Prediction of COVID-19 mortality among hospitalized patients in Sudan

Abstract

Background: COVID-19 was primarily reported in China. The mortality rate across countries had ranged from 1% up to more than 10% and it is underestimated in some countries. Advanced age is the most frequently reported factor associated to mortality. Other factors were the presence of comorbidities such as diabetes mellitus, hypertension and obesity. Several models for mortality prediction had been developed to assist in improving the prognosis. The aim of our study was to assess the factors related to mortality among COVID-19 patients and develop a prediction model based on these factors. Methods: A retrospective cohort study assessed the factors related to the mortality among COVID-19 patients who attended Imperial Hospital isolation centre on November- December, 2020, Khartoum, Sudan. Statistical tests performed were chi-square test, odds ratio and regression to develop the prediction model. Tests were considered statistically significant when p < 0.05. Results: 105 patients were studied. 29% of the patients were deceased, while, 71% were discharged alive. A statistically significant association was found between the age and severity with regards to mortality rate (p=0.034, 0.018 respectively). The model equation for mortality prediction: Mortality = -14.724+ (1.387* Age) + (-0.323* Gender) + (1.814* Admission) + ( 0.193* Ischemic Heart Disease) + ( -0.369* Fever) + ( 1.595* Cough) + ( 1.953* Complications) + ( 0.149* Duration of hospitalization) + ( 0.999* Enoxaparin dose). Conclusions: Age, admission ward, cough and enoxaparin dose were statistically significant predictors for COVID-19 mortality ( p= 0.014, 0.011, 0.015, 0.006 respectively).

Diabetes Mellitus is Associated With Higher COVID-19 Mortality Rates in Sub-Saharan Africa: A Systematic Review and Meta-analysis

“…The sample sizes of verified COVID-19 patients ranged from 105 to 2617. The prevalence of diabetes mellitus among the patients in the studies ranged from 6% to 49% [12][13][14][15][16][17][18]. The available meta-analysis on the association of diabetes mellitus and mortality risk with COVID-19 reported ORs ranging from 1.75 to 9.9.…”

“…Several observational studies on predictors of mortality in COVID-19 patients have been undertaken in Africa, with mixed results regarding the role of diabetes as a comorbidity in death. Diabetes has been demonstrated to be a predictor of mortality in some studies [ 12 - 14 ], although this idea has not been supported in others [ 15 - 18 ]. Varied study designs and populations provide different estimates and impact sizes in these published publications.…”

“…: odds ratio; RR: risk ratio; NA: not applicable; -: not clearly reported; GHS: Global health security detection index (Weighted sum of all the GHS data normalized to a scale of 0 to 100, where 100 = best health security condition Matangila et al 2020[15]; Bepouka et al 2020[17]; Nachega et al 2020[18]; Abraha et al 2021[12]; Jaspard et al 2021[16]; Osibogun et al 2021[13]; Ghada et al 2021[14]; Aggarwal et al[22]; Huang et al[7]; Miller et al[23]; Kumar et al[6]; Varikasuvu et al[8]; Wu et al[24]; Guo et al[25]; Montovani et al[10]; Bouba et al[26] …”

Mortality associated with COVID‐19 and hypertension in sub‐Saharan Africa. A systematic review and meta‐analysis

“…Some African studies have found hypertension to be a predictor of mortality, [14][15][16] while others have not. [17][18][19][20][21] These studies had different study designs and study populations and have therefore produced different estimates and effect sizes. Consequently, a comprehensive and systematic analysis was needed to minimize such variability.…”