Factors associated with hospitalization of adolescents with COVID-19 in Eswatini, March 2020 to January 2022

Abstract

Background Coronavirus disease (COVID-19) was amongst the leading global public health threats with high morbidity and mortality. During the COVID-19 pandemic adolescents were not spared from the effects of the COVID-19 infection. This study was aimed at assessing the factors associated with the hospitalization of adolescents with COVID-19 in Eswatini. Methods A cross-sectional study that utilized secondary data was conducted. Data used was from the Eswatini national COVID-19 database collected from March 2020 to January 2022. The data analyzed was of adolescents aged 10-19 years diagnosed with COVID-19 and hospitalized in health facilities in Eswatini. Descriptive statistics of demographic and clinical characteristics were presented using frequency tables and graphs. Differences in means were assessed using a Student’s t-test while differences in proportions were assessed using the Chi-square and Fisher’s exact test as necessary. The univariate and multivariate logistic regression analyses were used to determine the factors associated with COVID-19 related hospitalization. Results Of the 9277 adolescents diagnosed with COVID-19, 3.43% (n=318) were hospitalized. The mean±(standard deviation) age of the adolescents was 15.36, ±2.7 years. A total of 57.21% (n=5307) of the study participants were females. A majority, 76.73% (n=7118) of the adolescents had mild disease severity at diagnosis. Findings from the study revealed that after adjusting for other factors, being symptomatic increased the odds of COVID-19 hospitalization by 2.48 times (aOR=2.48; 95%CI: 1.43-4.28; p<0.001) compared to those without symptoms. Likewise compared to those living without, living with comorbidities was associated iv with 4-fold increased odds of COVID-19 hospitalization (aOR=4.04; 95%CI: 1.91- 8.52; p<0.001). Conclusion The findings from this study highlights the need for targeted interventions for adolescents as underscored by the risk factors found to be associated with hospitalization of adolescents with COVID-19 in Eswatini. COVID-19 patient management approaches like access to healthcare services such as vaccination even for marginalized populations should be targeted in resource-limited settings as they are crucial to managing COVID-19 infection.