Predisposing Factors Associated with the Severity of the Illness in Adults with Covid-19 in Nepal

Introduction: COVID-19 has currently become a global health hazard to humansociety as the disease has strained healthcare system worldwide. Individualswith increased risk of severity of the disease in particular need to be identifiedfor the protection, better health care management, and for in search of thepotential treatment. We aimed to identify the rate of the severity of COVID-19illness and its associated potential predictive factors in Nepal. Methods: we conducted a cross-sectional, observational study in 298 individualsconfirmed with COVID-19 cases admitted at COVID-19 care center at NepalArmed Police Force Hospital, Kathmandu, Nepal for two months (Dec 2020- Jan2021). Disease severity was evaluated as a core variable and age, sex, BMI,smoking history, alcohol history, Hypertension, diabetes mellitus were evaluatedas confounders. Results: Mean ages of the patients were 40.79±16.04 years, and about two thirdof the patients were male 146 (73.7%). More than half 57.1% (95%CI: 52.42-61.51)population had mild infection, whereas 16.7% (5%CI: 7.4-24.6%) had severe/critical ill. Each 1- year increase in age (OR: 1.05; P<0.001; 95%CI:1.030-1.081),each 1 unit increase in BMI (OR:1.12; 95%CI:1.02-1.25;P:0.033; P<0.033), comorbidillness (5.79; 95%CI;2.51-13.33; P<0.001), hypertension (OR:5.95;95%CI:2.66-13.30:P<0.001), diabetes mellitus(OR:3.26; 95%CI:1.30-8.15: P<0.005), fever(OR:34.64; 95%CI:7.98-150.38; P<0.001) were independently associated withsevere cases. Hypertension (OR: 5.22; 95%CI: 1.89-14.41; P=0.001) remainedsignificant predictor for increased severity of the disease even after adjustingfor age, sex, BMI, smoking history, comorbid illness, and diabetes mellitus. Conclusion: The majority of the patients with COVID-19 had mild illness, and16.7% manifested severe illness. Age, BMI, comorbidity, hypertension, diabetesmellitus, and temperature were identified as predictive factor for severity of thedisease, and hypertension remained the independent factor for severity of thedisease even after adjusting for significant confounders.