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Background <p>Coronavirus Disease 2019(COVID-19) pneumonia, caused by the Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2 virus), remains a significant global health challenge, contributing to millions of cases and deaths worldwide, including a substantial burden in Rwanda. Severe and critical cases often lead to respiratory failure, multi-organ dysfunction, and increased mortality. Despite global research, data on predictors of critical illness among hospitalized COVID-19 patients in Rwanda remain limited, highlighting the need for context-specific studies. This study aimed to assess the prevalence and identify risk factors for critical COVID-19 pneumonia among patients admitted to the Nyarugenge Major COVID-19 Referral Center in Rwanda.</p> Methods <p>A mixed-study design combining retrospective and prospective designs was conducted from February to October 2021, and we included 320 patients aged 15 to 65 years admitted with severe or critical COVID-19 pneumonia. Data were collected on socio-demographic factors, vital signs, and clinical symptoms. Multivariate logistic regression was performed using Stata 17 to identify independent predictors of critical illness.</p> Results <p>Of the 320 patients, 30% presented with critical illness, while 70% had severe illness. Independent predictors of critical illness included oxygen saturation ≤ 90% {Adjusted Odds Ratio (AOR) = 5.83, 95% Confidence Interval(CI): 2.95–11.52, <i>p</i> &lt; 0.001), respiratory rate &gt; 20 beat per minute(bpm), (AOR = 2.34, 95% CI: 1.11–4.93, <i>p</i> &lt; 0.05), and heart rate &gt; 100&#xa0;bpm (AOR = 2.49, 95% CI: 1.32–4.67, <i>p</i> &lt; 0.01).</p> Conclusions <p>Critical illness was prevalent in 30% of patients, with hypoxia, tachypnea, and tachycardia as significant predictors. These findings identify key clinical predictors of critical COVID-19 pneumonia and suggest that monitoring these indicators may help guide early intervention and optimize resource allocation in Rwanda and similar low- and middle-income settings.</p> Clinical trial number <p>Not applicable.</p>

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Prevalence and predictors of critical COVID-19 pneumonia among patients with COVID-19 admitted at Nyarugenge major COVID-19 Referral Center in Rwanda

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Mukantagengwa Marie Paul,
  • Ndahimana Raphael,
  • Nkeshimana Menelas,
  • Abimana Deborah,
  • Uwineza Jean Bonaventure,
  • Dushimimana Pasteur,
  • Murekatete Marie Beata,
  • Muhizi Epaphrodite,
  • Hafashimana Valens,
  • Ndayisaba Prosper,
  • Deborah Oluwaseun Shomuyiwa,
  • Muhirwa Samuel,
  • Rutaganda Eric

摘要

Background

Coronavirus Disease 2019(COVID-19) pneumonia, caused by the Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2 virus), remains a significant global health challenge, contributing to millions of cases and deaths worldwide, including a substantial burden in Rwanda. Severe and critical cases often lead to respiratory failure, multi-organ dysfunction, and increased mortality. Despite global research, data on predictors of critical illness among hospitalized COVID-19 patients in Rwanda remain limited, highlighting the need for context-specific studies. This study aimed to assess the prevalence and identify risk factors for critical COVID-19 pneumonia among patients admitted to the Nyarugenge Major COVID-19 Referral Center in Rwanda.

Methods

A mixed-study design combining retrospective and prospective designs was conducted from February to October 2021, and we included 320 patients aged 15 to 65 years admitted with severe or critical COVID-19 pneumonia. Data were collected on socio-demographic factors, vital signs, and clinical symptoms. Multivariate logistic regression was performed using Stata 17 to identify independent predictors of critical illness.

Results

Of the 320 patients, 30% presented with critical illness, while 70% had severe illness. Independent predictors of critical illness included oxygen saturation ≤ 90% {Adjusted Odds Ratio (AOR) = 5.83, 95% Confidence Interval(CI): 2.95–11.52, p < 0.001), respiratory rate > 20 beat per minute(bpm), (AOR = 2.34, 95% CI: 1.11–4.93, p < 0.05), and heart rate > 100 bpm (AOR = 2.49, 95% CI: 1.32–4.67, p < 0.01).

Conclusions

Critical illness was prevalent in 30% of patients, with hypoxia, tachypnea, and tachycardia as significant predictors. These findings identify key clinical predictors of critical COVID-19 pneumonia and suggest that monitoring these indicators may help guide early intervention and optimize resource allocation in Rwanda and similar low- and middle-income settings.

Clinical trial number

Not applicable.