Establishing a sentinel surveillance system for the novel COVID-19 in a resource-limited country: methods, system attributes and early findings

ObjectivesTo establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.DesignHospital-based surveillance.SettingThis study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.ParticipantsIn total...

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Bibliographic Details
Published in:	BMJ open 2021-12, Vol.11 (12), p.e055169-e055169
Main Authors:	Das, Pritimoy, Akhtar, Zubair, Mah-E-Muneer, Syeda, Islam, Md Ariful, Rahman, Mohammed Ziaur, Rahman, Mustafizur, Rahman, Mahmudur, Rahman, Mahbubur, Billah, Mallick Masum, Alamgir, ASM, Flora, Meerjady Sabrina, Shirin, Tahmina, Banu, Sayera, Chowdhury, Fahmida
Format:	Article
Language:	eng
Subjects:	Asymptomatic Coronaviruses COVID-19 COVID-19 diagnostic tests diagnostic microbiology Disease transmission Epidemiology Health surveillance Hospitals Influenza Laboratories Masks Medical diagnosis Mortality Pandemics Patients Public Health Severe acute respiratory syndrome coronavirus 2 Virology
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Summary:	ObjectivesTo establish a hospital-based platform to explore the epidemiological and clinical characteristics of patients screened for COVID-19.DesignHospital-based surveillance.SettingThis study was conducted in four selected hospitals in Bangladesh during 10 June–31 August 2020.ParticipantsIn total, 2345 patients of all age (68% male) attending the outpatient and inpatient departments of surveillance hospitals with any one or more of the following symptoms within last 7 days: fever, cough, sore throat and respiratory distress.Outcome measuresThe outcome measures were COVID-19 positivity and mortality rate among enrolled patients. Pearson’s χ2 test was used to compare the categorical variables (sign/symptoms, comorbidities, admission status and COVID-19 test results). Regression analysis was performed to determine the association between potential risk factors and death.ResultsCOVID-19 was detected among 922 (39%) enrolled patients. It was more common in outpatients with a peak positivity in second week of July (112, 54%). The median age of the confirmed COVID-19 cases was 38 years (IQR: 30–50), 654 (71%) were male and 83 (9%) were healthcare workers. Cough (615, 67%) was the most common symptom, followed by fever (493, 53%). Patients with diabetes were more likely to get COVID-19 than patients without diabetes (48% vs 38%; OR: 1.5; 95% CI: 1.2 to 1.9). The death rate among COVID-19 positive was 2.3%, n=21. Death was associated with age ≥60 years (adjusted OR (AOR): 13.9; 95% CI: 5.5 to 34), shortness of breath (AOR: 9.7; 95% CI: 3.0 to 30), comorbidity (AOR: 4.8; 95% CI: 1.1 to 21.7), smoking history (AOR: 2.2, 95% CI: 0.7 to 7.1), attending the hospital in
ISSN:	2044-6055 2044-6055