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. 2023 Mar-Apr;64(2):205-219.
Epub 2023 May 11.

Clinical profile and Predictors of Outcomes of Hospitalized Patients with Laboratory-Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 in Nigeria: A Retrospective Analysis of 13 High Burden States in Nigeria

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Clinical profile and Predictors of Outcomes of Hospitalized Patients with Laboratory-Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 in Nigeria: A Retrospective Analysis of 13 High Burden States in Nigeria

Christopher Sabo Yilgwan et al. Niger Med J. 2023 Mar-Apr.

Abstract

Background: The majority of global COVID deaths have occurred in developed countries. Not much is known about the clinical outcomes for the patients admitted with COVID in Nigeria. We thus described the clinical characteristics, outcomes, and predictors of outcomes of hospitalized Nigerian COVID-19 patients.

Methodology: We performed multilevel and mixed effects regression, Kaplan-Meir survival, and Cox proportionate hazards analyses to evaluate factors associated with death in patients admitted for COVID-19 in 13 high-burden states of Nigeria between 25th February 2020 and 30th August 2021.

Results: Of the 3462 patients (median age, 40 years (interquartile range 28 years 54 years), 2,990(60.6%) were male and, 213(6.15%) of them died while on admission. Male sex (adjusted odds ratio [aOR], 1.78 [95% confidence interval {CI}, 1.23-2.56]), age group 45-65 years (OR, 3.93 [95% CI, 1.29-12.02]), age group 66-75 years (aOR, 5.37 [95% CI, 1.68-17.14]), age group > 75 years (aOR, 6.81 [95% CI, 2.04-22.82]), chronic cardiac disease (aOR, 3.07 [95% CI, 1.20-7.86]), being diabetic (aOR, 2.16 [95% CI, 1.41-3.31]), and having chronic kidney disease (OR, 11.01 [95% CI, 2.74-44.24]),were strongly associated with increased odds of death. Having concurrent malaria (aOR, 0.45 [95% CI, 0.16-1.28]), use of Azithromycin for treatment (aOR, 0.33 [95% CI, 0.19-0.54]), and use of Chloroquine/Hydroxychloroquine for treatment (aOR, 0.07 [95% CI, 0.03-0.14]) were significantly associated with decreased odds of death.

Conclusions: The cumulative probability of death of male patients, diabetics, hypertensives, and patients with CKD was higher than that of female patients and those without those comorbidities while concurrent malaria and use of chloroquine/hydroxychloroquine in the treatment regimen were associated with a decreased risk of dying in patients treated in our isolation centers.

Keywords: COVID-19; Clinical Profile; High Burden States; Hospitalized Patients; Nigeria; Predictors of Outcomes; SARS-CoV-2.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1:
Figure 1:
Plot of sample sizes versus power
Figure 2:
Figure 2:
States with available data
Figure 3:
Figure 3:
Forest plot of standardized model coefficients
Figure 4a:
Figure 4a:
Survival curves of patients stratified by diabetes status.
Figure 4b:
Figure 4b:
Survival curves of patients stratified by gender.
Figure 4c:
Figure 4c:
Survival curves of patients stratified by hypertension status.
Figure 4d:
Figure 4d:
Survival curves of patients stratified by Systemic coagulation use.
Figure 4e:
Figure 4e:
Survival curves of patients stratified by Steroid use.

References

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