Background: COVID-19 revealed significant health disparities globally, with comorbidities exacerbating outcomes, Africa faced heightened risks from pre-existing conditions during the pandemic.

Objective: The aim of the study was to assess the association between comorbidities and mortality of hospitalised patients with corona virus disease in two African countries after adjusting for confounders such as age.

Setting: Study was conducted in treatment centres from 4 states in Nigeria and 6 regions in Ethiopia.

Methods: An unmatched case-control study with equal distribution of cases and controls, conducted using secondary data. All files of COVID-19 patients hospitalised between February 2020 and February 2021 were enlisted as participants in the study. A case was an individual who died of COVID-19 whereas a control was one who survived. Both cases and control were of African descent. Multi-variable logistic regression was conducted.

Results: A total of 2,576 adult hospitalised participants diagnosed with COVID-19 were enrolled in the study. Their mean age was 51.1±19.4 with the controls being 41±17.3 the cases being 61.3±15.7 years. Fifty-seven percent (57%) had at least one comorbidity. Presence of comorbidities, as opposed to no comorbidity, was associated with mortality (adjusted odds ratio: 1.91; 95% confidence intervals 1.41-2.59; p=<0.01) even after adjustment for sex, marital status, age, education level and occupation. Hypertension (p<0.001) and HIV/AIDS (p<0.001) were independently correlated with mortality”.

Conclusion: This study showed that comorbidities such as hypertension and HIV/AIDs were linked to mortality in patients with COVID-19 in Africa after adjusting for age.