Abstract:
In Ethiopia, infection by the new corona virus strain SARS-CoV-2 and its related
syndrome COVID-19 has been associated with more than seven thousand deaths. Patients of
higher age and with preexisting chronic health conditions are at an increased risk of fatal disease
outcome. There is scanty of evidence on predictors of mortality among hospitalized COVID 19
patients in the country, including the study area. Thus, it is crucial to know the level of the problem
and its predictors to make informed decision.
Objectives: To assess incidence and predictors of death among severe COVID 19 patients
hospitalized at Hiwot Fana Specialized University Hospital treatment center Harar, 2022.
Methods: An institution-based retrospective cohort design was conducted on severe COVID 19
patients from May 1 to 30, 2022. The source of data for this study was record review and the
medical records of all hospitalized sever COVID 19 patients with a confirmed positive COVID 19
result was included. The data were entered into Epi Data 3.1 and exported to STATA 14.2 for
analysis. Descriptive statistics were used to describe the variables in the study. Predictors of death
were identified by Cox regression model and results of predictors were presented using adjusted
hazard ratio with its 95% confidence interval. P value < 0.05 was used as a cut of point for
statistical significance.
Results: The incidence of death among severe covid-19 patients was 29 /1000 Person-Days. Of
the study variables preexisting cardiovascular disease (AHR=1.85, 95% CI: 1.04, 3.34)), presence
of headache (AHR=1.88, 95% CI: 1.15, 3.30) and altered consciousness (AHR=3.7, 95% CI: 1.62,
7.93) on admission and the taking of azithromycin (AHR=0.28, 95% CI: 0.17, 0.48) were found
to be independent predictors of death among COVID-19 patients.
Conclusion: The incidence of death among sever covid-19 patients was relatively high in the
current study. Preexisting cardiovascular disease, presence of headache and altered consciousness
at admission and requiring Azithromycin medication has statistically significant association with
the death of COVID-19. Therefore, specific counseling and education programs focusing on
patients with high risk factors need to be implemented to maximize implementation of preventive
measures recommended by WHO and treatment of cardiovascular disease is important for
prevention of covid-19 mortality.
