Characteristics and Clinical Outcomes of Hospitalized COVID-19 Patients in Bojanala, South Africa

COVID-19 was declared a pandemic as of 23^rd October 2020, followed by multiple waves, each driven by evolving SARS-CoV-2 variants. Comorbidities and age were known to influence COVID-19 outcomes adversely. This study will describe the demographic and clinical characteristics of COVID-19 patients hospitalized at public healthcare facilities.

A descriptive, analytical cross-sectional study was conducted using retrospective medical records of patients admitted with confirmed COVID-19 to five public hospitals in Bojanala District, North West Province, South Africa, from May to July 2020. All laboratory-confirmed COVID-19 patients admitted during this period were included. Descriptive statistics summarised patient profiles, while inferential analyses, including Chi-square tests, Mann-Whitney U tests, and multivariable logistic regression, were used to identify associations with mortality.

Medical records of 289 patients were included; a mean age of 45 years was observed, and most were male 57.1%. Hypertension, diabetes mellitus, and HIV were the most common comorbidities. Patients with two or more comorbidities experienced significantly higher mortality 46.2% compared to those with none or one. Multivariate analysis revealed that the use of antibiotics and anticoagulants remained independently associated with increased risk of death, even after adjusting for age and comorbidity burden. Conversely, age and comorbidity count lost significance after adjustment, suggesting their predictive effect may be mediated through clinical severity and treatment intensity.

Globally, variations in findings were noted in studies. Age, male gender, and multimorbidity were significant independent variables associated with severe COVID-19 outcomes and mortality. In most studies, older age and male gender were significant factors associated with mortality. The study reports that the correlation between the use of antibiotics, anticoagulants, and mortality was likely the result of these interventions functioning as indicators for advanced clinical severity rather than direct contributors to adverse outcomes.

Length of hospital stay was significantly shorter for patients who died compared to those who recovered. Emphasis on early screening of high-risk COVID-19 patients in settings with limited resources is advised, particularly older male patients with multimorbidity, including hypertension, diabetes, and HIV.