Abstract

HIRACHUND, Omishka; PENNEFATHER, Camilla  and  NAIDOO, Mergan. A single-centred retrospective observational analysis on mortality trends during the COVID-19 pandemic. SAFP [online]. 2023, vol.65, n.1, pp.1-9. ISSN 2078-6204.  http://dx.doi.org/10.4102/safp.v65i1.5700.

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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