Risk Factors for Mortality among COVID-19 Patients in Besut Region, Terengganu, Malaysia

Abstract

Background: COVID-19 mortality is a public health issue in Malaysia and its contributing factors need to be addressed thoroughly. This study aimed to determine the risk factors for COVID-19 mortality in Besut region of Malaysia. Materials and Methods: A 1:5 case-control study between deceased and survived groups among COVID-19 patients was conducted in Besut district, Terengganu state from 1st October 2020 until 16th September 2021 based on retrospective record review. The inclusion criteria for cases were individuals with laboratory RT-PCR confirmed positive test for COVID-19 and died during COVID-19 care period. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis. Result: There were 6464 COVID-19 cases in Besut district during the studied period. The proportion of COVID-19 mortality was 0.84%. Among the deceased group, majority of them were male (51.9%), symptomatic (87.0%), unvaccinated (94.4%); had COVID-19 of category 5 (31.5%) and comorbidity (81.5%). Multiple logistic regression revealed older age, stage 4 COVID-19, stage 5 COVID-19, symptomatic, cases with comorbidity and unvaccinated cases as the significant associated factors for COVID-19 mortality with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.01, 1.10), p<0.001; AOR 92.61 (95%CI: 7.07, 1212.02), p=0.001; AOR 274.97 (95%CI: 25.27, 2991.74), p<0.001; AOR 8.83 (95%CI: 3.21, 24.28), p<0.001; AOR 46.72 (95%CI: 15.29, 142.70), p<0.001; and AOR 16.94 (95%CI: 6.34, 121.22), p=0.001, respectively. Conclusion: Advanced age, severe stages of COVID-19, symptomatic cases, cases with comorbidity and unvaccinated cases were the risk factors for COVID-19 mortality. Emphasis should be given to these factors to ensure timely control and treatment strategies.