Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital: A Retrospective Study

Abstract

BackgroundThe advent of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. As of December 2021, there is inadequate data on the outcome of hospitalized patients suffering from COVID-19 in Africa. 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.MethodsThis was a single-center, retrospective cohort study in patients hospitalized with confirmed SARS-CoV-2 at Gulu Regional Referral Hospital in Northern Uganda. Socio-demographic characteristics, clinical presentations, co-morbidities, duration of hospital stay, and treatments were analyzed, and factors associated with the odds of mortality were determined.ResultsOf 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%), hypertensives 10 (31.3%), females 18 (56.3%), ≥50-year-olds 19 (59.4%), no formal education 14 (43.8%), peasant farmers 12 (37.5%) and those who presented with difficulty in breathing/shortness of breath and chest pain 32 (100.0%), oxygen saturation (SpO2) at admission <80 4 (12.5%), general body aches and pains 31 (96.9%), tiredness 30 (93.8%) and loss of speech and movements 11 (34.4%). The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95%CI: 0.059–0.827; p = 0.030; Diabetes mellitus AOR = 9.014, 95%CI: 1.726–47.067; p = 0.010; Ages of 50 years and above AOR = 2.725, 95%CI: 1.187–6.258; p = 0.018; tiredness AOR = 0.059, 95%CI: 0.009–0.371; p < 0.001; general body aches and pains AOR = 0.066, 95%CI: 0.007–0.605; p = 0.020; loss of speech and movement AOR = 0.134, 95%CI: 0.270–0.660; p = 0.010 and other co-morbidities AOR = 6.860, 95%CI: 1.309–35.957; p = 0.020.ConclusionThe overall Gulu Regional Hospital mortality was 32/664 (4.8%). Older age, people with diabetics, females, other comorbidities, severe forms of the disease, and those admitted to HDU were significant risk factors associated with hospital mortality. More efforts should be made to provide “additional social protection” to the most vulnerable population to avoid preventable morbidity and mortality of COVID-19 in Northern Uganda.

Factors Associated with 30-Day in-Hospital Mortality Among Patients Admitted with Severe Covid-19 in Mbarara Regional Referral Hospital

“…This is high compared to that reported from our national referral hospital and from another regional referral hospital in northern Uganda (34% and 4.8%, respectively). 7 , 11 The difference in mortality is attributed to the patient population included in the two studies. Our study included adult patients with severe COVID –19 hypoxia defined by oxygen saturation less than 90%.…”

Clinical and pharmacological factors associated with mortality in patients with COVID-19 in a high complexity hospital in Manaus: A retrospective study

“…However, in high-income countries, the mortality rate for COVID-19 has reduced over time, a trend not followed in lower-income countries [1,20]. Therefore, the objective of this study was to identify predictive factors for mortality in patients hospitalized with COVID-19 in a Brazilian hospital of high complexity, located in the city of Manaus, one of the epicenters of South America, as well as to describe demographic, clinical, and pharmacotherapeutic management characteristics used in these patients.…”

“…COVID-19 disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 -Severe Acute Respiratory Syndrome Coronavirus 2) has been a threat to global health [1][2][3][4], having its beginning in Wuhan, China, and quickly spreading around the world [5]. The clinical picture triggered by this virus is highly heterogeneous, ranging from asymptomatic infection to life-threatening complications [6].…”

Commentary: Factors Associated With Mortality Among the COVID-19 Patients Treated at Gulu Regional Referral Hospital

“…We read with interest the recently published article by Baguma and colleagues in the journal ( 1 ), reporting mortality rate among patients with COVID-19 admitted at Gulu Regional Referral Hospital, Gulu, Uganda. This retrospective chart review further attempted to describe factors associated with COVID-19 mortality at this tertiary hospital.…”

“…The authors indicate in the results and discussion sections that female gender, participants aged 50 years or older, diabetes mellitus and other chronic conditions were associated with higher odds of mortality. Furthermore, the study by Baguma et al ( 1 ) highlights that COVID-19 patients with certain symptoms at presentation such as tiredness, general aches and pains, loss of speech and movement, had higher odds of mortality. The paper further emphasizes through additional analysis that the increased odds of mortality among the female patients could be significantly attributed to chronic obstructive pulmonary disease and cardiovascular diseases.…”