Survival analysis of recovery among COVID‑19 patients managed under home‑based isolation and care: a retrospective cohort study, Addis Ababa, Ethiopia

COVID‑19, caused by SARS‑CoV‑2 has imposed global and national burden and strained health systems. Ethiopia particularly Addis Ababa experienced the large share of the country’s cases, and most infections have been managed through home‑based isolation and care (HBIC). Although HBIC is promoted to reduce community transmission and relieve facilities, evidence on recovery trajectories and predictors from sub‑Saharan Africa is limited. To determine time to recovery and its predictors among COVID‑19 patients receiving home‑based isolation and care service in Addis Ababa, Ethiopia. In our study, retrospective cohort study design was implemented. Sample size was calculated using Schoenfeld formula. Biomedical, behavioral and nutritional variables were evaluated to determine recovery time predictors. Analyses comprised Kaplan–Meier estimation, log‑rank tests, Bivariable and multivariable Cox regression. Model adequacy was evaluated using Schoenfeld residuals, Cox–Snell residuals and Harrell’s C‑index. Overall cumulative recovery rate was 88.6% (241/272), with 91.9% in vaccinated and 85.3% in unvaccinated patients. The overall median time to recovery was 7 days (7 days vaccinated; 8 days unvaccinated). Recovery incidence densities were 11.64, 13.19, and 10.34 per 100 person‑days for the overall, vaccinated, and unvaccinated groups, respectively. Vaccination (AHR 1.62), prior infection (AHR 2.11), age 30–39 (AHR 2.13) and absence of comorbidity (AHR 1.87) predicted faster recovery, while non‑mask use (AHR 0.39), smoking (AHR 0.44), public‑transport use (AHR 0.45), and abnormal BMI (underweight AHR 0.38; overweight AHR 0.67) were associated with slower recovery. The recovery time was short and associated with vaccination, comorbidity, prior infection, and preventive behaviors (mask use, hand hygiene). Advocating vaccination, integrating comorbidity management, and reinforcing preventive practices can optimize home‑based isolation programs, reduce facility burden, and inform policy. Not applicable.