{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:03:03Z","timestamp":1781650983159,"version":"3.54.5"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T00:00:00Z","timestamp":1636848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Coronavirus disease 2019 (COVID-19) is a pandemic caused by a newly discovered coronavirus. Although clinical manifestations of COVID-19 are mainly pulmonary, some patients have other systemic manifestations. This study aimed to describe the clinical finding and outcomes in Sudanese patients diagnosed with COVID-19.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This retrospective observational study is based on documented files that included patients diagnosed with COVID-19 in seven selected hospitals inside Khartoum. Clinical manifestations, complications and outcomes were extracted from patients\u2019 records using an extraction form designed for this study.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Data of 243 patients diagnosed with COVID-19 were analyzed. The mean (SD) age in years was 55.8 (18.4). Out of 116 participants, 27 of them (23.3%) had severe disease, 15 (12.9%) were critically ill. 67.5% of patients were admitted to the hospital within 7\u00a0days from onset of symptoms; most of them were admitted to the wards (<jats:italic>n<\/jats:italic>\u2009=\u2009140,72.5%). Fever (83.2%), cough (70.7%), and shortness of breath (69.2%) were the most commonly recorded clinical manifestations. Sepsis (9.8%) and acidosis (7.8%) were the most frequently reported complications. Death was the final outcome in 21.4% (56\/243). Older age and presence of diabetes were found significantly associated with in-hospital death. The laboratory results showed high CRP in 85.6% (119\/139), high ferritin in 88.9% (24\/27), lactate dehydrogenase had a median of 409.0 (359\u2013760), D-dimer had a median of 3.3 (1.2\u201316. 6), and 53\/105 (50.5%) had low albumin.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Fever was the most mentioned sign among the participants, followed by fatigue. Cough and shortness of breath were the most commonly recorded pulmonary symptoms manifested. Our study showed multiple variables were associated with in-hospital death. The mortality rate was high among severe and critically ill patients diagnosed with COVID-19.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s41182-021-00382-4","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T19:02:32Z","timestamp":1636916552000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical manifestations, complications, and outcomes of patients with COVID-19 in Sudan: a multicenter observational study"],"prefix":"10.1186","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9727-8620","authenticated-orcid":false,"given":"Elfatih A.","family":"Hasabo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima A.","family":"Ayyad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A. M.","family":"Alam Eldeen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malaz K.","family":"Noureldaim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tibyan A.","family":"Abdallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousra T.","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safaa","family":"Badi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed K.","family":"Khalid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hind A.","family":"Mirghani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yossra A.","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lubaba A.","family":"Alkhider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saada A.","family":"Hamad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna M.","family":"Tagelseed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethar H. A.","family":"Elsheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noon H.","family":"Khalid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samia A.","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara O.","family":"Elmobark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola O.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duaa A.","family":"Mohammed Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed S.","family":"Muneer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heitham","family":"Awadalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elfatih M.","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,14]]},"reference":[{"key":"382_CR1","unstructured":"Coronavirus disease (COVID-19). (cited 2021 Jan 26). https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019."