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Yu Z, Liang J, Guo L, Jiang L, Wang JY, Ke M, Shen L, Zhou N, Liu X. Psychosocial Intervention on the Dual-Process Model for a Group of COVID-19 Bereaved Individuals in Wuhan: A Pilot Study. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:701-717. [PMID: 35341382 PMCID: PMC8958304 DOI: 10.1177/00302228221083067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Wuhan was the first large city where the initial breakout of COVID-19 took numerous lives. A group of social workers and mental health specialists coordinated the "Be Together Program" (BTP), a psychosocial grief intervention program to help a group of Wuhan COVID-19 bereaved people. Under the Dual-process model framework, BTP used the internet and social media as the main tools, combined with group and individual intervention. Additionally, it employed a "Supermarket Mode" with abundant intervention themes and approaches for BTP participants to choose according to their special needs. Additionally, Chinese cultural elements are integrated into the program. At the end of the program, the grief scores of participants in the qualified sample reduced significantly, and the prevalence of the potential Prolonged Grief Disorder diagnosis reduced from 75% to 12%. The study also found that the BTP was especially effective for those who had high levels of grief reaction.
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Affiliation(s)
- Zhihong Yu
- School of Sociology, Wuhan University, Wuhan, China
| | - Jinjun Liang
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liping Guo
- Zhongshan Huineng Social Work Service Centre, Guangzhou, China
| | | | - Jian-ying Wang
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Moli Ke
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Liao Shen
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ningning Zhou
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Xinxian Liu
- Grief Healing Service, Independent Researcher, Westfield, NJ, USA
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Zheng K, Chong AY, Mentzer AJ. How could our genetics impact COVID-19 vaccine response? Expert Rev Clin Immunol 2024:1-13. [PMID: 38676712 DOI: 10.1080/1744666x.2024.2346584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented global health challenges since its emergence in December 2019. The rapid availability of vaccines has been estimated to save millions of lives, but there is variation in how individuals respond to vaccines, influencing their effectiveness at an individual, and population level. AREAS COVERED This review focuses on human genetic factors influencing the immune response and effectiveness of vaccines, highlighting the importance of associations across the HLA locus. Genome-Wide Association Studies (GWAS) and other genetic association analyses have identified statistically significant associations between specific HLA alleles including HLA-DRB1*13, DBQ1*06, and A*03 impacting antibody responses and the risk of breakthrough infections post-vaccination. Relationships between these associations and potential mechanisms and links with risks of natural infection or disease are explored, and this review concludes by emphasizing how understanding the mechanisms of these genetic determinants may inform the development of tailored vaccination strategies. EXPERT OPINION Although complex, we believe these findings from the SARS-CoV2 pandemic offer a unique opportunity to understand the relationships between HLA and infection and vaccine response, with a goal of optimizing individual protection against COVID-19 in the ongoing pandemic, and possibly influencing wider vaccine development in the future.
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Affiliation(s)
- Keyi Zheng
- Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Amanda Y Chong
- Centre for Human Genetics, University of Oxford, Oxford, UK
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Gedik B, Yuksel O, Kazim Erol M, Duman F, Dogan B, Suren E, Yavuz S. Evaluation of the retina, choroid and optic disc vascular structures in individuals with a history of COVID-19. J Fr Ophtalmol 2024; 47:104014. [PMID: 37925322 DOI: 10.1016/j.jfo.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/05/2023] [Accepted: 10/08/2023] [Indexed: 11/06/2023]
Abstract
INTRODUCTION In this study, we aimed to detect changes in posterior segment structures and vascular density caused by COVID-19 using an optical coherence tomography angiography (OCTA) device. MATERIALS AND METHODS The study included 20 eyes of 20 patients no systemic or ocular disease who were followed at the Ophthalmology Clinic of Health Sciences University Antalya Training and Research Hospital. The OCTA images of these individuals taken prior to contracting COVID-19 and six months after recovery were examined. RESULTS The mean choriocapillaris blood flow was 2.00±0.13mm2 before COVID-19 and 2.08±0.23mm2 after the disease, and the mean subfoveal choroidal thickness was 247.33±7.65μm before the disease and 273.08±4.92μm after the disease, indicating a statistically significant difference (P=0.003, P=0.001, respectively). The mean retinal nerve fiber layer thickness before and after COVID-19 were 119.33±3.88 and 117.50±3.92μm, respectively, representing a statistically significant decrease (P<0.001). CONCLUSION This is the first study in the literature to evaluate the post-COVID-19 changes in the vascular structures of the eye compared to the pre-disease values. In this study, we found statistically significant changes in choriocapillaris blood flow, subfoveal chroidal thickness and retinal nerve fiber layer thickness after COVID-19 infection. Further research with a greater sample size is needed to explore the effect of COVID-19 on these parameters.
