Predictors and outcomes of COVID-19 patients with hypoxemia in Lagos, Nigeria

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic is the current public health concern. Hypoxemia has been identified as an independent risk factor for mortality in COVID-19 patients regardless of age or sex. This study therefore aimed to assess the profile of COVID-19 patients with hypoxemia in Lagos, Nigeria and identify their associated socio-demographic and clinical risk factors, predictors, and outcomes. Materials and Methods: This was a retrospective cohort study in which data were extracted from medical records of real-time polymerase chain reaction confirmed COVID-19 positive patients admitted between April and October 2020. Data extracted included age, sex, comorbidities, disease category/classification, symptoms, lowest oxygen saturation (SPO2), and outcomes. Bivariate analysis was done to test associations between hypoxemia and other variables. Multivariate analysis was done to determine significant predictors of hypoxemia. Results: A total of 266 patients were included in the study; mean (SD) 49.80 (± 16.68) years. Hypoxemia (lowest SPO2 ≤ 90 in adults and < 92% in children) was found in 102 (38.3 %) of the cases. SPO2 of hypoxemic patients ranged from 33% to 90%, Mean ±SD of 77±13%. About half of the hypoxemic cases, 53 (52%) were ≥ 60 years and mostly male 70 (68.6%). Difficulty breathing was present in 56 (55%), while the common comorbidities were hypertension 86 (32.3%) and diabetes mellitus 47 (17.7%). Age ≥ 60, difficulty breathing, and fever were independent predictors of hypoxemia. Hypoxemia was significantly associated with death (X2-42.13; P < 0.001); odds ratio 14.5 (95% CI: 5.4–38.8). Conclusion: Hypoxemia occurred in 1 out of every 3 COVID-19 patients with poor prognosis. SPO2 monitoring and early presentation in hospital for those 60 years and above or with dyspnea may be essential for early identification and treatment of hypoxemia to reduce mortality.

Determinants of mortality among hospitalized patients with COVID-19 during first and second waves of the pandemic: A retrospective cohort study from an isolation center in Kano, Nigeria

“…Elimian et al reported among others that age > 51 years is an independent factor associated with mortality [8]. Similarly, Akinbolagbe et al, and Ibrahim et al, in Nigeria also reported increased mortality among the aged population [9,10]. Age has also been described as the most important variable in predicting COVID-19 mortality in an international study [22].…”

“…Furthermore, a nationwide study by Elimian and colleagues reported that age greater than 51years, farming occupation, cough, vomiting and difficulty in breathing are associated with mortality among COVID-19 patients in Nigeria [ 8 ]. Another study in Nigeria by Akinbolagbe et al, showed that, age greater than 60 years, difficulty in breathing, and fever were independent predictors of hypoxaemia and death [ 9 ]. Similarly, in another study, hypoxaemia, obesity, diabetes mellitus and longer duration of symptoms were identified as predictors of mortality [ 10 ].…”

Haematological indices and coagulation profile as predictors of disease severity and associations with clinical outcome among COVID-19 patients in Lagos, Nigeria

“…It was carried out in a dedicated 120-bedded national COVID-19 isolation ward of the Lagos University Teaching Hospital (LUTH). [ 13 ]…”