Epidemiological Characteristics of COVID-19 Inpatient Deaths during the First and Second Waves in Limpopo Province, South Africa

Abstract

More COVID-19 inpatient deaths occurred during the second wave when compared to the first wave in South Africa in both the public and private sectors. This study describes the characteristics of 969 COVID-19 inpatient deaths in the public sector of Limpopo Province during the first and second waves using population-based retrospective design. The results indicate that about 84% of deaths were aged 50+ years; 53.6% were females; 43% occurred in Capricorn district; 56% occurred in PUI wards; 64% had hypertension followed by diabetes mellitus; 88% manifested with shortness of breaths/respiratory distress on admission. The study concludes that as the average age among the population aged 60+ was greater among females than males, the increased death among females compared to males might be influenced by the older age of female inpatients during the first and second waves in Limpopo Province. Some COVID-19 inpatient deaths are possibly preventable if older women may be taken into consideration when planning prevention and management interventions in future pandemics.

Health System- and Patient-Related Factors Associated with COVID-19 Mortality among Hospitalized Patients in Limpopo Province of South Africa’s Public Hospitals

“…A total of 770 medical records kept by the provincial office across 41 hospitals were used for secondary data analysis. As reported in our previously published study [27], hypertension was common amongst hospitalized COVID-19 deaths (n = 586, 64%), followed by diabetes mellitus (n = 450, 52%), HIV/AIDS (n = 141, 19%), and obesity (n = 81, 12%). In terms of beds shortage, approximately 57% of COVID-19 patients did not have admission beds in the persons under investigation (PUI) ward followed by the general ward, as reported in our study that was previously published [27].…”

“…Theme 3: Advanced age of patients with known and unknown comorbidities The review findings indicate that most patients who had suffered severe stages of COVID-19 were in their advanced age with known and unknown comorbidities. For example, in the audit report within Limpopo Province, some of the COVID-19 patients with known and newly diagnosed comorbidities, such as diabetic mellitus, kidney failure, and hypertension, had severe stages of COVID-19 [27]. The discussion below summarizes the sub-themes related to COVID-19 complications and comorbidities.…”

“…The mixed-methods study protocol for the use of secondary data kept by LPDoH is reported elsewhere [ 26 ]. A quantitative study by Tshitangano et al describes, in detail, the process followed by LPDoH when collecting primary data on the COVID-19 response using a clinical mortality audit tool [ 27 ]. The study further describes the clinical mortality audit tool as having seven sections, being: facility details, demographic characteristics, clinical information, physical examination on admission, oxygen requirement during hospitalization, diagnosis on admission, and hospital outcome.…”

“…Ethical clearance was obtained from Turfloop Research Ethics Committee (TREC/293/2021: IR) while gatekeeper permission to conduct the study was obtained from Limpopo Province Department of Health (Ref: LP_2021-11-017) as indicated in the protocol [ 27 ]. Confidentiality, anonymity, and privacy of individual facilities and health workers were protected.…”

Factors associated with COVID-19 inpatient mortality cases within 24-hours South Africa

“…[11,12] Excess mortality has been reported in studies conducted worldwide, which are associated with comorbidities such as cancer, chronic kidney diseases, diabetes mellitus and hypertension. [11,13,14] Behavioural risk factors such as being a smoker were also noted as associated factors of COVID-19. [15] Length of hospital stay was significantly associated with severe COVID-19 patients.…”