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Affiliation(s)
- B Gedik
- Department of Ophthalmology, Antalya Serik State Hospital, Serik, Antalya 07500, Turkey.
| | - O Yuksel
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - M Kazim Erol
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - F Duman
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - B Dogan
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - E Suren
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - S Yavuz
- Department of Ophthalmology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
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Solomou I, Nikolaou F, Michaelides MP, Constantinidou F. Long-term psychological impact of the pandemic COVID-19: Identification of high-risk groups and assessment of precautionary measures five months after the first wave of restrictions was lifted. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002847. [PMID: 38394160 PMCID: PMC10889631 DOI: 10.1371/journal.pgph.0002847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/15/2023] [Indexed: 02/25/2024]
Abstract
Critical facets of our lives have been disrupted by the COVID-19 outbreak for almost three years. During this time, there has been a lot of clinical and research interest in issues related to mental health. However, few have examined the pandemic's long-term psychological effects. The aims of the present study were to assess the long-term psychological impact of the pandemic COVID -19, five months after the first wave restriction measures were lifted, to identify high-risk groups and to address the use of precautionary measures (PM). Information about sociodemographic characteristics, mental health, coping mechanisms, and compliance with precautionary measures (PM) were all gathered in Cyprus through an anonymous online survey. The poll was completed by 1128 people (73% of whom were female). For the purposes of the present study, descriptive statistics and structural equation modeling were used. 32.3% of participants experienced moderate-to-severe anxiety symptoms, where 16.4% and 23% reported moderate-to-severe depression and post-traumatic stress symptoms respectively. Lower levels of anxiety, depression, and post-traumatic stress symptoms as well as greater compliance to PM were linked to higher levels of resilience. Additionally, subgroups of participants, at a higher risk for negative psychological effects were identified, such as women and young adults. Our findings demonstrate the long-lasting effects of the COVID-19 pandemic on mental health and provide guidance on how to deal with similar situations. It also raises questions about the concurrent effects on people with the long COVID syndrome.
