COVID-19 Treatment Center Research Articles

Predictors of death among severe COVID-19 patients admitted in Hawassa City, Sidama, Southern Ethiopia: Unmatched case-control study.

Since COVID-19 was announced as a worldwide pandemic, the world has been struggling with this disease. In Ethiopia, there is some information on the epidemiological characteristics of the disease and treatment outcomes of COVID-19 patients. But, there is limited evidence related to predictors of death in COVID-19 patients. To assess the predictor of death among severely ill COVID-19 patients admitted in Hawassa city COVID-19 treatment centers. An institution-based unmatched case-control study was conducted at Hawassa city COVID-19 treatment centers from May 2021 to June 2021. All severe COVID-19-related deaths from May 2020 to May 2021 were included in the case group whereas randomly selected discharged severe COVID-19 patients were included in the control group. Extracted information was entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Multivariable binary logistic regression was run to assess predictors. The result was presented as an adjusted odds ratio with a 95% confidence interval. Variables with a 95% confidence interval which not included one were considered statistically significant. A total of 372 (124 cases and 248 controls) patients were included in the study. Multivariable analysis revealed age ≥ 65 years (AOR = 2.62, 95% CI = 1.33-5.14), having shortness of breath (AOR = 1.87, 95% CI = 1.02-3.44), fatigue (AOR 1.78, 95% CI = 1.09-2.90), altered consciousness (AOR 3.02, 95% CI = 1.40, 6.49), diabetic Mellitus (AOR = 2.79, 95% CI = 1.16-6.73), chronic cerebrovascular disease (AOR = 2.1, 95% CI = 1.23, 3.88) were found to be predictors of death. Older age, shortness of breath, fatigue, altered consciousness, and comorbidity were predictors of death in Severe COVID-19 patients.

A combination of vaccination, early multiple-round overall screening, traditional Chinese medicine intervention and “treatment window forward” can reduce the proportion of severe and critical patients with SARS-CoV-2 B.1.617.2 (Delta) variant infection—Experience from the COVID-19 treatment center of Heilongjiang Province

A combination of vaccination, early multiple-round overall screening, traditional Chinese medicine intervention and “treatment window forward” can reduce the proportion of severe and critical patients with SARS-CoV-2 B.1.617.2 (Delta) variant infection—Experience from the COVID-19 treatment center of Heilongjiang Province

Psychological Effects of Covid-19 Care; A Qualitative Study of Health Care Workers in Punjab Pakistan

The pandemic has caused severe psychological distress among Healthcare Workers. They were readily exposed to extreme workloads and physical and emotional turbulence throughout the pandemic which impacted them on both professional and personal fronts. Objectives: To explore the adverse impacts of Covid-19 on the mental health of the Healthcare Workers while delving into the relationship between occupational stress, communal norms, and mental health outcomes. Methods: It utilizes content gathered through observation and in-depth interviews of the frontline Healthcare Workers (n=32) that included doctors (n=14), nurses (n=12), and domestic staff (n=6) working in three COVID-19 treatment centers made in three major cities of Punjab, Pakistan, (Lahore, Faisalabad, and Sialkot) during Covid-19. Results: The results were divided into two themes followed by their sub-themes based on the results gathered through data collection tools. The themes were analyzed using the transactional model of stress and coping. The results reveal that the psychological distress faced by HCWs is directly related to occupational stress such as extreme workload/demand, while other challenges include fighting the community-imposed stigmas against the pandemic and social isolation. Conclusions: Psychological distress is a raising concern; current evidence reveals that low- and moderate-income communities, particularly in South Asian nations, have little or no understanding of workplace stress and its repercussions. Therefore, this study investigated Healthcare Workers’ perspectives on mental health concerning the pandemic.

