COVID-19: Understanding Its Impact in Kenya

On December 31, 2019, the Chinese government reported a new type of pneumonia-like illness affecting people in Wuhan. This illness was later identified as COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of now, over 636 million people worldwide have been infected, with more than 6.6 million deaths linked to this disease.

The virus rapidly spread from Wuhan, prompting the World Health Organization (WHO) to declare COVID-19 a pandemic on March 11, 2020. In Kenya, the first confirmed case was reported on March 12, 2020. Since then, the country has recorded about 340,888 cases, with around 334,208 recoveries and 5,684 deaths. Those with underlying health issues have been found to be more vulnerable to severe Symptoms and higher Mortality rates.

COVID-19 symptoms can vary greatly among individuals. Some may not show any symptoms at all, while others may experience issues ranging from a dry cough and shortness of breath to severe pneumonia and respiratory failure, which might require intensive care. Many studies have looked into what factors lead to severe cases of COVID-19, yet there is still a lack of understanding of how different health conditions affect the disease's progression, especially in diverse populations like that of Kenya.

#How COVID-19 Spreads

SARS-CoV-2 primarily spreads through respiratory droplets from infected individuals. Here are the main ways the virus can be transmitted:

1. Breathing in tiny droplets that the virus is in.
2. Droplets landing on the nose, mouth, or eyes.
3. Touching your face with hands that have come in contact with contaminated surfaces.

Infected respiratory droplets are released during activities like talking, breathing, exercising, singing, sneezing, and coughing. Larger droplets fall quickly, while smaller ones can linger in the air longer, raising the risk of transmission. The further away you are from someone with the virus, the lower your risk of getting infected.

Certain factors can increase the chance of getting infected, such as poor ventilation in enclosed spaces and being close to someone who is infected, especially if they are speaking loudly or exercising.

#Preventing COVID-19 Transmission

Research indicates that contamination from surfaces is a minor contributor to new infections. Instead, breathing in the virus is a significant mode of transmission. Despite limited knowledge about SARS-CoV-2, recommended preventative measures remain effective.

Some effective measures include:

• Practicing social distancing.
• Wearing well-fitting masks.
• Ensuring proper ventilation in indoor spaces.
• Avoiding crowds.

These actions help reduce the chances of the virus being breathed in or touching exposed mucous membranes. Good hygiene practices are also essential to prevent spreading the virus through contaminated surfaces and hands.

#Risk Factors for SARS-CoV-2

Infection rates show that adult males, typically aged between 34 and 59 years, are more likely to get COVID-19. Chronic conditions such as heart disease, strokes, and diabetes heighten the risk for severe illness. The elderly, especially those over 60 with pre-existing conditions, are at the highest risk.

Research also indicates that children under 15 generally have low infection rates. Most young patients have mild symptoms, and some remain asymptomatic despite testing positive.

#Clinical Course and Prognosis

In a study in Chicago, it was found that 21.1% of tested patients had COVID-19, with 17.1% of those requiring Hospitalization. Common symptoms included cough, fever, and shortness of breath. Factors like age and pre-existing heart conditions increased the likelihood of hospitalization and severe cases.

In various studies, underlying conditions like high blood pressure and diabetes were found to be prevalent in severe cases and deaths. In areas such as Southern Africa, high mortality rates were associated with Comorbidities, including HIV.

#Research Design

The study was a multicenter retrospective cohort analysis focusing on hospitalized patients from March 2020 to May 2022. It involved collecting patient data, including clinical signs and lab results, during admission and throughout their hospital stay.

#Statistical Analysis

The data was presented in percentages, frequencies for categorical variables, and mean values for continuous variables. A chi-square test was used for comparisons, and methods like Kaplan Meier were applied to analyze how comorbidities affected overall survival. Logistic regression was used to assess risks linked to pre-existing conditions, while Cox proportional hazards models determined connections to COVID-19 mortality.

#Ethical Considerations

All collected data was kept confidential, and the study obtained permission from local authorities. Ethical approval was sought to ensure the research met all necessary guidelines, with strict data management to protect the identities of participants.

#Clinical Characteristics of Hospitalized Patients with COVID-19

Among the patients studied, 43% had comorbid conditions, while 57% did not. Of those with comorbidities, 78% had diabetes, 28% had high blood pressure, and 36% reported a fever. Other symptoms included cough (61%), general malaise (33%), chest pain (32%), and headache (40%). A small percentage reported difficulty breathing or gastrointestinal symptoms.

#Laboratory Findings of COVID-19 Infection Survivors and Non-Survivors

The average age among survivors was 53 years, while non-survivors averaged 63 years. The data showed that survivors typically spent about four days sick before hospitalization compared to 4.4 days for those who did not survive.

Blood pressure readings were generally lower in survivors. Oxygen saturation levels also indicated that non-survivors had more significant respiratory issues, which could be reflected in their longer stays in intensive care.

#Association of Various Potential Risk Factors on Patients with COVID-19 at Admission

Data showed significant relationships between comorbidities like hypertension and diabetes with mortality rates. Higher rates of symptoms such as fever and breathing difficulties were connected to higher death rates. However, vaccination status did not significantly affect mortality risk, suggesting other factors played a larger role.

#Factors Associated with COVID-19 Death by Bivariate Binary Logistic Regression

Various health markers were identified as contributing factors to increased death risk. For example, each unit increase in diastolic pressure or heart rate raised the odds of mortality. Intensive care admissions were closely linked to death rates. On the other hand, age and certain symptoms were not significant predictors of mortality.

#Factors Associated with COVID-19 Death by Multivariate Logistic Regression

Individuals with comorbidities showed significantly increased odds of death. Symptoms like fever, chills, and chest pain were also linked to higher mortality. Notably, some vital signs and lab results such as white blood cell count and blood glucose levels were also connected to a greater risk of death.

#Factors Associated with COVID-19 Death by Bivariate Cox PH Model

This model indicated that men had a higher death risk compared to women, and older age groups were at increased risk. Comorbidities, symptoms, and specific laboratory values were closely associated with higher mortality.

#Factors Associated with COVID-19 Death by Multivariate Cox PH Model (Adjusted)

The risk of death was significantly higher for those with comorbidities compared to those without. Other factors included symptoms like loss of smell and certain lab values. However, gender and age alone did not show a significant impact on mortality in the adjusted model.

#Clinical Characteristics of Respondents

In this study, a higher percentage of male respondents was observed, consistent with other findings highlighting a gender disparity in COVID-19 outcomes. The majority of participants lived in rural areas, with a significant portion being educated at higher levels. A large majority reported being married, which may influence social support and health outcomes.

#Symptoms Reported by Respondents

The most common symptoms reported included fever and cough. A smaller percentage of respondents reported severe symptoms, suggesting that many had mild or moderate cases. Chest pain was noted in almost a third of the sample, pointing to potential heart-related complications.

#Conclusion

The findings reveal a complex relationship between various factors and mortality due to COVID-19. Comorbidities, specific symptoms, and various lab results greatly influence the severity of illness and outcomes. Monitoring at-risk individuals and taking preventative measures can help reduce the impact of the virus.

#Recommendations

In light of these findings, it is crucial to:

• Monitor those with existing health conditions closely.
• Identify and manage symptoms early.
• Keep track of lab values that could signal severe illness.
• Promote vaccination and public health measures to limit the spread of COVID-19.

Ultimately, collaboration among healthcare providers, researchers, and communities is essential in managing COVID-19 effectively. Continued research will be vital in understanding the disease better and improving health outcomes.