Determinants of mortality among hospitalized patients with COVID-19 during first and second waves of the pandemic: A retrospective cohort study from an isolation center in Kano, Nigeria (original) (raw)
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African Health Sciences
Background: Lagos State has the highest burden of COVID-19 in Nigeria. We assessed associated factors with death from COVID-19 among hospitalized patients in Lagos, Nigeria. Methods: A retrospective cross-sectional study was conducted using de-identified records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos State between February 27, 2020, and September 30, 2020. Results: A total of 2,858 COVID -19 patients were included in this study. The mean age of the patients was 41.9±15.5 years. A higher proportion of patients were males (65.8%), asymptomatic (55.5%), had no comorbid condition (72.2%) and had the mild disease (73.8%). The case fatality rate was 6.5%. The odds of death from COVID-19 infection increased by 4% with every increase in age (AOR 1.04, 95%CI 1.03–1.05, p<0.001). The chance of dying was 50% fold more among males (AOR 1.5, 95%CI 1.0 – 2.2, p = 0.042), 60% fold more among patients with comorbidity (AOR 1.6, 95%CI 1.3 – 2.4, p = ...
Predictors of Mortality Among Hospitalized COVID-19 Patients at a Tertiary Care Hospital in Ethiopia
Infection and Drug Resistance
Background: The very unprecedented virus causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has continued causing catastrophes in economy and loss of human lives. Despite countries' urgent and resilient public health actions against the COVID-19 pandemic, the disease is causing a large number of deaths. However, predictors of mortality among hospitalized COVID-19 patients have not been well investigated in Ethiopia. Therefore, this study aimed to identify the predictors of mortality among hospitalized COVID-19 patients at a tertiary care hospital in Ethiopia. Methods: A hospital-based retrospective cohort design study was implemented among hospitalized COVID-19 patients at a tertiary care hospital in Harar, Ethiopia from March 20 to August 20, 2021. Data of 531 admitted patients were entered using Epi-data 3.1 and exported to STATA 14.2 for analysis. Binary logistic regression was used to identify significant predictors of outcome variables with an adjusted odds ratio (AOR) with a 95% confidence interval. Results: Of the total 531 study participants, 101 deaths occurred. The mortality rate was 16.2 per 1000 person-days of observation with median survival time of 44 days with IQR [28, 74]. Smoking history [AOR=2.55, 95% CI (1.15, 5.65)], alcohol history [AOR=2.3, 95% CI (1.06, 4.97)], comorbidities [AOR=2.95, 95% CI (1.26, 6.91)], and increasing oxygen saturation [AOR=0.92, 95% CI (0.89, 0.95)], and lymphocyte count [AOR=0.90, 95% CI (0.88, 0.97)] were independent significant predictors of death from Covid-19. Conclusion: The incidence of mortality among hospitalized COVID-19 patients was found to be high. Devising individual, tailored management for patients with "risk" behaviors, comorbid conditions, and poor prognostic markers such as lymphopenia and low oxygen saturation, may reduce the incidence of death among hospitalized COVID-19 patients.
