Who Are at Most Risk to Develop Symptoms After SARS-Cov-2 Infection? Early Study in A Controlled Setting

Background: The clinical spectrum of COVID-19 disease includes asymptomatic infection, mild upper respiratory tract illness, and severe viral pneumonia with respiratory failure. The level of illness is associated with various individual factors. Therefore, this study aimed to assess factors that are associated with the development of symptoms among COVID-19 positive cases in a selected isolation and treatment center in Addis Ababa, Ethiopia. Method: The study was conducted at Eka Kotebe General Hospital, COVID-19 Isolation and Treatment Center, Addis Ababa from May 11-24, 2020. All participants admitted to the center during the study period, 347 confirmed COVID-19 positive cases, were enrolled in the study. The dependent variable was having sign or symptom for COVID-19. Association of age, gender, Body Mass Index (BMI), blood type, comorbidities and history of travel with the presence of sign or symptoms was assessed. A logistic regression analysis was conducted to assess the associations after adjusting for selected covariates. Significant level for all variables was reported at 95% Confidence Interval. Results: A total of 347 laboratory confirmed positive COVID-19 cases (mean age 33.9 ± 13.5) were included in the analysis. The large proportion (66%) of the study participants were males. Overall, 24% of the participants admitted to the hospital had at least one sign or symptom for COVID-19. Cough, headache, fever, sore throat and muscle ache were the most reported signs and symptoms. Cancer and HIV/AIDS were the leading comorbidities that the study participants reported. After adjusting for important covariates, gender, blood type, comorbidity and travel history were found to be significantly associated with having sign or symptom while being COVID-19 positive. However, age, BMI and income had no association with being symptomatic following the contraction of the COVID-19 infection. Conclusion: Gender, blood group, comorbidities, travel history were found to be significantly associated with being symptomatic while having COVID-19 disease in Ethiopia. Age and BMI had no associations with developing COVID-19 sign or symptom. Closer monitoring and intensified prevention strategies to protect those who are highly likely to develop symptoms may help efficient use of scarce resources in the control of the pandemic. We recommend further study to elaborate on the cause of association and to advance the knowledge base available.