According to the Epidemiological Surveillance Unit’s weekly report on Coronavirus published on Thursday, as of May 5, 83% of all Coronavirus cases in Cyprus (608 people) were locally acquired.
In addition, the death rate in Cyprus stands at 2.4% and a percentage of 45.6% (400 people) have recovered.
169 cases, or 19.3% received hospital care and 124 patients, or 73.4% were discharged from hospital alive.
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As of May 5th, a total of 878 COVID-19 cases and 21 deaths (case fatality rate: 2.4%) have been reported in the Republic of Cyprus.
Among these cases, 21.4% are health-care workers (n = 188) – 4.4% physicians (n = 39), 10.8% nurses (n = 95), 1.5% other health occupations (n = 13), and 4.7% auxiliary staff (n = 41).
The median age of cases is 46 years (interquartile range – IQR: 32-59 years); 50% are female and 50% are male.
Overall, of 733 cases for which the place of exposure was known, locally acquired infections (index cases and close-contacts of confirmed cases) were 608 (83%) – of these 10.2% (n = 62) were related to a health-care facility (General Hospital in Pafos) and 12.9% (n = 78) were reported in Aradippou municipality.
In total, 19.3% (n = 169) of cases received hospital care, of which 124 (73.4%) have been discharged alive from the hospital. Median age of all hospitalized patients is: 62 years (interquartile range: 49-73 years), and 65.1% are males.
Six patients were still in intensive care units (for part of the day if they died, were discharged or transferred on that day or for the whole day, by May 5th); of these 5 (83.3%) were intubated.
Overall, 400 (45.6%) cases have recovered.
A total of 66,876 tests have been performed as of May 5th (7,635.1 per 100,000 population).
Epidemiological surveillance in the Republic of Cyprus
Analyses are based on laboratory-confirmed cases notified to the Epidemiological Surveillance Unit of the Ministry of Health.
As of May 5th, 878 laboratory-confirmed cases of coronavirus disease 2019 (COVID19) have been reported (Figure 1 and 2).
The median time between symptoms onset and date of sampling was 4 days (Interquartile range – IQR: 2-7 days). It should be noted that for 14 cases the date of sample collection was before the onset of symptoms because of immediate testing of contacts of possible and laboratory-confirmed cases.
As of May 5th, the 14-day cumulative incidence rate of COVID-19 (per 100,000 population), a measure which reflects the number of active COVID-19 cases in the population (prevalence), is 10.3 per 100,000 population (Figure 3).
Characteristics of the cases
Among these cases, 50% are male (n = 439) and 50% female (n = 439). The median age of cases is 46 years (IQR: 32-59 years). By age groups, cases included 51 infants, children and adolescents aged 0-17 years-old (5.8%), 610 adults aged 18-59 years (69.5%), and 217 persons aged 60 years and older (24.7%) (Figure 4).
Among all cases, 337 (38.4%) were reported in Nicosia district, 229 (26.1%) in Larnaka, 155 (17.7%) in Pafos, 97 (11.0%) in Limassol, 41 (4.7%) in Ammochostos, and 19 (2.2%) were reported either in British bases or had a residence abroad, or information was not available (Table A1 in appendix).
Figure A1 in appendix shows the distribution of cases by postal code.
Notably, 121 cases (13.8%) were reported in Aradippou, a municipality in Larnaka district (Table A1 in appendix). Cases in Aradippou, including a cluster in a local bakery production line, are mainly males (58.7%; n = 71) and the median age is 49 years (IQR: 33-62 years). If the cluster is excluded, cases are mainly female (53.8%; n = 50) and the median age is 55 years (IQR: 42-69years).
Among the 878 cases, 21.4% are health-care workers (n = 188) – 4.4% physicians (n = 39), 10.8% nurses (n = 95), 1.5% other health occupations (n = 13), and 4.7% auxiliary staff (n = 41).
Table 1 shows the distribution of health-care workers by district of residence.
As of May 5th, place of exposure is available for 733 cases (83.5%).
In total, 14.2% (n = 125) of laboratory-confirmed COVID-19-cases had history of travel or residence abroad during the 14 days prior to symptom onset (imported). These cases have a direct link to the UK and Greece, mainly.
Locally acquired infections (index cases and close-contacts of confirmed cases) occurred in 83% (n = 608 of 733 with known place of exposure) of the cases, of which 10.2% (n = 62) were related to a health-care facility (General Hospital in Pafos).
Of all cases in Aradippou (Larnaka district) (n = 121), 78 (64.5%) were locally-acquired, 10 (8.3%) imported and for 33 cases (27.3%) the epidemiological link was not recorded at the moment.
Table A1 in the appendix shows the number and the rate (per 100,000 population) of locally-acquired cases by district of residence.