The psychological impact of the COVID-19 pandemic on the Sudanese healthcare workers in quarantine centers: a cross-sectional study 2020–2021

BackgroundAfter its emergence in Wuhan in December 2019, the COVID-19 virus disseminated around the globe creating an incredible panic and outweighing the healthcare system’s capacities. As a result of this hazardous situation, healthcare workers were placed at an unprecedented challenge making them vulnerable to a wide spectrum of mental health issues including anxiety and depression. This was a cross-sectional health facility-based study aiming to explore the psychological impact of the COVID-19 pandemic on Sudanese healthcare workers in COVID-19 treatment centers. Convenience sampling was applied. And two-part self-administered online questionnaire was used: the first part consisted of the demographic data and concerns related to COVID-19, and the second part consisted of the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. Ethical clearance was obtained from the Ministry of Health.ResultsOne-hundred thirty-three healthcare workers of different job titles were enrolled in this study. A total of 54% were females, and 46% were males. Most of the participants had borderline depression (44%) or anxiety scores (47%). Females had significantly a higher mean anxiety score than males. There was no significant difference between participants with and without chronic disease on both anxiety and depression scores.ConclusionsHealthcare workers at the forefront of the fight against COVID-19 pandemic are facing critical mental health challenges. An immediate intervention from the decision-makers is needed to mitigate this deleterious impact and to strengthen the healthcare system’s capacity in the face of healthcare emergencies in general.

Time to death and its predictors among adult patients with COVID-19: A retrospective cohort study in Ethiopia.

Coronavirus (COVID-19) disease affected people throughout the globe and has become a severe threat to the health and wellbeing of the global community. Time to death and predictors of mortality vary across settings. So far, no or few related studies have been undertaken in Ethiopia. Studying the time to death from COVID-19 and its predictors is essential to understand the characteristics of the disease and thereby contribute to the identification of indicators for early detection and initiation of treatment. Therefore, this study aimed to estimate time to death and its predictors among adults with COVID-19 in Ethiopia. A retrospective follow-up study was conducted among 602 adults with COVID-19 attending Eka Kotebe General Hospital, COVID-19 Treatment Center, between 13 March 2020 and 13 November 2020. The data were entered by Epi-data version 4.2 while the analysis was carried out using STATA version 16. A Kaplan-Meier survivor curve was computed to estimate the survival probabilities. A log-rank test was used to compare the difference in survival curves. Cox proportional hazard models were fitted to identify the predictors of time to death. The overall median time to death was 21 days. Older adults (aged ≥65 years) [adjusted hazard ratio (AHR) 2.22, 95% confidence interval (CI) 1.02-4.86], being men (AHR 3.04, 95% CI 1.61-5.74), shortness of breathing at admission (AHR 2.29, 95% CI 1.16-4.54), comorbidity (AHR 2.23, 95% CI 1.04-4.80), diabetes mellitus (AHR 2.31, 95% CI 1.30-4.08), altered cardiac function (AHR 2.07, 95% CI 1.21-3.43), and baseline white blood cell count of greater than 10 (103/µl) (AHR 2.62, 95% CI 1.55-4.44) were independent predictors of COVID-19 mortality. Male sex, older adults, shortness of breathing at admission, patients with comorbidities, and higher blood cell count were significant predictors of time to death from COVID-19. Therefore, concerned stakeholders should focus on those predictors of mortality and design interventions accordingly to enhance the survival of patients with COVID-19.

Assessment of Anxiety among Caregivers at the Covid-19 Treatment Centers in Grand-Bassam and Cocody-Abidjan from July to September 2020

Assessment of Anxiety among Caregivers at the Covid-19 Treatment Centers in Grand-Bassam and Cocody-Abidjan from July to September 2020

Improving the quality of COVID-19 care in Sierra Leone: A modified Delphi process and serial nationwide assessments of quality of COVID-19 care in Sierra Leone.

