Time to Discontinuation of Supplemental Oxygen Therapy and Predictors Among Adult Severe COVID-19 Patients Admitted at Eka Kotebe General Hospital, Addis Ababa, Ethiopia, 2022: Retrospective Follow Up Study

Abstract

Abstract Background: Understanding predictors of duration of oxygen requirement helps to identify risk groups for prolonged need of oxygen therapy and ensure timely treatment. However, not adequately studied including important predictors at admission such as baseline vital signs, laboratory biomarkers and treatments. Therefore, aim of this study was to assess time to discontinuation of supplemental oxygen therapy and its predictors among severe COVID-19 adult patients admitted at Eka Kotebe General Hospital, Addis Ababa, Ethiopia, 2022. Methods: A facility based retrospective follow-up study was conducted among severe COVID-19 adult patients received supplemental oxygen therapy admitted at Eka Kotebe General Hospital, Addis Ababa, Ethiopia from 13th March 2020 to 6th April 2022. Data were collected using structured data extraction checklist. Then coded and entered into EPI-data 3.1 cleaned and exported to StataSE 14 and recoded for analysis. Frequencies and percentage, median and interquartile range, Kaplan Meier plots and Log-rank tests were used to describe data and compare survival distribution between groups. Cox proportional hazard model assumption and model fitness were checked. Finally Stratified Cox regression model was fitted. Hazard ratio with 95% confidence interval and P-value < 0.05 were used as a statistically significant association and interpretation of results. Results: Median survival time to discontinuation of supplemental oxygen therapy was 10 days (IQR=6-15). Preexisting Comorbidities (AHR; 0.45, 95% CI:0.36-0.57), shortness of breath (AHR= 0.49, 95%CI:0.36-0.66), chest pain (AHR; 0.43, 95%CI: 0.26-0.71), nausea/vomiting (AHR= 0.51,95%CI:0.38-0.68),systolic blood pressure≥140mmHg (AHR= 0.45, 95%CI:0.33-0.61),high white blood cell count(AHR; 0.65,95%CI:0.49-0.85), neutrophil (AHR; 0.56, 95%CI:0.43-0.73), elevated alkaline phosphatase(AHR; 0.20, 95%CI:0.15-0.29), creatinine (AHR; 0.32, 95%CI:0.22-0.47) were significant predictors. Conclusions and Recommendations: Median survival time to discontinuation of supplemental oxygen was reasonably longer. Severe COVID-19 adult patients with preexisting comorbidities, shortness of breath, chest pain, nausea/vomiting, high systolic blood pressure, white blood cell, neutrophil count, elevated alkaline phosphatase and creatinine should be expected to require longer duration of oxygen therapy and identified early and given more attention.