Outcomes of home-isolated coronavirus disease 2019 patients in Bahrain

The coronavirus disease 2019 (COVID-19) pandemic resulted in a huge burden on healthcare systems and necessitated a risk assessment of patients and an update of the treatment protocol to include home isolation for low-risk patients. The primary objective was to describe the outcome of home isolation and the characteristics of patients at higher risk of admission. The secondary objectives were to determine the proportion of patients with pneumonia and hypoxemia and the correlation between cycle of the threshold (CT) value and severity of the disease.

For this study, 394 patients were randomly selected from a total of 8000 home-isolated COVID-19 patients during July to October 2020, and were followed by Bahrain International Hospital (BIH). All data were obtained from a live Excel sheet completed by physicians covering BIH during the study period. Data analysis included Chi-square test to determine significant association between categorical variable, Pearson correlation, and logistic regression analysis.

Of the 394 home-isolated patients followed, 18 patients with missing data were excluded. The overall admission rate was 50% for ≥50 age group compared to 13.3% for 18-49 age group, while only 2.8% in <18 age group. Moreover, Intensive Care Unit (ICU) admissions were significantly higher in the older age group: 15.2% for ≥50 age group (P < 0.001). About 14% of the patients with comorbidities needed ICU admission, compared with 1.8% of those without comorbidities (P < 0.001). Of the home-isolated patients, 6.3% were diagnosed with pneumonia and 9.9% of those presenting had low oxygen saturation. The CT value was significantly correlated with the severity of symptoms and the need for admission.

Home isolation of low-risk patients with monitoring and follow-up was a safe and necessary step in dealing with the COVID-19 pandemic.