Risk factors associated with disease severity in hospitalized Covid 19 patients, Belize, March 2020 – December 2022.

Abstract

Background. Belize has a high burden of chronic non-communicable diseases (NCDs), which may increase vulnerability to severe COVID-19 outcomes. This study identified socio-demographic and clinical risk factors for severe and critical COVID-19 illness among hospitalized patients in Belize. Population and Methods. A hospital-based case-control study was conducted using secondary data from the Belize Health Information System. Patients admitted with laboratory-confirmed COVID-19 between March 2020 and December 2022 were included. Cases were defined as patients meeting WHO criteria for severe or critical illness; controls were non-severe hospitalized patients. Stratified random sampling by district and laboratory date produced a final sample of 176 cases and 528 controls. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results. Severe illness was significantly associated with diabetes (aOR 5.1, 95% CI: 1.2–22.4), obesity (aOR 4.9, 95% CI: 1.5–16.4), and asthma (aOR 8.8, 95% CI: 1.1–72.2). Older age (>45 years) and male sex were associated with severity in univariate analysis but not after adjustment. Other comorbidities, including chronic renal failure, HIV, and cancer, showed no significant associations. Discussion. Diabetes, obesity, and asthma independently predicted severe COVID-19 among hospitalized patients in Belize. These findings emphasize the importance of targeted interventions for individuals with chronic conditions and underscore the need to strengthen NCD management as part of pandemic preparedness strategies in Belize and similar settings.