Njuguna Augustine Gatimu, Wangombe Ann Wanjiru, Walekhwa Michael N, Kamondo Davis Kiruki
Head of the Department, Health Sciences St. Paul's University.
Department of Mathematics University of Nairobi.
medRxiv. 2024 May 15:2024.05.15.24307403. doi: 10.1101/2024.05.15.24307403.
This study aims to investigate the clinical course and factors associated with hospital admission and mortality among SARS-CoV-2 patients within the Nairobi Metropolitan Area. The study utilizes a multicenter retrospective cohort design, collecting clinical characteristics and laboratory parameters of hospitalized patients from March 2020 to May 2022. Data analysis includes percentages, frequencies, chi-square tests, Kaplan-Meier analysis, pairwise comparisons, and multivariate regression models. Ethical considerations are observed throughout the research process. The study findings highlight significant associations between comorbidities, such as hypertension, and increased mortality risk due to COVID-19. Symptoms including fever, cough, dyspnea, chest pain, sore throat, and loss of smell/taste are also identified as predictors of mortality. Abnormal laboratory parameters, such as oxygen saturation, procalcitonin, glucose levels, serum creatinine, and gamma-glutamyl transpeptidase, are associated with mortality. However, demographic factors and certain vital signs do not exhibit significant associations. Recommendations based on this study suggest increased monitoring and management of comorbidities, early identification and management of symptoms, regular monitoring of laboratory parameters, continued research and collaboration, and implementation of preventive measures. Overall, a multidisciplinary approach involving healthcare professionals, researchers, policymakers, and the public is crucial to improve COVID-19 outcomes and reduce mortality rates. Adaptation of strategies based on emerging evidence and resource allocation is essential for effective management of the pandemic.
本研究旨在调查内罗毕大都市区感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）患者的临床病程以及与住院和死亡相关的因素。该研究采用多中心回顾性队列设计，收集了2020年3月至2022年5月期间住院患者的临床特征和实验室参数。数据分析包括百分比、频率、卡方检验、 Kaplan-Meier分析、两两比较和多变量回归模型。在整个研究过程中都遵循了伦理考量。研究结果突出了合并症（如高血压）与因2019冠状病毒病（COVID-19）导致的死亡风险增加之间的显著关联。发热、咳嗽、呼吸困难、胸痛、喉咙痛以及嗅觉/味觉丧失等症状也被确定为死亡的预测因素。异常的实验室参数，如血氧饱和度、降钙素原、血糖水平、血清肌酐和γ-谷氨酰转肽酶，与死亡率相关。然而，人口统计学因素和某些生命体征并未显示出显著关联。基于本研究的建议包括加强对合并症的监测和管理、早期识别和处理症状、定期监测实验室参数、持续开展研究与合作以及实施预防措施。总体而言，医疗保健专业人员、研究人员、政策制定者和公众共同参与的多学科方法对于改善COVID-19治疗效果和降低死亡率至关重要。根据新出现的证据调整策略并进行资源分配对于有效管理这一流行病至关重要。
