Table 2.
Factors associated with COVID-19 in-hospital mortality among patients admitted to hospital with laboratory-confirmed SARS-CoV-2 infection, South Africa (n=219 265)
| Case fatality ratio | Unadjusted OR (95% CI) unimputed | p value | Adjusted OR (95% CI) unimputed | p value | Unadjusted OR (95% CI) imputed | p value | Adjusted OR (95% CI) imputed* | p value | |
|---|---|---|---|---|---|---|---|---|---|
| Sex | |||||||||
| Female | 26 466/121 937 (21·7%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Male | 24 490/96 890 (25·3%) | 1·32 (1·29–1·34) | <0·0001 | 1·32 (1·27–1·37) | <0·0001 | 1·32 (1·29–1·34) | <0·0001 | 1·30 (1·27–1·33) | <0·0001 |
| Age, years | |||||||||
| <20 | 300/8605 (3·5%) | 1 (ref) | <0·0001 | 1 (ref) | <0·0001 | 1 (ref) | .. | 1 (ref) | .. |
| 20–39 | 3516/44 605 (7·9%) | 2·38 (2·11–2·70) | <0·0001 | 2·60 (2·02–3·28) | <0·0001 | 2·38 (2·11–2·70) | <0·0001 | 2·15 (1·90–2·44) | <0·0001 |
| 40–59 | 16 285/86 095 (18·9%) | 6·88 (6·11–7·76) | <0·0001 | 6·90 (5·45–8·74) | <0·0001 | 6·88 (6·11–7·76) | <0·0001 | 5·32 (4·71–6·00) | <0·0001 |
| 60–69 | 14 412/41 077 (35·1%) | 15·08 (13·38–17·01) | <0·0001 | 14·41 (11·36–18·28) | <0·0001 | 15·08 (13·38–17·01) | <0·0001 | 11·29 (9·99–12·76) | <0·0001 |
| 70–79 | 10 509/24 943 (42·1%) | 20·75 (18·38–23·42) | <0·0001 | 20·85 (16·40–26·49) | <0·0001 | 20·75 (18·38–23·42) | <0·0001 | 15·93 (14·06–18·04) | <0·0001 |
| ≥80 | 6015/13 940 (43·1%) | 24·85 (21·96–28·12) | <0·0001 | 28·89 (22·62–36·89) | <0·0001 | 24·85 (21·96–28·12) | <0·0001 | 20·67 (18·19–23·48) | <0·0001 |
| Race or ethnicity | |||||||||
| White | 2689/12 661 (21·2%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Black | 28 602/114 571 (25·0%) | 0·77 (0·73–0·81) | <0·0001 | 1·21 (1·13–1·30) | <0·0001 | 0·79 (0·74–0·84) | <0·0001 | 1·23 (1·15–1·32) | <0·0001 |
| Mixed | 2310/10 053 (23·0%) | 0·92 (0·85–0·99) | 0·022 | 1·31 (1·18–1·44) | <0·0001 | 0·89 (0·83–0·96) | 0·0037 | 1·24 (1·15–1·34) | <0·0001 |
| Indian | 2014/8591 (23·4%) | 1·08 (1·00–1·17) | 0·046 | 1·32 (1·20–1·46) | <0·0001 | 1·07 (0·99–1·14) | 0·078 | 1·35 (1·25–1·45) | <0·0001 |
| Hypertension | |||||||||
| No | 19 123/102 252 (18·7%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Yes | 19 668/61 098 (32·2%) | 1·92 (1·87–1·97) | <0·0001 | 1·16 (1·11–1·21) | <0·0001 | 2·03 (1·97–2·08) | <0·0001 | 1·07 (1·03–1·10) | 0·0004 |
| Diabetes | |||||||||
| No | 22 742/116 047 (19·6%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Yes | 14 707/43 885 (33·5%) | 1·92 (1·87–1·98) | <0·0001 | 1·42 (1·36–1·48) | <0·0001 | 2·01 (1·96–2·06) | <0·0001 | 1·40 (1·36–1·45) | <0·0001 |
