 | Marie Jaspard, Mamadou Saliou Sow, Sylvain Juchet, Eric Dienderé, Beatrice Serra, Richard Kojan, Billy Sivahera, Caroline Martin, Moumouni Kinda, Hans-Joerg Lang, Fodé Bangaly Sako, Fodé Amara Traoré, Eudoxie Koumbem, Halidou Tinto, Adama Sanou, Apoline Sondo, Flavien Kaboré, Joseph Donamou, Jean-Paul-Yassa Guilavogui, Fanny Velardo, Brice Bicaba, Olivier Marcy, Augustin Augier, Sani Sayadi, Armel Poda, Sakoba Keita, Xavier Anglaret, Denis Malvy, COVISTA group Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa (Journal Article) In: Int. J. Infect. Dis., vol. 108, pp. 45–52, 2021, ISSN: 1878-3511 1201-9712, (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
PMID: 34000419
PMCID: PMC8120805). @article{Jaspard2021-bl,
title = {Clinical presentation, outcomes and factors associated with mortality: A prospective study from three COVID-19 referral care centres in West Africa},
author = {Marie Jaspard and Mamadou Saliou Sow and Sylvain Juchet and Eric Diender\'{e} and Beatrice Serra and Richard Kojan and Billy Sivahera and Caroline Martin and Moumouni Kinda and Hans-Joerg Lang and Fod\'{e} Bangaly Sako and Fod\'{e} Amara Traor\'{e} and Eudoxie Koumbem and Halidou Tinto and Adama Sanou and Apoline Sondo and Flavien Kabor\'{e} and Joseph Donamou and Jean-Paul-Yassa Guilavogui and Fanny Velardo and Brice Bicaba and Olivier Marcy and Augustin Augier and Sani Sayadi and Armel Poda and Sakoba Keita and Xavier Anglaret and Denis Malvy and COVISTA group},
doi = {10.1016/j.ijid.2021.05.024},
issn = {1878-3511 1201-9712},
year = {2021},
date = {2021-07-01},
urldate = {2021-07-01},
journal = {Int. J. Infect. Dis.},
volume = {108},
pages = {45--52},
publisher = {Elsevier BV},
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 $geq$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 $geq$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.},
note = {Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
PMID: 34000419
PMCID: PMC8120805},
keywords = {Adult, Aged, Burkina Faso/epidemiology, Comorbidities, COVID-19, Female, Hospitalization, Humans, Male, Mortality, Prospective Studies, Referral and Consultation, SARS-Cov-2, sub-Saharan Africa},
pubstate = {published},
tppubtype = {article}
}
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 $geq$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 $geq$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. |
| Laura Skrip, Karim Derra, Mikaila Kaboré, Navideh Noori, Adama Gansané, Innocent Valéa, Halidou Tinto, Bicaba W Brice, Mollie Van Gordon, Brittany Hagedorn, Hervé Hien, Benjamin M Althouse, Edward A Wenger, André Lin Ouédraogo Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis (Journal Article) In: Int. J. Infect. Dis., vol. 101, pp. 194–200, 2020, ISSN: 1878-3511 1201-9712, (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
PMID: 32987177
PMCID: PMC7518969). @article{Skrip2020-fq,
title = {Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis},
author = {Laura Skrip and Karim Derra and Mikaila Kabor\'{e} and Navideh Noori and Adama Gansan\'{e} and Innocent Val\'{e}a and Halidou Tinto and Bicaba W Brice and Mollie Van Gordon and Brittany Hagedorn and Herv\'{e} Hien and Benjamin M Althouse and Edward A Wenger and Andr\'{e} Lin Ou\'{e}draogo},
doi = {10.1016/j.ijid.2020.09.1432},
issn = {1878-3511 1201-9712},
year = {2020},
date = {2020-12-01},
urldate = {2020-12-01},
journal = {Int. J. Infect. Dis.},
volume = {101},
pages = {194--200},
publisher = {Elsevier BV},
abstract = {BACKGROUND: Absolute numbers of COVID-19 cases and deaths
reported to date in the sub-Saharan Africa (SSA) region have
been significantly lower than those across the Americas, Asia
and Europe. As a result, there has been limited information
about the demographic and clinical characteristics of deceased
cases in the region, as well as the impacts of different case
management strategies. METHODS: Data from deceased cases
reported across SSA through 10 May 2020 and from hospitalized
cases in Burkina Faso through 15 April 2020 were analyzed.
