Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study
Tonny Kyagambiddwa, Timothy Mwanje Kintu, Emmanuel Miiro, Franchesca Nabalamba, Gloria Suubi Asiimwe, Anne Marion Namutebi, Fardous C Abeya, Boniface A Lumori, Isaac Ijuka, Rose K Muhindo, Andrew Mutekanga, Richard Musinguzi, Francis Natuhwera, Joseph Ngonzi, Edwin Nuwagira
Infection and Drug Resistance, doi:10.2147/idr.s405256
Background: There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods: We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results: Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32-6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48-32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion: There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.
Abbreviations
Ethics Approval and Informed Consent The study was approved by the Research Ethics Committee of Mbarara University of Science and Technology under reference number MUST-2022-435. The ethics committee waived the requirement for consent. Permission for access to medical records was granted by the necessary boards at respective hospitals. Study codes were used to ensure the anonymity of participants' data. Data generated from the study shall be used for research purposes only and shall be private and confidential at all times. All principles of data transfer and principles of protection of human research participants outlined in the Declaration of Helsinki were observed.
Disclosure The authors declare that they have no competing interests.
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