Preditors of Covid 19 Hospitalization . A Case of Thorngroove Hospital Bulawayo City, Zimbabwe

Abstract

COVID19 pandemic has negatively impacted health care systems in many countries. Properly understanding risk factors for hospitalization will help improve clinical management and facilitate targeted prevention messaging and forecasting and prioritization of clinical and public health resource needs. A case control study was conducted in Bulawayo City to identify predictors COVID 19 for hospitalization.An interviewer-administered questionnaire was used to collect data from the study participants. The data collection was done in private and at the most convenient place for the study respondents. Overall, 204 patients were included in the study comprising 102 hospitalised and 102 non-hospitalized patients controls.Two sampling frames were created from the Bulawayo city health department COVID-19 line-list. The first sampling frame was for the COVID-19 patients that were hospitalized at Thorngrove hospital. This sampling frame was used to systematically sample 102 cases. The second sampling frame was for the COVID-19 patients that were not hospitalized. This sampling frame was used to systematically sample 102 controls.The excel rand function was used to randomly select the first case or control. Both hospitalised and non hospitalized patients were systematically selected from the Bulawayo COVID 19 linelist. Data was analyzed using Epi-Info version 7. The statistical software was used to generate means, frequencies, proportions, and to perform bivariate, and multivariate logistic regression to determine the independent predictors for the hospitalization of COVID-19 patients. Hospitalized and nonhospitalized patients were identified from laboratory-confirmed COVID-19 cases reported to the Bulawayo City health and were linelisted. The results of the study showed that the independent predictors for being hospitalized were being HIV positive (adjusted Odds Ratio(aOR) =6.07; 95% CI: 2.0-18.3;p =0.01), and being hypertensive (adjusted Odds Ratio(aOR) =20.73; 95% CI 6.6-64.9;p =0.01). COVID- 19 patients with hypertension were 20.73 times more likely to be hospitalized compared to those who were not hypertensive. The study also showed that the independent protective factor for not being hospitalized was being female (adjusted Odds Ratio(aOR) 0.41; 95% CI 0.2-0.9; p=0.002). Females had 59% reduced odds of being hospitalized compared to men.The researcher recommends that case management pillar within City health should prioritize vaccine allocation, diagnosis, and treatment to high risk groups like the hypertensive and HIV positive population groups as well as optimisation of care by ensuring that high risk groups like HIV and hypertensive patients are compliant with their medication, monitoring of BP, viral load and follow up of non compliant patients by community health nurses.