ABSTRACT
OBJECTIVES: The overall death toll from COVID-19 in Africa is reported to be low but there is little individual-level evidence on the severity of the disease. This study examined the clinical spectrum and outcome of patients monitored in COVID-19 care centres (CCCs) in two West-African countries. METHODS: Burkina Faso and Guinea set up referral CCCs to hospitalise all symptomatic SARS-CoV-2 carriers, regardless of the severity of their symptoms. Data collected from hospitalised patients by November 2020 are presented. RESULT: A total of 1,805 patients (64% men, median age 41 years) were admitted with COVID-19. Symptoms lasted for a median of 7 days (IQR 4-11). During hospitalisation, 443 (25%) had a SpO2 < 94% at least once, 237 (13%) received oxygen and 266 (15%) took corticosteroids. Mortality was 5% overall, and 1%, 5% and 14% in patients aged <40, 40-59 and ≥60 years, respectively. In multivariable analysis, the risk of death was higher in men (aOR 2.0, 95% CI 1.1; 3.6), people aged ≥60 years (aOR 2.9, 95% CI 1.7; 4.8) and those with chronic hypertension (aOR 2.1, 95% CI 1.2; 3.4). CONCLUSION: COVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension.
Subject(s)
COVID-19 , Adult , Aged , Burkina Faso/epidemiology , Female , Hospitalization , Humans , Male , Prospective Studies , Referral and Consultation , SARS-CoV-2ABSTRACT
INTRODUCTION: the objective was to identify the predictive factors contributing to COVID-related deaths in Intensive Care Unit. METHODS: this was a 4-month (12th March to 12th July 2020) cross sectional study carried out in the intensive care unit of the COVID treatment center of Donka National Hospital, the only hospital with a COVID intensive care unit in Guinea. RESULTS: during our period of study 140 patients were hospitalized in the COVID intensive care unit and 35 patients died (25%). In univariate analysis, the occurrence of death was associated with: confusional syndrome (p<0.001), time to admission (p<0.001), use of an inotropic or vasopressor (p<0.001), Brescia score ≥ 2 (p=0.004), non-invasive ventilation (p=0.011), stroke (p=0.014), Acute Respiratory Distress Syndrome (ARDS) (p=0.015), male (p=0.021), provenance (p=0.021), acute renal failure (p=0.022), pulmonary embolism (p=0.022), invasive ventilation (p=0.022), and age > 60 years (p=0.047). In multivariate analysis, the factors predictive of mortality were: Acute Respiratory Distress Syndrome (ARDS) (OR= 6.33, 95% CI [1.66-29]; p=0.007), a Brescia score ≥ 2 (OR =5.8, 95% CI [1.7-19.2]; p=0.004) and admission delay (OR =5.6, 95% CI [1.8-17.5]; p=0.003). CONCLUSION: our study shows that the acute respiratory distress syndrome, then the Brescia score ≥ 2, and finally the time to admission to intensive care were all associated with an increased risk of death for patients. These results are different from those reported in Asia, Europe and North America.
Subject(s)
COVID-19/mortality , Intensive Care Units , Respiratory Distress Syndrome/mortality , Adult , COVID-19/complications , Cross-Sectional Studies , Female , Guinea , Humans , Male , Middle Aged , Respiratory Distress Syndrome/epidemiology , Respiratory Distress Syndrome/virology , Risk Factors , Time FactorsABSTRACT
Résumé Objectif Décrire les caractéristiques épidémiologiques et cliniques des patients COVID-19 admis au service de réanimation. Méthodes Il s’agissait d’une étude prospective observationnelle de 4 mois (12 mars au 12 juillet) réalisée au service de réanimation du Centre de Traitement COVID-19 de l’hôpital national Donka. Résultats Durant la période d’étude, 6044 malades ont été testés positifs au SARS-CoV-2,140 parmi eux ont été admis en réanimation soit une prévalence de 2,3 %. L’âge moyen des patients était de 59 ± 14ans. La majorité des patients (79 %) était de sexe masculin. Concernant les comorbidités, 77 % des patients avaient au moins une comorbidité médicale dont l’hypertension artérielle (55 %) et le diabète (38 %). Les signes cliniques les plus fréquents étaient la dyspnée, (81 %), l’asthénie physique (64 %) et la toux (60 %). La majorité de nos patients (91 %) a bénéficié d’une oxygénothérapie classique. Le Syndrome de Détresse Respiratoire Aiguë (SDRA) était la complication la plus représentée (38 %). Le taux de létalité était de 25 % sur l’ensemble des patients admis en réanimation. Conclusion Une faible proportion de patients COVID-19 ont été admis en réanimation. Ces patients étaient principalement des personnes âgées, de sexe masculin ayant au moins une comorbidité. La symptomatologie était dominée par la dyspnée et les complications par le SDRA. La létalité était comparable en Europe et aux États-Unis. Objective To describe the epidemiological and clinical characteristics of COVID-19 patients admitted to the intensive care unit. Methods This was a 4-month (from the 12th of March to the 12th of July) prospective and observational study carried out in the intensive care unit of the COVID-19 Treatment Centre at Donka National Hospital, Conakry, Guinea. Results During the duration of the study, 6044 patients tested positive for SARS-CoV-2, of whom 140 were admitted to intensive care, i.e. 2.31%. The average age of the patients was 59 ± 14 years. The majority of patients were male, 79% (n = 110). Concerning co-morbidities, 77% (n = 108) of the patients had at least 1 medical co-morbidity, mainly hypertension (55% of cases n = 77) and diabetes (38% of cases n = 53). Main clinical signs were dyspnea (81%), physical asthenia (64%) and cough (60%). The majority of our patients (91%) benefited from conventional oxygen therapy. Acute Respiratory Distress Syndrome (ARDS) was the most represented complication (38%). The lethality rate in resuscitation was 25%. Conclusion The rate of admission of COVID-19 patients to intensive care was relatively low, and it concerned mainly elderly, male patients with at least one comorbidity. The symptomatology was dominated by dyspnea and complications by ARDS with significant mortality.