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Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo
- Source :
- The American Journal of Tropical Medicine and Hygiene
- Publication Year :
- 2020
- Publisher :
- The American Society of Tropical Medicine and Hygiene, 2020.
-
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.
- Subjects :
- Male
Azithromycin
Severity of Illness Index
Lopinavir
law.invention
Interquartile range
law
Risk Factors
Hospital Mortality
Hazard ratio
Chloroquine
Articles
Middle Aged
Intensive care unit
Hospitals
Patient Discharge
Hospitalization
Drug Combinations
Intensive Care Units
Infectious Diseases
Treatment Outcome
Democratic Republic of the Congo
Female
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Virology
Internal medicine
Severity of illness
medicine
Humans
Obesity
Enoxaparin
Renal Insufficiency, Chronic
Pandemics
Retrospective Studies
Ritonavir
business.industry
SARS-CoV-2
COVID-19
Retrospective cohort study
Odds ratio
medicine.disease
COVID-19 Drug Treatment
Asymptomatic Diseases
Parasitology
business
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 14761645 and 00029637
- Volume :
- 103
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The American Journal of Tropical Medicine and Hygiene
- Accession number :
- edsair.doi.dedup.....5dd625289a868149c90836cd89542d64