Correlation between COVID-19 Patients' Characteristics and Mortality with the Disease in the Gambia
International Journal of Innovative Science and Research Technology , 2021
Background. A new coronavirus strain known as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) is responsible for the global pandemic that began in 2019 and continues to plague the planet. The disease's epidemiological features in Africa are different from those in other continents. The aim of this study is to establish the relationship that exists between COVID-19 patients' demographics, symptoms, comorbidities and the risk of COVID-19-related mortality in the Gambia between April 4, 2020 and March 31, 2021. Design. The researchers studied 3547 confirmed positive COVID-19 anonymized cases derived from the DHIS2 database in a retrospective cohort analysis. The factors analyzed include the demographics of the cases, their signs and symptoms, and their comorbidities. The main outcome of interest was death with COVID-19. Results. For the time period under consideration, 3547 anonymized positive COVID-19 events were analyzed. The fatality rate was 0.56%, with a median age of 60.5 (50-71) for those who died with COVID-19 and the pvalue < 0.001. Males are more likely to develop the disease and die from it (63.1% and 85%, respectively). Except for age and sex (both p < 0.05), all factors studied were considered to be statistically insignificantly correlated with the outcome. Cough (11.1%), fever (9.4%), and shortness of breath (4.3%) were the most common signs and symptoms identified by the cases. 4.62 % and 18.1 % of all confirmed positive COVID-19 cases, respectively, had one of the comorbidities and reported one of the COVID-19 signs and symptoms in TABLE 1. There was no statistically significant association between the signs and symptoms or the comorbidities and the outcome. CVD (2.7%), diabetes (1.5%), and ARDS (0.8%) and CLD (0.4%) were the most often identified comorbidities among the cases. Symptoms and comorbidities were reported more often by survivors than those who died with COVID-19. Age, shortness of breath, and diabetes all increase the risk of death with COVID-19, as per the multivariate logistic regression. In this analysis, however, only age was a significant predictor of mortality with COVID-19. Interpretation. The findings of our analysis are consistent with those of the Lusaka cohort, which reported that advanced age increased mortality with COVID-19, and that the most common comorbidities were CVD (hypertension) and diabetes, with a higher proportion of male COVID-19 cases. To better understand the characteristics of COVID-19 hospitalized cases in relation to death with COVID-19, length of hospitalization, and treatment, further exploratory data analysis is needed.
Background: The advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There is a lack of data on the outcome of hospitalized African patients suffering from COVID-19.This study aimed at identifying factors associated with hospital mortality in patients who suffered from COVID-19 at Gulu Regional Referral Hospital in Northern Uganda from March 2020 to October 2021.Methods: This was a single-center, retrospective study in patients hospitalized with confirmed COVID-19 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, comorbidities, duration of hospital stay, and treatment were analyzed, and factors associated with increased odds of mortality were determined.Results: Of the 664 patients treated, 661(99.5%) were unvaccinated, 632(95.2%) recovered and 32(4.8%) died. Mortality was highest in diabetics 11(34.4%), cardiovascular diseases 12(37.5%), hypertensive 10(31.3%), females 18(56....
International Journal of Translational Medical Research and Public Health
Background and Introduction: COVID-19 has affected almost 180 million people around the world, causing the death of about 5 million persons, as of November 16, 2021. The disease presents with a plethora of pulmonary and extrapulmonary symptoms of varying severity. After an exhaustive review of the literature, we found no data on the mild and moderate COVID-19 disease phenotypes in Northern Nigeria. Our objective is to describe the clinical characteristics of non-severe COVID -19 disease phenotypes in Kano State. Methods: This is a retrospective cohort study at the COVID-19 Isolation Center of Muhammad Buhari Specialist Hospital Kano, Nigeria. We included all patients admitted from May 2020 to December 2020. Patients’ medical records were assessed and evaluated to describe the clinical characteristics at presentation. We explored time to discharge between patients aged ≤ 50 years old versus those >50. We applied the Kaplan-Meier product-limit estimator to generate cumulative proba...
Predictors of mortality related to Covid-19
World Journal of Advanced Research and Reviews, 2022
Introduction: The new 2019 coronavirus has spread rapidly around the world, creating a pandemic. Since the beginning of the pandemic, 6.012.035 patients have died. The objective of this study is to identify clinical and biological parameters associated with high mortality in patients with COVID-19 pneumonia. Material and methods: We report a retrospective study carried out in a Covid department of the Mohamed VI University Hospital of Marrakech between 20 October and 20 December 2021. Patients were divided into 2 groups: a survivor group and a decedent group. Results: We collected 103 cases during this period. A male predominance was noted in 55.3% of cases. The group of deceased included 9 cases (8.7%) while the group of survivors contained 94 cases (91.2%). The average age of the patients in the survivor group was 44.6 years, while it was higher in the deceased group (60.6 years). We noted that the deceased patients had more arterial hypertension (55.6% vs. 10.6%) and heart diseas...
