Factors Associated with Asymptomatic COVID-19 Patients in a District in Sabah

Abstract

Introduction: The rapid spread of the COVID-19 worldwide has led the World Health Organization (WHO) to declare COVID-19 outbreak as a pandemic on March 11, 2020. This study aims to determine the factors associated with asymptomatic COVID-19 patients in a district in Sabah. Methods: Data on COVID-19 patients were extracted from the database of confirmed cases in a District Health Office in Sabah from 12th March 2020 to 30th May 2021. An asymptomatic laboratory-confirmed case is a person infected with COVID-19 who does not develop any symptoms. The study included socio-demographic variables and detailed information on the patients' clinical manifestations and co-morbidity. Descriptive and multivariable logistic regression analyses were conducted to determine the factors associated with asymptomatic patients. Results: The overall number of COVID-19 patients in a district in Sabah were 2969. Approximately 47.5% (N = 1409) of the patients were symptomatic while 52.5% (N = 1560) were asymptomatic. Multivariable logistic regression analyses revealed that factors significantly associated with asymptomatic patients were ages below 40 years old (aOR: 1.79, 95% CI 1.11, 2.86), non-Malaysians (aOR: 3.22, 95% CI 1.44, 7.19) and local cases (aOR: 2.51, 95% CI 1.42, 4.42). Gender, ethnicity, co-morbidity and township were not significantly associated with asymptomatic patients. Conclusion: Approximately half of the COVID-19 patients were asymptomatic and the risk factors identified were younger age, non-Malaysians and local cases. Rigorous epidemiological investigation and laboratory examinations are helpful in identifying COVID-19 cases among this group of people who are asymptomatic.