An Analytical Study of the Early COVID-19 Cases in Jordan
Abstract
Background: The daily cases and fatalities in the COVID-19 pandemic are still on the rise. This study aimed to examine the epidemiological trends of the COVID-19 patients at an early stage in the pandemic.
Methods: This study included all COVID-19 positive patients who were admitted to the Prince Hamza Hospital between the 2nd and 31st of March 2020. The demographic, clinical, and laboratory data of the COVID-19 positive patients were reviewed and analysed.
Results: Of the 132 patients admitted during the period of study, 81 were males, with a mean age of 38.9 years (SD ± 19 yrs). Of those, 55 (41.7%) had comorbidities, 9% required oxygen supplementation, and 3 (2.2%) died. The most common clinical manifestations on admission were fever (36.4%), dry cough (17.4%), shortness of breath (12.9%), and anosmia (10.6%). CRP was elevated in 45.4%, and ESR was also high in 22.7% of patients with CRP elevation and was statistically significant in symptomatic patients (p = 0.004). Likewise, D-dimer was markedly elevated in 42.1% of the symptomatic patients (p = 0.025). Chest CT scans in symptomatic patients showed statistically significant bilateral lung infection (17.2%) as compared to non-symptomatic patients (p = 0.049).
Conclusion: The COVID-19 outbreak in Jordan at the beginning of the pandemic had presented clinically significant symptoms associated with higher values of CRP and CT chest findings.
How to cite this article:
Jussani GN, Khasawneh AI, AL-Shudifat AE, Alnsour R, Azab M. An Analytical Study of the Early COVID-19 Cases in Jordan. J Commun Dis. 2022;54(1):67-75.
DOI: https://doi.org/10.24321/0019.5138.202252
References
Vilcek S. SARS-CoV-2: zoonotic origin of pandemic coronavirus. Acta Virol. 2020;64(3):281-7. [PubMed] [Google Scholar]
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R, Niu P, Zhan F, Ma X, Wang D, Xu W, Wu G, Gao GF, Tan W; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. [PubMed] [Google Scholar]
Habashi NM, Camporota L, Gatto LA, Nieman G. Functional pathophysiology of SARS-CoV-2-induced acute lung injury and clinical implications. J Appl Physiol [Internet]. 2021 Mar 1 [cited 2022 Mar 8];130(3):877-91. Available from: https://pubmed.ncbi.nlm.nih.gov/33444117/ [PubMed] [Google Scholar]
Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, Cereda D, Coluccello A, Foti G, Fumagalli R, Iotti G, Latronico N, Lorini L, Merler S, Natalini G, Piatti A, Ranieri MV, Scandroglio AM, Storti E, Cecconi M, Pesenti A; COVID-19 Lombardy ICU Network. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA [Internet]. 2020 Apr 28 [cited 2022 Mar 8];323(16):1574. Available from: https://pubmed.ncbi.nlm.nih.gov/32250385/ [ PubMed] [Google Scholar]
World Health Organization. Situation Report-12 situation in numbers total and new cases in last 24 hours. 2020.