Improving the quality of care that patients receive is paramount to improving patient outcomes and engendering trust during infectious disease outbreaks. Whilst Quality Improvement (QI) is well established to drive improvement in routine care and in health systems, there are fewer reports of its use during infectious disease outbreaks. A modified Delphi process was undertaken to create a standardized assessment tool for the quality of COVID-19 care in Sierra Leone. Four rounds of assessment were undertaken between July 2020 and July 2021. To assess change across the four assessment periods compared to baseline we used a mixed effects model and report coefficients and p values. During the Delphi process, 12/14 participants selected the domains to be assessed within the tool. The final 50 questions included 13 outcome questions, 17 process questions and 20 input questions. A total of 94 assessments were undertaken over four assessment periods at 27 facilities. An increase of 8.75 (p = <0.01) in total score was seen in round 2, 10.67 (p = <0.01) in round 3 and 2.17 (p = 0.43) in round 4 compared to baseline. Mean cumulative scores for COVID-19 Treatment Centres were higher than Hospital Isolation Units (p<0.02) at all four timepoints. Significant improvements were reported in coordination, diagnostics, staffing, infection prevention and control (IPC), nutrition, and vulnerable populations domains, but not in the oxygen, care processes, infrastructure and drugs domains. We demonstrate the feasibility of creating a quality of care assessment tool and conducting sequential nationwide assessments during an infectious disease outbreak. We report significant improvements in quality-of-care scores in round 2 and round 3 compared to baseline, however, these improvements were not sustained. We recommend the use of QI and the creation of standardised assessment tools to improve quality of care during outbreak responses.

How to improve the future efficiency of Covid-19 treatment centers? A hybrid framework combining artificial neural network and congestion approach of data envelopment analysis

Covid-19 virus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) threatens the health of human beings worldwide, imposing a concern for the world and prompting governments to control the contagion. Although vaccination is a proper tool to control the transmission, the efficient allocation of limited health-care resources to massive patients can improve the effectiveness of medical services. Relying on the Artificial Neural Network (ANN), the aim of this research is to enhance the future efficiency of Covid-19 treatment centers by forecasting their efficiency and providing benchmarks. To do this, we use the congestion approach of data envelopment analysis (DEA) based on the theory of economies of scale principles. In the traditional input-oriented DEA, inefficient decision-making units (DMUs) can become efficient merely by reducing the inputs. However, this may not always be true in real-world applications such as improving the efficiency of COVID-19 treatment centers (DMUs). Meaning that the treatment centers with less congested inputs (e.g., ventilators, test equipment, pulmonologists, and nurses, etc.) normally have higher mortality rates. For this reason, in this study, we take the congested inputs approach into account to provide proper benchmarks for the inefficient treatment centers. According to the congestion approach of DEA, an optimum increase in congested inputs can lead to a greater than a proportional increment in outputs. In other words, if more respiratory equipment, pulmonologists, patient rooms, nurses and beds, etc. are allocated to Covid-19 treatment centers, not only the number of deaths (undesirable outputs) are decreased, but also the number of recoveries (desirable outputs) are increased. Such an optimal rise in the congested inputs is determined in pairwise comparisons derived from the model. Accordingly, in this study, first, considering the congestion approach of DEA and historical data of five periods, we identify the initial efficiency of Iranian Covid-19 treatment centers. Then, by running ANN, we forecast the future inputs and outputs, the overall efficiency, and rank of the treatment centers. By doing this, the prospective efficient and inefficient DMUs are identified, and appropriate benchmarks are determined.

Evaluation of hospitalized patients with COVID-19 treated with or without convalescent plasma therapy: A retrospective descriptive cross-sectional study

Background: The socio-clinical characteristics have been considered an important variable associated with COVID-19 and a predictor of morbidity and mortality. Convalescent plasma therapy (CPT) was one of the modalities used worldwide for COVID-19 treatment. In Iraq, there is a paucity of studies evaluating the socio-clinical variables of patients with severe COVID-19 treated with CPT. Objectives: This study aims to describe the socio-clinical characteristics of patients with severe COVID-19 treated with and without CPT in one of the main COVID-19 treatment centers in Iraq. Materials and Methods: A descriptive cross-sectional study was conducted between May 15 and August 14, 2020, at the main COVID-19 treatment center in Anbar Governorate, west of Iraq. Out of 529 hospitalized patients, a total of 438 with severe disease were enrolled in the study. Results: The participants’ mean age was 49.9±13.8 years. The majority of the subjects were males, aged ≥40 years, residing in urban areas. 65.2% of the patients had at least one comorbidity, and 6.4% were smokers. Hypertension and diabetes mellitus represented the two commonest comorbid conditions. All patients have required oxygen therapy; 41.1% were performed with continuous positive airway pressure. Male patients aged ≥60, and patients with comorbidities received CPT at a higher frequency. Conclusion: This study corroborates the findings from other studies that certain socio-clinical characteristics had an association with hospitalization related to severe COVID-19. Convalescent plasma was administered in more than one-fifth of the COVID-19 hospitalized patients in Anbar during the early pandemic phase.

