SARS-CoV-2 PCR-positive and PCR-negative cases of pneumonia admitted to the hospital during the peak of COVID-19 pandemic: analysis of in-hospital and post-hospital mortality

Gaipov A. Gusmanov A. Abbay A. Sakko Y. Issanov A. Kadyrzhanuly K. Yermakhanova Z. Aliyeva L. Kashkynbayev A. Moldaliyev I. Crape B. Sarria-Santamera A.
December 2021 BioMed Central Ltd

BMC Infectious Diseases
2021 #21 Issue 1

Background: During the spike of COVID-19 pandemic in Kazakhstan (June-2020), multiple SARS-CoV-2 PCR-test negative pneumonia cases with higher mortality were reported by media. We aimed to study the epidemiologic characteristics of hospitalized PCR-test positive and negative patients with analysis of in-hospital and post-hospital mortality. We also compare the respiratory disease characteristics between 2019 and 2020. Methods: The study population consist of 17,691 (March–July-2020) and 4600 (March–July-2019) hospitalized patients with respiratory diseases (including COVID-19). The incidence rate, case-fatality rate and survival analysis for overall mortality (in-hospital and post-hospital) were assessed. Results: The incidence and mortality rates for respiratory diseases were 4-fold and 11-fold higher in 2020 compared to 2019 (877.5 vs 228.2 and 11.2 vs 1.2 per 100,000 respectively). The PCR-positive cases (compared to PCR-negative) had 2-fold higher risk of overall mortality. We observed 24% higher risk of death in males compared to females and in older patients compared to younger ones. Patients residing in rural areas had 66% higher risk of death compared to city residents and being treated in a provisional hospital was associated with 1.9-fold increased mortality compared to those who were treated in infectious disease hospitals. Conclusion: This is the first study from the Central Asia and Eurasia regions, evaluating the mortality of SARS-CoV-2 PCR-positive and PCR-negative respiratory system diseases during the peak of COVID-19 pandemic. We describe a higher mortality rate for PCR-test positive cases compared to PCR-test negative cases, for males compared to females, for elder patients compared to younger ones and for patients living in rural areas compared to city residents.

COVID-19-like pneumonia , In-hospital mortality , Infectious disease hospitals , Kazakhstan , PCR test , Post-hospital mortality , Provisional hospitals , SARS-CoV-2

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Department of Medicine, Nazarbayev University School of Medicine, Kerey and Zhanibek Khans Street 5/1, Room 345, Nur-Sultan city, Kazakhstan
Department of Emergency Medicine, Akhmet Yassawi University Medical Faculty, Turkestan, Kazakhstan
Department of expertise, Social Health Insurance Fund branch of the Turkestan Region, Turkestan, Kazakhstan
Department of Mathematics, Nazarbayev University School of Sciences and Humanities, Nur-Sultan, Kazakhstan
Department of Preventive Medicine, Akhmet Yassawi University Medical Faculty, Turkestan, Kazakhstan

Department of Medicine
Department of Emergency Medicine
Department of expertise
Department of Mathematics
Department of Preventive Medicine

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