Clinical manifestations and treatment outcomes among hospitalised COVID-19 patients in tertiary hospitals in Tanzania, 2021–2022: a retrospective cohort study

Author:

Osati Elisha Fred OtienoORCID,Shayo Grace Ambrose,Sangeda Raphael Z,Nagu Tumaini Joseph,Moshiro Candida,Adams Naveeda,Ramadhani Athumani,Wajanga Bahati,Muniko Albert,Seni Jeremiah,Nicholaus Mary A,Nyaisonga Gervas,Mbije Christian,Meda John Robson,Rainer Denis,Nkya Martha Elisande,Mhame Paulo,Samwel Lucy,Vumilia Liggyle,Shekalaghe Seif,Kilonzo Kajiru G,Makubi Abel

Abstract

BackgroundThere have been differential mortality rates from COVID-19 in different parts of the world. It is not clear whether the clinical presentation does also differ, thus the need for this study in a sub-Saharan African setting. The aim of this study was to describe the clinical manifestations and outcomes of patients diagnosed with COVID-19 in selected tertiary hospitals in Tanzania.MethodsThis was a retrospective analysis of hospitalised adults confirmed SAR-COV-2 infection in five tertiary-level hospitals in Tanzania. Data collected and analysed included sociodemographic, radiological and clinical characteristics of the patients as well as the outcome of the admission (discharge vs death).ResultsOut of 1387 COVID-19 patients, 52% were males. The median age was 60 years ((IQR)=(19–102)). The most common symptoms were dyspnoea (943,68%), cough (889, 64%), fever (597,43%) and fatigue (570, 41%). In-hospital mortality was (476, 34%). Mortality significantly increased with increasing age, being the most in age >90 years (aHR (95% CI)=4.4 (2.52 to 28.82), p=0.02). Other predictors of mortality were not possessing a health insurance, (aHR (95% CI)=3.7 (1.09 to 14.25), p=0.04); chest pain, (aHR (95% CI)=2.27 (1.36 to 4.13), p=0.03); HIV positivity, (aHR (95% CI)=3.9 (1.46 to 8.15), p=0.03); neutrophilia, (aHR (95% CI)=1.12 (1.01 to 2.65), p=0.03); no use of ivermectin, (aHR (95% CI)=1.21 (1.04 to 1.57), p=0.04) and non-use of steroids, (aHR (95% CI)=1.36 (1.18 to 2.78), p=0.04). The retrospective nature of this study which based on documented patients’ records, with a large number of patients left out of the analysis due to missed data, this might in a way affect the results of the present study.ConclusionIn-hospital mortality was 34%. The independent predictors of mortality were advanced age, HIV infection, no possession of a health insurance, chest pain, neutrophilia and no use of steroids or ivermectin.

Funder

Ministry of Health Tanzania, Muhimbili National Hospital

Publisher

BMJ

Reference53 articles.

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