Glob Health Action. 2025 Dec;18(1):2572010. doi: 10.1080/16549716.2025.2572010. Epub 2025 Nov 17.
ABSTRACT
BACKGROUND: Data are limited on the impact of chronic underlying conditions on COVID-19 treatment outcomes in sub-Saharan Africa.
OBJECTIVES: Determine the effect of underlying conditions on COVID-19 severity and treatment outcomes in Kenya.
METHODS: We conducted a retrospective cohort study using routine medical records from Kenya’s three large COVID-19 treatment centers. We examined two outcomes: mortality and clinical severity. Patients with lower respiratory tract illness without tachypnoea or difficulty in breathing were considered to have mild COVID-19. Underlying conditions were based on documentation in medical records. Logistic regression models assessed associations between underlying conditions and COVID-19 severity and mortality.
RESULTS: Among the 1,123 hospitalized COVID-19 patients included in the analysis, 59% (n = 664) had at least one underlying condition, 24.9% (n = 261) had severe disease, and 32.5% (n = 365) died. Hypertension (61.1%; n = 409), diabetes (38.9%; n = 258), and HIV (14.2%; n = 94) were the most common underlying conditions. Deaths were significantly higher among hospitalized COVID-19 patients with underlying conditions (35.4%) than those without (28.3%) (p = 0.01). The adjusted odds of severe COVID-19 were 50% higher among patients with hypertension (adjusted odds ratio [aOR] 1.50; 95% confidence interval [CI] 1.11-2.02). Mortality during COVID-19 hospitalization was nearly threefold higher among patients with heart disease (aOR 2.82; 95% CI 1.18-6.74) and 37% higher among patients with diabetes (aOR 1.37; 95% CI 1.00-1.88).
CONCLUSION: Patients with underlying conditions hospitalized for COVID-19 were more likely to die than those without. Hypertension was independently associated with disease severity, while heart disease and diabetes were independently associated with death during COVID-19 treatment.
PMID:41243672 | DOI:10.1080/16549716.2025.2572010
