Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study

Objective Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality i...

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Main Authors: Ibrahim Abubakar, Muhammad Usman, Chikwe Ihekweazu, Puja Myles, Kelly Osezele Elimian, Chinwe Lucia Ochu, Blessing Ebhodaghe, Emily E Crawford, Ehimario Igumbor, Winifred Ukponu, Adobola Olayinka, Olusola Aruna, Chioma Dan-Nwafor, Olatayo Ayodeji Olawepo, Oladipo Ogunbode, Rhoda Atteh, William Nwachukwu, Sudhir Venkatesan, Chijioke Obagha, Samuel Ngishe, Kabir Suleiman, Hakeem Abiola Yusuff, Ifeoma Nwadiuto, Abbas Aliyu Mohammed, Rabi Usman, Nwando Mba, Olaolu Aderinola, Elsie Ilori, John Oladejo
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/12/e044079.full
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author Ibrahim Abubakar
Muhammad Usman
Chikwe Ihekweazu
Puja Myles
Kelly Osezele Elimian
Chinwe Lucia Ochu
Blessing Ebhodaghe
Emily E Crawford
Ehimario Igumbor
Winifred Ukponu
Adobola Olayinka
Olusola Aruna
Chioma Dan-Nwafor
Olatayo Ayodeji Olawepo
Oladipo Ogunbode
Rhoda Atteh
William Nwachukwu
Sudhir Venkatesan
Chijioke Obagha
Samuel Ngishe
Kabir Suleiman
Hakeem Abiola Yusuff
Ifeoma Nwadiuto
Abbas Aliyu Mohammed
Rabi Usman
Nwando Mba
Olaolu Aderinola
Elsie Ilori
John Oladejo
author_facet Ibrahim Abubakar
Muhammad Usman
Chikwe Ihekweazu
Puja Myles
Kelly Osezele Elimian
Chinwe Lucia Ochu
Blessing Ebhodaghe
Emily E Crawford
Ehimario Igumbor
Winifred Ukponu
Adobola Olayinka
Olusola Aruna
Chioma Dan-Nwafor
Olatayo Ayodeji Olawepo
Oladipo Ogunbode
Rhoda Atteh
William Nwachukwu
Sudhir Venkatesan
Chijioke Obagha
Samuel Ngishe
Kabir Suleiman
Hakeem Abiola Yusuff
Ifeoma Nwadiuto
Abbas Aliyu Mohammed
Rabi Usman
Nwando Mba
Olaolu Aderinola
Elsie Ilori
John Oladejo
author_sort Ibrahim Abubakar
collection DOAJ
description Objective Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria.Design Retrospective cohort study.Setting COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control.Participants Individuals who were investigated for SARS-CoV-2 using real-time PCR testing during the study period 27 February–8 June 2020.Methods COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs.Results A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95% CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84).Conclusion The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals.
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spelling doaj-art-ed46f457a53541fcbba96f0794f7c4672025-08-20T02:23:31ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-044079Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort studyIbrahim Abubakar0Muhammad Usman1Chikwe Ihekweazu2Puja Myles3Kelly Osezele Elimian4Chinwe Lucia Ochu5Blessing Ebhodaghe6Emily E Crawford7Ehimario Igumbor8Winifred Ukponu9Adobola Olayinka10Olusola Aruna11Chioma Dan-Nwafor12Olatayo Ayodeji Olawepo13Oladipo Ogunbode14Rhoda Atteh15William Nwachukwu16Sudhir Venkatesan17Chijioke Obagha18Samuel Ngishe19Kabir Suleiman20Hakeem Abiola Yusuff21Ifeoma Nwadiuto22Abbas Aliyu Mohammed23Rabi Usman24Nwando Mba25Olaolu Aderinola26Elsie Ilori27John Oladejo28Institute for Global Health, UCL, London, UK5Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, NSW, AustraliaNigeria Centre for Disease Control, Abuja, Nigeriahead of observational researchDepartment of Microbiology, Faculty of Life Sciences, University of Benin, Benin City, NigeriaPrevention, Programme and Knowledge Management, Nigeria Centre for Disease Control, Abuja, NigeriaPrevention, Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, NigeriaPrevention, Programme and Knowledge Management, Nigeria Centre for Disease Control, Abuja, NigeriaPrevention Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, NigeriaCenter for Global Health Practice and Impact, Georgetown University, Abuja, NigeriaWHO, Abuja, NigeriaIHR Strengthening Programme in Nigeria, UK Health Security Agency, London, UKNigeria Centre for Disease Control, FCT, Abuja, NigeriaCenter for Global Health Practice and Impact, Georgetown University, Abuja, NigeriaPrevention Programmes and Knowledge Management, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, NigeriaSurveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, FCT, NigeriaSurveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, NigeriaEMEA Data Science Hub, IQVIA, London, UKMinistry of Health, Anambra State, Awka, Anambra, NigeriaPublic Health, Ministry of Health, Benue State, Makurdi, NigeriaMinistry of Health, Katsina State, Katsina, NigeriaOgun State Ministry of Health, Abeokuta, NigeriaRivers State Ministry of Health, Port Harcourt, NigeriaMinistry of Health, Sokoto State, Sokoto, NigeriaMinistry of Health, Zamfara State, Zamfara, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaHealth Emergency Preparedness and Response, Nigeria Centre for Disease Control, Abuja, Federal Capital Territory, NigeriaNigeria Centre for Disease Control, FCT, Abuja, NigeriaNigeria Centre for Disease Control, Abuja, NigeriaObjective Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria.Design Retrospective cohort study.Setting COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control.Participants Individuals who were investigated for SARS-CoV-2 using real-time PCR testing during the study period 27 February–8 June 2020.Methods COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs.Results A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95% CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84).Conclusion The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals.https://bmjopen.bmj.com/content/10/12/e044079.full
spellingShingle Ibrahim Abubakar
Muhammad Usman
Chikwe Ihekweazu
Puja Myles
Kelly Osezele Elimian
Chinwe Lucia Ochu
Blessing Ebhodaghe
Emily E Crawford
Ehimario Igumbor
Winifred Ukponu
Adobola Olayinka
Olusola Aruna
Chioma Dan-Nwafor
Olatayo Ayodeji Olawepo
Oladipo Ogunbode
Rhoda Atteh
William Nwachukwu
Sudhir Venkatesan
Chijioke Obagha
Samuel Ngishe
Kabir Suleiman
Hakeem Abiola Yusuff
Ifeoma Nwadiuto
Abbas Aliyu Mohammed
Rabi Usman
Nwando Mba
Olaolu Aderinola
Elsie Ilori
John Oladejo
Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
BMJ Open
title Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
title_full Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
title_fullStr Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
title_full_unstemmed Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
title_short Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study
title_sort patient characteristics associated with covid 19 positivity and fatality in nigeria retrospective cohort study
url https://bmjopen.bmj.com/content/10/12/e044079.full
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