Frequency and Predictors of COVID-19 Worsening Among Patients Initially Managed on An Outpatient Basis: An Observational Study in Sfax Governorate; Tunisia

Abstract

The COVID-19 pandemic is a crisis of mismatch between resources and infection burden. It has caused high utilization of healthcare resources including hospitalization [1]. In Tunisia, Since the discovery of the index case of COVID-19 in Marsh 2020, the spread of the virus has expanded exponentially due to community-based human-to-human transmission. The impact of the pandemic has put the spotlight on serious problems that
the Tunisian healthcare system suffers from including strained health institution. COVID-19 symptoms are variable ranging from no symptom to severe symptoms and need hospitalization [2]. Factors other than severity of symptoms could increase the risk of hospitalization and mortality. Indeed, elderly people and those with underlying health conditions are at higher risk of COVID-19 hospitalization, and even death [3,4]. Nevertheless, other studies show controversial results [5,6]. Some of the worsening of the
disease occurs early, but the vast majority of respiratory distress tables are observed late [7]. Thus, patients who initially had been managed on an outpatient basis may require late hospitalization or may even die. However, studies about COVID-19 ambulatory patients are under-described in the literature and the majority of studies on COVID 19 related hospitalization and death have been based on hospital samples. Knowledge of factors associated with the COVID-19 hospitalization and death is critical in implementing preventive measures and minimizing direct medical and indirect costs of COVID-19. In this regard, this study aimed to determine
the factors associated with the worsening of COVID-19 among patients who at first had been managed on an outpatient basis.