Risk Factors for COVID-19 Mortality in Epidemic Treatment Centers: A Case-Control Study from Decentralized Regions of Senegal
Agbogbenkou Tévi Dela-dem Lawson *
UFR of Health Sciences, Iba Der Thiam University of Thiès, Senegal and Regional Health Directorate of Thiès, Senegal.
SC. Sarr
Regional Health Directorate of Thiès, Senegal and UFR Health and Sustainable Development, Alioune Diop University of Bambey, Senegal.
M. Sidibé
Regional Health Directorate of Thiès, Senegal.
M. Bop
UFR Health and Sustainable Development, Alioune Diop University of Bambey, Senegal.
B. Ndiaye
UFR Health and Sustainable Development, Alioune Diop University of Bambey, Senegal.
M.M. Diaw
Regional Health Directorate of Thiès, Senegal.
SA Diop
UFR of Health Sciences, Iba Der Thiam University of Thiès, Senegal and Regional Health Directorate of Thiès, Senegal.
*Author to whom correspondence should be addressed.
Abstract
Introduction: The COVID-19 pandemic is an emerging viral zoonosis caused by SARS-CoV2. It is responsible for a systemic infection in humans, primarily respiratory. In Senegal, the Thiès Region confirmed its first case on March 14, 2020. The second epidemic wave occurring in 2021 was marked by high fatality, justifying our study on the factors associated with deaths among COVID-19 patients hospitalized at the Epidemic Treatment Centers (CTE) of the Regional Health Directorate of Thiès (Senegal).
Patients and Methods: Unmatched case-control study, 1 case to 2 controls, relating to COVID-19 deaths recorded in the Thiès Regional Health Directorate from January 1 to December 31, 2021. All patients who tested positive for COVID-19 (PCR/Antigenic test) hospitalized in CTEs were included. All confirmed COVID-19 patients who died were referred to as “cases,” and all recovered patients as “controls.” The sampling of deaths was exhaustive, standardized sociodemographic, clinical, therapeutic and evolutionary data collected from patient files after a pilot trial with quality control. The data was entered on kobo collect and analyzed on Epi info7. Quantitative variables (mean, standard deviation) and qualitative variables (proportions. Measures: odds ratio, chi2 or Fisher exact test, significance threshold set at p<0.05) were used.
Results: A total of 348 patients were recruited in this study including 116 deaths and 232 recovered, the average age was 68.9 years +/- 14.24 for the deceased patients compared to 61.5 +/- 14.24 for the recovered, with male predominance in both groups. The most common clinical signs (cases/controls) were dyspnea (98.3/84.49%), fever (71.5/68.1%), asthenia (57.8/65.4%). and cough (52.6/58.1%). Complications were dominated by acute respiratory distress (87.9/3.8%), (11.2%/0.4%) and pulmonary embolism (03.5/0%).
The factors associated with deaths found after multivariate analysis by logistic regression were male sex (OR: 4.11, 95% CI : 1.45 – 11.61 and p = 0.0076), patients aged over 60 years (OR=1.77, 95% CI: 1.0018-3.1438, p=0.049), complications such as stroke (OR=31.00; 95% CI: 5.69-168.73 and p=0 .0001), shock (OR22.61; 95% CI: 1.44-353.67 and p=0.026) and acute respiratory distress syndrome (OR: 204.09 95% CI : 70.44-591.30 and p = 0.000).
Conclusion: The factors associated with COVID-19 deaths in the CTEs of Thiès Region are age, male gender, the presence of complications; stroke in particular, the state of Shock and ARDS.
Keywords: COVID-19 deaths, associated factors, CTE, thiès regional health directorate