COVID-19 Case Fatality Rate and Factors Contributing to Mortality in Ethiopia: A Systematic Review of Current Evidence

Abstract

Background:The ongoing novel coronavirus disease 2019 (COVID-19) is triggering significant morbidity and mortality due to its contagious nature and absence of definitive management. In Ethiopia, despite a number of primary studies have been conducted to estimate the case fatality rate (CFR) of COVID-19, no review study has attempted to summarize the findings to better understand the nature of pandemics and the virulence of the disease. Objective: To summarize the CFR of COVID-19 and factors contributing to mortality in Ethiopia. Methods: PRISMA guideline was followed. PubMed, Science Direct, CINAHL, SCOPUS, Hinari, and Google Scholar were systematically searched using pre-specified keywords. Observational studies ie, cohort, cross-sectional, and case-control studies were included. The Newcastle-Ottawa scale adapted for observational studies was used to assess the quality of included studies. CFR was defined as the proportion of COVID-19 cases with the outcome of death within a given period. Factors contributing to COVID-19 mortality at p-value <0.05 were described narratively from the eligible articles. Results: A total of 13 observational studies were included in this study. Consequently, this review confirmed the CFR of COVID-19 in Ethiopia ranges between 1-20%. Additionally, comorbid conditions, older age group, male sex, substance use, clinical manifestations (abnormal oxygen saturation level, atypical lymphocyte count, fever, and shortness of breath), disease severity, and history of surgery/trauma increased the likelihood of death from COVID-19 death. Conclusion:This study shows that the range of CFR of COVID-19 in Ethiopia is almost equivalent to other countries, despite the country's low testing capacity and case detection rate in reference to its total population. Comorbid diseases, older age group, male sex, cigarette smoking, alcohol drinking, clinical manifestations and disease severity, and history of surgery/trauma were factors contributing to COVID-19 mortality in Ethiopia. Therefore, given the alarming global situation and rapidly evolving large-scale pandemics, urgent interdisciplinary interventions should be implemented in those vulnerable groups to lessen the risk of mortality. Furthermore, the CFR of COVID-19 should be estimated from all treatment and rehabilitation centers in the country, as underestimation could be linked to a lack of preparedness and mitigation. A large set of prospective studies are also compulsory to better understand the CFR of COVID-19 in Ethiopia.

COVID-19 mortality rate and its determinants in Ethiopia: a systematic review and meta-analysis

“…According to the global report, COVID-19 mortality rates in Ethiopia are relatively low, which is probably underreported. However, it is comparable with studies conducted in Kenya (10) and Ethiopia (11). The difference may be related to a difference in cultural norms (14), i.e., countries with more The association between COVID-19 morality and comorbidity.…”

“…In studies of sub-Saharan Africa, the pooled prevalence of mortality in COVID-19 patients was 4.8% ( 8 ) and 2.4% ( 9 ). In Kenya, 14% of patients with COVID-19 died ( 10 ). In Ethiopia, the case fatality rate of COVID-19 ranges between 1 and 20% ( 11 ) while the incidence of COVID-19 mortality was 9.13 per 1,000 person-days in Ethiopia ( 12 ).…”

The COVID-19 Severity and Its Association with Intestinal Parasite Coinfection and Urine Biochemical Parameters among COVID-19-Confirmed Patients Admitted to Debre Markos University COVID-19 Center, Northwest Ethiopia

“…The number of COVID-19 cases and fatalities is increasing throughout Ethiopia [20]. Studying the clinical profiles of patients with COVID-19 helps clinicians easily identify suspects from various backgrounds, determine targeted therapy, and improve patient management.…”

The global case fatality rate due to COVID-19 in hospitalized elderly patients by sex, year, gross domestic product, and continent: A systematic review, meta-analysis, and meta-regression

“…The ongoing novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); known as COVID-19; is triggering significant burden and fatality due to its infectious nature and the nonexistence of definitive management [ 1 , 2 ]. The COVID-19 infection imposed more than 474 million morbidities worldwide and about 6 million mortality as of March 24, 2022 [ 3 ].…”