Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study
Abstract Background Assessing factors associated with mortality among COVID-19 patients could guide in developing context relevant interventions to mitigate the risk. The study aimed to describe mortality and associated factors among COVID-19 patients admitted at six health facilities in Uganda. Met...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | Archives of Public Health |
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| Online Access: | https://doi.org/10.1186/s13690-022-00991-3 |
| _version_ | 1811319347010863104 |
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| author | Asad Muyinda Prossie M. Ingabire Susan Nakireka Criscent Tumuhaise Edith Namulema Felix Bongomin Agnes Napyo Quraish Sserwanja Rozen Ainembabazi Ronald Olum Ritah Nantale Phillip Akunguru Derrick Nomujuni William Olwit Milton W. Musaba Bridget Namubiru Pamela Aol Peter A. Babigumira Ian Munabi Sarah Kiguli David Mukunya |
| author_facet | Asad Muyinda Prossie M. Ingabire Susan Nakireka Criscent Tumuhaise Edith Namulema Felix Bongomin Agnes Napyo Quraish Sserwanja Rozen Ainembabazi Ronald Olum Ritah Nantale Phillip Akunguru Derrick Nomujuni William Olwit Milton W. Musaba Bridget Namubiru Pamela Aol Peter A. Babigumira Ian Munabi Sarah Kiguli David Mukunya |
| author_sort | Asad Muyinda |
| collection | DOAJ |
| description | Abstract Background Assessing factors associated with mortality among COVID-19 patients could guide in developing context relevant interventions to mitigate the risk. The study aimed to describe mortality and associated factors among COVID-19 patients admitted at six health facilities in Uganda. Methods We reviewed medical records of patients admitted with COVID-19 between January 1st 2021 and December 31st 2021 in six hospitals in Uganda. Using Stata version 17.0, Kaplan Meier and Cox regression analyses were performed to describe the time to death and estimate associations between various exposures and time to death. Finally, accelerated failure time (AFT) models with a lognormal distribution were used to estimate corresponding survival time ratios. Results Out of the 1040 study participants, 234 (22.5%: 95%CI 12.9 to 36.2%) died. The mortality rate was 30.7 deaths per 1000 person days, 95% CI (26.9 to 35.0). The median survival time was 33 days, IQR (9–82). Factors associated with time to COVID-19 death included; age ≥ 60 years [adjusted hazard ratio (aHR) = 2.4, 95% CI: [1.7, 3.4]], having malaria test at admission [aHR = 2.0, 95% CI:[1.0, 3.9]], a COVID-19 severity score of severe/critical [aHR = 6.7, 95% CI:[1.5, 29.1]] and admission to a public hospital [aHR = 0.4, 95% CI:[0.3, 0.6]]. The survival time of patients aged 60 years or more is estimated to be 63% shorter than that of patients aged less than 60 years [adjusted time ratio (aTR) 0.37, 95% CI 0.24, 0.56]. The survival time of patients admitted in public hospitals was 2.5 times that of patients admitted in private hospitals [aTR 2.5 to 95%CI 1.6, 3.9]. Finally, patients with a severe or critical COVID-19 severity score had 87% shorter survival time than those with a mild score [aTR 0.13, 95% CI 0.03, 0.56]. Conclusion In-hospital mortality among COVID-19 patients was high. Factors associated with shorter survival; age ≥ 60 years, a COVID-19 severity score of severe or critical, and having malaria at admission. We therefore recommend close monitoring of COVID-19 patients that are elderly and also screening for malaria in COVID-19 admitted patients. |
| first_indexed | 2024-04-13T12:40:57Z |
| format | Article |
| id | doaj.art-6ad19a53435743ffab54517b546619da |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-04-13T12:40:57Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-6ad19a53435743ffab54517b546619da2022-12-22T02:46:31ZengBMCArchives of Public Health2049-32582022-11-0180111110.1186/s13690-022-00991-3Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort studyAsad Muyinda0Prossie M. Ingabire1Susan Nakireka2Criscent Tumuhaise3Edith Namulema4Felix Bongomin5Agnes Napyo6Quraish Sserwanja7Rozen Ainembabazi8Ronald Olum9Ritah Nantale10Phillip Akunguru11Derrick Nomujuni12William Olwit13Milton W. Musaba14Bridget Namubiru15Pamela Aol16Peter A. Babigumira17Ian Munabi18Sarah Kiguli19David Mukunya20Department