Fagbule OF. 2019 Novel Coronavirus. Ann Ib Postgrad Med. 2019 Dec;17(2):108-10. [PubMed] [Google Scholar]
Bevova MR, Netesov SV, Aulchenko YS. The new Coronavirus COVID-19 infection. Mol Gen Microbiol Virol. 2020;35(2):53-60. [PubMed] [Google Scholar]
Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and multiorgan response. Curr Prob Cardiol. 2020;45(8):100618. [PubMed] [Google Scholar]
Das G, Mukherjee N, Ghosh S. Neurological insights of COVID-19 pandemic. ACS Chem Neurosci. 2020;11(9):1206-9. [PubMed] [Google Scholar]
Ye ZW, Yuan S, Yuen KS, Fung SY, Chan CP, Jin DY. Zoonotic origins of human coronaviruses. Int J Biol Sci. 2020;16(10):1686-97. [PubMed] [Google Scholar]
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL, Chen HD, Chen J, Luo Y, Guo H, Jiang RD, Liu MQ, Chen Y, Shen XR, Wang X, Zheng XS, Zhao K, Chen QJ, Deng F, Liu LL, Yan B, Zhan FX, Wang YY, Xiao GF, Shi ZL. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020 Mar 12;579(7798):270-3. [PubMed] [Google Scholar]
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung KS, Lau EH, Wong JY, Xing X, Xiang N, Wu Y, Li C, Chen Q, Li D, Liu T, Zhao J, Liu M, Tu W, Chen C, Jin L, Yang R, Wang Q, Zhou S, Wang R, Liu H, Luo Y, Liu Y, Shao G, Li H, Tao Z, Yang Y, Deng Z, Liu B, Ma Z, Zhang Y, Shi G, Lam TT, Wu JT, Gao GF, Cowling BJ, Yang B, Leung GM, Feng Z. Early transmission dynamics in Wuhan, China, of Novel Coronavirus–infected pneumonia. N Engl J Med. 2020; 382(13):1199-207. [PubMed] [Google Scholar]
Centers for Disease Control and Prevention [Internet]. COVIDView: a weekly surveillance summary of U.S.; 2020 [cited 2020 Dec 5]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
Yanes-Lane M, Winters N, Fregonese F, Bastos M, Perlman-Arrow S, Campbell JR, Menzies D. Proportion of asymptomatic infection among COVID-19 positive persons and their transmission potential: a systematic review and meta-analysis. PLoS One. 2020 Nov 1;15(11):e0241536. [PubMed] [Google Scholar]
Ren LL, Wang YM, Wu ZQ, Xiang ZC, Guo L, Xu T, Jiang YZ, Xiong Y, Li YJ, Li XW, Li H, Fan GH, Gu XY, Xiao Y, Gao H, Xu JY, Yang F, Wang XM, Wu C, Chen L, Liu YW, Liu B, Yang J, Wang XR, Dong J, Li L, Huang CL, Zhao JP, Hu Y, Cheng ZS, Liu LL, Qian ZH, Qin C, Jin Q, Cao B, Wang JW. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl). 2020 May 5;133(9):1015-24. [PubMed] [Google Scholar]
Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. J Med Virol. 2020 Apr;92(4):441-7. [PubMed] [Google Scholar]
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. [PubMed] [Google Scholar]
Lei J, Li J, Li X, Qi X. CT imaging of the 2019 novel coronavirus (2019-NCoV) pneumonia. Radiology. 2020;295(1):18. [PubMed] [Google Scholar]
Haigh K, Syrimi ZJ, Irvine S, Blanchard TJ, Pervaiz MS, Toth AG, Ratcliffe L. Hyperinflammation with COVID-19: the key to patient deterioration? Clin Infect Pract. 2020 Oct;7:100033. [PubMed] [Google Scholar]
Al Bahrani S, Al Ahmadi N, Hamdan S, Elsheikh N, Osman A, Almuthen S, Almajed GN, Alkhuraim AH, Jebakumar AZ, Al-Tawfiq JA. Clinical presentation and outcome of hospitalized patients with COVID-19 in the first and second waves in Saudi Arabia. Int J Infect Dis [Internet]. 2022 [cited 2022 Mar 8];118:104-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1201971222001278 [PubMed] [Google Scholar]
Iftimie S, Lopez-Azcona AF, Vallverdu I, Hernandez-Flix S, de Febrer G, Parra S, Hernández-Aguilera A, Riu F, Joven J, Andreychuk N, Baiges-Gaya G, Ballester F, Benavent M, Burdeos J, Català A, Castañé E, Castañé H, Colom J, Feliu M, Gabaldó X, Garrido D, Garrido P, Gil J, Guelbenzu P, Lozano C, Marimon F, Pardo P, Pujol I, Rabassa A, Revuelta L, RÃos M, Rius-Gordillo N, RodrÃguez-Tomà s E, Rojewski W, Roquer-Fanlo E, Sabaté N, Teixidó A, Vasco C, Camps J, Castro A. First and second waves of coronavirus disease-19: a comparative study in hospitalized patients in Reus, Spain. PLoS One [Internet]. 2021 Mar 1 [cited 2022 Mar 8];16(3):e0248029. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011765/ [PubMed] [Google Scholar]
Fox 13 [Internet]. Omicron vs. delta: study examines difference between two coronavirus variant symptoms; 2022 [cited 2022 Mar 8]. Available from: https://www.q13fox.com/news/omicron-delta-study-coronavirusvariant-symptoms
Islam S, Islam T, Islam MR. New Coronavirus variants are creating more challenges to global healthcare system: a brief report on the current knowledge. Clin Pathol [Internet]. 2022 [cited 2022 Mar 8];15:2632010X221075584. Available from: https://pubmed.ncbi.nlm.nih.gov/35141522/ [ PubMed] [Google Scholar]
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report - 57. 2020.
