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Andrew Mutekanga,1,* Edwin Nuwagira,1,* Elias Kumbakumba,2 Victoria Nyaiteera,3 Stephen Asiimwe,4 Medal Gasumuni,5 Nelson Wandera,5 Robert Natumanya,5 Denis Akena,5 Siraje Senoga,1 Joseph Kyobe Kiwanuka,6 George Kateregga,6 Emmanuel Munyarugero,6 Fardous Charles Abeya,1 Paul Stephen Obwoya,1 Stephen Ttendo,6 Rose Muhindo1,* 1Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pediatrics and Child Health, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of ENT, Mbarara University of Science and Technology, Mbarara, Uganda; 4Global Health Collaborative, Massachusetts General Hospital, Boston, MA, USA; 5Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda; 6Department of Anesthesiology and Critical Care, Mbarara University of Science and Technology, Mbarara, Uganda*These authors contributed equally to this workCorrespondence: Rose Muhindo, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda, Tel +256772406337, Email rosie@must.ac.ugBackground: COVID-19 has created a burden on the healthcare system globally. Severe COVID-19 is linked with high hospital mortality. Data regarding 30-day in-hospital mortality and its factors has not been explored in southwestern Uganda.Methods: We carried out a retrospective, single-center cohort study, and included all in-patients with laboratory-confirmed, radiological, or clinical severe COVID-19 admitted between April 2020 and September 2021 at Mbarara Regional Referral Hospital (MRRH). Demographic, laboratory, treatment, and clinical outcome data were extracted from patientsâ files. These data were described comparing survivors and non-survivors. We used logistic regression to explore the factors associated with 30-day in-hospital mortality.Results: Of the 283 patients with severe COVID-19 admitted at MRRH COVID-19 unit, 58.1% were male. The mean age ± standard deviation (SD) was 61± 17.4 years; there were no differences in mean age between survivors and non-survivors (59 ± 17.2 versus 64.4 ± 17.3, respectively, p=0.24) The median length of hospital stay was 7 (IQR 3â 10) days (non-survivors had a shorter median length of stay 5 (IQR 2â 9) days compared to the survivors; 8 (IQR 5â 11) days, p< 0.001. The most frequent comorbidities were hypertension (30.5%) and diabetes mellitus (30%). The overall 30-day in-hospital mortality was 134 of 279 (48%) mortality rate of 47,350à 105 with a standard error of 2.99%. The factors associated with 30-day in-hospital mortality were age: 65 years and above (aOR, 3.88; 95% CI, 1.24â 11.70; P =0.020) a neutrophil to lymphocyte ratio above 5 (aOR, 4.83; 95% CI, 1.53â 15.28; P =0.007) and oxygen requirement ⥠15L/min (aOR, 15.80; 95% CI, 5.17â 48.25; P < 0.001).Conclusion: We found a high 30-day in-hospital mortality among patients with severe forms of COVID-19. The identified factors could help clinicians to identify patients with poor prognosis at an early stage of admission.Keywords: severe, COVID-19, 30-day in hospital mortality |
