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Challenges of Case Management of COVID-19 in University of Uyo Teaching Hospital: A One-Year Experience.
Oloyede, I P; Onukak, A; Motilewa, O O; Ekuma, A; Udoette, S; Eyo, C; Abudu, E K; Umoh, V A; Bassey, E; Peters, E.
  • Oloyede IP; Department of Paediatrics, University of Uyo/ University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Onukak A; Department of Internal Medicine, University of Uyo/University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Motilewa OO; Department of Community Medicine, University of Uyo/University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Ekuma A; Department of Medical Microbiology, University of Uyo/ University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Udoette S; Department of Internal Medicine, University of Uyo/University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Eyo C; Department of Anaesthesia, University of Uyo/ University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Abudu EK; Department of Pathology, University of Uyo and University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Umoh VA; Department of Internal Medicine, University of Uyo/University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Bassey E; Department of Obstetrics and Gynaecology, University of Uyo/ University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
  • Peters E; Department of Internal Medicine, University of Uyo/University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria.
West Afr J Med ; 39(11): 1119-1126, 2022 Nov 30.
Article in English | MEDLINE | ID: covidwho-2125655
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Coronavirus disease 2019 (COVID-19) is a global pandemic. Older people and those with poorly controlled co-morbidities have higher risk of mortality. This study was conducted to highlight the clinical features, challenges of management and outcome for the patients we have seen in our centre over the past one year.

METHODS:

This was a retrospective cross-sectional study involving all patients admitted in the COVID-19 Isolation unit of University of Uyo Teaching Hospital (UUTH) from June, 2020-May, 2021. Clinical and laboratory information were obtained from the patient case notes. Ethical clearance for the conduct of the study was obtained from the Ethics committee, UUTH, Uyo. Data was analysed with STATA version 13.

RESULTS:

Thirty-three (37.9%) patients were COVID-19 PCR positive. The mean ± SD age of COVID-19 PCR positive patients was 57.3 ± 13.4 years with majority (69.7%) being above 50 years. There was a male preponderance (75%). Eleven (34.4%) patients died while 21(65.6%) were discharged. The highest co-morbidity associated with COVID-19 mortality was diabetes mellitus (7 out of 11; 63.6%). There was a poor uptake of supportive investigations for the management of COVID-19 patients. A raised body temperature (P=0.0006), a low SPO2 (0.00004), high respiratory rate (0.0009) on admission and shorter duration of admission (0.0002), were associated with mortality.

CONCLUSION:

The presence of co-morbidities, fever, low SPO2 and high respiratory rates on admission are associated with increased mortality from COVID-19 disease. A paucity of supportive investigations was a major challenge to COVID-19 management. We therefore recommend the strengthening of our laboratory capacity.
CONTEXTE ET OBJECTIFS La maladie de coronavirus 2019 (COVID-19) est une pandémie mondiale. Les personnes âgées et celles qui présentent des comorbidités mal contrôlées ont un risque de mortalité plus élevé. Cette étude a été menée pour mettre en évidence les caractéristiques cliniques, les défis de la gestion et le résultat des patients que nous avons vus dans notre centre au cours de la dernière année. MÉTHODES Il s'agissait d'une étude transversale rétrospective impliquant tous les patients admis dans l'unité d'isolement COVID- 19 de l'University of Uyo Teaching Hospital (UUTH) de juin 2020 à mai 2021. Les informations cliniques et de laboratoire ont été obtenues à partir des notes de cas des patients. L'autorisation éthique pour la réalisation de l'étude a été obtenue auprès du comité d'éthique de l'UUTH, Uyo. Les données ont été analysées avec STATA version 13. RÉSULTATS Trente-trois (37,9%) patients étaient positifs à la PCR COVID-19. L'âge moyen ± SD des patients positifs au COVID-19 PCR était de 57,3 ± 13,4 ans, la majorité (69,7%) ayant plus de 50 ans. Il y avait une prépondérance masculine (75 %). Onze (34,4 %) patients sont décédés et 21 (65,6 %) sont sortis de l'hôpital. La comorbidité la plus importante associée à la mortalité de COVID-19 était le diabète miletus (7 sur 11 63 6 %). Les investigations de soutien pour la gestion des patients COVID-19 ont été peu utilisées. Une température corporelle élevée (P=0,0006), une faible SPO2 (0,00004), une fréquence respiratoire élevée (0,0009) à l'admission et une durée d'admission plus courte (0,0002) étaient associées à la mortalité.

CONCLUSION:

La présence de comorbidités, de fièvre, d'une faible SPO2 et d'une fréquence respiratoire élevée à l'admission est associée à une mortalité accrue de la maladie de COVID-19. Le manque d'investigations de soutien a été un défi majeur pour la gestion de la maladie COVID-19. Nous recommandons donc le renforcement de la capacité de nos laboratoires. Mots clés COVID-19, défis, gestion des cas, Nigeria.
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Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Humans / Male / Middle aged Language: English Journal: West Afr J Med Year: 2022 Document Type: Article Affiliation country: Nigeria

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Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Humans / Male / Middle aged Language: English Journal: West Afr J Med Year: 2022 Document Type: Article Affiliation country: Nigeria