Healthcare workers' experiences in caring for critically ill COVID-19 patients at a tertiary hospital in Malawi.

The coronavirus pandemic overwhelmed the healthcare landscape, placing a strain on healthcare workers worldwide. In addition to directly causing the deaths of people, the COVID-19 pandemic disrupted critical health services in developing countries. The study aimed to explore the experiences of healthcare workers who cared for critically ill COVID-19 patients at a tertiary hospital in Malawi. A qualitative descriptive design was used. Data were gathered through in-depth interviews with doctors, clinical officers, nurses, and allied staff (n=25) who were involved in the care of critically ill COVID-19 patients at the hospital's COVID-19 treatment centres during the first and second waves of the pandemic in Malawi. The interviews were conducted in English, audiotaped, and later transcribed verbatim. Conventional content analysis was used to analyse the data following the steps proposed by Hsieh and Shannon1. The overall experience of the health workers was negative. However, delivering care to critically ill COVID-19 patients was associated with positive and negative experiences. The positive experience was a result of teamwork among staff and support from hospital authorities and the community. Negative experiences, on the other hand, were attributed to a lack of knowledge and skills in managing critically ill COVID-19 patients, a lack of resources, and abuse by some patients and members of the community. Furthermore, there was fear of contracting the virus from patients and fellow health workers while providing care. The findings point to the need for adequate preparedness within the health sector to support and protect the healthcare workers and individuals they look after. There is a need for disease awareness strategies for health workers and the general public for future pandemics.

Clinical Characteristics and Outcomes of Patients Hospitalized With COVID-19 During the First 4 Waves in Zambia

Few epidemiologic studies related to COVID-19 have emerged from countries in Africa, where demographic characteristics, epidemiology, and health system capacity differ from other parts of the world. To describe the characteristics and outcomes of patients admitted to COVID-19 treatment centers, assess risk factors for in-hospital death, and explore how treatment center admissions were affected by COVID-19 waves in Zambia. This retrospective cohort study assessed patients admitted to COVID-19 treatment centers in 5 Zambian cities between March 1, 2020, and February 28, 2022. Risk factors for in-hospital mortality, including patient age and severity of COVID-19, at treatment center admission. Patient information was collected, including inpatient disposition (discharged or died). Differences across and within COVID-19 waves were assessed. Mixed-effects logistic regression models were used to assess associations between risk factors and in-hospital mortality as well as between characteristics of admitted patients and timing of admission. A total of 3876 patients were admitted during 4 COVID-19 waves (mean [SD] age, 50.6 [19.5] years; 2103 male [54.3%]). Compared with the first 3 waves (pooled), the proportion of patients who were 60 years or older admitted during wave 4, when the Omicron variant was circulating, was significantly lower (250 of 1009 [24.8%] vs 1116 of 2837 [39.3%]; P < .001). Factors associated with in-hospital mortality included older age (≥60 vs <30 years; adjusted odds ratio [aOR], 3.55; 95% CI, 2.34-5.52) and HIV infection (aOR, 1.39; 95% CI, 1.07-1.79). Within waves, patients who were admitted during weeks 5 to 9 had significantly higher odds of being 60 years or older (aOR, 2.09; 95% CI, 1.79-2.45) or having severe COVID-19 at admission (aOR, 2.49; 95% CI, 2.14-2.90) than those admitted during the first 4 weeks. The characteristics of admitted patients during the Omicron wave and risk factors for in-hospital mortality in Zambia reflect data reported elsewhere. Within-wave analyses revealed a pattern in which it appeared that admission of higher-risk patients was prioritized during periods when there were surges in demand for health services during COVID-19 waves. These findings support the need to expand health system capacity and improve health system resiliency in Zambia and other countries with resource-limited health systems.

