1. Predictors of Mortality in COVID-19 Patients at Kinshasa Medical Center and A Survival Analysis: A Retrospective Cohort Study
- Author
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Philippe Azika, Yves Mboloko, Melinda Brecknell, Olivier Tuyinama, Marie-France Mboliassa, Joseph Tshangu, Asma Sehli, Cathy Mukuku, Patrick Boloko, Léo Bergeret, Aliocha Nkodila, Patrick Kobo, Rosita Kitenge, Karel Van Eckout, Pally Mafuta, Jean-Pierre Kanku, Dauphin Mulumba Bena, Justine B. Bukabau, Golan Kalifa, Ahmed Rodolphe, Junior Sakaji, Jean-Robert Mpoke Nkumu, Yannick Mompango Engole, Jessy Mukamamvula Abatha, David Benchetritt, Jean-Michel Mavungu, Yannick Mayamba Nlandu, Magloire Atantama, and Danny Mafuta
- Subjects
Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Infectious and parasitic diseases ,RC109-216 ,Cohort Studies ,Humans ,Medicine ,Center (algebra and category theory) ,Mortality ,African people ,Survival analysis ,Aged ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,COVID-19 ,Retrospective cohort study ,Middle Aged ,Acute kidney injury ,Infectious Diseases ,Democratic Republic of the Congo ,business ,Procalcitonin ,Research Article - Abstract
BackgroundDespite it being a global pandemic, there is little research examining the clinical features of severe COVID-19 in sub-Saharan Africa. This study aims to identify predictors of mortality in COVID-19 patients at Kinshasa Medical Center (KMC).MethodsIn this retrospective, observational, cohort study carried out at the Kinshasa Medical Center (KMC) between March 10, 2020 and July 10, 2020, we included all adult inpatients (≥ 18 years old) with a positive COVID-19 PCR result. The end point of the study was survival. The study population was dichotomized into survivors and non-survivors group. Kaplan–Meier plot was used for survival analyses. The Log-Rank test was employed to compare the survival curves. Predictors of mortality were identified by Cox regression models. The significance level of p value was set at 0.05.Results432 patients with confirmed COVID-19 were identified and only 106 (24.5%) patients with moderate, severe or critical illness (mean age 55.6 ± 13.2 years old, 80.2% were male) were included in this study, of whom 34 (32%) died during their hospitalisation. The main complications of the patients included ARDS in 59/66 (89.4%) patients, coagulopathy in 35/93 (37.6%) patients, acute cardiac injury in 24/98 (24.5%) patients, AKI in 15/74 (20.3%) patients and secondary infection in 12/81 (14.8%) patients. The independent predictors of mortality were found to be age [aHR 1.38; 95% CI 1.10–1.82], AKI stage 3 [aHR 2.51; 95% CI 1.33–6.80], proteinuria [aHR 2.60; 95% CI 1.40–6.42], respiratory rate [aHR 1.42; 95% CI 1.09–1.92] and procalcitonin [aHR 1.08; 95% CI 1.03–1.14]. The median survival time of the entire group was 12 days. The cumulative survival rate of COVID-19 patients was 86.9%, 65.0% and 19.9% respectively at 5, 10 and 20 days.Levels of creatinine (p = 0.012), were clearly elevated in non-survivors compared with survivors throughout the clinical course and increased deterioration.ConclusionMortality rate of COVID-19 patients is high, particularly in intubated patients and is associated with age, respiratory rate, proteinuria, procalcitonin and acute kidney injury.
- Published
- 2021