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Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective
Henry Surendra1,2,3, Iqbal Rf Elyazar1,3, Bimandra A Djaafara1,4
1Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia.
Insights
COVID-19 in-hospital mortality in Jakarta was 12%, lower than in high-income countries, likely due to a younger population and fewer comorbidities. However, significant mortality was observed in children under 5 and adults over 50.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Limited data exists on COVID-19 mortality in low-resource settings.
- This study focuses on Jakarta, Indonesia, a densely populated urban area.
Purpose of the Study:
- To examine clinical characteristics of COVID-19 patients.
- To identify factors associated with in-hospital mortality in Jakarta.
Main Methods:
- Retrospective cohort study of 4265 hospitalized patients with PCR-confirmed COVID-19.
- Data extracted from 55 hospitals in Jakarta.
- Logistic regression used to analyze mortality risk factors.
Main Results:
- Overall in-hospital mortality was 12% (497/4265).
- Mortality risk increased with age, male sex, comorbidities (hypertension, diabetes, CKD), pneumonia, multiple symptoms, and ICU admission/intubation.
- Patients under 50 with >1 comorbidity had a six-fold increased mortality risk (27% vs 3%).
Conclusions:
- In-hospital COVID-19 mortality in Jakarta was lower than in high-income countries, potentially due to younger demographics and fewer comorbidities.
- Deaths occurred across all age groups, with over 10% mortality in children under 5 and adults over 50.
- Comorbidities significantly increased mortality risk, especially in younger adults.
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.
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