Study the ENT Manifestations of Covid-19 Patients, Aden, Yemen

Objective: To study and document the ENT manifestations of covid-19 infection of patients in Aden, Yemen Materials and method: This was a retrospective descriptive study, in which we reviewed the medical records of 81 patients with Covid-19 seen at Covid-19 Treatment Center at Al-Gamhoria Teaching Hospital in Aden during the period April 2020 to March 2021. The Fisher test was used to determine whether the difference between means and values are significant. A p-value &lt;0.05 was considered statistically significant. Results: Out of 81 patients, 52 patients were males (64.2%) and 29 patients (35.8%) were females and the mean age was 40.2 ±13.9 years. The mean age of male patients was 41.8 ± 13.6 years while for females was 37.3 ± 14.5 years. The age ranged between 18 to 66 years; the association between means is statistically significant, in addition the age group &lt; 45 years represented 59.3%. Anosmia-dysgeusia with sore throat and pharyngeal erythema, were the most common ENT manifestations, 77.8%, and 77.8% respectively. The male patients had a higher probability of developing ENT manifestations. The relation between anosmia-dysgeusia and sex was statistically significant (p &lt; 0.05). The manifestation of anosmia-dysgeusia more common among patients of the age group &lt; 45 years with 43.2%. Fever was found in (93.8%) patients, followed by general weakness &amp; fatigue in (85.2%), sleep disorders in (84.0%), and muscular ache in (79.0%). Among comorbid conditions diabetes mellitus was found as most common in (16.0%) patients. Conclusion: The most common ENT manifestations were anosmia-dysgeusia with sore throat and pharyngeal erythema. Keywords: ENT manifestations, general symptoms, comorbid diseases, Covid-19, Aden.

Time to recovery and its predictors among COVID-19 positive patients admitted to treatment centers of Southwestern Ethiopian hospitals. A multicenter retrospective cohort study.

Nowadays, coronavirus disease is a leading cause of death. Therefore, the study aimed to assess the time to recovery and its predictors among Covid-19 positive patients. A hospital-based retrospective cohort study was conducted among 300 COVID-19 patients admitted to Southwestern Ethiopian hospital COVID-19 treatment centers from August 7, 2020 to February 7, 2022. Kaplan Meier was used to estimate the survival time and the Log-rank test was used to compare the survival time between groups of categorical variables. The multivariable survival regression model was used to identify a significant predictor of time to recovery among COVID-19 patients at a P value⩽0.05 with a 95% CI. In this study, 92% of patients admitted to Jimma University COVID-19 treatment center and Mettu Karl Comprehensive Specialized Hospital COVID-19 treatment center were recovered from COVID-19 after a maximum of 33 days of follow-up. The overall incidence density was 11.99/100 PD (person day) with a 95% CI of [11.273, 12.719] per 100 PD after a total of 3452 PD observations. The median time of recovery from COVID-19 was 10 days. Age (AHR=1.945, 95% CI: 1.157, 3.268), hypertension (AHR=1.856, 95% CI, 1.30, 2.63), diabetes (AHR=1.406, 95% CI, 1.05, 1.84), being critical (0.298, 2039, 0.434), cancer (AHR=3.050, 95% CI, 1.172, 7.943), and tuberculosis (AHR=2.487, 95% CI, 1.504, 4.110) were found to be independent predictors of time to recovery of COVID-19 patients. A total of 92% of patients were recovered within 10 days of the median time. Age, hypertension, diabetes mellitus, tuberculosis, severity of the case, cancer, and the presence of acute kidney injury were predictors of recovery time of COVID-19 patients. Therefore, healthcare providers should give strict follow-up and priority to elderly patients with chronic illnesses and those under supportive care.

