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. 2021 Nov 18;8(11):ofab530.
doi: 10.1093/ofid/ofab530. eCollection 2021 Nov.

High Mortality During the Second Wave of the Coronavirus Disease 2019 (COVID-19) Pandemic in Uganda: Experience From a National Referral COVID-19 Treatment Unit

Felix Bongomin  1   2 , Brian Fleischer  3 , Ronald Olum  2 , Barbra Natukunda  2 , Sarah Kiguli  4 , Pauline Byakika-Kibwika  2 , Joseph Baruch Baluku  5   6 , Frederick Nelson Nakwagala  7
Affiliations

High Mortality During the Second Wave of the Coronavirus Disease 2019 (COVID-19) Pandemic in Uganda: Experience From a National Referral COVID-19 Treatment Unit

Felix Bongomin et al. Open Forum Infect Dis. .

Abstract

Background: We evaluated clinical outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) in the second wave of the pandemic in a national COVID-19 treatment unit (CTU) in Uganda.

Methods: We conducted a retrospective cohort study of COVID-19 patients hospitalized at the Mulago National Referral Hospital CTU between May 1 and July 11, 2021. We performed Kaplan-Meier analysis to evaluate all-cause in-hospital mortality.

Results: Of the 477 participants, 247 (52%) were female, 15 (3%) had received at least 1 dose of the COVID-19 vaccine, and 223 (46%) had at least 1 comorbidity. The median age was 52 (interquartile range, 41-65) years. More than 80% of the patients presented with severe (19%, n=91) or critical (66%, n=315) COVID-19 illness. Overall, 174 (37%) patients died. Predictors of all-cause in-hospital mortality were as follows; age ≥50 years (adjusted odds ratio [aOR], 1.9; 95% confidence interval [CI], 1.2-3.2; P=.011), oxygen saturation at admission of ≥92% (aOR, 0.97; 95% CI, 0.91-0.95; P<.001), and admission pulse rate of ≥100 beats per minute (aOR, 1.01; 95% CI, 1.00-1.02; P=.042). The risk of death was 1.4-fold higher in female participants compared with their male counterparts (hazards ratio, 1.4; 95% CI, 1.0-2.0; P=.025).

Conclusions: In this cohort, where the majority of the patients presented with severe or critical illness, more than one third of the patients hospitalized with COVID-19 at a national CTU died of the illness.

Keywords: COVID-19; Uganda; high-dependency unit; mortality; second wave.

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Figures

Figure 1.
Figure 1.
Kaplan-Meier curve showing survival after admission with coronavirus disease 2019.
Figure 2.
Figure 2.
Kaplan-Meier curve showing survival after admission with coronavirus disease 2019 stratified by sex.
Figure 3.
Figure 3.
Kaplan-Meier curve showing survival after admission with coronavirus disease 2019 stratified by age.
See this image and copyright information in PMC

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