Observational studyBMC infectious diseases2026
Characteristics of COVID-19 cases and factors associated with disease severity in Lao People's Democratic Republic: a nationwide study.
Observational study in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis is the first nationwide analysis to describe the epidemiological and clinical characteristics of COVID-19 cases in Lao People's Democratic Republic (Lao PDR) and to identify factors associated with symptom-based disease severity during the early phase of the COVID-19 pandemic in Lao PDR.
methodsThis retrospective observational study analyzed 114,434 laboratory-confirmed COVID-19 cases reported in the national online surveillance system of the National Center for Laboratory and Epidemiology, Lao PDR, from 2020 to 2021.
resultsDuring 2020-2021, 1,408,839 suspected cases had tests for COVID-19 and 114,434 cases were confirmed positive. The cumulative number of laboratory-confirmed cases over the two-year period was 1,546.3 per 100,000 population and the case fatality rate was 0.14% (162 deaths). Most cases identified during the study period were aged 20-39 years, Laotian, residents in the central region, asymptomatic, and had received COVID-19 vaccinations. The factors associated with severe cases (n = 1,235, 1.08%) were males (adjusted odds ratio [AOR] = 1.43), older age (30-39 years, AOR = 1.44; 50-59 years, AOR = 1.74; 60-69 years, AOR = 2.01; and ≥ 70 years, AOR = 4.10) (vs. 0-9 years), Laotian (vs. foreigner; AOR = 4.42), employees of a non-governmental organization (AOR = 1.30) and prisoners (AOR = 1.76) (vs. unemployed), residents in the northern region (vs. the central region; AOR = 1.78), and the presence of comorbidity (AOR = 4.43). People living in the southern region (AOR = 0.67) and teachers (AOR = 0.40) were less likely to develop severe disease. Exposure in high-risk settings was associated with severity (AOR = 1.29), whereas travel-related (AOR = 0.48) and unlinked infections (AOR = 0.39) were inversely associated. Vaccination dose was not significantly associated with severe COVID-19 among all confirmed cases.
conclusionsSevere COVID-19 was rare in Lao PDR during 2020-2021 but occurred more frequently among males, older adults, cases with comorbidities, and residents of the northern region. No significant association was observed between vaccination dose and severe disease. Maintaining a robust surveillance infrastructure alongside evidence-based vaccination programs may strengthen preparedness for future public health emergencies in Lao PDR.
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