Abstract
Background
As of November 30, 2021, there were a disproportionately high number of COVID-19-related fatalities documented in the Free State Province (FSP), South Africa. The province's COVID-19 mortality has not been linked with clear-cut evidence of the risk factors' effects. Therefore, it is essential to pinpoint the risk factors contributing to COVID-19 death and to support the Free State Department of Health (FSDoH) in reducing and managing the disease's fatality rate across the province.
Objective
The purpose of this study was to examine COVID-19 mortality patterns and health factors associated with the disease among South African citizens living in the FSP between March 2020 and November 2021.
Methods
A cross-sectional retrospective examination of cases that were confirmed to have the SARS-Co-2 virus between March 1, 2020, and November 30, 2021, both in-hospital and out-of-hospital (isolation), was carried out. The FSDoH provided the administrative COVID-19 records, which were then subjected to analysis. All laboratory-identified COVID-19 cases (n=4556) in and out of the province's hospitals during the designated study period were included as study participants. Data management was performed using Excel from Microsoft Office Professional Plus 2013 and analysis was carried out using EpiInfo version 7.2.3.0 and International Business Machines (IBM) statistical software, the Statistical Package for Social Sciences (SPSS) version 28.0.1.0. The connection between the various research variables was evaluated using the binary logistic regression model, and the resulting outputs were presented as the Adjusted Odds Ratio (AOR) and the corresponding 95% Confidence Intervals (CI).
Results
The results of the predictive mortality trend showed that more females than males (AAMR of 45.60 per 100000 population) were likely to die from the COVID-19 disease. The investigation also established that male COVID-19 individuals had a considerably higher mortality risk than female
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cases (AOR 1.19; 95% CI: 1.03 - 1.38). The age group 55 to 64 had a substantial risk of death (AOR 10.96; 95% Cl: 5.73 to 20.94), with those 75 and older having the highest chance of passing away. Compared to patients with the same clinical status in isolation, cases admitted to the ICU had a higher risk of dying from SARS-CoV-2 infection (AOR 61.13; 95% CL: 21.09 - 177.14). The comorbidities that had the highest odds ratios for mortality were kidney disease (AOR 2.30; 95% CI: 1.24 - 4.27), lung disease (AOR 1.75; 95% CI: 1.33 - 2.29), cardiovascular disease (AOR 1.63; 95% CI: 1.30 - 2.05), and diabetes (AOR 1.38; 95% CI: 1.13 - 1.67). While among the other clinical factors, pneumonia (AOR 2.21; 95% Cl: 1.28 - 3.80) was the one that was most substantially linked to an elevated risk of mortality.
Conclusion
The risk of mortality associated with COVID-19 may be significantly decreased by the adequate and prompt enactment of protection and intervention services for COVID-19 patients in the FSP, particularly but not exclusively for male patients with advanced age having comorbidities such as renal disorder, lung disorder, cardiovascular disorder, and diabetes with pneumonia as presented symptoms.
Key Words
Risk Factors, COVID-19, Mortality, SARS-CoV-2, Free State Province (FSP), South Africa.