Nzinnou Mbiaketcha Imelda Sonia, Buh Nkum Collins, Tchio-Nighie Ketina Hirma, Njoudap Mfopou Iliasou, Nguegoue Tchokouaha Francois, Ateudjieu Jérôme
Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang Cameroon, Dschang, Cameroun.
Department of Health Research, M.A. SANTE (Meilleur Acces aux Soins de Sante), Yaounde, Cameroon.
PLOS Glob Public Health. 2023 Feb 23;3(2):e0001572. doi: 10.1371/journal.pgph.0001572. eCollection 2023.
Reducing mortality among COVID-19 cases is a major challenge for most health systems worldwide. Estimating the risk of preexisting comorbidities on COVID-19 mortality may promote the importance of targeting at-risk populations to improve survival through primary and secondary prevention. This study was conducted to explore the contribution of exposure to some chronic diseases on the mortality of COVID-19. This was a case control study. The data were collected from the records of all patients hospitalised at Bafoussam Regional Hospital (BRH) from March 2020 to December 2021. A grid was used to extract data on patient history, case management and outcome of hospitalised patients. We estimated the frequency of each common chronic disease and assessed the association between suffering from all and each chronic disease (Diabetes or/and Hypertension, immunodeficiency condition, obesity, tuberculosis, chronic kidney disease) and fatal outcome of hospitalised patients by estimating crude and adjusted odd ratios and their corresponding 95% confidence intervals (CI) using time to symptom onset and hospital admission up to three days, age range 65 years and above, health professional worker and married status as confounder's factors. Of 645 included patients, 120(20.23%) deaths were recorded. Among these 645 patients, 262(40.62%) were males, 128(19.84%) aged 65 years and above. The mean length of stay was 11.07. On admission, 204 (31.62%) patients presented at least one chronic disease. The most common chronic disease were hypertension (HBP) 73(11.32%), followed by diabetes + HBP 62 (9.61%), by diabetes 55(8.53%) and Immunodeficiency condition 14(2.17%). Diabetes and Diabetes + HBP were associated with a higher risk of death respectively aOR = 2.71[95%CI = 1.19-6.18] and aOR = 2.07[95% CI = 1.01-4.23] but HBP did not significantly increased the risk of death. These results suggest that health authorities should prioritize these specific group to adopt primary and secondary preventive interventions against SARS-CoV-2 infection.
降低新冠病毒感染病例的死亡率是全球大多数卫生系统面临的一项重大挑战。评估既有合并症对新冠病毒感染死亡率的风险，可能会凸显针对高危人群进行一级和二级预防以提高生存率的重要性。本研究旨在探讨某些慢性病暴露对新冠病毒感染死亡率的影响。这是一项病例对照研究。数据收集自2020年3月至2021年12月在巴富萨姆地区医院（BRH）住院的所有患者的记录。使用一个表格来提取关于患者病史、病例管理和住院患者结局的数据。我们估计了每种常见慢性病的发生率，并通过使用症状出现至住院三天的时间、65岁及以上的年龄范围、卫生专业人员和婚姻状况作为混杂因素，估计粗比值比和调整后的比值比及其相应的95%置信区间（CI），评估了患有所有慢性病和每种慢性病（糖尿病或/和高血压、免疫缺陷病、肥胖症、结核病、慢性肾脏病）与住院患者死亡结局之间的关联。在纳入的645名患者中，记录了120例（20.23%）死亡病例。在这645名患者中，262名（40.62%）为男性，128名（19.84%）年龄在65岁及以上。平均住院时间为11.07天。入院时，204名（31.62%）患者至少患有一种慢性病。最常见的慢性病是高血压（HBP）73例（11.32%），其次是糖尿病 + 高血压62例（9.61%）、糖尿病55例（8.53%）和免疫缺陷病14例（2.17%）。糖尿病和糖尿病 + 高血压分别与较高的死亡风险相关，调整后的比值比分别为aOR = 2.71[95%CI = 1.19 - 6.18]和aOR = 2.07[95%CI = 1.01 - 4.23]，但高血压并未显著增加死亡风险。这些结果表明，卫生当局应优先关注这些特定群体，采取针对严重急性呼吸综合征冠状病毒2感染的一级和二级预防干预措施。
