Measles, a re-emerging disease in Albania: Epidemiology and clinical presentations

Aim: Measles is a highly contagious disease caused by the measles virus. Albania is one of many European countries that have successfully interrupted endemic transmission of this disease. However, during the years 2018-2019, an outbreak of measles occurred in Albania. The aim of this study was to describe the clinical features and complications of hospitalized measles patients in Tirana, Albania, as related to age-group and risk factors. Methods: All patients hospitalized for over 24 hours from January 2018 to December 2019 at the Service of Infectious Diseases, University Hospital Centre “Mother Teresa” in Tirana were included in this study. We included patients over 14 years old as this is an Infectious Diseases Service for adult patients only. Clinical and laboratory data were analysed. Results: Of the 318 hospitalized patients (139 females), about 35%, 26%, 17%, 14%, and 7% were 15-24, 25-34, 35-44, 45-54, and over 55 years old, respectively. Females constituted 37% of the total number of patients. The average and median ages were 30.9 years and 28.5 years, respectively. Average time from the first symptom to the hospital presentation was 3.8 days. Contact with other patients with measles was noted in 21% of the patients. Body rashes were identified as maculopapular in 96% of the patients. Pathognomonic enanthema or Koplik spots and conjunctivitis were detected in 62% and 52% of the patients, respectively. Measles-related complications were noted in 53% of the patients; pneumonia/pneumonitis, hepatitis, neurological complications were presented by 24%, 26%, and 3% of the patients, respectively. Average duration of hospitalization was 5.4 days, whereas mortality was 0.3%. Conclusion: This study provides valuable evidence about the distribution and clinical features of measles in Albania. Measles is a highly contagious disease and, as long as the measles virus is circulating, the risk of transmission remains high. &nbsp

Overview on epidemiological and clinical manifestation of COVID-19 in Albanian adults

On March 9, 2020 the first two cases of Sars-Cov-2 were identified and hospitalized in Albania. In this paper we present a retrospective analysis of 3000 consecutive COVID-19 confirmed cases in Albanian adults admitted at the Infectious Diseases Service which includes three tertiary care wards, part of Tirana University Hospital Center “Mother Teresa”. The period included in this analysis is from March 2020 – April 30, 2021. The paper provides a general overview including demographic distribution, symptomatic diversity and clinical signs manifested among cases, as well as the association observed with underlying pathologies. The analysis included 1944 males and 1056 females. Overall, the age groups included range from 15 to 99 years (median 65 years; mean value 63.4±13.4 years). There were no statistically significant age differences between males and females (mean ages were: 63.5±13.1 in females and 63.3±13.5 in males; median ages were: 64 years in females and 65 years in males; P=0.67). There was evidence of a statistically significant difference between sexes regarding the presence of symptoms, which were more predominant in males (P<0.001). On the whole, we observed 19 cases with specific signs and symptoms, most of them (82.9%) among patients who reported the presence of such symptoms 5-14 days before hospitalization. The comorbidities encountered were ranked according to systems and organs, classifying them in 22 categories, among which the most frequent were hypertension (52%) and diabetes mellitus (26.4%). Age was a strong risk factor for severe illness, complications, and death. Analyzing symptom onset with total symptoms and comorbidities, it showed that some patients were affected for many days with few symptoms and few comorbidities. It seems they started as mild cases for many days unpredictably precipitating. There were also a few cases with many comorbidities, but a few symptoms upon hospital admission. &nbsp

Measles, a re-emerging disease in Albania: Epidemiology and clinical presentations

