The Epidemiological Surveillance Unit of the Ministry of Health released on Wednesday its latest report on the development of Covid-19 in Cyprus up to April 14, according to which the mortality rate among confirmed cases stands at 2.4%.
The majority of cases still concerns healthcare workers at a rate of 22.9%. It also found that 21.5% of positive cases received hospital care, of which 58.0% were discharged alive from the hospital.
You can read the Epidemiological Surveillance Unit’s full report below.
Summary
- As of April 14th, a total of 697 COVID-19 cases and 17 deaths (case fatality rate:
2.4%) have been reported in the Republic of Cyprus. - Among these cases, 22.9% are health-care workers (n = 160) – 5.3% physicians
(n = 37), 11.9% nurses (n = 83), 1.3% other health occupations (n = 9), and
4.4% auxiliary staff (n = 31). - The median age of cases is 47 years (interquartile range – IQR: 33-60 years); 51%
are male. - Overall, of 574 cases for which the place of exposure was known, locally
acquired infections (index cases and close-contacts of confirmed cases) were
479 (83.5%) – of these 10% (n = 49) were related to a health-care facility (General
Hospital in Pafos) and 16.1% (n = 77) were reported in Aradippou municipality. - In total, 21.5% (n = 150) of cases received hospital care, of which 87 (58.0%) have
been discharged alive from the hospital. Median age of all hospitalized patients
is: 63 years (interquartile range: 51-74 years), and 68% are males. - Fourteen (9.3% of all hospitalized patients) patients were still in intensive care
units (for part of the day if he/she died, discharged or transferred on that day
or for the whole day, by April 14th). - A total of 20,517 tests have been performed as of April 14th (2,342.3 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 April 14th, 697 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 (IQR: 2-
7 days). It should be noted that for 11 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 April 14th, 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)1, is 44.9 per 100,000 population (Figure 3).
Characteristics of the cases
Among these cases, 51% are male (n = 354) and 49% female (n = 343).
The median age of cases is 47 years (interquartile range: 33-60 years). By age groups,
cases included 37 infants, children and adolescents aged 0-17 years-old (5.4%), 474
adults aged 18-59 years (68.6%), and 180 persons aged 60 years and older (26%). The
age of six notified cases has not been recorded at the moment (Figure 4).
Among all cases, 245 (35.2%) were reported in Nicosia district, 198 (28.4%) in Larnaka,
124 (17.8%) in Pafos, 75 (10.8%) in Limassol, and 38 (5.5%) in Ammochostos. Seventeen
cases (2.4%) 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, 113 cases (16.2%) 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 (58.4%; n = 66) and the median age is 49 years
(interquartile range: 34-65 years). If the cluster is excluded, cases are mainly female
(55.3%; n = 47) and the median age is 56 years (interquartile range: 45-71 years).
Among the 697 cases, 22.9% are health-care workers2 (n = 160), of which 5.3%
physicians (n = 37), 11.9% nurses (n = 83), 1.3% other health occupations (n = 9), and
4.4% auxiliary staff (n = 31).
Table 1 shows the distribution of health-care workers by district of residence.
Epidemiological link
As of April 14th, place of exposure is available for 574 cases (82.4%), and 123 cases
(17.6%) are under investigation.
In total, 16.5% (n = 95) 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 83.5% (n = 479 of 574 with known place of exposure) of the cases, of which
10% (n = 49) were related to a health-care facility (General Hospital in Pafos).
Of all cases in Aradippou (Larnaka district) (n = 113), 77 (68.1%) were locally-acquired,
seven (6.2%) imported and for 29 cases (25.7%) 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.
Clinical features
Of the 697 laboratory-confirmed COVID-19-cases, clinical information is available for
95.4% (n = 665), of which 26.2% (n = 174) reported no symptoms at diagnosis and
73.8% (n = 491) reported at least one symptom. The most commonly reported
symptoms were:
- cough (261/625; 41.8%),
- fever (232/639; 36.3%),
- myalgia (171/636; 26.9%),
- sore throat (129/634; 20.3%),
- anosmia (92/470; 19.6%), and
- shortness of breath (97/607; 16.0%).
Other reported symptoms were runny nose, diarrhoea, and headache.
Table A2 in appendix reports the sex and age distribution of asymptomatic cases at
diagnosis.
Pre-existing conditions
Information on comorbidities was available for 564 (80.9%) cases. Of these, 248 (44%)
reported at least one comorbidity.
The most commonly reported comorbidities were:
- hypertension (101/551; 18.3%),
- diabetes (61/552; 11.1%),
- heart disease (54/548; 9.9%), and
- cancer (13/330; 3.9%).
Other reported comorbidities were chronic kidney disease, autoimmune disease, and
chronic respiratory disease.
Deaths
As of April 14th, 17 deaths were reported in Cyprus (Case Fatality Rate – CFR: 2.4%).
The mortality rate for COVID-19 is 1.9 per 100,000 population.
Thirteen deaths (76.5%) occurred in men and four (23.5%) in women; the median age
of all deaths was 76 years (IQR: 66-79 years). Six deaths were reported among
residents in Larnaka, five in Pafos, 2 in Nicosia, Limassol and Ammochostos, each
(Appendix Table A3).
The median time from date of sampling to death was 6.5 days (IQR: 3.5-12.5 days)
(information on date of sampling was available for 16 cases). Of the 17 people who
died, 10 were admitted to an Intensive Care Unit (ICU) with a median length of stay
there of 7 days (IQR: 0-9 days). Figures A3 and A4 in the Appendix show the KaplanMeier curves of the time from date of sampling to death and of the length of stay in
ICU for the people who died.
For 12 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, 21.5% (n = 150) patients received hospital care, and 87 patients (58.0%) have
been discharged alive from the hospital. When age was available (n = 147), the median
age of hospitalized patients was 63 years (interquartile range: 51-74 years).
Hospitalized cases were mainly males (n = 100; 66.7%).
Overall, 27 cases (18% of all hospitalized patients) have been admitted to ICU, of
which 14 (9.3% of all hospitalized patients) were still in ICU (as of April 14th).
The median age of patients admitted to ICU was 69 years (interquartile range: 61-76
years); for one patient age is not recorded at the moment. The number of cases in ICU
is 1.6 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 April 14th are 5.3 per
100,000 population (n = 3,186) and 11.2 per 100,000 population (n = 1,122)
Figure 6 shows the number of patients in ICU by day. Table A4 in the appendix shows
the total number of ICU admissions by date.
Notes:
- Data on hospitalisation and ICU are provisional and should be interpreted with caution because delay in data reporting is likely; for the construction of the curve, people are no longer in an ICU the day next to the date of their discharge, death or transfer.
- Intensive care unit (ICU) refers only to the ICU in Limassol General Hospital and to the ICU in Nicosia General Hospital.
Recovered
As of April 14th, 9.3% (n = 65) of COVID-19 cases have recovered.
The median time between the second negative result and the first date of sampling
was 16 days (IQR: 12-19 days).
Table 2 shows the number and percentage of recovered cases and their characteristics.
Notes:Â
- 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).
Comparison with selected countries
As of April 14th, in Cyprus the reporting rate was 79.6 cases per 100,000 population,
the mortality rate was 1.9 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
2,342.3 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.
Appendix
