Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo.
Am J Trop Med Hyg
; 103(6): 2419-2428, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-809794
ABSTRACT
Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median (interquartile range [IQR]) age of 46 (34-58) years. One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI 10.9-15.8), and almost 50% among those in the ICU. Independent risk factors for death were age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI 1.85-23.64), 40-59 years (aHR = 4.45, 95% CI 1.83-10.79), and ≥ 60 years (aHR = 13.63, 95% CI 5.70-32.60) compared with those aged 20-39 years, with obesity (aHR = 2.30, 95% CI 1.24-4.27), and with chronic kidney disease (aHR = 5.33, 95% CI 1.85-15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1.53, 95% CI 0.88-2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI 0.35-1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high mortality among patients aged < 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Hospital Mortality
/
Pandemics
/
SARS-CoV-2
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Africa
Language:
English
Journal:
Am J Trop Med Hyg
Year:
2020
Document Type:
Article
Affiliation country:
Ajtmh.20-1240
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