Clinical predictors of Covid-19 mortality in a tertiary hospital in Lagos, Nigeria: A retrospective cohort study.

Background: The predictors of mortality among patients presenting with severe to critical disease in Nigeria are presently unknown. Aim: The aim of this study was to identify the predictors of mortality among patients with COVID-19 presenting for admission in a tertiary referral hospital in Lagos, Nigeria. Patients and Methods: The study was a retrospective study. Patients' sociodemographics, clinical characteristics, comorbidities, complications, treatment outcomes, and hospital duration were documented. Pearson's Chi-square, Fischer's Exact test, or Student's t-test were used to assess the relationship between the variables and mortality. To compare the survival experience across medical comorbidities, Kaplan Meir plots and life tables were used. Univariable and multivariable Cox-proportional hazard analyses were conducted. Results: A total of 734 patients were recruited. Participants' age ranged from five months to 92 years, with a mean ± SD of 47.4 ± 17.2 years, and a male preponderance (58.5% vs. 41.5%). The mortality rate was 9.07 per thousand person-days. About 73.9% (n = 51/69) of the deceased had one or more co-morbidities, compared to 41.6% (252/606) of those discharged. Patients who were older than 50 years, with diabetes mellitus, hypertension, chronic renal illness, and cancer had a statistically significant relationship with mortality. Conclusion: These findings call for a more comprehensive approach to the control of non-communicable diseases, the allocation of sufficient resources for ICU care during outbreaks, an improvement in the quality of health care available to Nigerians, and further research into the relationship between obesity and COVID-19 in Nigerians.

Pattern and outcome of adult tetanus in Ile-Ife, Nigeria.

OBJECTIVE: This is a retrospective study of all adult patients with tetanus managed at the Obafemi Awolowo University Teaching Hospitals Complex from 1995-2004. The aim was to study the pattern of adult tetanus in Ile-Ife, Nigeria, and see what improvements could be made in the future in particular with regard to decreasing the prevalence in our environment. METHOD: Data was obtained from the hospital records of all the patients, the admission and discharge registers of the medical wards of the hospital. RESULT: 79 adult patients with tetanus were managed during the study period and they accounted for 44% of neurological admissions. There were 56 males and 23 females giving a M:F ratio of 2.4 to 1. 45 (57%) of the patients were under 30 yrs of age and two-thirds (67%) had puncture wounds in the lower limbs. 20 patients (25%) had mild tetanus, 16 (20%) had moderate disease and 43 (55%) had severe tetanus. The patients were treated with tetanus antitoxin, antibiotics and sedatives. The mortality rate was 45% and laryngeal spasm was the most common cause of death. None of the patients was managed in the intensive care unit (ICU). CONCLUSION: Tetanus remains a major public health problem in Nigeria. It is commonly associated with high mortality due to late presentation. Health education should be promoted to reduce the unacceptable prevalence in our practice setting.