Predictors of Mortality Among Hospitalized COVID-19 Patients at a Tertiary Care Hospital in Ethiopia

Abstract

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.

COVID-19 Case Fatality Rate and Factors Contributing to Mortality in Ethiopia: A Systematic Review of Current Evidence

“…26 However, all the other included studies have reported the CFR. 25,[27][28][29][30][31][32][33][34][35][36][37] Accordingly, the present study confirmed the CFR of COVID-19 in Ethiopia ranges from nearly 1-20% (Table 3).…”

“…In this review, of the total included studies, eight reported the factors contributing to mortality from COVID-19 in the Ethiopian population. 26,28,[30][31][32][33][34]37 As a result, we found that the presence of a high rate of one or more comorbid conditions was significantly associated with COVID-19 mortality and/or poor treatment outcome. 26,28,30,[32][33][34]37 Furthermore, non-modifiable risk factors…”

“…26,28,[30][31][32][33][34]37 As a result, we found that the presence of a high rate of one or more comorbid conditions was significantly associated with COVID-19 mortality and/or poor treatment outcome. 26,28,30,[32][33][34]37 Furthermore, non-modifiable risk factors…”

“…A total of thirteen studies [25][26][27][28][29][30][31][32][33][34][35][36][37] were included in the review. All studies had been published between 2020 and 2022 with sample sizes ranging from 33 to 4398.…”

“…All studies had been published between 2020 and 2022 with sample sizes ranging from 33 to 4398. Four studies were done in Addis Ababa, 26,28,33,35 three were in Oromia region, 29,36,37 two were in Amhara region, 27,31 one study was in Benishangul-Gumuz region, 30 one study was in Harari region, 34 one study was in Tigray region, 32 and one study was at national level. 25 Besides, study design included was one case-control, 26 six cohorts, [28][29][30][32][33][34] 25,27,31,[35][36][37] Moreover, from the encompassed studies, seven reported on both case fatality rate and factors contributing to COVID-19 mortality, 28,[30][31][32][33][34]37 whereas, five reported only a case fatality rate, 25,27,29,35,36 and one reported only on factors contributing to COVID-19 mortality, 26 and (Table 2).…”