Aim: Measles is a highly contagious disease caused by the measles virus. Albania is one of many European countries that have successfully interrupted endemic transmission of this disease. However, during the years 2018-2019, an outbreak of measles occurred in Albania. The aim of this study was to describe the clinical features and complications of hospitalized measles patients in Tirana, Albania, as related to age-group and risk factors.   Methods: All patients hospitalized for over 24 hours from January 2018 to December 2019 at the Service of Infectious Diseases, University Hospital Centre “Mother Teresa” in Tirana were included in this study. We included patients over 14 years old as this is an Infectious Diseases Service for adult patients only. Clinical and laboratory data were analysed.   Results: Of the 318 hospitalized patients (139 females), about 35%, 26%, 17%, 14%, and 7% were 15-24, 25-34, 35-44, 45-54, and over 55 years old, respectively. Females constituted 37% of the total number of patients. The average and median ages were 30.9 years and 28.5 years, respectively. Average time from the first symptom to the hospital presentation was 3.8 days. Contact with other patients with measles was noted in 21% of the patients. Body rashes were identified as maculopapular in 96% of the patients. Pathognomonic enanthema or Koplik spots and conjunctivitis were detected in 62% and 52% of the patients, respectively. Measles-related complications were noted in 53% of the patients; pneumonia/pneumonitis, hepatitis, neurological complications were presented by 24%, 26%, and 3% of the patients, respectively. Average duration of hospitalization was 5.4 days, whereas mortality was 0.3%.   Conclusion: This study provides valuable evidence about the distribution and clinical features of measles in Albania. Measles is a highly contagious disease and, as long as the measles virus is circulating, the risk of transmission remains high.   Conflicts of interest: None declared

Overview on epidemiological and clinical manifestation of COVID-19 in Albanian adults

On March 9, 2020 the first two cases of Sars-Cov-2 were identified and hospitalized in Albania. In this paper we present a retrospective analysis of 3000 consecutive COVID-19 confirmed cases in Albanian adults admitted at the Infectious Diseases Service which includes three tertiary care wards, part of Tirana University Hospital Center “Mother Teresa”. The period included in this analysis is from March 2020 – April 30, 2021. The paper provides a general overview including demographic distribution, symptomatic diversity and clinical signs manifested among cases, as well as the association observed with underlying pathologies. The analysis included 1944 males and 1056 females. Overall, the age groups included range from 15 to 99 years (median 65 years; mean value 63.4±13.4 years). There were no statistically significant age differences between males and females (mean ages were: 63.5±13.1 in females and 63.3±13.5 in males; median ages were: 64 years in females and 65 years in males; P=0.67). There was evidence of a statistically significant difference between sexes regarding the presence of symptoms, which were more predominant in males (P<0.001). On the whole, we observed 19 cases with specific signs and symptoms, most of them (82.9%) among patients who reported the presence of such symptoms 5-14 days before hospitalization. The comorbidities encountered were ranked according to systems and organs, classifying them in 22 categories, among which the most frequent were hypertension (52%) and diabetes mellitus (26.4%). Age was a strong risk factor for severe illness, complications, and death. Analyzing symptom onset with total symptoms and comorbidities, it showed that some patients were affected for many days with few symptoms and few comorbidities. It seems they started as mild cases for many days unpredictably precipitating. There were also a few cases with many comorbidities, but a few symptoms upon hospital admission.   Conflicts of interest: None declared

Severity and Mortality Predictors of COVID-19 Patients with Thrombotic Events-Evidence from the “COVID-One” Hospital in Albania

COVID-19 vaccination leads to lower infection, morbidity, and mortality rates. However, COVID-19 infection leads to the development of coagulopathy-related manifestations in the form of both venous and arterial thromboembolism. This study aimed to assess the severity and mortality predictors of COVID-19 patients with thrombotic events in hospitalized patients in Albania. This is a retrospective study conducted in the “Mother Tereza” University Hospital of Tirana. Data were retrieved from the electronic databases of the hospital and only COVID-19 cases admitted to the infectious department during August–December 2020 were selected. Patients who, at admission, had a C-reactive protein (CRP) (mg/L) more than double and a D-dimer (ng/mL) more than triple according to international standards were included in the study. We performed univariate and multivariable logistic regression analysis, calculating unadjusted and adjusted odds ratios (ORs). A p-value < 0.05 was considered statistically significant. The study population included 60 hospitalized persons with a mean age of 64.4 years. Increased lactate dehydrogenase (LDH) (OR = 2.93; 95% CI = 0.82–10.42, p-value = 0.1) and increased creatine kinase (CK) (OR = 2.17; 95% CI = 0.63–7.46, p-value = 0.22) were related with increased probability of death. Moreover, a decreased number of lymphocytes was associated with increased mortality but with no statistical significance (OR = 0.40; 95% CI = 0.11–1.40, p-value = 0.15). The survival rate was higher for patients without comorbidities (p = 0.045). These results could serve as a baseline and as a reference for healthcare personnel who provides services to hospitalized patients with COVID-19. Further studies should take into consideration the vaccination of the population as well as including more hospitals and patients