An update on oral clinical courses among patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: A clinical follow-up (a prospective prevalent cohort) study.

Contemporary literature has revealed that Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes acute sialadenitis and related symptoms, such as discomfort, pain, swelling, and secretory dysfunction in salivary glands. The secretory dysfunction is due to SARS-CoV-2 infection-induced xerostomia and other associated clinical courses such as sore tongue, mucosal ulcer, and gingivitis in the oral cavity. Furthermore, it has been reported that COVID-19 causes the development of other oral manifestations. A prospective clinical follow-up (a prevalent cohort) study was conducted to identify the possible oral manifestations of SARS-CoV-2 infection among patients admitted toat the Eka General Hospital COVID-19 treatment center. Furthermore, the study aimed to calculate the prevalence rate of oral clinical courses in the cohorts. The study consisted of two follow-up phases: Hospital and patient-home-based. A total of 55 patients (36 males and 19 females) met the inclusion criteria and were followed for 7.5 weeks. The 3.5 weeks hospital-based prospective follow-up study documented an 18% (n = 10) prevalence rate of oral clinical courses among the cohorts. Twelve oral symptoms appeared in these ten patients. The manifested oral symptoms were oral mucosal lesions (n = 6), xerostomia (n = 5), and thickening of saliva (n = 1). The oral mucosal lesions per se consisted of aphthous lesions (n = 3), candidiasis (n = 1), geographic tongue (n = 1), and localized gingivitis (n = 1). The four weeks' home-based follow-up study disclosed four newly manifested oral symptoms: hemorrhagic crust, bulla, buccal mucositis, and petechiae. These manifestations appeared among six patients (four males and two females) who had not manifested any oral symptoms during the hospital-based follow-up. Accordingly, the overall prevalence of oral clinical courses among patients presented with SARS-CoV-2 is raised from 18% (n = 10) to 29% (n = 16). Similarly, the number of clinical courses increased from 12 to 16 after four additional weeks of follow-up. The study's findings suggest the importance of initiating oral health care for patients with COVID-19. Therefore, multidisciplinary healthcare approaches should be delivered to assure optimal health outcomes. Accordingly, oral health professionals must be a substantial part of the interdisciplinary approach in caring for patients with COVID-19.

Early versus late intubation on the outcome of intensive care unit-admitted COVID-19 patients at Addis Ababa COVID-19 treatment centers, Addis Ababa, Ethiopia: A multicenter retrospective cohort study

BackgroundCoronavirus disease 2019 (COVID-19) has resulted in severe acute respiratory failure, requiring intubation and an invasive mechanical ventilation. However, the time for initiation of intubation remains debatable. Therefore, this study aimed to compare early and late intubation on the outcome of COVID-19 patients admitted to the intensive care unit (ICU) of selected Addis Ababa COVID-19 treatment centers, Ethiopia. MethodsA multicenter retrospective cohort study was conducted on 94 early and late intubated ICU-admitted COVID-19 patients from October 1, 2020, to October 31, 2021, in three selected COVID-19 treatment centers in Addis Ababa, Ethiopia. A simple random sampling technique was used to select study participants. An independent t-test, Mann Whitney U test and Fisher's exact test were used for statistical analysis, as appropriate. A P value < 0.05 was used to declare a statistical significance. ResultsA total of 94 patients participated, for a response rate of 94.68%. There was a statistically insignificant difference in the rates of death between the early intubated (47.2%) and the late intubated (46.1%) groups (P = 0.678). There was no difference in the median length of stay on a mechanical ventilator (in days) between the groups (P = 0.11). However, the maximum length of stay in the ICU to discharge was significantly shorter in the early intubated (33.1 days) than late intubated groups (63.79 days) (P < 0.001). ConclusionOutcomes (death or survival) were similar whether early or late intubation was used. Early intubation did appear to improve length of ICU stay in ICU-admitted COVID-19 patients.

