Abstract:
Introduction: COVID-19 is an infectious disease caused by severe acute respiratory
syndrome coronavirus-2. It was first reported in December 2019 in Wuhan, China, and
has since spread to pandemic proportions. Since then, the virus has rapidly spread to
the world and has caused over 637.351 million confirmed cases, more than 6,604 million
deaths, and more than 616.952 million recoveries worldwide as of November 05, 2022.
The accelerated failure time model which is an alternative to the proportional hazard
model when the proportional hazard assumptions doesn’t hold was used to analyze time
of event, death from COVID-19 pandemic.
Objective: This study aimed to analyze the time-to-death of COVID-19 pandemic
patients in Jimma Zone, southwest Ethiopia.
Methodology: A retrospective cohort study was conducted on 809 COVID-19 patients
who admitted to Jimma university medical center and Shenen gibe generalized hospital
from May 16, 2020 to March 9, 2022 in Jimma Zone, southwest Ethiopia. KaplanMeier plots and Log-Rank test were used to compare the survival experience of different
categories and semi-parametric survival model and acceleration failure time models were
employed to identify survival time of the patients. The performances of acceleration
failure time models were compared using Akakie Information Criteria.
Results: From 809 patients, 135(16.7%) died in the follow-up period. Log-logistic
acceleration failure time model is better fit the data than other models. The result of
this model shows that the survival time of COVID-19 patients significantly affected by
age, comorbidity, status at admission, HIV/AIDS, symptom at admission, intranasal
oxygen use and diabetes.
Conclusions: The AFT model is a more valuable and realistic alternative to the
Cox PH model in situations where PH assumption cannot hold and therefore should be
considered as an alternative to the Cox PH for analyzing the time to death of COVID-19
patients. Older age, comorbidity, moderate or severe status at admission, HIV/AIDS,
being asymptomatic at admission, intranasal oxygen use, and diabetes are factors that
accelerate time to death in COVID-19 patients
