Abstract

Introduction: The COVID-19 pandemic has presented severe challenges worldwide, especially in conflict-affected and resource-constrained countries like Yemen. Yemen’s fragile health system, weakened by ongoing conflict and humanitarian crises, has struggled to respond effectively. This study aimed to assess the clinical characteristics, outcomes, and mortality risk factors among COVID-19 patients admitted to public isolation units during the first pandemic wave across multiple governorates in Yemen.

Methods: A retrospective observational cross-sectional study was conducted using data from 308 laboratory-confirmed COVID-19 patients admitted to isolation units across eight governorates between May and June 2020. Demographic details, comorbidities, clinical presentations, and outcomes (discharge, ongoing treatment, and death) were collected from Ministry of Public Health and Population records and analyzed using SPSS version 23.0. Findings were presented as frequencies and percentages.

Results: Most cases were males (72.7%), with middle-aged adults (45–69 years) comprising the largest group (53.2%). Mortality was notably higher among males (80.3%) and older adults (≥70). The most prevalent comorbidities were diabetes mellitus (34.7%) and arterial hypertension (27.6%); both strongly linked to increased mortality. Fever (92.9%), cough (89.3%), and difficulty breathing (87.7%) were the predominant symptoms, with many patients presenting at advanced diseases stages characterized by respiratory complications.

Conclusion: Older age, male sex, and chronic comorbidities, particularly Cardiovascular diseases, Pneumonia and Diabetes Mellitus, are major characteristics linked to poor COVID-19 outcomes in Yemen. These findings highlight the critical need for integrated chronic disease management within emergency health responses. Strengthening primary healthcare services, expanding early case detection, and improving health system resilience are vital to reduce mortality and enhance pandemic preparedness in fragile conflict-affected settings.

Keywords: COVID-19, Yemen, Mortality, Comorbidities, Health System, Conflict, Clinical Outcomes.

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