Author(s)

Francois Adrien Bokalli^1,2*, Fru McWright Chi^2*, Ephesians Anutebeh², Caven Ngoe², Mbachan Takere², Edwin Ewane², Dieudonne Akanji², Conrald Ekukole², Marie-Solange Ndom³, Mireille-Laurent Endale³, David Mekolo^1,4, Henry Luma⁵, Jacqueline Ze Minkande⁶, Marcelin Ngowe Ngowe⁷

¹Specialised COVID-19 Treatment Centre Yassa, Douala, Cameroon.
²Department of Medicine, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
³Department of Medicine, Laquintinie Hospital, Douala, Cameroon.
⁴Intensive Care and Emergency Department, Laquintinie Hospital, Douala, Cameroon.
⁵Department of Internal Medicine, Douala General Hospital, Douala, Cameroon.
⁶Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon.
⁷Department of Surgery and Specialties, Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon.

Background: In March 2020, the World Health Organization declared the coronavirus disease 2019 a pandemic, this was caused by the Severe Acute Respiratory Syndrome Coronavirus 2. The overall mortality from this remains high, yet there are limited studies assessing the associated factors in Africa. Objective: To identify the factors associated with mortality in hospitalized COVID-19 patients in Douala, Cameroon. Method: We conducted a single-centre retrospective cross-sectional study by reviewing records of patients managed for COVID-19 between March and June 2020. Diagnosis was confirmed by real-time RT-PCR. Outcome of interest was mortality during hospitalization. We inputted and analyzed data using SPSS version 25.0, compared mortality between groups using the Chi’s squared test and the Fisher’s exact test where appropriately investigated for associations using the Logistic regression in a stepwise approach and alpha-value set at P = 0.05. Results: We analyzed 282 case files, 68% were males (M:F = 2:1) and a mean age of 52 (±15) years. We had an overall mortality of 31.5% (89/282 patients) and 54% (50/92 patients) admitted in the ICU died. Patients aged 0 - 39 years had a significantly lesser odds of mortality compared to those > 70 years (OR: 0.2 (0.1 - 0.5) P < 0.001). Hemodynamic instability at presentation showed association with mortality (P < 0.001) ranging as follows; moderate disease OR: 7.3 (2.4 - 21.8) versus Sepsis OR: 317 (58.3 - 1729.3). Mortality was as high as 63% in those with alveolar consolidation on CT scan (OR: 0.3 (0.1 - 0.6)), those with a 75% - 100% involvement of the lung parenchyma had a significantly higher mortality compared with those of <10% involvement (OR: 0.02 (0.01 - 0.06) P < 0.001). About 55% of patients placed on supplemental oxygen died (OR: 0.2 (0.1 - 0.3)) and up to 80% (OR: 0.1 (0.01 - 1.0)) of intubated patients died. In the ICU population, placement on non-invasive mechanical ventilation (AOR: 0.5 (0.2 - 1.2)) and intubation (AOR: 0.3 (0.03 - 2.6)) showed no significant differences in terms of mortality. Conclusion: The in-hospital mortality in COVID-19 patients is very high and hospitalisation into the ICU is associated with even higher mortality. Advanced age, diffused lung involvement (particularly with alveolar consolidation), hemodynamic instability at presentation and altered level of consciousness favoured hospitalisation in the ICU. Once in the ICU, placement on mechanical ventilation did not reduce death discernibly.

COVID-19, Risk Factors, Mortality, Cameroon

Bokalli, F. , Chi, F. , Anutebeh, E. , Ngoe, C. , Takere, M. , Ewane, E. , Akanji, D. , Ekukole, C. , Ndom, M. , Endale, M. , Mekolo, D. , Luma, H. , Minkande, J. and Ngowe, M. (2022) Mortality and Associated Risk Factors among In-Patients with Covid-19 in Douala, Cameroon: A Retrospective Cross-Sectional Study. Advances in Infectious Diseases, 12, 1-19. doi: 10.4236/aid.2022.121001.