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Published on: October 24, 2019
COVID-19 outbreak in Jordan: Epidemiological features, clinical characteristics, and laboratory findings
Shaher M Samrah1, Abdel-Hameed W Al-Mistarehi2, Ali M Ibnian1
1Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan.
Insights
This study analyzed the first COVID-19 outbreak in northern Jordan, finding it primarily affected young females with mild symptoms. Early outbreak response measures likely contributed to the outbreak's lenient course.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- The first coronavirus disease 2019 (COVID-19) outbreak in northern Jordan was detected in March 2020.
- This retrospective study details the initial epidemiologic, clinical, laboratory, and radiologic features of COVID-19 patients in Jordan.
Purpose of the Study:
- To characterize the initial COVID-19 outbreak in northern Jordan.
- To identify demographic, clinical, and laboratory findings associated with COVID-19 in this region.
Main Methods:
- Retrospective review of laboratory-confirmed COVID-19 cases (RT-PCR positive) admitted between March 15 and April 2, 2020.
- Analysis of clinical presentations, radiological findings, and laboratory results.
Main Results:
- Eighty-one patients were identified, with 97.5% linked to travelers from endemic areas.
- The mean age was 40 years; 54.3% were female, and 75% of symptomatic cases were female.
- Common symptoms included nasal congestion, sore throat, and dry cough. Elevated D-dimer (97.5%), ESR (50%), and CRP (42.7%) were frequent. High ESR predicted abnormal chest radiographs (16% of patients).
Conclusions:
- The initial COVID-19 outbreak in northern Jordan predominantly affected females and younger individuals, with predominantly mild illness.
- Strict early outbreak response measures may have contributed to the observed mildness.
- Further research is needed to explain the variability in COVID-19 presentation and outcomes.
Background:
In March 2020, an outbreak of coronavirus 19 (COVID-19) was detected in the North of Jordan. This retrospective study is the first from Jordan to report the epidemiologic, clinical, laboratory, and radiologic characteristics of COVID-19 infected patients.
Methods:
All patients with laboratory-confirmed COVID-19 infection by RT-PCR in the North of Jordan admitted between March 15 and April 2, 2020 were included. The clinical features, radiological, and laboratory findings were reviewed.
Results:
Of 81 patients affected, 79 (97.5%) shared a common exposure to four recent travelers from endemic areas. The mean age was 40 years. Although about half (44 [54.3%]) were females, symptomatic patients were mostly females (75%). The most common presenting symptoms were nasal congestion, sore throat and dry cough. Less than one-third (31%) had chronic diseases. Although 84% of patients reported receiving Bacille Calmette-Guérin (BCG) vaccination, more asymptomatic patients had BCG than symptomatic (p = 0.017). Almost all patients (97.5%) had an elevated D-dimer level. Erythrocyte sedimentation rate (ESR) and c-reactive protein were elevated in 50% and 42.7% of patients, respectively. High ESR found to be the predictor of abnormal chest radiograph observed in 13 (16%) patients with OR of 14.26 (95% CI 1.37-147.97, p = 0.026).
Conclusions:
An outbreak of COVID-19 infection in northern Jordan affected more females and relatively young individuals and caused mainly mild illnesses. The strict outbreak response measures applied at early stages probably contributed to the lenient nature of this outbreak, but the contribution of other factors to such variability in COVID-19 presentation is yet to be explained.
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