of Medicine, Jinja Regional Referral HospitalDepartment of Medicine, Nsambya HospitalDepartment of medicine, Mengo HospitalDepartment of Medicine, Our Lady Health of the Sick, Nkozi HospitalCovid Task Force Institution, Mengo HospitalDepartment of Medical Microbiology, Gulu UniversityDepartment of Community and Public Health, Busitema UniversiyDepartment of Programmes, GOALDepartment of Medicine, Jaro HospitalDepartment of Medicine, Nsambya HospitalDepartment of Nursing, Busitema UniversityDepartment of Medicine, Moroto HospitalDepartment of Medicine, Mulago HospitalDepartment of Medicine, Nsambya HospitalDepartment of Obstetrics and Gynaecology, Mbale Regional Referral and Teaching HospitalDepartment of medicine, Mengo HospitalDepartment of Pediatrics, Lacor HospitalDepartment of Global Health Security, Ministry of HealthDepartment of Anatomy, Makerere UniversityDepartment of Pediatrics and Child Health, Makerere UniversityDepartment of Community and Public Health, Busitema UniversiyAbstract Background Assessing factors associated with mortality among COVID-19 patients could guide in developing context relevant interventions to mitigate the risk. The study aimed to describe mortality and associated factors among COVID-19 patients admitted at six health facilities in Uganda. Methods We reviewed medical records of patients admitted with COVID-19 between January 1st 2021 and December 31st 2021 in six hospitals in Uganda. Using Stata version 17.0, Kaplan Meier and Cox regression analyses were performed to describe the time to death and estimate associations between various exposures and time to death. Finally, accelerated failure time (AFT) models with a lognormal distribution were used to estimate corresponding survival time ratios. Results Out of the 1040 study participants, 234 (22.5%: 95%CI 12.9 to 36.2%) died. The mortality rate was 30.7 deaths per 1000 person days, 95% CI (26.9 to 35.0). The median survival time was 33 days, IQR (9–82). Factors associated with time to COVID-19 death included; age ≥ 60 years [adjusted hazard ratio (aHR) = 2.4, 95% CI: [1.7, 3.4]], having malaria test at admission [aHR = 2.0, 95% CI:[1.0, 3.9]], a COVID-19 severity score of severe/critical [aHR = 6.7, 95% CI:[1.5, 29.1]] and admission to a public hospital [aHR = 0.4, 95% CI:[0.3, 0.6]]. The survival time of patients aged 60 years or more is estimated to be 63% shorter than that of patients aged less than 60 years [adjusted time ratio (aTR) 0.37, 95% CI 0.24, 0.56]. The survival time of patients admitted in public hospitals was 2.5 times that of patients admitted in private hospitals [aTR 2.5 to 95%CI 1.6, 3.9]. Finally, patients with a severe or critical COVID-19 severity score had 87% shorter survival time than those with a mild score [aTR 0.13, 95% CI 0.03, 0.56]. Conclusion In-hospital mortality among COVID-19 patients was high. Factors associated with shorter survival; age ≥ 60 years, a COVID-19 severity score of severe or critical, and having malaria at admission. We therefore recommend close monitoring of COVID-19 patients that are elderly and also screening for malaria in COVID-19 admitted patients.https://doi.org/10.1186/s13690-022-00991-3COVID-19SurvivalUganda |
| spellingShingle | Asad Muyinda Prossie M. Ingabire Susan Nakireka Criscent Tumuhaise Edith Namulema Felix Bongomin Agnes Napyo Quraish Sserwanja Rozen Ainembabazi Ronald Olum Ritah Nantale Phillip Akunguru Derrick Nomujuni William Olwit Milton W. Musaba Bridget Namubiru Pamela Aol Peter A. Babigumira Ian Munabi Sarah Kiguli David Mukunya Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study Archives of Public Health COVID-19 Survival Uganda |
| title | Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study |
| title_full | Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study |
| title_fullStr | Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study |
| title_full_unstemmed | Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study |
| title_short | Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study |
| title_sort | survival analysis of patients with covid 19 admitted at six hospitals in uganda in 2021 a cohort study |
| topic | COVID-19 Survival Uganda |
| url | https://doi.org/10.1186/s13690-022-00991-3 |
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