Demographic, epidemiological and clinical information on
deceased cases in SSA was derived through a line-list of
publicly available information and, for cases in Burkina Faso,
from aggregate records at the Centre Hospitalier Universitaire
de Tengandogo in Ouagadougou. A synthetic case population was
probabilistically derived using distributions of age, sex and
underlying conditions from populations of West African countries
to assess individual risk factors and treatment effect sizes.
Logistic regression analysis was conducted to evaluate the
adjusted odds of survival for patients receiving oxygen therapy
or convalescent plasma, based on therapeutic effectiveness
observed for other respiratory illnesses. RESULTS: Across SSA,
deceased cases for which demographic data were available were
predominantly male (63/103, 61.2%) and aged \>50 years (59/75,
78.7%). In Burkina Faso, specifically, the majority of deceased
cases either did not seek care at all or were hospitalized for a
single day (59.4%, 19/32). Hypertension and diabetes were often
reported as underlying conditions. After adjustment for sex, age
and underlying conditions in the synthetic case population, the
odds of mortality for cases not receiving oxygen therapy were
significantly higher than for those receiving oxygen, such as
due to disruptions to standard care (OR 2.07; 95% CI
1.56-2.75). Cases receiving convalescent plasma had 50% reduced
odds of mortality than those who did not (95% CI 0.24-0.93).
CONCLUSIONS: Investment in sustainable production and
maintenance of supplies for oxygen therapy, along with messaging
around early and appropriate use for healthcare providers,
caregivers and patients could reduce COVID-19 deaths in SSA.
Further investigation into convalescent plasma is warranted
until data on its effectiveness specifically in treating
COVID-19 becomes available. The success of supportive or
curative clinical interventions will depend on earlier treatment
seeking, such that community engagement and risk communication
will be critical components of the response.},
note = {Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
PMID: 32987177
PMCID: PMC7518969},
keywords = {Adolescent, Adult, Africa South of the Sahara, Aged, Antiviral Agents/administration \& dosage, Asia/epidemiology, Burkina Faso, Burkina Faso/epidemiology, Child, Clinical management of SARS-CoV-2 infection: convalescent plasma, COVID-19/drug therapy/epidemiology/mortality/therapy, Europe/epidemiology, Female, Health systems strengthening, Humans, Immunization, Infant, Male, Mortality, Oxygen therapy, Pandemics, Passive, Preschool, Retrospective Studies, SARS-CoV-2 infection, SARS-CoV-2/drug effects/physiology, sub-Saharan Africa, Young Adult},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Absolute numbers of COVID-19 cases and deaths
reported to date in the sub-Saharan Africa (SSA) region have
been significantly lower than those across the Americas, Asia
and Europe. As a result, there has been limited information
about the demographic and clinical characteristics of deceased
cases in the region, as well as the impacts of different case
management strategies. METHODS: Data from deceased cases
reported across SSA through 10 May 2020 and from hospitalized
cases in Burkina Faso through 15 April 2020 were analyzed.
Demographic, epidemiological and clinical information on
deceased cases in SSA was derived through a line-list of
publicly available information and, for cases in Burkina Faso,
from aggregate records at the Centre Hospitalier Universitaire
de Tengandogo in Ouagadougou. A synthetic case population was
probabilistically derived using distributions of age, sex and
underlying conditions from populations of West African countries
to assess individual risk factors and treatment effect sizes.
Logistic regression analysis was conducted to evaluate the
adjusted odds of survival for patients receiving oxygen therapy
or convalescent plasma, based on therapeutic effectiveness
observed for other respiratory illnesses. RESULTS: Across SSA,
deceased cases for which demographic data were available were
predominantly male (63/103, 61.2%) and aged >50 years (59/75,
78.7%). In Burkina Faso, specifically, the majority of deceased
cases either did not seek care at all or were hospitalized for a
single day (59.4%, 19/32). Hypertension and diabetes were often
reported as underlying conditions. After adjustment for sex, age
and underlying conditions in the synthetic case population, the
odds of mortality for cases not receiving oxygen therapy were
significantly higher than for those receiving oxygen, such as
due to disruptions to standard care (OR 2.07; 95% CI
1.56-2.75). Cases receiving convalescent plasma had 50% reduced
odds of mortality than those who did not (95% CI 0.24-0.93).
CONCLUSIONS: Investment in sustainable production and
maintenance of supplies for oxygen therapy, along with messaging
around early and appropriate use for healthcare providers,
caregivers and patients could reduce COVID-19 deaths in SSA.
Further investigation into convalescent plasma is warranted
until data on its effectiveness specifically in treating
COVID-19 becomes available. The success of supportive or
curative clinical interventions will depend on earlier treatment
seeking, such that community engagement and risk communication
will be critical components of the response. |
