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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Peter M. Mphekgwana & Musa E. Sono-Setati & Tania V. Mokgophi & Yehenew G. Kifle & Sphiwe Madiba & Perpetua Modjadji, 2023. "Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression," IJERPH, MDPI, vol. 20(10), pages 1-15, May.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:10:p:5799-:d:1145243
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    References listed on IDEAS

    as
    1. Peter M. Mphekgwana & Nancy Malema & Kotsedi D. Monyeki & Tebogo M. Mothiba & Mpsanyana Makgahlela & Nancy Kgatla & Irene Makgato & Tholene Sodi, 2020. "Hypertension Prevalence and Determinants among Black South African Adults in Semi-Urban and Rural Areas," IJERPH, MDPI, vol. 17(20), pages 1-12, October.
    2. Naomi Hlongwane & Sphiwe Madiba, 2020. "Navigating Life with HIV as an Older Adult in South African Communities: A Phenomenological Study," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
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    Cited by:

    1. Glory Makhado & Busisiwe Ntuli & Lindiwe Zungu & Ntevhe Thovhogi & Peter Modupi Mphekgwana & Sogolo Lucky Lebelo & Sphiwe Madiba & Perpetua Modjadji, 2024. "The Wellbeing of Healthcare Workers during COVID-19 Era in Public Primary Health Facilities in Johannesburg, South Africa," IJERPH, MDPI, vol. 21(3), pages 1-20, March.

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