Of the 878 laboratory-confirmed COVID-19-cases, clinical information is available for 98.4% (n = 864), of which 31.1% (n = 269) reported no symptoms at diagnosis and 68.9% (n = 595) reported at least one symptom.
The most commonly reported symptoms were:
cough (304/854; 35.6%),
fever (276/852; 32.4%),
myalgia (194/851; 22.8%),
sore throat (154/849; 18.1%),
anosmia (107/759; 14.1%), and
shortness of breath (104/836; 12.4%).
Other reported symptoms were diarrhoea, runny nose, and headache.
Table A2 in appendix reports the sex and age distribution of asymptomatic cases at diagnosis.
Information on comorbidities was available for 766 (87.2%) cases. Of these, 317 (41.4%) reported at least one comorbidity.
The most commonly reported comorbidities were:
hypertension (123/761; 16.2%),
diabetes (69/769; 9.0%),
heart disease (62/764; 8.1%), and
cancer (18/467; 3.9%).
Other reported comorbidities were chronic kidney disease, autoimmune disease, and
chronic respiratory disease.
As of May 5th, 21 deaths were reported in Cyprus (Case Fatality Rate – CFR: 2.4%). The mortality rate for COVID-19 is 2.4 per 100,000 population.
Seventeen deaths (81%) occurred in men and four (19%) in women; the median age of all deaths was 76 years (IQR: 67-79 years). Seven deaths were reported among residents in Larnaka, six in Pafos, three in Nicosia and Ammochostos, each, and two in Limassol (Appendix Table A3).
The median time from date of sampling to death was 7 days (IQR: 4-15 days). Figure A3 shows the Kaplan-Meier curve of the time from date of sampling to death.
For 15 deaths, COVID-19 was the underlying cause of death (COVID-19 CFR: 1.7%).
Figure 5 reports the number of deaths by date.
Hospitalization and intensive care unit (ICU) admissions
In total, 19.3% (n = 169) of people with COVID-19 received hospital care, and 124 patients (73.4%) have been discharged alive from the hospital. The median age of hospitalized patients was 62 years (IQR: 49-73 years). Hospitalized cases were mainly males (n = 110; 65.1%).
Figure 6 shows the total number of hospital admissions by date.
Overall, 32 cases (18.9% of all hospitalized patients) have been admitted to ICU, of which 6 were still in ICU (as of May 5th).
A total of 27 ICU patients (83.4% of all ICU patients) have been intubated, of which 5 (83.3% of all patients currently in ICU) are still intubated.
The overall median length of stay in ICU (for all 32 ICU cases, considering those still in ICU until May 5th) was 10.5 days (IQR: 8-27 days). Figure A4 shows the KaplanMeier curve of the length of stay in ICU.
For patients who died while in ICU (n = 14), the median length of stay in ICU was 9.5 days (IQR: 3-17). Figure A5 shows the Kaplan-Meier curve of the length of stay in ICU for the people who died.
For patients transferred/discharged alive from ICU (n = 13), the median length of stay in ICU was 10 days (IQR: 8-27 days).
The median age of patients ever admitted to ICU was 65.5 years (IQR: 56-75 years). ICU patients are mainly male (n = 23; 71.9%).
The number of cases currently in ICU is 0.7 per 100,000 population. For comparison, Italy and Lombardia reported the highest rates of 6.7 per 100,000 population (n = 4,068) and 13.8 per 100,000 population (n = 1,381) on April 3rd. The ICU rates in Italy and Lombardia on May 5th are 2.4 per 100,000 population (n = 1,479) and 5.1 per 100,000 population (n = 509).
As of May 5th, 45.6% (n = 400) of COVID-19 cases have recovered (For symptomatic cases, or for cases hospitalised, a COVID-19 case can be considered cured after the resolution of symptoms and two negative tests for SARS-CoV-2 at 24-hour interval at least.
For asymptomatic cases, or for persons isolated at home, the negative tests to document virus clearance should be obtained at a minimum of 14 days after the initial positive test (end of the quarantine period).
The median time between the second negative result and the first date of sampling was 20 days (IQR: 17-26 days).
Table 2 shows the number and percentage of recovered cases and their characteristics.
Comparison with selected countries
As of May 5th, in Cyprus the reporting rate was 100.2 cases per 100,000 population, the mortality rate was 2.4 deaths per 100,000 population and the CFR was 2.4%.
Table 3 shows COVID-19 indicators for Cyprus and other selected countries.
Figure A2 in appendix reports the rates of cumulative tests and cases (per 100,000 population) in Cyprus and other selected countries. In Cyprus the testing rate is 7,635.1 per 100,000 population.
It should be noted that the number of cases, tests and deaths for Cyprus are aggregated and include people from abroad and the British bases, while the total population does not include inhabitants from abroad or from the British bases.