Abstract Preview:
Background Despite global efforts to mitigate COVID-19 infection through vaccination and therapeutic interven-tions, morbidity and mortality rates continued at variable rates. Although mortality risk and clinical features of COVID-19 are well-documented, recovery patterns and prognostic factors post-admission remain inconclusive, particu-larly in resource-limited settings like Ethiopia. This systematic review and meta-analysis (SRM) aimed to estimatethe pooled incidence rate of recovery and predictors among hospitalized COVID-19 patients in Ethiopia.Methods We searched (N = 1,191) articles using Preferred Reporting Items for Systematic Reviews and Meta-Anal-yses (PRISMA) guideline from PubMed/MEDLINE (N = 755), Scopus (N = 137), Web of Science (N = 84), Science Direct(N = 148), Cochran (N = 25), and Google Scholar searching (N = 42) from December 2019 to February 2024. The datawere extracted using a Microsoft Excel spreadsheet and exported to Stata TM version 17.0 for further analysis. The Arti-cle quality was assessed using the Joanna Briggs Institute checklist. The pooled incidence rate of recovery was esti-mated using a weighted inverse variance random-effects meta-regression. Heterogeneity among studies was evalu-ated using the I2 statistic. Subgroup analyses and sensitivity tests were also conducted to explore publication bias. Thisfile is registered in international Prospero with ID (CRD42024518569).Result Sixteen (N = 16) published studies with 7,676 hospitalized COVID-19 patients were included in the finalreport. The mean age of participants ranged from 29 (± 17) to 57.5 (± 3) years, with male patients constitutingthe largest proportion of participants, 4,491(58.5%). During recovery screening, 6,304(82.21%) cases were dischargedas improved, 159 (2.1%) attriters, and 818 (10.6%) died during inpatient treatment. The pooled incidence of recovery,mortality, and attrition rates were found to be 82.32% (95% CI: 78.81–85.83; I 2 = 94.8%), 14.3% (I2 = 98.45%), and 2.7%(I 2 = 81.34%), respectively. Incidence of recovery rate varied across regions and epidemic phases, with the highest rateobserved in Addis Ababa (89.94%, I 2 = 78.33%) and the lowest reported in the Tigray region (59.7%, I2 = 0.0%). Acrossepidemic phases, the recovery rate was 88.05% (I 2 = 29.56%) in Phase II, 84.09% (I2 = 97.57%) in Phase I, and 78.92%(I 2 = 96.9%) in Phase III, respectively. Factors included being aged 15–30 years (pooled OR = 2.01), male sex (pooledOR = 1.46), no dyspnea (pooled OR = 2.4; I 2 = 79%), and no baseline comorbidities (pooled OR = 1.15; I2 = 89.3%) werepredictors for recovery.Conclusion and recommendation In Ethiopia, more than eight out of ten hospitalized COVID-19 patientsrecovered after inpatient treatment. However, the incidence of recovery rates varied significantly across epidemicphases, study settings, and regions. Factors including younger age, male sex, no dyspnea (shortness of breathing), and no underlying comorbidity heightened recovery. It is highly recommended those inpatients cares should focuson high-risk groups (older adults) and implement standardized treatment protocols in each study setting. Regionswith lower recovery rates need aid in logistical support and training for healthcare providers.Keywords Admitted patients, COVID-19 infection, Ethiopia, SARS-CoV- 2 cases
Full Abstract:
Background Despite global efforts to mitigate COVID-19 infection through vaccination and therapeutic interven-tions, morbidity and mortality rates continued at variable rates. Although mortality risk and clinical features of COVID-19 are well-documented, recovery patterns and prognostic factors post-admission remain inconclusive, particu-larly in resource-limited settings like Ethiopia. This systematic review and meta-analysis (SRM) aimed to estimatethe pooled incidence rate of recovery and predictors among hospitalized COVID-19 patients in Ethiopia.Methods We searched (N = 1,191) articles using Preferred Reporting Items for Systematic Reviews and Meta-Anal-yses (PRISMA) guideline from PubMed/MEDLINE (N = 755), Scopus (N = 137), Web of Science (N = 84), Science Direct(N = 148), Cochran (N = 25), and Google Scholar searching (N = 42) from December 2019 to February 2024. The datawere extracted using a Microsoft Excel spreadsheet and exported to Stata TM version 17.0 for further analysis. The Arti-cle quality was assessed using the Joanna Briggs Institute checklist. The pooled incidence rate of recovery was esti-mated using a weighted inverse variance random-effects meta-regression. Heterogeneity among studies was evalu-ated using the I2 statistic. Subgroup analyses and sensitivity tests were also conducted to explore publication bias. Thisfile is registered in international Prospero with ID (CRD42024518569).Result Sixteen (N = 16) published studies with 7,676 hospitalized COVID-19 patients were included in the finalreport. The mean age of participants ranged from 29 (± 17) to 57.5 (± 3) years, with male patients constitutingthe largest proportion of participants, 4,491(58.5%). During recovery screening, 6,304(82.21%) cases were dischargedas improved, 159 (2.1%) attriters, and 818 (10.6%) died during inpatient treatment. The pooled incidence of recovery,mortality, and attrition rates were found to be 82.32% (95% CI: 78.81–85.83; I 2 = 94.8%), 14.3% (I2 = 98.45%), and 2.7%(I 2 = 81.34%), respectively. Incidence of recovery rate varied across regions and epidemic phases, with the highest rateobserved in Addis Ababa (89.94%, I 2 = 78.33%) and the lowest reported in the Tigray region (59.7%, I2 = 0.0%). Acrossepidemic phases, the recovery rate was 88.05% (I 2 = 29.56%) in Phase II, 84.09% (I2 = 97.57%) in Phase I, and 78.92%(I 2 = 96.9%) in Phase III, respectively. Factors included being aged 15–30 years (pooled OR = 2.01), male sex (pooledOR = 1.46), no dyspnea (pooled OR = 2.4; I 2 = 79%), and no baseline comorbidities (pooled OR = 1.15; I2 = 89.3%) werepredictors for recovery.Conclusion and recommendation In Ethiopia, more than eight out of ten hospitalized COVID-19 patientsrecovered after inpatient treatment. However, the incidence of recovery rates varied significantly across epidemicphases, study settings, and regions. Factors including younger age, male sex, no dyspnea (shortness of breathing), and no underlying comorbidity heightened recovery. It is highly recommended those inpatients cares should focuson high-risk groups (older adults) and implement standardized treatment protocols in each study setting. Regionswith lower recovery rates need aid in logistical support and training for healthcare providers.Keywords Admitted patients, COVID-19 infection, Ethiopia, SARS-CoV- 2 cases