COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria.

Kelly ElimianAnwar Musah Carina KingEhimario IgumborPuja Myles Olaolu Aderinola Cyril Oshomah Erameh Nwachukwu E William Oluwatosin Wuraola AkandeNdembi NicaiseOladipo Ogunbode Abiodun Egwuenu Emily E Crawford Giulia GaudenziIsmail Abdus-SalamOlubunmi Olopha Yahya DisuAbimbola BowaleCyprian OshomaCornelius Ohonsi Chinedu Chukwujekwu Arinze Sikiru BadaruBlessing EbhodagheZaiyad Habib Michael Olugbile Chioma Cindy Dan-Nwafor Jafiya AbubakarEmmanuel PembiLauryn DunkwuIfeanyi IkeEkaete Alice TobinBamidele MutiuRejoice Luka-LawalObinna NwaforMildred OkowaChidiebere Ezeokafor Emem IwaraSebastian YennanSunday EziechinaDavid Olatunji Olanrewaju Falodun Emmanuel JosephIfeanyi AbaliTarik MohammedBenjamin YigaKhadeejah Kamaldeen Emmanuel Agogo Nwando Mba John Oladejo Elsie Ilori Olusola ArunaGeoffrey NamaraStephen ObaroKhadeejah HamzaMichael AsuzuShaibu Bello Friday E OkonofuaYusuf DeeniIbrahim Abubakar Tobias Alfvén Chinwe Lucia Ochu Chikwe Ihekweazu

Published in: PLOS global public health (2022)

COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98-57∙73)] than in the second wave [19∙19 (17∙60-20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35-2∙02) and second wave 1∙52 (1∙11-2∙06)], being symptomatic [aIRR 3∙17 (2∙59-3∙89) and 3∙04 (2∙20-4∙21)], and being hospitalised [aIRR 4∙19 (3∙26-5∙39) and 7∙84 (4∙90-12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country's surveillance system during the study.

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