Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali
Abstract Objectives To analyze the clinical and biological characteristics and to evaluate the risk factors associated with the mortality of patients with COVID-19 in Commune IV of the District of Bamako. Methods The cohort consisted of COVID-19 patients managed from March 2020 to June 2022 at the B...
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BMC
2025-01-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-025-10456-x |
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| author | Abdoulaye Mamadou Traore Mamadou Karim Toure Yaya Ibrahim Coulibaly Modibo Keita Bakary Diarra Salif Sanafo Garan Dabo Mamoudou Kodio Bourama Traore Aminata Diarra Adama Dicko Hamar A. Traore Ousmane Faye Daouda K. Minta |
| author_facet | Abdoulaye Mamadou Traore Mamadou Karim Toure Yaya Ibrahim Coulibaly Modibo Keita Bakary Diarra Salif Sanafo Garan Dabo Mamoudou Kodio Bourama Traore Aminata Diarra Adama Dicko Hamar A. Traore Ousmane Faye Daouda K. Minta |
| author_sort | Abdoulaye Mamadou Traore |
| collection | DOAJ |
| description | Abstract Objectives To analyze the clinical and biological characteristics and to evaluate the risk factors associated with the mortality of patients with COVID-19 in Commune IV of the District of Bamako. Methods The cohort consisted of COVID-19 patients managed from March 2020 to June 2022 at the Bamako Dermatology Hospital and the Pasteur Polyclinic in Commune IV in Bamako. The studied variables were sociodemographic, clinical, and biological. For the analysis of deaths, explanatory variables were grouped into sociodemographic factors, comorbidities and symptoms. Binomial logistic regression models were used to identify mortality associated risk factors. Results Among the 1319 included patients, 38.4% were asymptomatic, 46% and 15.5% developed moderate or severe COVID-19 respectively. The predominant signs were cough (48.5%), respiratory difficulty (24.6%) and headache (19.7%). Male were more common (58.2%). High blood pressure (19.9%) and diabetes (10%) were the main comorbidities. D-dimers < 0.5 μg/l was found in 53.3% of cases and the mean hemoglobin level was 12.9 ± 1.7 g/l. The case fatality rate was 3.71% in our series. In bivariate analysis, age > 60 years, high blood pressure, diabetes, clinical severity, D-dimers < 0.5 μg/l were associated with death. Using binomial logistic regression method, age > 60 years, increased heart rate, disease severity level and mainly acute respiratory distress syndrome (polypnea, difficulty breathing) were the factors found associated with death. After adjusting for all the assessed factors, age < 60 years [aHR = 0.15 (0.06–0.35)] and administration of azithromycin [aHR = 0.31 (0.1–0.97)] were protective factors while higher respiratory rate [aHR = 1.14 (1.07–1.22)] and difficulty breathing [aHR = 3.06 (1.03–9.13)] were risk factors associated with death. Conclusion These main findings elucidate the factors associated with severity and lethality external of health care system constraints. Advanced age, higher heart rate and the development of respiratory distress were the factors significantly associated with increased fatalities. |
| format | Article |
| id | doaj-art-8f73b3bceee645ca9e1508ebb0853dcb |
| institution | Kabale University |
| issn | 1471-2334 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj-art-8f73b3bceee645ca9e1508ebb0853dcb2025-01-19T12:11:52ZengBMCBMC Infectious Diseases1471-23342025-01-0125111110.1186/s12879-025-10456-xFactors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, MaliAbdoulaye Mamadou Traore0Mamadou Karim Toure1Yaya Ibrahim Coulibaly2Modibo Keita3Bakary Diarra4Salif Sanafo5Garan Dabo6Mamoudou Kodio7Bourama Traore8Aminata Diarra9Adama Dicko10Hamar A. Traore11Ousmane Faye12Daouda K. Minta13Centre Hospitalier Universitaire du Point G (Point G University Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Polyclinique Pasteur (Pasteur Polyclinic)Polyclinique Pasteur (Pasteur Polyclinic)Hopital du Mali (Mali HospitalHopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Polyclinique Pasteur (Pasteur Polyclinic)Hopital de Dermatologie de Bamako (Bamako Dermatology Hospital)Centre Hospitalier Universitaire du Point G (Point G University Hospital)Abstract Objectives To analyze the clinical and biological characteristics and to evaluate the risk factors associated with the mortality of patients with COVID-19 in Commune IV of the District of Bamako. Methods The cohort consisted of COVID-19 patients managed from March 2020 to June 2022 at the Bamako Dermatology Hospital and the Pasteur Polyclinic in Commune IV in Bamako. The studied variables were sociodemographic, clinical, and biological. For the analysis of deaths, explanatory variables were grouped into sociodemographic factors, comorbidities and symptoms. Binomial logistic regression models were used to identify mortality associated risk factors. Results Among the 1319 included patients, 38.4% were asymptomatic, 46% and 15.5% developed moderate or severe COVID-19 respectively. The predominant signs were cough (48.5%), respiratory difficulty (24.6%) and headache (19.7%). Male were more common (58.2%). High blood pressure (19.9%) and diabetes (10%) were the main comorbidities. D-dimers < 0.5 μg/l was found in 53.3% of cases and the mean hemoglobin level was 12.9 ± 1.7 g/l. The case fatality rate was 3.71% in our series. In bivariate analysis, age > 60 years, high blood pressure, diabetes, clinical severity, D-dimers < 0.5 μg/l were associated with death. Using binomial logistic regression method, age > 60 years, increased heart rate, disease severity level and mainly acute respiratory distress syndrome (polypnea, difficulty breathing) were the factors found associated with death. After adjusting for all the assessed factors, age < 60 years [aHR = 0.15 (0.06–0.35)] and administration of azithromycin [aHR = 0.31 (0.1–0.97)] were protective factors while higher respiratory rate [aHR = 1.14 (1.07–1.22)] and difficulty breathing [aHR = 3.06 (1.03–9.13)] were risk factors associated with death. Conclusion These main findings elucidate the factors associated with severity and lethality external of health care system constraints. Advanced age, higher heart rate and the development of respiratory distress were the factors significantly associated with increased fatalities.https://doi.org/10.1186/s12879-025-10456-xCOVID-19SeverityDeathBamako |
| spellingShingle | Abdoulaye Mamadou Traore Mamadou Karim Toure Yaya Ibrahim Coulibaly Modibo Keita Bakary Diarra Salif Sanafo Garan Dabo Mamoudou Kodio Bourama Traore Aminata Diarra Adama Dicko Hamar A. Traore Ousmane Faye Daouda K. Minta Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali BMC Infectious Diseases COVID-19 Severity Death Bamako |
| title | Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali |
| title_full | Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali |
| title_fullStr | Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali |
| title_full_unstemmed | Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali |
| title_short | Factors of progression to severity and death in COVID-19 patients at two health care sites in Bamako, Mali |
| title_sort | factors of progression to severity and death in covid 19 patients at two health care sites in bamako mali |
| topic | COVID-19 Severity Death Bamako |
| url | https://doi.org/10.1186/s12879-025-10456-x |
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