COVID-19 Vaccine Effectiveness Against Progression to In-Hospital Mortality in Zambia, 2021-2022.

Coronavirus disease 2019 (COVID-19) vaccines are highly effective for reducing severe disease and mortality. However, vaccine effectiveness data are limited from Sub-Saharan Africa. We report COVID-19 vaccine effectiveness against progression to in-hospital mortality in Zambia. We conducted a retrospective cohort study among admitted patients at 8 COVID-19 treatment centers across Zambia during April 2021 through March 2022, when the Delta and Omicron variants were circulating. Patient demographic and clinical information including vaccination status and hospitalization outcome (discharged or died) were collected. Multivariable logistic regression was used to assess the odds of in-hospital mortality by vaccination status, adjusted for age, sex, number of comorbid conditions, disease severity, hospitalization month, and COVID-19 treatment center. Vaccine effectiveness of ≥1 vaccine dose was calculated from the adjusted odds ratio. Among 1653 patients with data on their vaccination status and hospitalization outcome, 365 (22.1%) died. Overall, 236 (14.3%) patients had received ≥1 vaccine dose before hospital admission. Of the patients who had received ≥1 vaccine dose, 22 (9.3%) died compared with 343 (24.2%) among unvaccinated patients (P < .01). The median time since receipt of a first vaccine dose (interquartile range) was 52.5 (28-107) days. Vaccine effectiveness for progression to in-hospital mortality among hospitalized patients was 64.8% (95% CI, 42.3%-79.4%). Among patients admitted to COVID-19 treatment centers in Zambia, COVID-19 vaccination was associated with lower progression to in-hospital mortality. These data are consistent with evidence from other countries demonstrating the benefit of COVID-19 vaccination against severe complications. Vaccination is a critical tool for reducing the consequences of COVID-19 in Zambia.

Assessing the short, intermediate and long-term health effects of COVID-19 on the survivors in Zambia: a prospective quantitative study protocol

IntroductionLittle is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health...

Risk stratification and prognostic value of prothrombin time and activated partial thromboplastin time among COVID-19 patients.

BackgroundCOVID-19 is a viral disease caused by a new strain of corona virus. Currently, prognosis and risk stratification of COVID-19 patients is done by the disease’s clinical presentation. Therefore, identifying laboratory biomarkers for disease prognosis and risk stratification of COVID-19 patients is critical for prompt treatment. Therefore, the main objective of this study was to assess the risk stratification and prognostic value of basic coagulation parameters and factors associated with disease severity among COVID-19 patients at the Tibebe Ghion Specialized Hospital, COVID-19 treatment center, Northwest Ethiopia.MethodsA follow-up study was conducted among conveniently recruited COVID-19 patients attended from March to June 2021. Socio-demographic and clinical data were collected using a structured questionnaire and checklist, respectively. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were analyzed by the HUMACLOT DUE PLUS® machine. Descriptive statistics were used to summarize the socio-demographic and clinical characteristics of study participants. Kruskal Wallis tests were used to compare the difference between parametric and non-parametric continuous variables, respectively. The area under the receiver operating characteristic curve (AUC) was used to evaluate the value of PT and APTT in the risk stratification and disease prognosis of COVID-19 patients. Ordinal logistic regression was used to identify the factors associated with disease severity and prognosis. A P-value < 0.05 was defined as statistically significant for all results.ResultBaseline PT at a cut-off value ≥ 16.25 seconds differentiated severe COVID-19 patients from mild and moderate patients (AUC: 0.89, 95% CI: 0.83–0.95). PT also differentiated mild COVID-19 patients from moderate and severe patients at a cut-off value ≤ 15.35 seconds (AUC: 0.90, 95% CI: 0.84–0.96). Moreover, alcohol drinkers were a 3.52 times more likely chance of having severe disease than non-drinkers (95% CI: 1.41–8.81). A one-year increment in age also increased the odds of disease severity by 6% (95% CI: 3–9%). An increment of ≥ 0.65 seconds from the baseline PT predicted poor prognosis (AUC: 0.93, 0.87–0.99).Conclusions and recommendationsProlonged baseline PT was observed in severe COVID-19 patients. Prolonged baseline PT was also predicted to worsen prognosis. An increase from the baseline PT was associated with worsen prognosis. Therefore, PT can be used as a risk stratification and prognostic marker in COVID-19 patients.

