Survival Time to COVID-19 Severity and Its Predictors in South Gondar Zone, North-West Ethiopia: A Prospective Cohort Study

Background: Coronavirus disease is still a global public health emergency. Due to an inadequate healthcare system in low-income nations like Ethiopia, the pandemic has had a devastating impact. Despite this, information on the severity of COVID-19 and related difficulties in Ethiopia is sparse. Therefore, we aimed to determine the survival time to severity and predictors of COVID-19 in Northwest Ethiopia. Methods: A prospective follow-up study was conducted among 202 adult COVID-19 patients in the South Gondar zone treatment centers. Data were entered using EpiData version 3.1 and then exported to Stata 16 for analysis. Kaplan-Meier was used to estimate mean survival time, and Log rank tests were used to compare survival time between explanatory variable groups. A cox-proportional hazards regression model with a 95% confidence interval and a p-value of 0.05 was used to identify covariates associated with the outcome variable. Results: The patients' average age was 41.2 years. With an IQR of 4-7 days, the median time to COVID-19 severity was 5 days. The overall COVID-19 severity rate was 6.35 (95% CI: 5.17-7.86) per 100 person-days observed. Senior adult age group (51-59 years) (AHR = 3.59, 95% CI: 1.05,12.23), elderly age group (>60 years) (AHR = 2.11, 95% CI: 1.09, 12.67), comorbidity (AHR = 3.26, 95% CI: 1.48, 7.18), high blood pressure at admission (AHR = 4.36, 95% CI: 1.99, 9.54), and high temperature at admission (AHR = 5.60, 95% CI: 2.55, 12.46) were significantly associated with COVID-19 severity time. Conclusion and Recommendation: Patients with COVID-19 had a short median severity time, and factors like older age, comorbidity, high temperature, and high blood pressure were all independent predictors of severity time. Patients with high body temperature, blood pressure, comorbidity, and advanced age should be the focus of interventions to reduce progression time and improve clinical outcomes. Keywords: COVID-19, time to severity, predictors, South Gondar zone, Ethiopia