39.7) | 1402 (21.7) | 62 (21.3) | 95 (40.1) | ||||
5th (delta) wave | 5231 (39.3) | 176 (36.1) | 139 (33) | 3574 (55.3) | 132 (47.4) | 96 (40.5) | ||||
6th (omicron) wave | 2143 (16.1) | 75 (15.4) | 43 (10.2) | 836 (12.9) | 42 (14.4) | 19 (12.2) | ||||
Hospitalization outcomeb | ||||||||||
Length of stay, days, median (IQR) | 5 (4) | 11 (14) | < 0.001 | 7 (14) | < 0.001 | 5 (3) | 11 (13) | < 0.001 | 5 (3) | < 0.001 |
Length of stay, days, Mean ± SD | 7.2 ± 9.5 | 15.8 ± 17.8 | < 0.001 | 12 ± 14.3 | < 0.001 | 6.7 ± 8.1 | 14.2 ± 12.3 | < 0.001 | 6.4 ± 7.9 | < 0.001 |
The rRT-PCR cycle threshold values
Characteristic | Total | Ct value range | p-value | ||
---|---|---|---|---|---|
9 - 20 | 21 - 30 | 31 - 40 | |||
Overall | 6379 | 1695 | 3879 | 805 | – |
Median age, yrs., (IQR) | 54 (26) | 55 (27) | 53 (25) | 54 (25) | 0.066 |
Mean ± SD age, yrs | 52.93 ± 18.81 | 53.03 ± 20.5 | 52.9 ± 17.9 | 52.6 ± 19.6 | 0.744 |
Age group, yrs | |||||
< 18 | 245 (3.8) | 101 (6) | 101 (2.6) | 43 (5.3) | < 0.001 |
18–49 | 2363 (37.1) | 560 (33.1) | 1531 (39.5) | 272 (23.8) | |
50–64 | 2003 (31.4) | 528 (31.2) | 1208 (31.2) | 267 (33.2) | |
65-79 | 1277 (20) | 346 (20.4) | 774 (20) | 157 (19.5) | |
≥ 80 | 487 (7.6) | 159 (9.4) | 262 (6.8) | 66 (8.2) | |
Sexa | |||||
Men | 2769 (43.8) | 734 (43.3) | 1681 (43.3) | 381 (47.3) | 0.101 |
Women | 3583 (56.2) | 961 (56.7) | 2198 (56.7) | 424 (52.7) | |
Underlying diseases | |||||
CVD | 1162 (18.2) | 313 (18.5) | 685 (17.7) | 164 (20.4) | 0.183 |
Diabetics | 1032 (16.2) | 287 (16.9) | 600 (15.5) | 145 (18) | 0.126 |
Kidney diseases | 135 (2.1) | 51 (3) | 68 (1.8) | 16 (2) | 0.011 |
Hypertension | 524 (8.2) | 119 (7) | 337 (8.7) | 68 (8.4) | 0.11 |
Malignancies | 135 (2.1) | 39 (2.3) | 75 (1.9) | 21 (2.6) | 0.397 |
RD | 146 (2.3) | 39 (2.3) | 88 (2.3) | 19 (2.4) | 0.987 |
Liver diseases | 33 (0.5) | 8 (0.5) | 23 (0.6) | 2 (0.2) | 0.443 |
GID | 4 (0.06) | 1 (0.06) | 3 (0.1) | 0 (0.0) | 0.726 |
BND | 240 (3.4) | 72 (4.2) | 140 (3.6) | 28 (3.5) | 0.464 |
BD | 24 (0.4) | 7 (0.4) | 15 (0.4) | 2 (0.2) | 0.809 |
Pregnancy | 94 (1.5) | 38 (2.2) | 47 (1.2) | 9 (1.1) | 0.009 |
Others | 47 (0.7) | 11 (0.6) | 27 (0.7) | 9 (1.1) | 0.393 |
Comorbidities | |||||
No-Comorbidities | 3834 (60.1) | 983 (58) | 2394 (61.7) | 457 (56.8) | 0.009 |
One | 1701 (26.7) | 492 (29) | 977 (25.2) | 232 (28.8) | |
≥ Two | 844 (13.2) | 220 (13) | 508 (13.1) | 116 (14.4) | |
Hospitalization outcome | |||||
Length of stay, days, median (IQR) | 5 (3) | 5 (3) | 5 (3) | 5 (3) | 0.054 |
Length of stay, days, Mean ± SD | 6.7 ± 8.1 | 6.8 ± 7.01 | 6.60 ± 7.85 | 6.69 ± 11.39 | 0.054 |
ICU admission | 289 (4.5) | 90 (5.3) | 175 (4.5) | 24 (3) | 0.33 |
Death | 235 (307) | 103 (6.1) | 103 (2.7) | 29 (3.6) | < 0.001 |
SARS-CoV-2 epidemic waves and variant predominance status | |||||
Waves 0 | 633 (9.9) | 106 (6.3) | 427 (11) | 100 (12.4) | < 0.001 |
4th (alpha) wave | 1355 (21.2) | 444 (26.2) | 742 (19.1) | 169 (21) | |
5th (delta) wave | 3554 (55.7) | 919 (54.2) | 2207 (56.9) | 428 (53.2) | |
6th (omicron) wave | 836 (13.1) | 226 (13.3) | 502 (12.9) | 108 (13.4) |