Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: Retrospective cohort study

Kelly Osezele Elimian*, Chinwe Lucia Ochu, Blessing Ebhodaghe, Puja Myles, Emily E. Crawford, Ehimario Igumbor, Winifred Ukponu, Adobola Olayinka, Olusola Aruna, Chioma Dan-Nwafor, Olatayo Ayodeji Olawepo, Oladipo Ogunbode, Rhoda Atteh, William Nwachukwu, Sudhir Venkatesan, Chijioke Obagha, Samuel Ngishe, Kabir Suleiman, Muhammad Usman, Hakeem Abiola YusuffIfeoma Nwadiuto, Abbas Aliyu Mohammed, Rabi Usman, Nwando Mba, Olaolu Aderinola, Elsie Ilori, John Oladejo, Ibrahim Abubakar, Chikwe Ihekweazu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objective Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria. Design Retrospective cohort study. Setting COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control. Participants Individuals who were investigated for SARS-CoV-2 using real-time PCR testing during the study period 27 February-8 June 2020. Methods COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs. Results A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95% CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84). Conclusion The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals.

Original languageEnglish
Article numbere044079
JournalBMJ Open
Issue number12
Publication statusPublished - 17 Dec 2020

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  • epidemiology
  • public health
  • respiratory infections


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