Table 4.
Risk factors for increased risk for death in studies using regression models.
| Authors | Setting | Regression model | Significant risk factors (effect estimate, 95% CI) |
|---|---|---|---|
| 1. Abayomi et al[19] | Nine treatment centers in Lagos state, Southwest Nigeria | Multivariable logistic regression models | The most significant symptom predictor of COVID-19 death was difficulty in breathing (OR: 19.26, 95% CI 10.95–33.88), followed by weakness (OR: 3.04, 95% CI 1.44–6.42), Cough (OR: 1.87, 95% CI 1.04–3.37%). Let us also point out that advanced age (OR: 1.04, 95% CI 1.02–1.06), males gender (OR: 2.21, 95% CI 1.06–4.58), and admission at critical or severe stage (OR: 153.47, 95% CI 30.74–766.35) were a predictor of death |
| 2. AbdelGhaffar et al[20] | Six hospitals affiliated to the General Organization For Teaching Hospitals and Institutes (GOTHI) in Egypt | Multivariate logistic regression model (forward stepwise selection) | Age > 60 years (OR: 2.83, 95% CI 2.38–3.35, P = .001), male gender (OR: 1.211, 95% CI 1.1–1.43, P = .025), diabetes mellitus (OR: 1.25, 95% CI 1.034–1.53, P = .022), hypertension (OR: 1.51, 95% CI 1.243–1.84; P = .001), and chronic renal insufficiency (OR: 3.398, 95% CI 2.45–4.71, P = .001) were independent predictors for mortality among admitted patients. |
| 3. Abebe et al [21] | Six COVID-19 isolation and treatment centers namely Mekelle, Maichew, Axum, Adigrat, Shire and Humera in Ethiopia. | Multivariable binary logistic regression | The odds of mortality was higher for patients who had cardiovascular diseases (AOR = 2.49, 95% CI: 1.03–6.03), shortness of breath (AOR = 9.71, 95% CI: 4.73–19.93) and body weakness (AOR = 3.04, 95% CI: 1.50–6.18). Moreover, the estimated odds of mortality significantly increased with patient’s age. |
| 4. Allwood et al[22] | Tygerberg Hospital, a 1380-bed tertiary hospital in Cape Town, South Africa | Cox’s proportional hazards model | An elevated D-dimer level was associated with increased risk of death in the ICU [HR 1.05, 95% confidence interval (CI) 1.00–1.11] |
| 5. Apiyo et al[23] | Single-center, at Case Hospital, Kampala, Uganda. | A multivariable logistic regression model | Factors strongly associated with all-cause mortality were as follows: age >50 years (odds ratio [OR]: 8.6, 95% confidence interval [CI]: 1.1–69.2, and P = .042), having at least 1 comorbidity (OR: 3.2, 95% CI: 1.1–8.9, and P = .029), hypertension (OR: 3.2, 95% CI: 1.2–8.6, and P = .024), diabetes mellitus (OR: 2.9, 95% CI: 1.0–8.5, and P = .056), and oxygen saturation < 92% (OR: 5.1, 95% CI: 1.8–14.4, and P = .002) |
| 6. Baguma et al[24] | Gulu Regional Referral Hospital in Northern Uganda | Multivariable logistical regression analysis. | The independent factors associated with mortality among the COVID-19 patients were females AOR = 0.220, 95% CI: 0.059–0.827; P = .030; Diabetes mellitus AOR = 9.014, 95% CI: 1.726–47.067; P = .010; Ages of 50 years and above AOR = 2.725, 95% CI: 1.187–6.258; P = .018; tiredness AOR = 0.059, 95% CI: 0.009–0.371; P < .001; general body aches and pains AOR = 0.066, 95% CI: 0.007–0.605; P = .020; loss of speech and movement AOR = 0.134, 95% CI: 0.270–0.660; P = .010 and other co-morbidities AOR = 6.860, 95% CI: 1.309–35.957; P = .020. |
| 7. Bepouka et al[25] | The Kinshasa University Hospital, a large regional hospital in DRC. | Multivariate Cox model | Age between 40 and 59 years [adjusted Hazard Ratio (aHR): 4.07; 95% CI: 1.16–8.30], age at least 60 years (aHR: 6.65; 95% CI: 1.48–8.88), severe or critical COVID-19 (aHR: 14.05; 95% CI: 6.3–15.67) and presence of dyspnea (aHR: 5.67; 95% CI: 1.46-21.98) were independently and significantly associated with the risk of death |
