Abstract
ObjectivesThe 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. MethodsBurkina 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. ResultA 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). ConclusionCOVID-19 is as severe in Africa as elsewhere, and there must be more vigilance for common risk factors such as older age and hypertension.
Highlights
As of 05 May 2021, it was estimated that 153 million people had been infected with SARS-CoV-2 and that COVID-19 had killed 3.2 million people worldwide
It is believed that this is the first African study describing the clinical presentation and outcomes of COVID-19 among symptomatic patients prospectively monitored in specialist hospital care centres
In two West African countries where the policy was to hospitalise everyone with a positive SARS-Cov-2 RT-PCR test, regardless of the severity of the clinical picture, 5% of symptomatic people who were hospitalised died
Summary
As of 05 May 2021, it was estimated that 153 million people had been infected with SARS-CoV-2 and that COVID-19 had killed 3.2 million people worldwide. The death toll from COVID-19 seemed lower in Africa than in Europe and North America, some predictions indicated the opposite (Martinez-Alvarez et al, 2020) This may have been due to the heterogeneity of systems for reporting cases and causes of death, the level of preparedness in a continent that has faced threatening epidemics in the recent past, or differences in environmental characteristics, circulating strains or population susceptibility (Galloway et al, 2020; Nagai et al, 2020; Price-Haywood et al, 2020; Williamson et al, 2020). This study reports prospectively collected clinical data on patients hospitalised in the COVID-19 referral care centres of two West African countries between March and November 2020
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