Characterization and determinant factors of critical illness and in-hospital mortality of COVID-19 patients: A retrospective cohort of 1,792 patients in Kenya

Limited data is available on the coronavirus disease 2019(COVID-19),critical illness rate,and in-hospital mortality in the African setting.This study investigates determinants of critical illness and in-hospital mortality among COVID-19 patients in Kenya.We conducted a retrospective cohort study at Kenyatta National Hospital(KNH)in Kenya.Multivariate logistic regression and Cox proportional hazard regression were employed to determine predictor factors for intensive care unit(ICU)admission and in-hospital mortality,respectively.In addition,the Kaplan-Meier model was used to compare the survival times using log-rank tests.As a result,346(19.3%)COVID-19 patients were admitted to ICU,and 271(15.1%)died.The majority of those admitted to the hospital were male,1,137(63.4%)and asymptomatic,1,357(75.7%).The most prevalent clinical features were shortness of breath,fever,and dry cough.In addition,older age,male,health status,patient on oxygen(O2),oxygen saturation levels(SPO2),headache,dry cough,comorbidities,obesity,cardiovascular diseases(CVDs),diabetes,chronic lung disease(CLD),and malignancy/cancer can predicate the risk of ICU admission,with an area under the receiver operating characteristic curve(AUC-ROC)of 0.90(95%confidence interval[CI]:0.88–0.92).Survival analysis indicated 271(15.1%)patients died and identified older age,male,headache,shortness of breath,health status,patient on oxygen,SPO2,headache,comorbidity,CVDs,diabetes,CLD,malignancy/cancer,and smoking as risk factors for mortality(AUC-ROC:0.90,95%CI:0.89–0.91).This is the first attempt to explore predictors for ICU admission and hospital mortality among COVID-19 patients in Kenya.