Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

Peter M. Mphekgwana (), Musa E. Sono-Setati, Tania V. Mokgophi, Yehenew G. Kifle, Sphiwe Madiba and Perpetua Modjadji
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Peter M. Mphekgwana: Research Administration and Development, University of Limpopo, Polokwane 0727, South Africa
Musa E. Sono-Setati: Department of Public Health Medicine, University of Limpopo, Private Bag X1106, Sovenga, Polokwane 0727, South Africa
Tania V. Mokgophi: Department of Statistics and Operations Research, University of Limpopo, Polokwane 0727, South Africa
Yehenew G. Kifle: Department of Mathematics and Statistics, University of Maryland Baltimore County, Baltimore, MD 21250, USA
Sphiwe Madiba: Faculty of Health Sciences, University of Limpopo, Polokwane 0727, South Africa
Perpetua Modjadji: Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa

IJERPH, 2023, vol. 20, issue 10, 1-15

Abstract: Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21–33%), hypertension (32–43%), diabetes (34–47%), and HIV (31–45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.

Keywords: metabolic syndrome; non-communicable diseases; HIV; COVID-19; hospitalization; South Africa (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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Citations: View citations in EconPapers (1)

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