High Mortality Rate in Adult COVID-19 Inpatients in Eastern Sudan: A Retrospective Study

Abstract

Aim: The current pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2). It is a global public health concern that has resulted in the rapid growth in the number of infected patients with significant mortality rates. Hence, we conducted a retrospective study in Gadarif Hospital to evaluate the presenting manifestations, mortality rate, and the risk factors associated with mortality in hospitalized patients. Methods: A retrospective study was conducted at Gadarif Hospital in Eastern Sudan. Medical files of the patients admitted during the period between April and July 2020 were reviewed. All the files of the adult patients (aged 18 or above), of both sexes, who had a confirmed COVID-19-positive status via laboratory testing using PCR and who were admitted during this period were reviewed. The data extracted included patients’ demographics and initial clinical presentation, symptoms, signs, and the laboratory and radiographic findings. The data were analyzed using SPSS v22. Results: Eighty-eight patients were admitted with COVID-19. The median (interquartile) age was 62 (55.00– 70.00) years old, and 72 (81.8%) of them were males. Most patients (75%) experienced a one-week duration of symptoms. A fever (87.5%), cough (80.68%), and shortness of breath (77.27%) were the most common presenting symptoms. Following a clinical assessment, both the systolic and diastolic blood pressure were found to be normal in most patients, at 92.05% and 89.77%, respectively. An oxygen saturation of less than 90% was seen in 71.59% of patients. The general mortality rate was 37.5% and most deaths occurred during the first 24 h of admission (21/33 [63.64%]). There was no significant difference in the death rate between females and males (5/16 [31.3%] vs 28/72 [38.9%], P = 0.776). There was no significant difference in the body mass index, tobacco use, or education level between the patients who died and those who survived. A logistic regression showed that being older (AOR = 1.05, 95% CI = [1.01, 1.10]) and having a lower PO₂ level (AOR = 1.11, 95% CI = [1.04, 1.16]) were associated with mortality. Conclusion: The general mortality rate was 37.5%, and the risk factors that could predict increased mortality in hospitalized COVID-19 positive cases included old age and a lower PO₂ level.