Factors Associated with Mortality in Hospitalized COVID-19 Patients with Non-Communicable Diseases in Dire Dawa, Ethiopia

Background: COVID-19 has disproportionately affected individuals with preexisting non-communicable diseases (NCDs). Despite the acknowledged risk, there is a notable gap in studies exclusively focusing on COVID-19 patients with underlying NCDs, particularly in the context of hospitalization. This study aimed to assess factors influencing mortality in COVID-19 patients with NCDs in Dire Dawa, Eastern Ethiopia. Methods: A 1:2 case-control study was conducted from December 15, 2022, to January 15, 2023. Cases included COVID-19 hospital deaths (June 1, 2020–June 30, 2022); controls were recoveries. Data from randomly selected medical records were extracted and entered in to Epi-data v3.1 and analyzed using SPSS v22. Baseline vital signs and lab parameters were compared using t-test and Mann-Whitney U test. AOR alongside a 95% CI and p-values (<0.05) were computed via binary logistic analysis to identify factors associated with COVID-19 mortality. Result: A total of 125 cases and 247 controls were included in the analysis. Cases (mean age: 60 ±14.7 years) were older than controls (53 ±15.9 years), with more females among cases (50.4%) and more males among controls (63.6%). Cases had higher vital signs and lab values. In multivariate analysis, men had lower COVID-19 mortality risk (AOR=0.5, 95% CI (0.32-0.92)). Whereas, age ≥ 60 year (AOR=2.5, 95% CI (1.1-5.63)), hypertension (AOR = 2, 95% CI (1.14- 3.35)), diabetes mellitus (AOR = 1.9, 95% CI (1.1- 3.16)), severe COVID-19 (AOR = 4.9, 95% CI (2.25- 10.86)), critical COVID-19 (AOR = 6.2, 95% CI (2.38-16.06)) and ICU admission (AOR = 2.9, 95% CI (1.5-5.56)) were significant risk factors for COVID-19 mortality. Conclusion: The study revealed that older age, hypertension, diabetes, disease severity, and ICU hospitalization were associated with increased odds of COVID-19 mortality. while male gender showed a lower mortality risk. Tailored interventions for vulnerable groups and enhanced critical care are crucial. Furthermore, public health strategies should address gender-specific disparities in COVID-19 outcomes and prioritize preventive measures accordingly.