| Chronic cardiac disease | |||||||||
| No | 32 498/145 854 (22·3%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | ..ç |
| Yes | 1564/4178 (37·4%) | 1·95 (1·82–2·09) | <0·0001 | 1·22 (1·11–1·34) | <0·0001 | 3·47 (3·28–3·66) | <0·0001 | 2·21 (2·08–2·35) | <0·0001 |
| Chronic renal disease | |||||||||
| No | 32 009/145 095 (22·1%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Yes | 1785/4121 (43·3%) | 2·56 (2·39–2·74) | <0·0001 | 1·68 (1·50–1·89) | <0·0001 | 2·68 (2·51–2·87) | <0·0001 | 1·45 (1·33–1·60) | <0·0001 |
| Malignancy in the past 5 years | |||||||||
| No | 33 136/147 659 (22·4%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Yes | 439/1143 (38·4%) | 2·04 (1·80–2·32) | <0·0001 | 1·75 (1·48–2·08) | <0·0001 | 2·24 (2·02–2·49) | <0·0001 | 1·47 (1·29–1·66) | <0·0001 |
| Tuberculosis | |||||||||
| Never | 31 276/141 099 (22·2%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Past | 759/3001 (25·3%) | 0·93 (0·85–1·02) | 0·12 | 1·12 (0·95–1·30) | 0·17 | 1·16 (1·07–1·26) | 0·0006 | 1·26 (1·15–1·38) | <0·0001 |
| Current | 258/993 (26·0%) | 1·08 (0·93–1·25) | 0·33 | 1·58 (1·30–1·92) | <0·0001 | 1·04 (0·90–1·20) | 0·59 | 1·42 (1·22–1·64) | <0·0001 |
| Current and past | 307/1288 (23·8%) | 0·98 (0·85–1·14) | 0·80 | 2·05 (1·59–2·64) | <0·0001 | 1·14 (1·03–1·27) | 0·013 | 1·48 (1·32–1·67) | <0·0001 |
| HIV | |||||||||
| No | 30 697/137 986 (22·2%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Yes | 3407/13 793 (24·7%) | 0·84 (0·80–0·88) | <0·0001 | 1·29 (1·20–1·39) | <0·0001 | 0·86 (0·82–0·90) | <0·0001 | 1·34 (1·27–1·43) | <0·0001 |
| Admission | |||||||||
| March, 2020 | 45/400 (11·3%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| April, 2020 | 185/1449 (12·8%) | 1·26 (0·88–1·79) | 0·21 | 0·83 (0·48–1·43) | 0·51 | 1·26 (0·88–1·79) | 0·21 | 1·18 (0·81–1·72) | 0·38 |
| May, 2020 | 1072/5787 (18·5%) | 1·89 (1·37–2·61) | 0·0001 | 1·12 (0·68–1·84) | 0·66 | 1·89 (1·37–2·61) | 0·0001 | 1·67 (1·19–2·35) | 0·0033 |
| June, 2020 | 3698/18 209 (20·3%) | 2·22 (1·62–3·06) | <0·0001 | 1·39 (0·85–2·26) | 0·19 | 2·22 (1·62–3·05) | <0·0001 | 1·90 (1·36–2·66) | 0·0002 |
| July, 2020 | 8335/38 226 (21·8%) | 2·43 (1·77–3·34) | <0·0001 | 1·45 (0·89–2·37) | 0·13 | 2·43 (1·77–3·34) | <0·0001 | 1·98 (1·42–2·77) | 0·0001 |
| August, 2020 | 3707/19 671 (18·8%) | 2·00 (1·46–2·75) | <0·0001 | 1·19 (0·73–1·95) | 0·49 | 2·00 (1·45–2·75) | <0·0001 | 1·54 (1·10–2·16) | 0·012 |
| September, 2020 | 1314/8851 (14·8%) | 1·51 (1·09–2·08) | 0·013 | 0·94 (0·57–1·55) | 0·80 | 1·51 (1·09–2·08) | 0·013 | 1·25 (0·89–1·76) | 0·20 |
