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. 2021 Apr:105:776-783.
doi: 10.1016/j.ijid.2021.03.037. Epub 2021 Mar 16.

Clinical features and risk factors associated with morbidity and mortality among patients with COVID-19 in northern Ethiopia

Hiluf Ebuy Abraha  1 , Zekarias Gessesse  1 , Teklay Gebrecherkos  1 , Yazezew Kebede  1 , Aregawi Weldegebreal Weldegiargis  2 , Mengistu Hagazi Tequare  1 , Abadi Luel Welderufael  1 , Dawit Zenebe  1 , Asqual Gebreslassie Gebremariam  1 , Tsega Cherkos Dawit  1 , Daniel Woldu Gebremedhin  1 , Tobias Rinke de Wit  3 , Dawit Wolday  4
Affiliations

Clinical features and risk factors associated with morbidity and mortality among patients with COVID-19 in northern Ethiopia

Hiluf Ebuy Abraha et al. Int J Infect Dis. 2021 Apr.

Abstract

Objective: To describe the clinical features and assess the determinants of severity and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) from a unique setting in Ethiopia.

Methods: Consecutive patients admitted to a COVID-19 isolation and treatment centre were included in this study. The overall clinical spectrum of COVID-19, and factors associated with risk of severe COVID-19 and in-hospital mortality were analysed.

Results: Of 2617 quarantined patients, three-quarters (n = 1935, 74%) were asymptomatic and only 114 (4.4%) presented with severe COVID-19. Common characteristics among the 682 symptomatic patients were cough (n = 354, 50.6%), myalgia (n = 212, 31.1%), headache (n = 196, 28.7%), fever (n = 161, 23.6%), dyspnoea (n = 111, 16.3%), anosmia and/or dysgeusia (n = 90, 13.2%), sore throat (n = 87, 12.8%) and chest pain (n = 77, 11.3%). Factors associated with severe COVID-19 were older age [adjusted relative risk (aRR) 1.78, 95% confidence interval (CI) 1.61-1.97; P < 0.0001], diabetes (aRR 2.00, 95% CI 1.20-3.32; P = 0.007), cardiovascular disease (aRR 2.53, 95% CI 1.53-4.17; P < 0.0001), malignancy (aRR 4.57, 95% CI 1.62-12.87; P = 0.004), surgery/trauma (aRR 23.98, 95% CI 10.35-55.57; P < 0.0001) and human immunodeficiency virus infection (aRR 4.24, 95% CI 1.55-11.61; P = 005). Factors associated with risk of in-hospital mortality included older age (aRR 2.37, 95% CI 1.90-2.95; P < 0.001), malignancy (aRR 6.73, 95% CI 1.50-30.16; P = 0.013) and surgery/trauma (aRR 59.52, 95% CI 12.90-274.68; P < 0.0001).

Conclusions: A significant proportion of cases of COVID-19 were asymptomatic, and key comorbid conditions increased the risk of severe COVID-19 and in-hospital mortality. These findings could help in the design of appropriate management strategies for patients.

Keywords: Africa; COVID-19; Clinical features; Comorbidities; Ethiopia; Mortality; SARS-CoV-2.

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Figures

Figure 1
Figure 1
Flow diagram of the clinical spectrum of coronavirus disease 2019. RT-PCR, reverse transcription polymerase chain reaction.
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