Mortality and associated factors among hospitalized COVID 19 patients in Lira regional referral hospital, a cross sectional study

Background

Corona Virus Disease 2019 (COVID-19) caused public emergency with serious morbidity and mortality worldwide between 2020 and 2022, The direct impact of the disease and associated mortality may have been relatively limited in Sub-Saharan Africa (SSA), compared to the impact in other regions. The factors that are considered high risk for acquisition of COVID-19 and associated high mortality rate amongst in-patients are varied in different settings, there are limited data from regional referral designated COVID-19 Treatment Units (CTU) in Uganda. This research assessed the mortality rate, the sub-populations at high risk and characteristics of COVID-19 patients hospitalized in Lira Regional Referral Hospital (LRRH).

Objective

To describe COVID-19 characteristic, mortality and associated risk factors among patients admitted at the Lira Regional referral hospital COVID 19 Treatment Unit in northern Uganda.

Design

Cross Sectional Study with use of Secondary Data

Setting

This study was conducted at Lira RRH between January 2023 and December 2023. The data used were for patients admitted from May 2020 to March 2022.

Participant

In this study all the patients with confirmed COVID-19 were selected by simple census sampling technique, 490 participants were included in the study and these were a) moderately to critically ill patients, b) mild or asymptomatic patients with comorbidity, c) those with positive COVID-19 test and d) those who were admitted in the hospital.

Results

In the final analysis, 490 participants were considered. Out of this, 251 (52%) were females. Majority 203(41%) were older than 60 years of age. Most of the patients presented with cough 369(89.56%), difficulty in breathing (DIB) 293(78.76%), chest pain 237(69.3%), general body weakness (GBW) 199(63.38%) and fever 179(61.3%). Common pre-existing comorbidities were hypertension 139(29.96%), diabetes mellitus 89(19.47%) and HIV 44(10%). Of all the patients admitted, 187(40%) had severe disease and 34(7%) were critically ill.

Overall from May 2020 to March 2022, 142(29%) died. Oxygen saturation (SPO2) 92-100% had 89% decreased mortality (aOR-0.11, 95% CI 0.03-0.44, p-value-0.002). Body temperature 35.5-37.5 degrees Celsius had 78% decreased mortality (aOR-0.22, 95% CI 0.05-0.99, p-value-0.049). Those without Chronic Liver Disease (CLD) had 99% decreased mortality (aOR-0.01, 95% CI 0.001-0.46, p-value-0.017). Age 31-45yrs had 86% decreased mortality (aOR-0.14, 95% CI 0.03-0.74, p-value-0.021)

Conclusion

The in-hospital mortality rate in our cohort of COVID 19 patients admitted at LRRH was high. Not having chronic liver disease, normal oxygen saturation, normal body temperature and younger age were associated with decreased likelihood of death.