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1. EPIDEMIOLOGICAL AND CLINICAL CHARACTERISTICS OF COVID-19 PATIENTS IN KENYA

Author

Munyu W, Samuel M. Thumbi, Sudi P, Omu Anzala, Mutono N, Sood M, Ali Loo Am, MC Maritim, Juma P, Reena Shah, Frederick K. Wangai, Odhiambo J, Loice Ombajo, Amoth P, Mutua M, and Evanson Kamuri

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Proportional hazards model, Medical record, Hazard ratio, Disease, medicine.disease, Internal medicine, Diabetes mellitus, Epidemiology, Medicine, Risk of death, business
Abstract

BackgroundMore than 49,000 cases of infection and 900 deaths from COVID-19 have been recorded in the Kenya. However, the characteristics and risk factors for severe outcomes among hospitalized COVID-19 patients in this setting have not been described.MethodsWe extracted demographic, laboratory, clinical and outcome data from medical records of RT-PCR confirmed SARS-CoV2 patients admitted in six hospitals in Kenya between March and September, 2020. We used Cox proportional hazards regressions to determine factors related to in-hospital mortality.ResultsData from 787 COVID-19 patients was available. The median age was 43 years (IQR 30-53), with 505 (64%) males. At admission, 455 (58%) were symptomatic. The commonest symptoms were cough (337, 43%), loss of taste or smell (279, 35%), and fever (126, 16%). Co-morbidities were reported in 340 (43%), with cardiovascular disease, diabetes and HIV documented in 130 (17%), 116 (15%), 53 (7%) respectively. 90 (11%) were admitted to ICU for a mean of 11 days, 52 (7%) were ventilated with a mean of 10 days, 107 (14%) died. The risk of death increased with age [hazard ratio (HR) 1.57 (95% CI 1.13 – 2.19)] for persons >60 years compared to those ConclusionsWe identify the risk factors for mortality that may guide stratification of high risk patients.

Published
2020
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2. Epidemiological and clinical characteristics of patients hospitalised with COVID-19 in Kenya: a multicentre cohort study.

Author

Ombajo LA, Mutono N, Sudi P, Mutua M, Sood M, Loo AM, Juma P, Odhiambo J, Shah R, Wangai F, Maritim M, Anzala O, Amoth P, Kamuri E, Munyu W, and Thumbi SM

Subjects
Adult, Cohort Studies, Female, Hospitalization, Humans, Intensive Care Units, Kenya epidemiology, Male, Middle Aged, RNA, Viral, SARS-CoV-2, COVID-19 epidemiology
Abstract

Objectives: To assess outcomes of patients admitted to hospital with COVID-19 and to determine the predictors of mortality., Setting: This study was conducted in six facilities, which included both government and privately run secondary and tertiary level facilities in the central and coastal regions of Kenya., Participants: We enrolled 787 reverse transcriptase-PCR-confirmed SARS-CoV2-infected persons. Patients whose records could not be accessed were excluded., Primary and Secondary Outcome Measures: The primary outcome was COVID-19-related death. We used Cox proportional hazards regressions to determine factors related to in-hospital mortality., Results: Data from patients with 787 COVID-19 were available. The median age was 43 years (IQR 30-53), with 505 (64%) being men. At admission, 455 (58%) were symptomatic with an additional 63 (9%) developing clinical symptoms during hospitalisation. The most common symptoms were cough (337, 43%), loss of taste or smell (279, 35%) and fever (126, 16%). Comorbidities were reported in 340 (43%), with cardiovascular disease, diabetes and HIV documented in 130 (17%), 116 (15%), 53 (7%), respectively. 90 (11%) were admitted to the Intensive Care Unit (ICU) for a mean of 11 days, 52 (7%) were ventilated with a mean of 10 days, 107 (14%) died. The risk of death increased with age (HR 1.57 (95% CI 1.13 to 2.19)) for persons >60 years compared with those <60 years old; having comorbidities (HR 2.34 (1.68 to 3.25)) and among men (HR 1.76 (1.27 to 2.44)) compared with women. Elevated white cell count and aspartate aminotransferase were associated with higher risk of death., Conclusions: The risk of death from COVID-19 is high among older patients, those with comorbidities and among men. Clinical parameters including patient clinical signs, haematology and liver function tests were associated with risk of death and may guide stratification of high-risk patients., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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