Severity and Mortality Risk Factors among Hospitalized COVID-19 Patients in AlMahara April 2020-October 2021

  • Respiratory Diseases
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The novel coronavirus disease 2019 (COVID-19) has become a global health emergency. The cumulative numbers of confirmed cases and deaths are still increasing. In Yemen, the first patient was reported On April10th, 2020 and due to country situation; scarce data is available about COVID-19 situation, particularly in AlMahara governorate. This study aimed to analyze the patterns and risk factors of COVID-19 severity and mortality.

A retrospective cohort study was conducted based on a review of surveillance and clinical records of COVID-19 patients in AlMahara within the period April 2020-October 2021. WHO’s COVID-19 case definitions and severity classifications were used. Multivariate regression with odds ratio (OR) at confidence interval (CI) of 95% was used to determine risk factors for severity and mortality among patients.

A total of 352 COVID-19 patients were reported in AlMahara and nearly two-thirds recovered. Three waves of COVID-19 were identified, with the number of monthly cases peaked in March, followed by October 2021. Of all hospitalized patients (89/352, 25.3%), (87.6%) were males, (46%) aged 45-60 years, (2.27%) were healthcare workers, and (77.6%) had critical/severe disease. Case fatality rate (CFR) was (50.6%) among hospitalized vs (5.3%) among non-hospitalized patients. Age > 65 years (AOR=12.6, CI:1.54-103.7) and Diabetes Mellitus (DM) (AOR=9.78, CI:1.18-80.93) were the risk factors associated with severity, while mechanical ventilation (AOR= 3.72, CI:1.51-11.37), DM (AOR= 4.51, CI:1.27-16.02), lymphopenia (AOR= 13.05, CI:1.27-133.8), and leukocytosis (AOR= 3.58, CI:1.14-11.18) were associated with mortality.

Findings highlight the most hospitalized patients had severe/critical disease with high CFR, which probably associated with presentation and suboptimal management. Advanced ages with DM were the main predictors of severity and mortality. Therefore, Augmenting awareness about severity and mortality factors and management with restrengthening of prevention and control measures are necessary for disease control.

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