},{"key":"382_CR2","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","volume":"323","author":"D Wang","year":"2020","unstructured":"Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1061\u20139. https:\/\/doi.org\/10.1001\/jama.2020.1585.","journal-title":"JAMA"},{"key":"382_CR3","doi-asserted-by":"crossref","unstructured":"Coronavirus Disease 2019 (COVID-19)|CDC. (cited 2020 May 14). https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html.","DOI":"10.7175\/cmi.v14i1.1467"},{"key":"382_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/jamainternmed.2020.0994","volume":"2020","author":"C Wu","year":"2019","unstructured":"Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with Acute Respiratory Distress Syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2019;2020:1\u201310. https:\/\/doi.org\/10.1001\/jamainternmed.2020.0994.","journal-title":"JAMA Intern Med"},{"key":"382_CR5","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1001\/jama.2020.3204","volume":"323","author":"BE Young","year":"2020","unstructured":"Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J, et al. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA. 2020;323:1488\u201394. https:\/\/doi.org\/10.1001\/jama.2020.3204.","journal-title":"JAMA"},{"key":"382_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25774","author":"BE Fan","year":"2020","unstructured":"Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020. https:\/\/doi.org\/10.1002\/ajh.25774.","journal-title":"Am J Hematol"},{"key":"382_CR7","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1016\/S2213-2600(20)30079-5","volume":"8","author":"X Yang","year":"2020","unstructured":"Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8:475\u201381. https:\/\/doi.org\/10.1016\/S2213-2600(20)30079-5.","journal-title":"Lancet Respir Med"},{"key":"382_CR8","doi-asserted-by":"publisher","first-page":"64","DOI":"10.5334\/gh.814","volume":"15","author":"K Matsushita","year":"2020","unstructured":"Matsushita K, Ding N, Kou M, Hu X, Chen M, Gao Y, et al. The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: a systematic review and meta-analysis. Glob Heart. 2020;15:64. https:\/\/doi.org\/10.5334\/gh.814.","journal-title":"Glob Heart"},{"key":"382_CR9","unstructured":"Sudan: WHO Coronavirus Disease (COVID-19) Dashboard | WHO Coronavirus Disease (COVID-19) Dashboard (cited 2021 Jan 26). https:\/\/covid19.who.int\/region\/emro\/country\/sd."},{"key":"382_CR10","unstructured":"COVID- 19 Case Management Protocols. (cited 2020 Jun 1). http:\/\/fmoh.gov.sd\/index.php\/files\/download\/396."},{"key":"382_CR11","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","volume":"395","author":"C Huang","year":"2020","unstructured":"Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497\u2013506. https:\/\/doi.org\/10.1016\/S0140-6736(20)30183-5.","journal-title":"Lancet"},{"key":"382_CR12","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1001\/jama.2020.6775","volume":"323","author":"S Richardson","year":"2020","unstructured":"Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020;323:2052\u20139. https:\/\/doi.org\/10.1001\/jama.2020.6775.","journal-title":"JAMA"},{"key":"382_CR13","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/S0140-6736(20)30251-8","volume":"395","author":"R Lu","year":"2020","unstructured":"Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565\u201374. https:\/\/doi.org\/10.1016\/S0140-6736(20)30251-8.","journal-title":"Lancet"},{"key":"382_CR14","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.virol.2007.04.03","volume":"367","author":"W Li","year":"2007","unstructured":"Li W, Sui J, Huang IC, Kuhn JH, Radoshitzky SR, Marasco WA, et al. The S proteins of human coronavirus NL63 and severe acute respiratory syndrome coronavirus bind overlapping regions of ACE2. Virology. 2007;367:367\u201374. https:\/\/doi.org\/10.1016\/j.virol.2007.04.03.","journal-title":"Virology"},{"key":"382_CR15","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2020.1791212","author":"R de la Vega","year":"2020","unstructured":"de la Vega R, Ru\u00edz-Barqu\u00edn R, Boros S, Szabo A. Could attitudes toward COVID-19 in Spain render men more vulnerable than women? Glob Public Health. 2020. https:\/\/doi.org\/10.1080\/17441692.2020.1791212.","journal-title":"Glob Public Health"},{"key":"382_CR16","doi-asserted-by":"publisher","first-page":"9959","DOI":"10.18632\/aging.103344","volume":"12","author":"AL Mueller","year":"2020","unstructured":"Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY). 