Khatatbeh M. Efficacy of nationwide curfew to encounter spread of COVID-19: a case from Jordan. Front Public Health. 2020;8:394. [PubMed] [Google Scholar]
World Health Organization [Internet]. Weekly epidemiological update - 24 November 2020; 2020 [cited 2020 Nov 27]. Available from: https://www.who.int/publications/m/item/weekly-epidemiologicalupdate---24-november-2020
World Health Organization [Internet]. Weekly epidemiological update - 7 September 2020; 2020 [cited 2020 Nov 27]. Available from: https://www. who.int/publications/m/item/weekly-epidemiologicalupdate---7-september-2020
Samrah SM, Al-Mistarehi AH, Ibnian AM, Raffee LA, Momany SM, Al-Ali M, Hayajneh WA, Yusef DH, Awad SM, Khassawneh BY. COVID-19 outbreak in Jordan: epidemiological features, clinical characteristics, and laboratory findings. Ann Med Surg (London). 2020;57:103-8. [PubMed] [Google Scholar]
Khamis F, Al-Zakwani I, Al Naamani H, Al Lawati S, Pandak N, Omar MB, Al Bahrani M, Al Bulushi Z, Al Khalili H, Al Salmi I, Al Ismaili R, Al Awaidy ST. Clinical characteristics and outcomes of the first 63 adult patients hospitalized with COVID-19: an experience from Oman. J Infect Public Health. 2020 Jul;13(7):906-13. [PubMed] [Google Scholar]
Nikpouraghdam M, Farahani AJ, Alishiri GH, Heydari S, Ebrahimnia M, Samadinia H, Sepandi M, Jafari NJ, Izadi M, Qazvini A, Dorostkar R, Tat M, Shahriary A, Farnoosh G, Zijoud SR, Taghdir M, Alimohamadi Y, Abbaszadeh S, Ghaleh HE, Bagheri M. Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in Iran: a single center study. J Clin Virol. 2020 Jun 1;127:104378. [PubMed] [Google Scholar]
Al Mutair A, Alhumaid S, Alhuqbani WN, Zaidi AR, Alkoraisi S, Al-Subaie MF, AlHindi AM, Abogosh AK, Alrasheed AK, Alsharafi AA, Alhuqbani MN, Alhowar NA, Salih S, Alhedaithy MA, Al-Tawfiq JA, Al-Shammari H, Abdulqawi R, Ismail AF, Hamdan N, Saad F, Olhaye FA, Eltahir TA, Rabaan AA, Al-Omari A. Clinical, epidemiological, and laboratory characteristics of mild-to-moderate COVID-19 patients in Saudi Arabia: an observational cohort study. Eur J Med Res. 2020;25(1):61. [PubMed] [Google Scholar]
Wang F, Cao J, Yu Y, Ding J, Eshak ES, Liu K, Mubarik S, Shi f, Wen H, Zeng Z, Bai J, Yu C. Epidemiological characteristics of patients with severe COVID-19 infection in Wuhan, China: evidence from a retrospective observational study. Int J Epidemiol. 2021 Jan;49(6):1940-50. [PubMed] [Google Scholar]
Liu H, Gao J, Wang Y, Jie J, Luo J, Xu Y, Sun H, Song L, Li D, Peng L, Hua S. Epidemiological and clinical characteristics of 2019 novel coronavirus disease (COVID-19) in Jilin, China: a descriptive study. Medicine (Baltimore). 2020 Nov;99(47):e23407. [PubMed] [Google Scholar]
Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020;323(14):1335. [PubMed] [Google Scholar]
