Clinical profile and predictors of outcomes of hospitalized patients with laboratory-confirmed severe acute respiratory syndrome Coronavirus 2 in Nigeria: A retrospective analysis of 13 high burden states in Nigeria

Abstract

Background: The majority of global COVID deaths have occurred in developed countries. Not much is known about the clinical outcomes for the patients admitted with COVID in Nigeria. We thus described the clinical characteristics, outcomes, and predictors of outcomes of hospitalized Nigerian COVID-19 patients.

Methodology: We performed multilevel and mixed effects regression, Kaplan-Meir survival, and Cox proportionate hazards analyses to evaluate factors associated with death in patients admitted for COVID-19 in 13 high-burden states of Nigeria between 25^th February 2020 and 30^th August 2021.

Results: Of the 3462 patients (median age, 40 years (interquartile range 28 years 54 years), 2,990(60.6%) were male and, 213(6.15%) of them died while on admission. Male sex (adjusted odds ratio [aOR], 1.78 [95% confidence interval {CI}, 1.23–2.56]), age group 45-65 years (OR, 3.93 [95% CI, 1.29–12.02]), age group 66-75 years (aOR, 5.37 [95% CI, 1.68–17.14]), age group > 75 years (aOR, 6.81 [95% CI, 2.04– 22.82]), chronic cardiac disease (aOR, 3.07 [95% CI, 1.20–7.86]), being diabetic (aOR, 2.16 [95% CI, 1.41– 3.31]), and having chronic kidney disease (OR, 11.01 [95% CI, 2.74–44.24]),were strongly associated with increased odds of death. Having concurrent malaria (aOR, 0.45 [95% CI, 0.16–1.28]), use of Azithromycin for treatment (aOR, 0.33 [95% CI, 0.19–0.54]), and use of Chloroquine/Hydroxychloroquine for treatment (aOR, 0.07 [95% CI, 0.03–0.14]) were significantly associated with decreased odds of death.

Conclusions: The cumulative probability of death of male patients, diabetics, hypertensives, and patients with CKD was higher than that of female patients and those without those comorbidities while concurrent malaria and use of chloroquine/hydroxychloroquine in the treatment regimen were associated with a decreased risk of dying in patients treated in our isolation centers.