BMC infectious diseases · 2025
Prevalence and predictors of critical COVID-19 pneumonia among patients with COVID-19 admitted at Nyarugenge major COVID-19 Referral Center in Rwanda.
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Paul Mukantagengwa Marie, Raphael Ndahimana, Menelas Nkeshimana, Deborah Abimana, Bonaventure Uwineza Jean, Pasteur Dushimimana, Beata Murekatete Marie, Epaphrodite Muhizi, Valens Hafashimana, Prosper Ndayisaba, Shomuyiwa Deborah Oluwaseun, Samuel Muhirwa, Eric Rutaganda
Аннотация
BACKGROUND: Coronavirus Disease 2019(COVID-19) pneumonia, caused by the Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2 virus), remains a significant global health challenge, contributing to millions of cases and deaths worldwide, including a substantial burden in Rwanda. Severe and critical cases often lead to respiratory failure, multi-organ dysfunction, and increased mortality. Despite global research, data on predictors of critical illness among hospitalized COVID-19 patients in Rwanda remain limited, highlighting the need for context-specific studies. This study aimed to assess the prevalence and identify risk factors for critical COVID-19 pneumonia among patients admitted to the Nyarugenge Major COVID-19 Referral Center in Rwanda.
METHODS: A mixed-study design combining retrospective and prospective designs was conducted from February to October 2021, and we included 320 patients aged 15 to 65 years admitted with severe or critical COVID-19 pneumonia. Data were collected on socio-demographic factors, vital signs, and clinical symptoms. Multivariate logistic regression was performed using Stata 17 to identify independent predictors of critical illness.
RESULTS: Of the 320 patients, 30% presented with critical illness, while 70% had severe illness. Independent predictors of critical illness included oxygen saturation ≤ 90% {Adjusted Odds Ratio (AOR) = 5.83, 95% Confidence Interval(CI): 2.95-11.52, p < 0.001), respiratory rate > 20 beat per minute(bpm), (AOR = 2.34, 95% CI: 1.11-4.93, p < 0.05), and heart rate > 100 bpm (AOR = 2.49, 95% CI: 1.32-4.67, p < 0.01).
CONCLUSIONS: Critical illness was prevalent in 30% of patients, with hypoxia, tachypnea, and tachycardia as significant predictors. These findings identify key clinical predictors of critical COVID-19 pneumonia and suggest that monitoring these indicators may help guide early intervention and optimize resource allocation in Rwanda and similar low- and middle-income settings.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: A mixed-study design combining retrospective and prospective designs was conducted from February to October 2021, and we included 320 patients aged 15 to 65 years admitted with severe or critical COVID-19 pneumonia. Data were collected on socio-demographic factors, vital signs, and clinical symptoms. Multivariate logistic regression was performed using Stata 17 to identify independent predictors of critical illness.
RESULTS: Of the 320 patients, 30% presented with critical illness, while 70% had severe illness. Independent predictors of critical illness included oxygen saturation ≤ 90% {Adjusted Odds Ratio (AOR) = 5.83, 95% Confidence Interval(CI): 2.95-11.52, p < 0.001), respiratory rate > 20 beat per minute(bpm), (AOR = 2.34, 95% CI: 1.11-4.93, p < 0.05), and heart rate > 100 bpm (AOR = 2.49, 95% CI: 1.32-4.67, p < 0.01).
CONCLUSIONS: Critical illness was prevalent in 30% of patients, with hypoxia, tachypnea, and tachycardia as significant predictors. These findings identify key clinical predictors of critical COVID-19 pneumonia and suggest that monitoring these indicators may help guide early intervention and optimize resource allocation in Rwanda and similar low- and middle-income settings.
CLINICAL TRIAL NUMBER: Not applicable.