Young BE, Ong SW, Kalimuddin S, Low JG, Tan SY, Loh J, Ng OT, Marimuthu K, Ang LW, Mak TM, Lau SK, Anderson DE, Chan KS, Tan TY, Ng TY, Cui L, Said Z, Kurupatham L, Chen MI, Chan M, Vasoo S, Wang LF, Tan BH, Lin RT, Lee VJ, Leo YS, Lye DC; Singapore 2019 Novel Coronavirus Outbreak Research Team. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020;323(15):1488-94. [PubMed] [Google Scholar]
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium; Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020 May;323(20):2052-9. [PubMed] [Google Scholar]
Mohan A, Tiwari P, Bhatnagar S, Patel A, Maurya A, Dar L, Pahuja S, Garg R, Gupta N, Sahoo B, Gupta R, Meena VP, Vig S, Pandit A, Mittal S, Madan K, Hadda V, Dwivedi T, Choudhary A, Brijwal M, Soneja M, Guleria R, Ratre B, Kumar B, Bhopale S, Panda S, Singh AR, Singh S, Wundavalli L. Clinico-demographic profile & hospital outcomes of COVID-19 patients admitted at a tertiary care centre in north India. Indian J Med Res. 2020 Jul;152(1&2):61-9. [PubMed] [Google Scholar]
Tang N, Li D, Wang X, Sun Z. Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost. 2020;18(4):844-7. [PubMed] [Google Scholar]
Wong HY, Lam HY, Fong AH, Leung ST, Chin TW, Lo CS, Mei-Sze Lui M, Lee JC, Wan-Hang Chiu K, Wai-Hin Chung T, Lee EY, Wan EY, Hung IF, Lam TP, Kuo MD, Ng MY. Frequency and distribution of chest radiographic findings in patients positive for COVID-19. Radiology. 2020 Aug;296(2):E72-8. [PubMed] [Google Scholar]
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report-72 Highlights. 2020.
Worldometers [Internet]. Coronavirus Update (Live): 61,908,045 Cases and 1,447,158 Deaths from COVID-19 Virus Pandemic - Worldometer; 2020 [cited 2020 Nov 28]. Available from: https://www.worldometers.info/coronavirus/
Malik YS, Ansari MI, Ganesh B, Sircar S, Bhat S, Pande T, Vinodhkumar OR, Kumar P, Yatoo MI, Tiwari R, Touil N, Patel SK, Pathak M, Sharun K, Dhama K. BCG vaccine: a hope to control COVID-19 pandemic amid crisis. Hum Vaccin Immunother. 2020;16(12):2954-62. [PubMed] [Google Scholar]
Kinoshita M, Tanaka M. Impact of routine infant BCG vaccination on COVID-19. J Infect. 2020 Oct;81(4):625-33.
PubMed] [Google Scholar]
Alsulaiman JW, Khasawneh AI, Kheirallah KA. Could “trained immunity†be induced by live attenuated vaccines protect against COVID-19? Review of available evidence. J Infect Dev Ctries. 2020;14(9):957-62. [PubMed] [Google Scholar]
Hensel J, McAndrews KM, McGrail DJ, Dowlatshahi DP, LeBleu VS, Kalluri R. Protection against SARS-CoV-2 by BCG vaccination is not supported by epidemiological analyses. Sci Rep. 2020;10(1):18377. [PubMed] [Google Scholar]
Australian Government. COVID-19 Australia: Epidemiology Report 29. 2020.
Copyright (c) 2022 Open Access
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
