Background: Coronavirus infectious disease 2019 (COVID-19) pandemic is a global public health issue due to a new coronavirus called severe acute respiratory syndrome virus 2 (SARS-Cov-2). It is a very contagious infectious disease with often benign symptoms. However, some patients present with severe clinical signs and are more at risk to die. The aim of this study was to assess the factors associated with severe COVID-19 in an Epidemic Treatment Center (ETC) at Dakar, Senegal.
Method:We conducted a prospective descriptive analytical study dealing with COVID-19 patients treated in the ETC at the Military Principal Hospital of Dakar, from April 4, 2020 to November 2, 2020. Univariate and multivariate logistic regression were performed to identify the factors associated with severe COVID-19, which was defined as cases with oxygen saturation < 90% on room air.Results: During the study period, 238 patients with COVID-19 were enrolled. The mean age was 53 ± 18 years and male to female ratio was 1.38. There were six different nationalities, including 226 Senegalese (95%). Of those included, 17 (7.1%) were smokers and 126 (52.9%) had at least one comorbidity. These comorbidities included high blood pressure in 64 (26.9%), diabetes mellitus in 59 (24.8%), asthma in 16 (6.7%), heart disease in 8 (3.4%), obesity 5 (2.1%), chronic obstructive pulmonary disease in 2 (0.8%), and chronic kidney disease in 2 (0.8%). Main symptoms that patients presented were fatigue in 141 (59.2%), cough in 138 (58%), fever in 133 (55.9%), headaches in 123 (51.7%), myalgia in 110 (46.2%), dyspnea in 73 (30.7%), anosmia in 45 (18.9%), ageusia in 43 (18%), sore throat in 38 (16%) and nasal congestion in 25 (10.5%). The mean oxygen saturation on room air was 96% ± 6%. Patients with severe COVID-19 represented 35 (14.7%). Hydroxychloroquine and azithromycin were administered to 177 (74.4%) patients. The mean hospital days was 12 ± 5 days. We recorded 10 deaths, corresponding to a mortality rate of 4.2%. After a multivariate analysis, the factors independently associated with severe COVID-19 were: advanced age (OR = 1.05; CI 95% [1.01-1.08]), heart disease (OR=7.7; CI 95% [1.1-53.4]), the delay of diagnosis (OR=1.08; CI 95% [1.01-1.16]), and community origin of ).
Conclusion:The identification of factors associated with severe forms of COVID-19 may help better manage highrisk patients and reduce their mortality.