2020;12:9959\u201381.","journal-title":"Aging (Albany NY)"},{"key":"382_CR17","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.ijid.2020.03.017","volume":"94","author":"J Yang","year":"2020","unstructured":"Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91\u20135. https:\/\/doi.org\/10.1016\/j.ijid.2020.03.017.","journal-title":"Int J Infect Dis"},{"key":"382_CR18","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1111\/dme.14300","volume":"37","author":"RCW Ma","year":"2020","unstructured":"Ma RCW, Holt RIG. COVID-19 and diabetes. Diabet Med. 2020;37:723\u20135. https:\/\/doi.org\/10.1111\/dme.14300.","journal-title":"Diabet Med"},{"key":"382_CR19","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","volume":"395","author":"N Chen","year":"2020","unstructured":"Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507\u201313. https:\/\/doi.org\/10.1016\/S0140-6736(20)30211-7.","journal-title":"Lancet"},{"key":"382_CR20","first-page":"1","volume":"11","author":"C Poignon","year":"2020","unstructured":"Poignon C, Blaize M, Vezinet C, Lampros A, Monsel A, Fekkar A, et al. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect. 2020;11:1\u201314.","journal-title":"Clin Microbiol Infect"},{"key":"382_CR21","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","volume":"323","author":"D Wang","year":"2020","unstructured":"Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1061. https:\/\/doi.org\/10.1001\/jama.2020.1585.","journal-title":"JAMA"},{"key":"382_CR22","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1097\/CM9.0000000000000744","volume":"133","author":"K Liu","year":"2020","unstructured":"Liu K, Fang Y-Y, Deng Y, Liu W, Wang M-F, Ma J-P, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J (Engl). 2020;133:1025\u201331. https:\/\/doi.org\/10.1097\/CM9.0000000000000744.","journal-title":"Chin Med J (Engl)"},{"key":"382_CR23","doi-asserted-by":"publisher","first-page":"1708","DOI":"10.1056\/NEJMoa2002032","volume":"382","author":"W Guan","year":"2020","unstructured":"Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708\u201320. https:\/\/doi.org\/10.1056\/NEJMoa2002032.","journal-title":"N Engl J Med"},{"key":"382_CR24","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1159\/000509774","volume":"38","author":"P Ramachandran","year":"2020","unstructured":"Ramachandran P, Onukogu I, Ghanta S, Gajendran M, Perisetti A, Goyal H, et al. Gastrointestinal symptoms and outcomes in hospitalized coronavirus disease 2019 patients. Dig Dis. 2020;38:373\u20139. https:\/\/doi.org\/10.1159\/000509774.","journal-title":"Dig Dis"},{"key":"382_CR25","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","volume":"77","author":"L Mao","year":"2020","unstructured":"Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77:683. https:\/\/doi.org\/10.1001\/jamaneurol.2020.1127.","journal-title":"JAMA Neurol"},{"key":"382_CR26","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.bbi.2020.03.031","volume":"87","author":"Y Wu","year":"2020","unstructured":"Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18\u201322. https:\/\/doi.org\/10.1016\/j.bbi.2020.03.031.","journal-title":"Brain Behav Immun"},{"key":"382_CR27","doi-asserted-by":"publisher","first-page":"e19636","DOI":"10.2196\/19636","volume":"22","author":"J Li","year":"2020","unstructured":"Li J, Chen Z, Nie Y, Ma Y, Guo Q, Dai X. Identification of symptoms prognostic of covid-19 severity: multivariate data analysis of a case series in Henan Province. J Med Internet Res. 2020;22:e19636. https:\/\/doi.org\/10.2196\/19636.","journal-title":"J Med Internet Res"},{"key":"382_CR28","doi-asserted-by":"publisher","first-page":"100060","DOI":"10.1016\/j.puhip.2020.100060","volume":"1","author":"DE Lucero-Prisno","year":"2020","unstructured":"Lucero-Prisno DE, Elhadi YAM, Modber MAA, Musa MB, Mohammed SEE, Hassan KF, et al. Drug shortage crisis in Sudan in times of COVID-19. Public Heal Pract. 2020;1:100060. https:\/\/doi.org\/10.1016\/j.puhip.2020.100060.","journal-title":"Public Heal Pract"}],"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-021-00382-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-021-00382-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41182-021-00382-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T19:07:22Z","timestamp":1636916842000},"score":1,"resource":{"primary":{"URL":"https:\/\/tropmedhealth.biomedcentral.com\/articles\/10.1186\/s41182-021-00382-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,14]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["382"],"URL":"https:\/\/doi.org\/10.1186\/s41182-021-00382-4","relation":{},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,14]]},"assertion":[{"value":"11 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval had been taken from the national health research ethics committee, Sudan\u2019s federal health ministry (27.08.2020\/ certificate number: 4-7-20). Permission was obtained from hospital administrators and statistics offices of each hospital to outreach the patients\u2019 records. Study participant\u2019s consent was not required as the study did not use identifiable data. The data collected for this research will not be used for any other purposes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"91"}}