Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria

Background: Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. Objective(s): To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. Method(s): A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Result(s): Mean age was 60.9+/-16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71+/-22% and 38+/-11/minute in non-survivors and 90+/-7% and 31+/-7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Conclusion(s): Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.Copyright © 2023 Adekanmbi O et al. Licensee African Health Sciences.

Association of Diabetes Mellitus with Coronavirus Disease 2019 Severity: A Retrospective Study from a Center in South Western Nigeria.

BACKGROUND AND OBJECTIVES: Coronavirus Disease 2019 (COVID-19) is a novel viral infection, now a pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Diabetes mellitus (DM) has been associated with severe COVID-19 and poor glycaemic control is reportedly the link between these conditions. This study aimed to determine the association between DM and the severity of COVID-19. METHODS: This was a retrospective study involving 86 patients with COVID-19 admitted to a tertiary hospital in South-Western Nigeria. Socio-demographic, clinical and laboratory data were extracted from their medical records. Ethical approval was obtained and descriptive and inferential statistics computed. RESULTS: The mean age of the patients was 61 ± 16.1 years and 61.6% were males. Fever was noted in 67.4% of patients and, similarly, 67.4% of the patients had an SpO2<94% in ambient air when admitted. Thirty-six percent (36%) of the study patients had DM. Amongst patients with DM and those without DM, 72.2% and 62%, respectively, had severe or critical COVID-19 (p=0.323). Patients with DM were older than those without DM (65.8 years vs 57.3 years; p=0.015). The frequency of oxygen desaturation, respiratory failure, acute kidney injury (AKI) and multi-organ failure were significantly higher in COVID-19 patients with DM (p=0.037, 0.043, 0.004 and 0.016, respectively). Mortality was higher in COVID-19 patients with DM but this was not statistically significant (p=0.214). The odds of a patient with diabetes and COVID-19 developing respiratory failure and acute kidney injury were 1.395 (95%CI 1.154-6.913) and 1.125 (95%CI 1.025-1.621), respectively. CONCLUSION: Diabetes mellitus was recorded in older patients with COVID-19 and associated with suboptimal oxygen saturation at presentation, respiratory failure, and acute kidney injury. There was no association found between DM and COVID-19 severity and mortality.

CONTEXTE ET OBJECTIFS: La maladie de coronavirus 2019 (COVID-19) est une nouvelle infection virale, aujourd'hui pandémique, causée par le coronavirus-2 du syndrome respiratoire aigu sévère (SARS-CoV-2). Le diabète sucré (DM) a été associé à une COVID-19 sévère et un mauvais contrôle glycémique serait le lien entre ces deux pathologies. Cette étude vise à déterminer l'association entre le DM et la sévérité du COVID-19. MÉTHODES: Il s'agit d'une étude rétrospective portant sur 86 patients atteints de COVID-19 admis dans un hôpital tertiaire du sud-ouest du Nigeria. Les données sociodémographiques, cliniques et de laboratoire ont été extraites de leurs dossiers médicaux. Une approbation éthique a été obtenue et des statistiques descriptives et inférentielles ont été calculées. RÉSULTATS: L'âge moyen des patients était de 61 ± 16,1 ans et 61,6% étaient des hommes. De la fièvre a été notée chez 67,4 % des patients et de même, 67,4 % des patients avaient une SpO2<94 % à l'air ambiant lors de leur admission. Trente-six pour cent (36 %) des patients de l'étude étaient atteints de diabète. Parmi les patients atteints de DM et ceux qui ne l'étaient pas, 72,2 % et 62 % respectivement présentaient un COVID-19 sévère ou critique (p=0,323). Les patients atteints de DM étaient plus âgés que ceux sans DM (65,8 vs 57,3 ; p=0,015). La fréquence de la désaturation en oxygène, de l'insuffisance respiratoire, de l'insuffisance rénale aiguë (IRA) et de la défaillance multi-organique était significativement plus élevée chez les patients atteints de diabète de type 1 (p=0,037, 0,043, 0,004 et 0,016 respectivement). La mortalité était plus élevée chez les patients diabétiques de COVID-19, mais cela n'était pas statistiquement significatif (p=0,214). Les probabilités qu'un patient diabétique et COVID-19 développe une insuffisance respiratoire et une lésion rénale aiguë étaient de 1,395 (95%CI 1,154-6,913) et 1,125 (95%CI 1,025-1,621). CONCLUSION: Le diabète sucré a été enregistré chez les patients âgés atteints de COVID-19 et associé à une saturation en oxygène sous-optimale à la présentation, à une insuffisance respiratoire et à des lésions rénales aiguës. Aucune association n'a été trouvée entre le DM et la sévérité du COVID-19 et la mortalité. Mots clés: COVID-19 ; Diabète Mellitus ; SRAS- CoV-2.

Impact of Impaired Kidney Function on Outcomes of Nigerians with COVID-9 Infection: Report of Two Cases from the University College Hospital, Ibadan

COVID-19 infection predominantly affects the respiratory system;however, other systems and organs are also affected. The kidneys are among the organs commonly affected by SARS-CoV-2 and this has been reported to be a predictor of increased severity, need for intensive care (ICU), admission, and death. We presented two cases of COVID-19 that were associated with co-morbidities that include diabetes mellitus, systemic hypertension and impaired kidney function. The relationship of the multiple co-morbidities particularly the impaired kidney function with the outcomes of COVID-19 infection and the challenges of offering dialysis for patients with COVID-19 infection with kidney failure were discussed. The two cases presented also highlighted the state of preparedness for the management of COVID-19 and its various complications and co-morbidities, particularly kidney failure in a tertiary hospital in Nigeria at onset of the COVID-19 outbreak.