tetano
Editor, Senior Moderator
Biosaf Health
. 2022 Jun 27.
doi: 10.1016/j.bsheal.2022.06.002. Online ahead of print.
Characterization and Determinant Factors of Critical Illness and In-Hospital Mortality of COVID-19 Patients: A Retrospective Cohort of 1792 Patients in Kenya
Isinta M Elijah[SUP] 1 [/SUP], Endawoke Amsalu[SUP] 2 [/SUP], Xuening Jian[SUP] 1 [/SUP], Mingyang Cao[SUP] 1 [/SUP], Eric K Mibei[SUP] 3 [/SUP], Danvas O Kerosi[SUP] 4 [/SUP], Francis G Mwatsahu[SUP] 5 [/SUP], Wei Wang[SUP] 1 6 [/SUP], Faith Onyangore[SUP] 3 [/SUP], Youxin Wang[SUP] 1 6 [/SUP]
Affiliations
Abstract
Limited data is available on the coronavirus disease 2019 (COVID-19) critical illness rate and in-hospital mortality in the African setting. This study investigates determinants of critical illness and in-hospital mortality among COVID-19 patients in Kenya. We conducted a retrospective cohort study at Kenyatta National Hospital in Kenya. Multivariate logistic regression and Cox proportional hazard regression were employed to determine factors for ICU (intensive care unit) admission and in-hospital mortality, respectively. In addition, the Kaplan-Meier model was used to compare the survival times using log-rank tests. As a result, 346(19.3%) COVID-19 patients were admitted to ICU, and 271 (15.1%) died. The majority of those admitted were male, 1,137(63.4%) and asymptomatic, 1,357(75.7%), with the most prevalent clinical features of shortness of breath, fever, and dry cough. In addition, older age, male, health status, patient on oxygen (O[SUB]2[/SUB]), oxygen saturation levels (SPO[SUB]2[/SUB]), headache, dry cough, comorbidities, obesity, CVDs (cardiovascular diseases), diabetes, chronic lung disease(CLD), and malignancy/cancer can predicate the risk of ICU admission, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.90 (95% confidence interval (CI): 0.88-0.92). Survival analysis indicated 271(15.1%) patients died and identified older age, male, headache, shortness of breath, health status, patient on oxygen, SPO[SUB]2[/SUB], headache, comorbidity, CVDs, diabetes, CLD, malignancy/cancer, and smoking as risk factors for mortality (AUC-ROC: 0.90, 95% CI: 0.89-0.91). This is the first attempt to explore predictors for ICU admission and hospital mortality among COVID-19 patients in Kenya.
Keywords: COVID-19; Comorbidities; Critical illness; ICU; SARS-CoV-2.
. 2022 Jun 27.
doi: 10.1016/j.bsheal.2022.06.002. Online ahead of print.
Characterization and Determinant Factors of Critical Illness and In-Hospital Mortality of COVID-19 Patients: A Retrospective Cohort of 1792 Patients in Kenya
Isinta M Elijah[SUP] 1 [/SUP], Endawoke Amsalu[SUP] 2 [/SUP], Xuening Jian[SUP] 1 [/SUP], Mingyang Cao[SUP] 1 [/SUP], Eric K Mibei[SUP] 3 [/SUP], Danvas O Kerosi[SUP] 4 [/SUP], Francis G Mwatsahu[SUP] 5 [/SUP], Wei Wang[SUP] 1 6 [/SUP], Faith Onyangore[SUP] 3 [/SUP], Youxin Wang[SUP] 1 6 [/SUP]
Affiliations
- PMID: 35782165
- PMCID: PMC9236624
- DOI: 10.1016/j.bsheal.2022.06.002
Abstract
Limited data is available on the coronavirus disease 2019 (COVID-19) critical illness rate and in-hospital mortality in the African setting. This study investigates determinants of critical illness and in-hospital mortality among COVID-19 patients in Kenya. We conducted a retrospective cohort study at Kenyatta National Hospital in Kenya. Multivariate logistic regression and Cox proportional hazard regression were employed to determine factors for ICU (intensive care unit) admission and in-hospital mortality, respectively. In addition, the Kaplan-Meier model was used to compare the survival times using log-rank tests. As a result, 346(19.3%) COVID-19 patients were admitted to ICU, and 271 (15.1%) died. The majority of those admitted were male, 1,137(63.4%) and asymptomatic, 1,357(75.7%), with the most prevalent clinical features of shortness of breath, fever, and dry cough. In addition, older age, male, health status, patient on oxygen (O[SUB]2[/SUB]), oxygen saturation levels (SPO[SUB]2[/SUB]), headache, dry cough, comorbidities, obesity, CVDs (cardiovascular diseases), diabetes, chronic lung disease(CLD), and malignancy/cancer can predicate the risk of ICU admission, with an area under the receiver operating characteristic curve (AUC-ROC) of 0.90 (95% confidence interval (CI): 0.88-0.92). Survival analysis indicated 271(15.1%) patients died and identified older age, male, headache, shortness of breath, health status, patient on oxygen, SPO[SUB]2[/SUB], headache, comorbidity, CVDs, diabetes, CLD, malignancy/cancer, and smoking as risk factors for mortality (AUC-ROC: 0.90, 95% CI: 0.89-0.91). This is the first attempt to explore predictors for ICU admission and hospital mortality among COVID-19 patients in Kenya.
Keywords: COVID-19; Comorbidities; Critical illness; ICU; SARS-CoV-2.