Original Research

A single-centred retrospective observational analysis on mortality trends during the COVID-19 pandemic

Omishka Hirachund, Camilla Pennefather, Mergan Naidoo
South African Family Practice | Vol 65, No 1 : Part 3| a5700 | DOI: https://doi.org/10.4102/safp.v65i1.5700 | © 2023 Omishka Hirachund, Camilla Pennefather, Mergan Naidoo | This work is licensed under CC Attribution 4.0
Submitted: 23 December 2022 | Published: 05 June 2023

About the author(s)

Omishka Hirachund, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Camilla Pennefather, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
Mergan Naidoo, Discipline of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa

Abstract

Background: South Africa experienced high mortality during the COVID-19 pandemic. Resources were limited, particularly at the district hospital (DH) level. Overwhelmed healthcare facilities and a lack of research at a primary care level made the management of patients with COVID-19 challenging. The objective of this study was to describe the in-hospital mortality trends among individuals with COVID-19 at a DH in South Africa.

Methods: Retrospective observational analysis of all adults who demised in hospital from COVID-19 between 01 March 2020 and 31 August 2021 at a DH in South Africa. Variables analysed included: background history, clinical presentation, investigations and management.

Results: Of the 328 participants who demised in hospital, 60.1% were female, 66.5% were older than 60 and 59.6% were of black African descent. Hypertension and diabetes mellitus were the most common comorbidities (61.3% and 47.6%, respectively). The most common symptoms were dyspnoea (83.8%) and cough (70.1%). ‘Ground-glass’ features on admission chest X-rays were visible in 90.0% of participants, and 82.8% had arterial oxygen saturations less than 95% on admission. Renal impairment was the most common complication present on admission (63.7%). The median duration of admission before death was four days (interquartile range [IQR]: 1.5–8). The overall crude fatality rate was 15.3%, with the highest crude fatality rate found in wave two (33.0%).

Conclusion: Older participants with uncontrolled comorbidities were most likely to demise from COVID-19. Wave two (characterised by the ‘Beta’ variant) had the highest mortality rate.

Contribution: This study provides insight into the risk factors associated with death in a resource-constrained environment.


Keywords

severe acute respiratory syndrome coronavirus 2, SARS-CoV-2; COVID-19; mortality trends; risk factors for mortality; district hospital; South Africa

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