Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa. (July 2021)

• Record Type: Journal Article
• Authors: Jaspard, Marie; Sow, Mamadou Saliou; Juchet, Sylvain; Dienderé, Eric; Serra, Beatrice; Kojan, Richard; Sivahera, Billy; Martin, Caroline; Kinda, Moumouni; Lang, Hans-Joerg; Bangaly Sako, Fodé; Amara Traoré, Fodé; Koumbem, Eudoxie; Tinto, Halidou; Sanou, Adama; Sondo, Apoline; Kaboré, Flavien; Donamou, Joseph; Guilavogui, Jean-Paul-Yassa; Velardo, Fanny; Bicaba, Brice; Marcy, Olivier; Augier, Augustin; Sayadi, Sani; Poda, Armel; Keita, Sakoba; Anglaret, Xavier; Malvy, Denis
• Is Part Of: International journal of infectious diseases. Volume 108(2021)
• Page Start: 45
• Page End: 52
• Publication Date: 2021-07
• Subjects: SARS-Cov-2 -- COVID-19 -- Sub-Saharan Africa -- Mortality -- Comorbidities; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.05.024
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Few data are available regarding the clinical presentation of COVID-19 in Africa. Almost one-third of patients hospitalised for COVID-19 show clinical worsening. SARS-CoV2 mortality is 5% in West Africa, a result similar to Europe. Factors associated with mortality are age, male gender and high blood pressure. Diabetes is associated with clinical worsening in COVID-19 patients. 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.