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Affiliation(s)
- Ioulia Solomou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Flora Nikolaou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | | | - Fofi Constantinidou
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
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Burhan E, Liu K, Marwali EM, Huth S, Wulung NGHML, Juzar DA, Taufik MA, Wijaya SO, Wati DK, Kusumastuti NP, Yuliarto S, Pratomo BY, Pradian E, Somasetia DH, Rusmawatiningtyas D, Fatoni AZ, Mandei JM, Lantang EY, Perdhana F, Semedi BP, Rayhan M, Tarigan TRS, White N, Bassi GL, Suen JY, Fraser JF. Characteristics and outcomes of patients with severe COVID-19 in Indonesia: Lessons from the first wave. PLoS One 2023; 18:e0290964. [PMID: 37747884 PMCID: PMC10519602 DOI: 10.1371/journal.pone.0290964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 08/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Indonesia's national response to COVID-19 evolved rapidly throughout 2020. Understanding pandemic response and outcomes is crucial for better mitigation strategies ahead. This study describes the characteristics and outcomes of patients admitted to ICU during the early stages of the pandemic. METHODS This is a multi-centre prospective observational study including patients from twelve collaborating hospitals in Indonesia. All patients were clinically suspected or laboratory-confirmed COVID-19 cases admitted to ICU between January 2020 and March 2021. The primary outcome was monthly ICU mortality. Descriptive statistics of patient characteristics and treatment were generated as secondary outcomes. RESULTS From 559 subjects, the overall mortality was 68% and decreased over the study period, while the mortality of patients that received mechanical ventilation was 92%, consistently high over the study period. Fatal cases showed 2- and 4-day delays from symptoms onset to hospital admissions and ICU admissions, respectively. Evidence-backed approaches which could influence patient outcome, such as extracorporeal membrane oxygenation, prone positioning, renal replacement therapy, and neuromuscular blockade were scarcely administered. CONCLUSIONS The mortality rate of COVID-19 patients in Indonesia was extremely high during the first major outbreak of disease, particularly in those mechanically ventilated. Delayed admission and unavailability of evidence-based approaches due to high burden on health facility during COVID-19 crisis could be addressed by efficient public health measures and enhancing health infrastructure to improve the future pandemic response.
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Affiliation(s)
- Erlina Burhan
- Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, Universitas Indonesia and Persahabatan Hospital, Jakarta, Indonesia
| | - Keibun Liu
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Eva M. Marwali
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Samuel Huth
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | | | - Dafsah A. Juzar
- Departement of Cardiology and Vascular Medicine, Intensive Cardiovascular Care Unit, National Cardiovascular Center Harapan Kita and Universitas Indonesia, Jakarta, Indonesia
| | - Muhammad A. Taufik
- Anesthesiology and Critical Care Department, Fatmawati General Hospital, Jakarta, Indonesia
| | - Surya O. Wijaya
- Intensive Care Unit, Sulianti Saroso Hospital, Jakarta, Indonesia
| | - Dyah K. Wati
- Pediatric Intensive Care Unit, Sanglah Hospital, Denpasar, Bali, Indonesia
| | - Neurinda P. Kusumastuti
- Pediatric Intensive Care Unit, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | - Saptadi Yuliarto
- Pediatric Intensive Care Unit, Saiful Anwar Hospital, Malang, East Java, Indonesia
| | | | - Erwin Pradian
- Intensive Care Unit, Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Dadang H. Somasetia
- Pediatric Intensive Care Unit, Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | | | - Arie Z. Fatoni
- Intensive Care Unit, Saiful Anwar Hospital, Malang, East Java, Indonesia
| | - Jose M. Mandei
- Pediatric Intensive Care Unit, RSUP Prof Dr R. D. Kandou Manado, Indonesia
| | - Eka Y. Lantang
- Intensive Care Unit, RSUP Prof Dr R. D. Kandou Manado, Indonesia
| | - Fajar Perdhana
- Intensive Care Unit, Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Muhammad Rayhan
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Tiffany R. S. Tarigan
- Pediatric Cardiac Intensive Care Unit, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | | | - Gianluigi L. Bassi
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Jacky Y. Suen
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - John F. Fraser
- Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Riziki Ghislain M, Muzumbukilwa WT, Magula N. Risk factors for death in hospitalized COVID-19 patients in Africa: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34405. [PMID: 37657047 PMCID: PMC10476721 DOI: 10.1097/md.0000000000034405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/28/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 has quickly spread worldwide since it first appeared in Wuhan, China, in late 2019. The most affected country in Africa was South Africa. This study aimed to identify the risk factors for death in hospitalized COVID-19 patients in Africa. METHODS We conducted a systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We searched articles from the following database: PubMed, Embase, Cochrane Library, Medline, and COVID-19 Research Database. We used Google Scholar for gray literature. The language used in this article was English. The last search was conducted on January 15, 2023. Pooled HRs, or ORs, and 95% confidence intervals, were calculated separately to identify the risk factors for death in hospitalized COVID-19 patients. Heterogeneity was assessed by Cochran's Q statistic and the I2 test. The Egger test was used to assess publication bias. Subgroup analysis was performed to determine the source of heterogeneity. Data analysis was performed using Stata version 17. A P value < .05 was considered significant. RESULTS A total of 16,600 articles were obtained from the database search; finally, 16 articles met the inclusion criteria and were eligible for data extraction. The analysis revealed that the pooled prevalence of mortality in hospitalized COVID-19 patients was 13.9%. Advanced age was a significant risk factor for death in hospitalized COVID-19 patients, with the pooled coronavirus mortality HR and OR being 3.73 (95% CI: 2.27-5.19) and 1.04 (95% CI: 1.02-1.06), respectively. In addition, male gender (pOR 1.23; 95% CI: 1.07-1.40), patients with diabetes mellitus (DM) (pOR 1.26; 95% CI: 1.01-1.51), hypertension (HTN) (pOR 1.56; 95% CI: 1.27-1.85), chronic kidney disease (CKD) (pHR 5.43; 95% CI: 0.18-10.67), severe or critical conditions (pOR 9.04; 95% CI: 3.14-14.94) had a significantly increased risk of coronavirus-related mortality. The main limitations of the present study stem from the predominant use of published studies, which could introduce publication bias. CONCLUSION According to this study, advanced age, male gender, hypertension, diabetes mellitus, chronic kidney disease, and severe or critical condition were clinical risk factors associated with death outcomes in hospitalized COVID-19 patients in Africa.
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Affiliation(s)
- Manimani Riziki Ghislain
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Willy Tambwe Muzumbukilwa
- The Discipline of Pharmaceutical Sciences, Westville Campus, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Nombulelo Magula
- The Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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Getahun GK, Dinku A, Jara D, Shitemaw T, Negash Z. Magnitude and associated factors of mortality among patients admitted with COVID-19 in Addis Ababa, Ethiopia. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000420. [PMID: 37590230 PMCID: PMC10434868 DOI: 10.1371/journal.pgph.0000420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/19/2023] [Indexed: 08/19/2023]
Abstract
The COVID-19 pandemic continues to grow around the world and has caused enormous mortality and morbidity. The severity and mortality of coronavirus disease are associated with various comorbidities. The infection fatality rate was reported to be inconsistent with different studies. Therefore, the aim of this study was to assess the magnitude and factors associated with mortality among patients admitted to Eka Kotebe General Hospital, Addis Ababa, Ethiopia. An institutional-based cross-sectional study was conducted at Eka Kotebe General Hospital among patients who were admitted for COVID-19 from January 15, 2021, to June 30, 2021. A total of 393 records of patients were selected by simple random sampling. Data was extracted from compiled data forms where available information was already tabulated. Data was entered and analyzed using SPSS version 25. The determinant factors associated with mortality among COVID-19 patients were identified using bivariate and multivariable logistic regression analysis. A statistical association was declared with multivariable logistic regression using a 95% confidence interval and a P-value of less than 0.05. The proportion of COVID-19 mortality among patients admitted to Eka Kotebe General Hospital was 8.1% (95% CI (5.4-10.8%)). Age >50 years [AOR = 7.91; 95% CI (2.34-25.70)], being male [AOR = 2.09; 95% CI (1.20-3.65)], having diabetes mellitus [AOR = 2.64; 95% CI (1.30-5.35)], having hypertension [AOR = 2.67; 95% CI (1.22-5.88)] and having chronic kidney disease [AOR = 12.04; 95% CI (4.03-14.22)] were determinant factors of COVID-19 mortality. The current study findings revealed that COVID-19 mortality was high among hospitalized COVID-19 patients. Furthermore, age, gender, diabetes mellitus, hypertension, and chronic kidney disease were discovered to be independent predictors of COVID-19 mortality. Therefore, older COVID-19 patients and those with established comorbidities such as hypertension, diabetes, and end-stage renal disease should receive comprehensive preventative efforts, including vaccination.