| 8. Bepouka et al[26] | Kinshasa University Hospital, a big regional hospital in DRC | Cox regression models | Low oxygen saturation of < 90% (aHR 1.69; 95% CI [1.03–2.77]; P = .038) was an independent predictor of mortality. |
| 9. Boateng et al[27] | Treatment center of the University Hospital, Kumasi, Ghana | Multivariable logistic regression analysis. | Increasing age and high systolic blood pressure in unadjusted but no factors in multivariate analysis |
| 10. Donamou et al[28] | Intensive Care Unit of the COVID Treatment Center of Donka National Hospital, in Guinea. | multivariate logistic regression analysis | Acute Respiratory Distress Syndrome (ARDS) (OR = 6.33, 95% CI [1.66–29]; P = .007), a Brescia score ≥ 2 (OR = 5.8, 95% CI [1.7–19.2]; P = .004) and admission delay (OR = 5.6, 95% CI [1.8–17.5]; P = .003). |
| 11. Jaspard et al[29] | Hospitals in Burkina Faso and Guinea | Multivariable logistic regression | In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1–3.6), people aged ≥ 60 years (aOR 2.9, 95% CI 1.7–4.8), admission at severe stage (aOR 9.0 95% CI 5.0–16.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2–3.4). |
| 12. Kaso et al [30] | Bokoji Hospital COVID-19 treatment center, in Ethiopia | Cox regression analysis | Patients that age between 31 and 45 years (aHR = 2.55; 95% CI: 1.03–6.34), older than 46 years (aHR = 2.59; ; 95% CI: 1.27–5.30), chronic obstructive pulmonary disease (aHR = 4.60, 95% CI: 2.37–8.91), Chronic kidney disease (aHR = 5.58, 95% CI: 1.70–18.37), HIV/AIDS (aHR = 3.66, 95% CI: 1.20–11.10), admission to the Intensive care unit (aHR = 7.44, 95% CI: 1.82–30.42), and being on intranasal oxygen care (aHR = 6.27, 95% CI: 2.75–4.30) were independent risk factors increasing risk of death from COVID-19 disease than their counterparts. |
| 13. Katoto et al[31] | Hospitals from all 8 political regions (Niamey, Agadez, Diffa, Dosso, Maradi, Tahaoua, Tillaberi and Zinder) in Niger | Cox regression analysis | Comorbidity (adjusted hazards ratio [aHR] 2.04; 95% CI: 2.38–6.35), shortness of breath at baseline (aHR 2.04; 95% CI: 2.38–6.35) and being 60 years or older (aHR 3.32; 95% CI: 1.88–5.89) increased the risk of COVID-19 mortality 2- to 5-folds |
| 14. Matangila et al[32] | Clinique Ngaliema, a public hospital in Kinshasa, DRC | Multivariate logistic regression models | OR: Older age: 1.06 (1.0–1.11), lower SpO2: 0.94 (0.90–0.98), higher heart rate: 1.06 (1.02–1.11), elevated AST: 1.02 (1.01–1.03) |
| 15. Nachega et al [33] | 7 largest health facility in Kinshasa, DRC | Cox regression | Age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI: 1.85–23.64), 40–59 years (aHR = 4.45, 95% CI: 1.83–10.79), and ≥ 60 years (aHR = 13.63, 95% CI: 5.70–32.60) compared with those aged 20–39 years, with obesity (aHR = 2.30, 95% CI: 1.24–4.27), and with chronic kidney disease (aHR = 5.33, 95% CI: 1.85–15.35) |
| 16. Nassar et al[34] | 2 ICUs of Cairo University Hospitals in Egypt | Forward stepwise multivariable logistic regression analysis | Ischemic heart disease (OR: 13.04, 95% CI: 3.66−46.43, P < .001), history of smoking (OR: 5.28, 95% CI: 1.19–23.41, P = .029), and the occurrence of bacterial pneumonia during the ICU stay (OR: 4.87, 95% CI: 1.67−14.24, P = .004) were independently associated with a higher risk of in-hospital death. |
aHR = adjusted hazard ratio, aOR = adjusted odds ratio, ARDS Acute respiratory distress syndrome, aRR = adjusted risk ratio, AST = aspartate aminotransferase, CI = confidence interval, DRC = the Democratic Republic of the Congo, HIV = human immunodeficiency virus, ICU = intensive care unit, OR = odds ratio, sp O2 = oxygen saturation.