77% of Cyprus coronavirus cases in past fortnight imported

By June 30th, a total of 998 COVID-19 cases and 26 deaths (case fatality rate: 2.6%) were reported in the Republic of Cyprus.

Within the last 14 days, including June 17, 13 new cases were reported, of which 10 (77%) were imported, and three (23%) were locally acquired.

Overall, the 853 cases for which the place of exposure was known, 667 (79.4%) were locally acquired infections, of which 57 (8.4%) were identified at the Paphos General Hospital, and 84 (12.4%) were reported in the Aradippou municipality.

Among all cases recorded until June 30, according to data released Friday by the epidemiological unit of the Health Ministry, 191 (19.1%) are health-care workers - 3.8% physicians (n=39), 9.8% nurses (n=97), 1.3% other health occupations (n=13), and 4.2% auxiliary staff (n= 42).

The median age of cases is 44.5 years (Interquartile range - IQR: 30-59 years); 50.9% are male and 49.1% are female.

In total, 18.1% (n=181) of cases received hospital care, and three (1.7%) are still hospitalised (either for treatment of COVID-19 symptoms or for pre-existing conditions). Median age of all hospitalized patients is 62 years (IQR: 48-73 years) and 64.6% are males.

There are no patients in intensive care units.

Among cases alive, 839 (86.3%) have recovered (without symptoms and with two negative tests following their diagnosis or released 21 days after diagnosis).

A total of 157,102 tests have been performed until June 30th (17,936.1 per 100,000 population).

A total of 50.9% of the cases are male (n= 508) and 49.1% female (n=490). The median age of cases is 44.5 years (IQR: 30-59 years). By age groups, cases included 65 infants, children and adolescents aged 0-17 years-old (6.5%), 701 adults aged 18-59 years (70.2%), and 232 persons aged 60 years and older (23.2%).

Figures show that 128 cases (12.8%) were reported in Aradippou, a municipality in Larnaca district. Cases in Aradippou, including a cluster in a local bakery production line, are mainly males (58.6%; n=75) and the median age is 49 years (IQR: 32-61.5 years). If the cluster is excluded, cases are mainly females (53%; n=53) and the median age is 54.5 years (IQR: 35.5-69 years).

By June 30th, place of exposure is available for 853 cases (85.5%).

In total, 20.6% (n=176) 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, mainly.

Locally acquired infections (index cases and close-contacts of confirmed cases) occurred in 79.4% (n=677 of 853 with known place of exposure) of the cases, of which 8.4% (n=57) were related to a health-care facility (General Hospital in Paphos).

Of all cases in Aradippou (Larnaca district) (n=128), 84 (65.6%) were locally-acquired, 11 (8.6%) imported and for 33 cases (25.8%) the epidemiological link was not recorded at the moment.

Of the 998 laboratory-confirmed COVID-19-cases, clinical information is available for 98.6% (n=984), of which 34.5% (n=339) reported no symptoms at diagnosis and 65.5% (n=645) reported at least one symptom. The most commonly reported symptoms were:

• cough (317/971; 32.7%),

• fever (302/971; 31.1%),

• myalgia (207/970; 21.3%),

• sore throat (160/968; 16.5%),

• anosmia (111/880; 12.6%), and

• shortness of breath (108/955; 11.3%).

Other reported symptoms were diarrhoea, runny nose, and headache.

As regards pre-existing conditions, information on comorbidities was available for 891 (89.3%) cases. Of these, 347 (39%) reported at least one comorbidity.

The most commonly reported comorbidities were:

• hypertension (130/884; 14.7%),

• diabetes (77/891; 8.6%),

• heart disease (66/885; 7.5%), and

• cancer (25/891; 2.8%).

Other reported comorbidities were immunosuppression, chronic respiratory disease, chronic kidney disease, and autoimmune disease.

Until June 30th, 26 deaths were reported in Cyprus (Case Fatality Rate - CFR: 2.6%).

The mortality rate for COVID-19 is 3 per 100,000 population.

Eighteen deaths (73%) occurred in men and seven (27%) in women; the median age of all deaths was 75 years (IQR: 66-79 years). Nine deaths were reported among residents in Larnaca, eight in Paphos, four in Nicosia, three in Ammochostos, and two in Limassol.

The median time from date of sampling to death was 12.5 days (IQR: 5-30 days).

For 19 deaths, COVID-19 was the underlying cause of death (COVID-19 CFR: 1.9%).

In total, 18.1% (n=181) of people with COVID-19 received hospital care, and three (1.7%) are still hospitalised (either for treatment of COVID-19 symptoms or for pre-existing conditions). The median age of hospitalized patients was 62 years (IQR: 48-73 years). Hospitalized cases were mainly males (n=117; 64.6%).

Overall, 32 cases (17.7% of all hospitalized patients) have been admitted to ICUs, and currently there are no cases in ICU (by June 30th).

A total of 27 ICU patients (84.4% of all ICU patients) have been intubated, and currently there no patients intubated.

By June 30th, among cases alive, 86.3% (n = 839) of COVID-19 cases have recovered5; of which 759 (90.5%) tested negative two consecutive times, and 80 (9.5%) have been released as per the new guidelines6. The median time between the second negative result and the first date of sampling was 25 days (IQR: 19-37 days).

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).

Until June 30th, in Cyprus the reporting rate was 113.9 cases per 100,000 population, the mortality rate was 3 deaths per 100,000 population and the CFR was 2.6%.