Clinical Features and Risk Factors Associated with Morbidity and Mortality Among COVID-19 Patients in Northern Ethiopia

Abraha, Hiluf Ebuy; Gessesse, Zekarias; Gebrecherkos, Teklay; Kebede, Yazezew; Weldegiorgis, Aregawi Weldegabreal; Tequare, Mengistu Hagazi; Welderifael, Abadi Luel; Zenebe, Dawit; Gebremariam, Asqual Gebreslassie; Dawit, Tsega Cherkos; Gebremedhin, Daniel Woldu; de Wit, Tobias Rinke; Wolday, Dawit

Objective To describe clinical features and assess determinants of severity and in-hospital mortality of COVID-19 patients from unique setting in Ethiopia. Methods Consecutive patients admitted to COVID-19 quarantine and isolation center were included. We analyzed proportions of clinical spectrum of COVID-19, factors associated with risk of severe COVID-19 and in-hospital mortality. Results Of 2617 patients, three-quarter of the quarantined (N = 1935; 74%) appeared asymptomatic, and only 114 (4.4%) presented with severe COVID-19. Common characteristics among the 682 symptomatics were cough (N = 354; 50.6%), myalgia (N = 212; 31.1%), head ache (N = 196; 28.7%), fever (N = 161; 23.6%), dyspnea (N = 111; 16.3%), anosmia and/or dysgeusia (N = 90; 13.2%), sore throat (N = 87; 12.8%) and chest pain (N = 77; 11.3%). Factors associated with severe COVID-19 were older age [adjusted relative risk (aRR) 1.78, 95% CI 1.61 to 1.97; p < 0.0001], diabetes (aRR 2.00, 95% CI 1.20 to 3.32; p = 0.007), cardiovascular diseases (aRR 2.53, 95% CI 1.53 to 4.17; p < 0.0001), malignancy (aRR 4.57, 95% CI 1.62 to 12.87; p = 0.004), surgery/trauma (aRR 23.98, 95% CI 10.35 to 55.57; p < 0.0001), and infection with HIV-1 (aRR 4.24, 95% CI 1.55 to 11.61; p = 005). Factors associated with risk of in-hospital mortality included older age (aRR 2.37, 95% CI 1.90 to 2.95; p < 0.001), malignancy (aRR 6.73, 95% CI 1.50 to 30.16; p = 0.013) and surgery/trauma (aRR 59.52, 95% CI 12.90 to 274.68; p < 0.0001). Conclusions Significant proportion of SARS-CoV-2 infection were asymptomatic and key comorbid conditions increased risk of COVID-19 severity and in-hospital mortality. These findings could help in the design of appropriate management of patients.