Factors associated with development of symptomatic disease in Ethiopian COVID-19 patients: a case-control study

• Main Authors: Tigist W. Leulseged, Degu G. Alemahu, Ishmael S. Hassen, Endalkachew H. Maru, Wuletaw C. Zewde, Negat W. Chamiso, Kalkidan T. Yegele, Daniel S. Abebe, Firaol M. Abdi, Etsegenet Y. Minyelshewa, Tegenu G. Gerbi, Helen T. Hagos
• Format: Article
• Language: English
• Published: BMC 2021-08-01
• Series: BMC Infectious Diseases
• Subjects: Symptomatic/ asymptomatic COVID-19; Case-control; Logistic regression; Ethiopia
• Online Access: https://doi.org/10.1186/s12879-021-06465-1

Abstract Background Studies show that having some symptoms seems to be associated with more severe disease and poor prognosis. Therefore, knowing who is more susceptible to symptomatic COVID-19 disease is important to provide targeted preventive and management practice. The aim of the study was to assess factors associated with the development of symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia. Methods A case-control study was conducted from August to September 2020 among a randomly selected 730 COVID-19 patients (337 Asymptomatic and 393 Symptomatic patients). Chi-square test and independent t-test were used to detect the presence of a statistically significant difference in the characteristics of the cases (symptomatic) and controls (asymptomatic), where p-value of < 0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the independent variables and developing symptomatic COVID-19 where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results. Results The result of the multivariable binary logistic regression shows that age group (AOR = 1.89, 95% CI = 1.25, 2.87, p-value = 0.002 for 30–39 years; AOR = 1.69, 95% CI = 1.06, 2.73, p-value = 0.028 for 40–49 years and AOR = 4.42, 95% CI = 2.75, 7.12, p-value = 0.0001 for ≥50 years), sex (AOR = 1.76, 95% CI = 1.26, 2.45, p-value = 0.001) and history of diabetes mellitus (AOR = 3.90, 95% CI = 1.92, 7.94, p-value = 0.0001) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients. Conclusions Developing a symptomatic COVID-19 disease was found to be associated with exposures of old age, male sex, and being diabetic. Therefore, patients with the above factors should be given enough attention in the prevention and management process, including inpatient management, to pick symptoms earlier and to manage accordingly so that these patients can have a favorable treatment outcome.