Incidence of Death and Its Predictors of COVID-19 in Amhara Region, Ethiopia: A Retrospective Follow Up Study

BackgroundRisk factors associated with COVID-19 incidence of death would aid to notify the most favorable management strategies, hang about undecided, Moreover, studies regarding this issue are limited in Ethiopia and no region-wise study is conducted. Hence, the study investigated the COVID-19 incidence of death and its predictors in the Amhara regional state, Ethiopia.MethodsA facility-based retrospective survey was conducted at all Amhara regional state COVID-19 treatment centers from 13 March 2020, through 13 January 2022. Epidata version 3.1 and STATA version 14 were used for data entry and analysis, respectively. Linearized survey analysis in a stratified Cox regression model was fitted to identify independent risk factors. P-value with 95% CI for hazard ratio was used for testing the significance at alpha 0.05.ResultsA total of 28,533 study participants were analyzed in this study. Of these, 2873 (11.2%) died and 25,660 (88.8%) were recovered from COVID-19. The death rate was 11.78 per 1000 person-days of observation with a median survival time of 32 days with IQR [12, 44]. Patients with co-morbidities (AHR = 1.54: 95% CI: 1.51–1.55), patients with age <5-year (AHR = 1.69: 95% CI: 1.78–1.81) and patients with age 60+ years (AHR = 2.91: 95% CI: 1.79–3.99), patients with asymptomatic diseases condition (AHR =1.15: 95% CI: 1.01–1.19), and being male (AHR = 1.22: 95% CI: 1.18–1.27) were independent significant risk factors of death from COVID-19.ConclusionA relatively high incidence of death from COVID-19 was found in this study. Significant risk factors were identified as patients with age <5 years, patients with age 60+ Years, being male, patients having at least one comorbid condition, and patients with asymptomatic disease conditions. These factors should be taken into consideration for a strategy of quarantining and treating COVID-19 patients.

Clinical Characteristics and Treatment Outcomes of COVID-19 Patients at Eka Kotebe General Hospital, Addis Ababa, Ethiopia.

ABSTRACT.Data from much of Africa are still scarce on the clinical characteristics, outcomes of treatment, and factors associated with disease severity and mortality of COVID-19. A cross-sectional study was conducted at Eka Kotebe General Hospital, Ethiopia’s first COVID-19 treatment center. All consecutive symptomatic SARS CoV-2 RT-PCR positive individuals, aged 18 and older, admitted to the hospital between March 13 and September 16, 2020, were included. Of the total 463 cases, 319 (68.9%) were male. The median age was 45 years (interquartile range 32–62). The most common three symptoms were cough (69%), shortness of breath (SOB; 44%), and fatigue (37%). Hypertension was the most prevalent comorbidity, followed by diabetes mellitus. The age groups 40 to 59 and ≥ 60 were more likely to have severe disease compared with those < 40 years of age (adjusted odds ratio [aOR] = 3.45, 95% confidence interval [CI]: 1.88–6.31 and aOR = 3.46, 95% CI: 1.91–6.90, respectively). Other factors associated with disease severity included the presence of any malignancy (aOR = 4.64, 95% CI: 1.32–16.33) and SOB (aOR = 3.83, 95% CI: 2.35–6.25). The age group ≥ 60 was significantly associated with greater in-hospital mortality compared with those < 40 years. In addition, the presence of any malignancy, SOB, and vomiting were associated with higher odds of mortality. In Ethiopia, most COVID-19 patients were male and presented with cough, SOB, and fatigue. Older age, any malignancy, and SOB were associated with disease severity; these factors, in addition to vomiting, also predicted mortality.