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Tshongo C, Baguma M, Mateso G, Makali SL, Bedha A, Mwene‐Batu P, Mihigo M, Nzabara F, Balola C, Kabuya P, Bapolisi A, Masimango MI, Bahizire E, Maheshe‐Balemba G, Shindano TA, Cirhuza C. Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study. Health Sci Rep 2024; 7:e1803. [PMID: 38213779 PMCID: PMC10782469 DOI: 10.1002/hsr2.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
Background and Aim The coronavirus disease 2019 (COVID-19) pandemic was a priority public health problem because of its high mortality rate. This study mainly aimed to determine factors associated with a poor outcome in COVID-19 hospitalized patients in South-Kivu, an eastern province of the Democratic Republic of the Congo (DRC). Methods This observational study retrospectively evaluated medical records of patients consecutively admitted for probable or confirmed COVID-19 between May 01 and July 31, 2020 at the Hôpital Provincial Général de Référence de Bukavu (HPGRB), a tertiary hospital located in South-Kivu. A binary logistic regression model was performed to determine the predictors of mortality. Results A total of 157 hospitalized COVID-19 patients aged 57.7 (13.2) years were included in this study. Male gender (69.4%), older age (52.9%), medical history of diabetes (38.2%), and arterial hypertension (35.1%) were the most frequent risk factors. Most patients presented with fever (73.3%), cough (72.6%), and dyspnea (66.2%). Overall, 45.1% of patients died. Intrahospital mortality was significantly associated with advanced age [odds ratio, OR (95% confidence interval, CI) = 2.34 (1.06-5.38)], hypoxemia [OR (95% CI) = 4.67 (2.02-10.77)], hyperglycemia [OR (95% CI) = 2.14 (1.06-4.31)], kidney failure [OR (95% CI) = 2.82 (1.4-5.68)], hyperleukocytosis [OR (95% CI) = 3.33 (1.67-6.66)], and higher C-reactive protein (CRP) levels [OR (95% CI) = 3.93 (1.93-8.01)]. After adjustment for various covariates, only higher CRP levels [OR (95% CI) = 3.23 (1.23-8.5)] and hyperglycemia [OR (95% CI) = 2.5 (1.02-6.11)] at admission were independently associated with mortality. Conclusion Hyperglycemia and marked inflammatory syndrome were the major predictors of poor outcomes in patients hospitalized for COVID-19 in South-Kivu. These two factors should be quantified at hospital admission to establish the patient's prognosis.
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Affiliation(s)
- Christian Tshongo
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Marius Baguma
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Guy‐Quesney Mateso
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Samuel Lwamushi Makali
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Aline Bedha
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pacifique Mwene‐Batu
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Martine Mihigo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Cordule Balola
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pierre Kabuya
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Achille Bapolisi
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Mannix I. Masimango
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Esto Bahizire
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Ghislain Maheshe‐Balemba
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Tony A. Shindano
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Cikomola Cirhuza
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
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Mateso GQ, Makali S, Shamamba A, Ntaboba B, Urbain V, Eric M, Murhabazi E, Mihigo M, Mwene-Batu P, Kabego L, Baguma M. Etiologies and factors associated with mortality in patients with non-traumatic coma in a tertiary hospital in Bukavu, eastern Democratic Republic of the Congo. Heliyon 2023; 9:e18398. [PMID: 37520991 PMCID: PMC10382283 DOI: 10.1016/j.heliyon.2023.e18398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/01/2023] Open
Abstract
Non-traumatic coma (NTC) is a common medical condition often associated with poor outcomes. Identifying underlying causes is crucial for effective management and prognostication, particularly in resource-poor settings. This study aimed to identify the most common causes and prognostic factors of NTC in a tertiary hospital in Bukavu, in the eastern Democratic Republic of the Congo (DRC), using the Glasgow Coma Scale (GCS) as well as other simple and affordable clinical and paraclinical tools. This retrospective observational study included 219 consecutive patients admitted to the intensive care unit of the Provincial General Hospital of Bukavu between January 2016 and December 2018. Sociodemographic, clinical, and laboratory data were also collected. Bivariate and multivariate analyses were performed to identify different causes and factors associated with poor outcomes in these patients. The median age of the patients was 49 (interquartile range [IQR]: 33-61) years, and they were predominantly men (62.8%). The most common causes of NTC were stroke (25.7%), acute metabolic complications of diabetes (21.9%), and primary brain infections (meningoencephalitis, 16.0%; and cerebral malaria, 14.2%). The NTC-related in-hospital mortality rate was 35.2%. A high mortality was significantly and independently associated with a GCS<7 (adjusted odds ratio [OR]: 4.30, 95% confidence interval [CI]: 1.73-10.71), the presence of meningismus at clinical evaluation (adjusted odds ratio [aOR] 3.86, 95%CI: 1.41-10.55), oxygen saturation <90% (aOR 3.99, 95%CI: 1.71-9.28), the consumption of traditional herbal medicines prior to hospital admission (aOR 2.82, 95%CI: 1.16-6.86), and elevated serum creatinine (aOR 1.64, 95%CI: 1.17-2.29). In conclusion, clinical neurological examinations, along with simple and affordable paraclinical investigations, can provide sufficient information to determine the etiology of NTC and evaluate the prognosis of comatose patients, even in resource-poor settings. Physicians may use the GCS as a simple, reliable, and affordable tool to identify patients who require special attention and care.
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Affiliation(s)
- Guy-Quesney Mateso
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
| | - Samuel Makali
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, The Democratic Republic of the Congo
| | - Ashuza Shamamba
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
| | - Balola Ntaboba
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
| | - Victoire Urbain
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
| | - Musingilwa Eric
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
| | - Emmanuel Murhabazi
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
| | - Martine Mihigo
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
| | - Pacifique Mwene-Batu
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
- École Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, The Democratic Republic of the Congo
| | - Landry Kabego
- Department of Medical Biology, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Marius Baguma
- Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, The Democratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH), Université Catholique de Bukavu (UCB), Bukavu, The Democratic Republic of the Congo
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