Clinical features and predictors of mortality among hospitalized patients with COVID-19 in Niger
Conflict and Health, 2021
Introduction COVID-19 has spread across the African continent, including Niger. Yet very little is known about the phenotype of people who tested positive for COVID-19. In this humanitarian crises region, we aimed at characterizing variation in clinical features among hospitalized patients with COVID-19-like syndrome and to determine predictors associated with COVID-19 mortality among those with confirmed COVID-19. Methods The study was a retrospective nationwide cohort of hospitalized patients isolated for COVID-19 infection, using the health data of the National Health Information System from 19 March 2020 (onset of the pandemic) to 17 November 2020. All hospitalized patients with COVID-19-like syndrome at admission were included. A Cox-proportional regression model was built to identify predictors of in-hospital death among patients with confirmed COVID-19. Results Sixty-five percent (472/729) of patients hospitalized with COVID-19 like syndrome tested positive for SARS-CoV-2 amo...
Epidemiology of COVID-19 and Predictors of Outcome in Nigeria: A Single-Center Study
The American Journal of Tropical Medicine and Hygiene, 2020
There is a paucity of information regarding the epidemiology and outcome of COVID-19 from low/middleincome countries, including from Nigeria. This single-center study described the clinical features, laboratory findings, and predictors of in-hospital mortality of COVID-19 patients. Patients admitted between April 10, 2020 and June 10, 2020 were included. Forty-five patients with a mean age of 43 (16) years, predominantly male (87%), presented with fever (38%), cough (29%), or dyspnea (24%). In-hospital mortality was 16%. The independent predictors of mortality were hypoxemia (adjusted odds ratio [aOR]: 2.5; 95% CI: 1.3-5.1) and creatinine > 1.5 mg/dL (aOR: 4.3; 95% CI: 1.9-9.8).
Travel Medicine and Infectious Disease, 2022
Background: Despite being a global pandemic, little is known about the factors influencing in-hospital mortality of COVID-19 patients in sub-Saharan Africa. This study aimed to provide data on in-hospital mortality among COVID-19 patients hospitalized in a single large center in Cameroon. Methods: A hospital-based prospective follow-up was conducted from March 18 to June 30, 2020, including patients >18 years with positive PCR for SARS-COV-2 on nasopharyngeal swab admitted to the Laquintinie Douala hospital COVID unit. Predictors of in-hospital mortality were assessed using Kaplan Meir survival curves and Weibull regression for the accelerated time failure model. Statistical significance was considered as p < 0.05. Results: Overall 712 patients (65,7% men) were included, mean age 52,80 ± 14,09 years. There were 580 (67,8% men) in-hospital patients. The median duration of hospital stay was eight days. The in-hospital mortality was 22.2%. Deceased patients compared to survivors were significantly older, had a higher temperature, respiratory rate, and heart rate, and lowest peripheral oxygen saturation at admission. After adjusting for age, sex, and other clinical patient characteristics, increased heart rate, increased temperature, decreased peripheral oxygen saturation. The critical clinical status was significantly associated with increased in-hospital mortality. In contrast, hospitalization duration greater than eight days and the use of hydroxychloroquine (HCQ) + azithromycin (AZM) therapy was associated with decreased risk of in-hospital mortality. Conclusion: One in five hospitalized COVID-19 patients die in a low-middle income setting. Critical clinical status, dyspnea, and increased heart rate were predictors of in-hospital mortality. This study will serve as a prerequisite for more robust subsequent follow-up studies. Also, these results will aid in revising national guidelines for the management of COVID-19 in Cameroon.
Ghana Medical Journal, 2020
Summary Background In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4–5%. However, data on COVID-19 admissions from sub-Saharan Africa are scanty. Objective To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana. Methods A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020. They were managed and followed up for outcomes. Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling. Results The mean age of the patients was 59.3 ± 20.6 years, and 14 (56%) were males. The main symptoms at presentation were breathlessness (68%) followed by fever (56%). The cas...