Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study

Christian Tshongo; Marius Baguma; Guy-Quesney Mateso; Samuel Lwamushi Makali; Aline Bedha; Pacifique Mwene-Batu; Martine Mihigo; Fabrice Nzabara; Cordule Balola; Pierre Kabuya; Achille Bapolisi; Mannix I Masimango; Esto Bahizire; Ghislain Maheshe-Balemba; Tony A Shindano; Cikomola Cirhuza

doi:10.1002/hsr2.1803

Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study

Health Sci Rep. 2024 Jan 11;7(1):e1803. doi: 10.1002/hsr2.1803. eCollection 2024 Jan.

Authors

Christian Tshongo^{1

2}, Marius Baguma^{1

2

3}, Guy-Quesney Mateso², Samuel Lwamushi Makali^{2

4}, Aline Bedha^{1

2}, Pacifique Mwene-Batu^{1

2

4}, Martine Mihigo², Fabrice Nzabara², Cordule Balola², Pierre Kabuya², Achille Bapolisi^{1

2}, Mannix I Masimango^{1

2}, Esto Bahizire¹, Ghislain Maheshe-Balemba^{1

2

4}, Tony A Shindano^{1

2

3}, Cikomola Cirhuza^{1

2

3}

Affiliations

¹ Faculty of Medicine Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo.
² Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo.
³ Center for Tropical Diseases and Global Health (CTDGH) Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo.
⁴ École Régionale de Santé Publique Université Catholique de Bukavu Bukavu Democratic Republic of the Congo.

Abstract

Background and aim: The coronavirus disease 2019 (COVID-19) pandemic was a priority public health problem because of its high mortality rate. This study mainly aimed to determine factors associated with a poor outcome in COVID-19 hospitalized patients in South-Kivu, an eastern province of the Democratic Republic of the Congo (DRC).

Methods: This observational study retrospectively evaluated medical records of patients consecutively admitted for probable or confirmed COVID-19 between May 01 and July 31, 2020 at the Hôpital Provincial Général de Référence de Bukavu (HPGRB), a tertiary hospital located in South-Kivu. A binary logistic regression model was performed to determine the predictors of mortality.

Results: A total of 157 hospitalized COVID-19 patients aged 57.7 (13.2) years were included in this study. Male gender (69.4%), older age (52.9%), medical history of diabetes (38.2%), and arterial hypertension (35.1%) were the most frequent risk factors. Most patients presented with fever (73.3%), cough (72.6%), and dyspnea (66.2%). Overall, 45.1% of patients died. Intrahospital mortality was significantly associated with advanced age [odds ratio, OR (95% confidence interval, CI) = 2.34 (1.06-5.38)], hypoxemia [OR (95% CI) = 4.67 (2.02-10.77)], hyperglycemia [OR (95% CI) = 2.14 (1.06-4.31)], kidney failure [OR (95% CI) = 2.82 (1.4-5.68)], hyperleukocytosis [OR (95% CI) = 3.33 (1.67-6.66)], and higher C-reactive protein (CRP) levels [OR (95% CI) = 3.93 (1.93-8.01)]. After adjustment for various covariates, only higher CRP levels [OR (95% CI) = 3.23 (1.23-8.5)] and hyperglycemia [OR (95% CI) = 2.5 (1.02-6.11)] at admission were independently associated with mortality.

Conclusion: Hyperglycemia and marked inflammatory syndrome were the major predictors of poor outcomes in patients hospitalized for COVID-19 in South-Kivu. These two factors should be quantified at hospital admission to establish the patient's prognosis.

Keywords: COVID‐19; South‐Kivu; hospital mortality; hyperglycemia; inflammation; prognosis.