Recovery Rate and Predictors for Cure of Admitted COVID-19 Patients in Ethiopia; A Systemic Review and Meta-Analysis

Abstract

BACKGROUND. Despite the global efforts to curb COVID-19 infection using vaccines and drugs, the burden of illness, hospitalization, and death are continued as a deadly pandemic. Previous study finding estimated recovery time of 2 weeks for mild and 3 to 6 weeks for hospitalized cases. However, in low and middle-income countries like Ethiopia, recovery rate and viral negative conversion time are lowballed and underestimated due to the new variant incidence, limited resources and lacked skilled healthcare providers for admitted COVID-19 patients. This study aimed to estimate pooled recovery rate, and predictors for cure among admitted COVID-19 patients in Ethiopia. METHODS. Five electronic databases (Medline, PubMed, HINARY, Africa Journals Online, and Google Scholar) were searched. A total of 529 articles were extracted from cohort studies published in English spanning from December 30, 2019, to December 30, 2023. PRISMA guidelines were adhered to articles screening and extracted using Microsoft Excel. The quality of eligible articles was evaluated using the JBI checklist. The pooled effect size and adjusted odds ratio (AOR) with 95% confidence intervals were determined using the random-effect meta-regression using STATA version 17. Heterogeneity among studies was assessed using Cochran's Q-test, and the variation was estimated by I2, and presented in a forest plot. Subgroup analysis was also used to identify sources of heterogeneity among studies. RESULT. A total of 12 studies were included in the final meta-analysis. During the recovery screening of 5,152 admitted COVID-19 cases, 4,411 participants were discharged as cured. The pooled recovery rate was estimated at 90.6% (95% CI: 87.1-94.23, I² = 96.11%, P = 0.001). In subgroup analysis, Addis Ababa exhibited the highest recovery rate with 95.1%, followed by Oromia (94.6%), and Southern nation nationalities (SNN) region (91.55%). The recovery rate was higher for individuals aged 15-30 years (AHR = 2.01, 95% CI: 1.41-2.86, P = 0.001), males’ gender (AHR=1.46, 95% CI: 1.14-1.88, P=0.002), and cases admitted with ≥37.5°C (AHR = 2.01, 95% CI: 1.41-2.86, P = 0.001) compared to their counterparts. This manuscript is ongoing a submitted for registered in Prospero.  CONCLUSION. In Ethiopia, nearly nine in every ten (90%) admitted COVID-19 cases recovered. However, the recovery rate exhibits a significant variation across each study region, setting, and pandemic phase. Therefore, healthcare providers prioritize care for critical cases to increase the overall survival rate of admitted patients.