Clinical, hematological, and biochemical characteristics as well as treatments administered and predictors of survival in covid-19 patients hospitalized at selected central hospitals in Malawi : a retrospective study.
| dc.contributor.author | Munthali, Ackim | |
| dc.date.accessioned | 2025-01-15T11:51:39Z | |
| dc.date.available | 2025-01-15T11:51:39Z | |
| dc.date.issued | 2024 | |
| dc.description | Thesis of Master of Science in One Health Laboratory Diagnostic Sciences. | |
| dc.description.abstract | COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). It can present as asymptomatic, mild, or severe pneumonia, with the latter exhibiting signs of multiorgan dysfunction and contributing to millions of deaths. Limited predictive laboratory markers for identifying COVID-19 severity across populations, including Malawi, delays timely intervention. Hence, this study assessed the clinical, hematological and biochemical characteristics, as well as administered treatments, and predictors of survival in COVID-19 patients hospitalized in Malawi. The study employed a retrospective design of 367 COVID-19 patients hospitalized between 2020 and 2022 at Mzuzu, Queen Elizabeth, and Zomba Central Hospitals. The data was analyzed using IBM SPSS version 26. Numerical variables were checked for normality by Kolmogorov-Smirnov test and compared between survivors and nonsurvivors by Mann–Whitney U-test. Categorical variables were compared by either Chi-square test or Fisher’s exact test where applicable. Univariate and multivariate regression were conducted to ascertain parameters associated with survival during hospitalization. Statistical significance was defined as p< 0.05 for all tests. Of the 367 cases, 59.1% were survivors, with a median age of 44 years, and 40.9% were non-survivors, with a median age of 50.5 years. The majority (51.5%) were males. Overall prevalence of comorbidities was 51.2%, that included HIV (22.9%), hypertension (20.4%), and diabetes mellitus (15.8%). Predominant signs and symptoms were cough (83.1%), dyspnea (78.2%), fever (70.8%), and headache (60.2%). Hematological characteristics displayed elevated leukocytes, neutrophils, and Neutrophil-to-Lymphocyte Ratio in non-survivors. Biochemical characteristics indicated high median levels of γ-glutamyl transferase (γ-GT), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH). Markedly high levels of aspartate transaminase (AST), alanine transaminase (ALT), γ-GT, ALP, LDH, urea, and creatinine (Cr) were in non-survivors. Treatments administered included antibiotics, glucocorticoids, oxygen therapy, enoxaparin, omeprazole, vitamins, zinc, and nevirapine. Non-survival was associated with old age, low oxygen saturation, increased levels of ALT, Cr, LDH, and low albumin alongside hydroxychloroquine use. Thus, the findings suggest that COVID-19 patients who are elderly and present with high levels of ALT, LDH, and creatinine, as well as low albumin and oxygen saturation at the time of admission, should be prioritized for timely and appropriate intervention. | |
| dc.identifier.uri | https://dspace.unza.zm/handle/123456789/9084 | |
| dc.language.iso | en | |
| dc.publisher | The University of Zambia | |
| dc.title | Clinical, hematological, and biochemical characteristics as well as treatments administered and predictors of survival in covid-19 patients hospitalized at selected central hospitals in Malawi : a retrospective study. | |
| dc.type | Thesis |