transmission is household-based (using the standard
formula for attributable fraction) (13).
Thus, home-based isolation may fail to effectively
prevent both household and non-household transmission
of COVID-19.
In this study, we aimed to examine the potential
impact of home-based isolation on the outcome of
patients suffering from COVID-19 in Egypt, to provide
policymakers evidence-based decision-making about the
impact of home-based isolation in mitigating the COVID-
19 pandemic.
Specific objectives: 1- To measure the proportion of
patients admitted to hospital or visited the emergency care
setting while isolated at home. 2- To estimate the
infection rate among household contacts while patients
isolated at home. 3- To determine the proportion of
patients with prolonged symptoms while isolated at home.
4- To assess patients' and household contacts’ compliance
to physicians’ instructions while isolated at home. 5- To
explore factors affecting home-based isolation abiding
and 6- To assess patients’ satisfaction regarding follow-
up phone calls.
Methods:
Study Design and setting: A cross-sectional analytical
study was conducted at Cairo University Hospitals to
assess the impact of home-based isolation on the outcome
of patients suffering from COVID-19 in Egypt.
Study population: The study was conducted on Egyptian
patients suffering from mild to moderate symptoms of
COVID-19.
Sample Size and Technique: A total sample of 393
patients diagnosed with COVID-19 who visited Cairo
University Hospital seeking treatment from the 1st of June
to the 30th of September 2020 were included and were
followed-up for 3 months.
Inclusion criteria: All Egyptian patients diagnosed with
mild symptoms of COVID-19, visited Cairo University
Hospital seeking treatment, giving their cell phone
numbers, and agreed to participate in the study, were
included.
Exclusion criteria: Patients with severe symptoms not
feasible for home isolation, patients refusing to give their
cell phone numbers or had no cell phones and patients
who couldn’t complete the questionnaire, or refusing to
complete the questionnaire.
Data Collection Tool:
A structured questionnaire, composed of 35 questions
was administered. Questions were presented in the Arabic
language. Content and face validity were checked by the
authors. The questionnaire was pretested on 20
participants who were later on omitted from the analysis.
The internal consistency of the study questionnaire was
assessed by calculating the Cronbach alpha (0.812). A
group of physicians (40) from different departments at the
Faculty of Medicine, Cairo University were assigned to
contact the patients and fill in the questionnaire. Each
physician was assigned to 10 patients and called them 3
times through the 14-day isolation period from 1st of June
to 30th of September 2020.
The questionnaire enclosed the following sections (I)
Demographic characters (4 items): age, gender,
occupation, phone number.
(II) Different Symptoms of COVID-19 (11 items).
(III) assessment of home based-isolation (14 items): the
need for hospital admission or emergency care,
satisfaction with phone calls, restriction to home isolation
rules, presence of a separate room with good ventilation,
presence of own bathroom, or sterilization of a shared
bathroom after each use, eating personal items, share
eating or sitting with family members, wearing a mask,
social distancing at home, using air conditioning or fan,
washing hands frequently with every use of tissue for
coughing or sneezing, measuring temperature daily, who
was helping with food preparation/cleaning, if family
members wearing masks and gloves when dealing with
him/her and if there were infections among household
contacts. The score used for assessment of home-based
isolation (14 items): correct responses assigned one point
while do not know or incorrect responses received nil.
Those who attained ≥ 8 points (out of 14 points, the 60th
percentile or average for the score) were assigned as
achieving good score, while those who attained < 8 points
were assigned as achieving bad score.
Ethical Consideration:
Objectives of the study were explained to the
participants, and they were completely free to accept
or refuse to participate. Strict confidentiality about
participants’ data (this was secured by the
questionnaire being anonymous) was maintained
throughout data collection, entry, and analysis
(according to the Helsinki declaration). This study was
approved by the Research Ethics Committee, Faculty
of Medicine, Cairo University (N- 83- 2020).
Data Analysis
The data were coded and exported on a data sheet
prepared on Excel program, version 2013. The statistical
package for social science (SPSS version 21) was used for
data analysis. Simple descriptive statistics were used for