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. 2022 Apr 25:9:20499361221095731.
doi: 10.1177/20499361221095731. eCollection 2022 Jan-Dec.

Cardiovascular risk factors and clinical outcomes of patients hospitalized with COVID-19 pneumonia in Somalia

Mohammed A M Ahmed  1 , Ahmed Mohamud Hussein  2 , Aweis Ahmed Moalim Abdullahi  3 , Abdirizak Yusuf Ahmed  4 , Hamdi M A Hussain  5 , Abdiaziz Mohamed Ali  3 , Abdulqadir Abdinur Barre  2 , Farhia Mohamud Yusuf  2 , Ronald Olum  6 , Senai Goitom Sereke  7 , Maisa Ahmed Elfadul  8 , Robert Colebunders  9 , Felix Bongomin  10
Affiliations

Cardiovascular risk factors and clinical outcomes of patients hospitalized with COVID-19 pneumonia in Somalia

Mohammed A M Ahmed et al. Ther Adv Infect Dis. .

Abstract

Background: Coronavirus disease-2019 (COVID-19) is a potentially life-threatening illness with no established treatment. Cardiovascular risk factors (CRFs) exacerbate COVID-19 morbidity and mortality.

Objective: To determine the prevalence of CRF and clinical outcomes of patients hospitalized with COVID-19 in a tertiary hospital in Somalia.

Methods: We reviewed the medical records of patients aged 18 years or older with a real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 hospitalized at the De Martino Hospital in Mogadishu, Somalia, between March and July 2020.

Results: We enrolled 230 participants; 159 (69.1%) males, median age was 56 (41-66) years. In-hospital mortality was 19.6% (n = 45); 77.8% in the intensive care unit (ICU) compared with 22.2%, in the general wards (p < 0.001). Age ⩾ 40 years [odds ratio (OR): 3.6, 95% confidence interval (CI): 1.2-10.6, p = 0.020], chronic heart disease (OR: 9.3, 95% CI: 2.2-38.9, p = 0.002), and diabetes mellitus (OR: 3.2, 95% CI: 1.6-6.2, p < 0.001) were associated with increased odds of mortality. Forty-three (18.7%) participants required ICU admission. Age ⩾ 40 years (OR: 7.5, 95% CI: 1.7-32.1, p = 0.007), diabetes mellitus (OR: 3.2, 95% CI: 1.6-6.3, p < 0.001), and hypertension (OR: 2.5, 95% CI: 1.2-5.2, p = 0.014) were associated with ICU admission. For every additional CRF, the odds of admission into the ICU increased threefold (OR: 2.7, 95% CI: 1.2-5.2, p < 0.001), while the odds of dying increased twofold (OR: 2.1, 95% CI: 1.3-3.2, p < 0.001).

Conclusions: We report a very high prevalence of CRF among patients hospitalized with COVID-19 in Somalia. Mortality rates were unacceptably high, particularly among those with advanced age, underlying chronic heart disease, and diabetes.

Keywords: COVID-19; Somalia; cardiovascular disease; clinical outcomes; diabetes; mortality; risk factors.

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Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Underlying comorbidities of the participants. Heart disease included cardiomyopathies, vulvular heart diseases, and coronary artery diseases.
Figure 2.
Figure 2.
Number of comorbidities among the 230 hospitalized patients.
Figure 3.
Figure 3.
Severity of COVID-19 illness among the participants.
Figure 4.
Figure 4.
Kaplan–Meier curve showing overall survival.
Figure 5.
Figure 5.
Kaplan–Meier curve showing survival in patients with diabetes mellitus versus those without (log-rank test, p = 0.002). DM, diabetes mellitus.
Figure 6.
Figure 6.
Kaplan–Meier curve showing survival from admission (log-rank test p value < 0.0001). ICU, intensive care unit.
See this image and copyright information in PMC

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