Clinical features and predictors of mortality among hospitalized patients with COVID-19 in Niger

Patrick D M C Katoto; Issoufou Aboubacar; Batouré Oumarou; Eric Adehossi; Blanche-Philomene Melanga Anya; Aida Mounkaila; Adamou Moustapha; El Khalef Ishagh; Gbaguidi Aichatou Diawara; Biey Joseph Nsiari-Muzeyi; Tambwe Didier; Charles Shey Wiysonge

doi:10.1186/s13031-021-00426-w

Clinical features and predictors of mortality among hospitalized patients with COVID-19 in Niger

Confl Health. 2021 Dec 14;15(1):89. doi: 10.1186/s13031-021-00426-w.

Authors

Patrick D M C Katoto^#^{1

2

3

4}, Issoufou Aboubacar^#⁵, Batouré Oumarou⁵, Eric Adehossi⁶, Blanche-Philomene Melanga Anya⁵, Aida Mounkaila⁷, Adamou Moustapha⁸, El Khalef Ishagh⁵, Gbaguidi Aichatou Diawara⁵, Biey Joseph Nsiari-Muzeyi⁹, Tambwe Didier⁵, Charles Shey Wiysonge^{10

11

12}

Affiliations

¹ Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa.
² Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.
³ Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa.
⁴ Centre for Tropical Medicine and Global Health, Faculty of Medicine, Catholic University of Bukavu, Bugabo 02, Bukavu, Democratic Republic of Congo.
⁵ Country Office, World Health Organization, Quartier Plateau, Avenue Mohamed VI, 1204, Niamey, Niger.
⁶ Department of Internal Medicine, Niamey General Reference Hospital, BP 12674, Niamey, Niger.
⁷ Directorate of Statistics, Ministry of Public Health, Niamey, Niger.
⁸ Direction of Surveillance and Response to Epidemics, Ministry of Public Health, Niamey, Niger.
⁹ Sub-Regional Office for West Africa, World Health Organization, Independence Street, Gate 0058, Ouagadougou, Burkina Faso.
¹⁰ Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa. Charles.Wiysonge@mrc.ac.za.
¹¹ Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Cape Town, 7505, South Africa. Charles.Wiysonge@mrc.ac.za.
¹² School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, 7935, South Africa. Charles.Wiysonge@mrc.ac.za.

^# Contributed equally.

Abstract

Introduction: COVID-19 has spread across the African continent, including Niger. Yet very little is known about the phenotype of people who tested positive for COVID-19. In this humanitarian crises region, we aimed at characterizing variation in clinical features among hospitalized patients with COVID-19-like syndrome and to determine predictors associated with COVID-19 mortality among those with confirmed COVID-19.

Methods: The study was a retrospective nationwide cohort of hospitalized patients isolated for COVID-19 infection, using the health data of the National Health Information System from 19 March 2020 (onset of the pandemic) to 17 November 2020. All hospitalized patients with COVID-19-like syndrome at admission were included. A Cox-proportional regression model was built to identify predictors of in-hospital death among patients with confirmed COVID-19.

Results: Sixty-five percent (472/729) of patients hospitalized with COVID-19 like syndrome tested positive for SARS-CoV-2 among which, 70 (15%) died. Among the patients with confirmed COVID-19 infection, age was significantly associated with increased odds of reporting cough (adjusted odds ratio [aOR] 1.02; 95% confidence interval [CI] 1.01-1.03) and fever/chills (aOR 1.02; 95% CI 1.02-1.04). Comorbidity was associated with increased odds of presenting with cough (aOR 1.59; 95% CI 1.03-2.45) and shortness of breath (aOR 2.03; 95% CI 1.27-3.26) at admission. In addition, comorbidity (adjusted hazards ratio [aHR] 2.04; 95% CI 2.38-6.35), shortness of breath at baseline (aHR 2.04; 95% CI 2.38-6.35) and being 60 years or older (aHR 5.34; 95% CI 3.25-8.75) increased the risk of COVID-19 mortality two to five folds.

Conclusion: Comorbidity, shortness of breath on admission, and being aged 60 years or older are associated with a higher risk of death among patients hospitalized with COVID-19 in a humanitarian crisis setting. While robust prospective data are needed to guide evidence, our data might aid intensive care resource allocation in Niger.

Keywords: Africa; Baseline characteristics; Humanitarian crisis; Mortality; SARS-CoV-2.

Grants and funding

001/WHO_/World Health Organization/International