| October, 2020 | 1167/7735 (15·1%) | 1·45 (1·05–2·00) | 0·024 | 0·95 (0·57–1·57) | 0·84 | 1·45 (1·05–2·00) | 0·024 | 1·25 (0·89–1·76) | 0·20 |
| November, 2020 | 2506/11 110 (22·6%) | 2·17 (1·58–2·99) | <0·0001 | 1·63 (0·99–2·68) | 0·053 | 2·17 (1·58–2·99) | <0·0001 | 1·92 (1·37–2·69) | 0·0002 |
| December, 2020 | 10 621/39 582 (26·8%) | 2·98 (2·17–4·09) | <0·0001 | 1·94 (1·19–3·17) | 0·0081 | 2·98 (2·17–4·09) | <0·0001 | 2·64 (1·89–3·69) | <0·0001 |
| January, 2021 | 15 264/52 019 (29·3%) | 3·33 (2·42–4·57) | <0·0001 | 1·86 (1·14–3·04) | 0·013 | 3·32 (2·42–4·56) | <0·0001 | 2·69 (1·92–3·76) | <0·0001 |
| February, 2021 | 2380/11 940 (19·9%) | 2·00 (1·45–2·75) | <0·0001 | 1·34 (0·81–2·20) | 0·25 | 2·00 (1·45–2·75) | <0·0001 | 1·75 (1·25–2·45) | 0·0012 |
| March, 2021 | 737/4235 (17·4%) | 1·71 (1·23–2·37) | 0·0013 | 1·47 (0·87–2·46) | 0·15 | 1·71 (1·23–2·36) | 0·0014 | 1·73 (1·22–2·43) | 0·0020 |
| Health sector | |||||||||
| Private | 19 763/105 409 (18·7%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Public | 31 274/113 856 (27·5%) | 1·99 (1·70–2·33) | <0·0001 | 1·50 (1·28–1·75) | <0·0001 | 1·99 (1·70–2·33) | <0·0001 | 1·28 (1·12–1·48) | 0·0005 |
| Province | |||||||||
| Western Cape | 9739/45 341 (21·5%) | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. | 1 (ref) | .. |
| Eastern Cape | 9334/28 671 (32·6%) | 2·32 (1·79–3·01) | <0·0001 | 1·94 (1·51–2·49) | <0·0001 | 2·32 (1·79–3·01) | <0·0001 | 2·15 (1·71–2·70) | <0·0001 |
| Free State | 2627/11 759 (22·3%) | 1·14 (0·83–1·56) | 0·43 | 1·19 (0·89–1·59) | 0·24 | 1·14 (0·83–1·56) | 0·43 | 1·33 (1·01–1·74) | 0·044 |
| Gauteng | 11 938/59 548 (20·0%) | 0·76 (0·60–0·98) | 0·033 | 1·15 (0·90–1·47) | 0·28 | 0·76 (0·60–0·98) | 0·033 | 1·02 (0·82–1·26) | 0·88 |
| KwaZulu-Natal | 10 411/42 712 (24·4%) | 1·45 (1·13–1·86) | 0·0040 | 1·41 (1·11–1·80) | 0·0056 | 1·45 (1·13–1·86) | 0·0040 | 1·41 (1·13–1·75) | 0·0021 |
| Limpopo | 2431/8110 (30·0%) | 1·98 (1·44–2·72) | <0·0001 | 1·32 (0·95–1·82) | 0·095 | 1·98 (1·44–2·72) | <0·0001 | 1·72 (1·30–2·27) | 0·0001 |
| Mpumalanga | 2209/8287 (26·7%) | 2·27 (1·62–3·20) | <0·0001 | 1·43 (0·99–2·06) | 0·060 | 2·27 (1·62–3·20) | <0·0001 | 2·01 (1·50–2·71) | <0·0001 |
| North West | 1651/11 343 (14·6%) | 0·73 (0·49–1·09) | 0·12 | 1·18 (0·79–1·76) | 0·43 | 0·73 (0·49–1·09) | 0·12 | 0·91 (0·64–1·27) | 0·57 |
| Northern Cape | 697/3494 (19·9%) | 1·32 (0·84–2·08) | 0·23 | 1·43 (0·85–2·40) | 0·18 | 1·32 (0·84–2·08) | 0·23 | 1·44 (0·97–2·14) | 0·073 |
OR=odds ratio.
*
Chronic pulmonary disease and asthma variable excluded in the final multivariate model due to being not significant.