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. 2024 Aug 16;2(2):e000881.
doi: 10.1136/bmjph-2023-000881. eCollection 2024 Dec.

Clinical manifestations and treatment outcomes among hospitalised COVID-19 patients in tertiary hospitals in Tanzania, 2021-2022: a retrospective cohort study

Elisha Fred Otieno Osati  1   2 , Grace Ambrose Shayo  1   2 , Raphael Z Sangeda  3 , Tumaini Joseph Nagu  1   2 , Candida Moshiro  1 , Naveeda Adams  2 , Athumani Ramadhani  2 , Bahati Wajanga  4 , Albert Muniko  4 , Jeremiah Seni  5 , Mary A Nicholaus  6 , Gervas Nyaisonga  7 , Christian Mbije  7 , John Robson Meda  8 , Denis Rainer  9 , Martha Elisande Nkya  10 , Paulo Mhame  11 , Lucy Samwel  11 , Liggyle Vumilia  11 , Seif Shekalaghe  11 , Kajiru G Kilonzo  6 , Abel Makubi  11
Affiliations

Clinical manifestations and treatment outcomes among hospitalised COVID-19 patients in tertiary hospitals in Tanzania, 2021-2022: a retrospective cohort study

Elisha Fred Otieno Osati et al. BMJ Public Health. .

Abstract

Background: There have been differential mortality rates from COVID-19 in different parts of the world. It is not clear whether the clinical presentation does also differ, thus the need for this study in a sub-Saharan African setting. The aim of this study was to describe the clinical manifestations and outcomes of patients diagnosed with COVID-19 in selected tertiary hospitals in Tanzania.

Methods: This was a retrospective analysis of hospitalised adults confirmed SAR-COV-2 infection in five tertiary-level hospitals in Tanzania. Data collected and analysed included sociodemographic, radiological and clinical characteristics of the patients as well as the outcome of the admission (discharge vs death).

Results: Out of 1387 COVID-19 patients, 52% were males. The median age was 60 years ((IQR)=(19-102)). The most common symptoms were dyspnoea (943,68%), cough (889, 64%), fever (597,43%) and fatigue (570, 41%). In-hospital mortality was (476, 34%). Mortality significantly increased with increasing age, being the most in age >90 years (aHR (95% CI)=4.4 (2.52 to 28.82), p=0.02). Other predictors of mortality were not possessing a health insurance, (aHR (95% CI)=3.7 (1.09 to 14.25), p=0.04); chest pain, (aHR (95% CI)=2.27 (1.36 to 4.13), p=0.03); HIV positivity, (aHR (95% CI)=3.9 (1.46 to 8.15), p=0.03); neutrophilia, (aHR (95% CI)=1.12 (1.01 to 2.65), p=0.03); no use of ivermectin, (aHR (95% CI)=1.21 (1.04 to 1.57), p=0.04) and non-use of steroids, (aHR (95% CI)=1.36 (1.18 to 2.78), p=0.04). The retrospective nature of this study which based on documented patients' records, with a large number of patients left out of the analysis due to missed data, this might in a way affect the results of the present study.

Conclusion: In-hospital mortality was 34%. The independent predictors of mortality were advanced age, HIV infection, no possession of a health insurance, chest pain, neutrophilia and no use of steroids or ivermectin.

Keywords: COVID-19; HIV; Public Health; SARS-CoV-2.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Patients screening and recruitment flow.
Figure 2
Figure 2. Number of studied patients in each participating hospital and estimated population in the regions of domicile.
See this image and copyright information in PMC

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