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Affiliation(s)
- Genanew Kassie Getahun
- Menelik II Medical and Health Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | | | - Dube Jara
- Debre Markos University, Debre Markos, Ethiopia
| | - Tewodros Shitemaw
- Menelik II Medical and Health Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
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Gautam S, Kumar R, Bhadoria DP, Mawari G, Kumar N, Daga MK, Pandit S, Anuradha S, Pradhan GS, Garg S, Sharma G, Raghu RV, Ritchie N, Jayamsulekha D. Clinical profile of hospitalised moderate category COVID-19 patients: Short study from a Tertiary Care Centre in Delhi. J Family Med Prim Care 2023; 12:1644-1653. [PMID: 37767420 PMCID: PMC10521840 DOI: 10.4103/jfmpc.jfmpc_2245_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/28/2023] [Accepted: 05/29/2023] [Indexed: 09/29/2023] Open
Abstract
Background The clinical profile of hospitalized moderate-category COVID-19 patients has been understudied globally and in India. Aim The present study was conducted to study the clinical profile and assess the proportions of patients who progressed to severe disease and its predictors among moderate COVID-19 patients. Materials and Methods In this single-center observational study, 100 moderate-category COVID-19 patients as per Ministry of Health and Family Welfare (MoHFW) criteria of age ≥18 years of either sex, excluding pregnant females from February to November 2021, were studied by analyzing their clinical profiles and assessing Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score 2 (NEWS-2), and chest computed-tomography severity score (CTSS) to predict progression to severe disease. Severe disease was defined as per MoHFW criteria. Results Out of 100 moderate-category COVID-19 patients, progression to severe disease was seen in 11 patients (11%), among which eight patients had expired, three patients were discharged, and the rest of the 89 patients (89%) who did not progress to severe disease were discharged. A higher age (62.2± 19.5 vs 54.8 ± 14.6 years), along with multivariate analysis revealing male sex (1.25 times), chronic kidney disease (2.86 times), leukocytosis (6.10 times), thrombocytopenia (1.04 times), anemia (9.3 times), a higher qSOFA score (3.6 times), and a higher NEWS-2 score on admission (1.56 times) had higher odds of progression to severe disease. A significant correlation (P < .05) of qSOFA score with serum LDH, ferritin, and hs-CRP levels; CT severity score with the serum ferritin, IL-6, and LDH levels; and NEWS-2 with serum LDH, hs-CRP, and ferritin levels were found. Moreover, the NEWS-2 score was found slightly better than qSOFA on receiver operating characteristic (ROC) curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, predicting progression to severe disease. Conclusion Our study revealed male gender, chronic kidney disease, leukocytosis, anemia, thrombocytopenia, a higher qSOFA and NEWS-2 score on admission, and further, NEWS-2 score better than qSOFA on ROC curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, in predicting severe disease among hospitalized moderate COVID-19 patients.
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Affiliation(s)
- Sachin Gautam
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Rahul Kumar
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Dharam Pal Bhadoria
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Govind Mawari
- Department of Centre for Occupational and Environmental Health (COEH), Maulana Azad Medical College, New Delhi, India
| | - Naresh Kumar
- Department of Pulmonary Medicine, Maulana Azad Medical College, New Delhi, India
| | - Mradul K. Daga
- Department of Internal Medicine and Infectious Disease, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Sanjay Pandit
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - S. Anuradha
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | | | - Sandeep Garg
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Gaurav Sharma
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - RV Raghu
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Nupur Ritchie
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Dasari Jayamsulekha
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
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Ogunsola FT, Ejekam CS, Balogun M, Ugonna I, Odukoya O, Oduyebo O, Adeyemo WL, Oladele RO, Akanmu SA. Universal use of face mask for the prevention of the spread of COVID-19 in community settings in a South-western State of Nigeria: willingness and barriers. Antimicrob Resist Infect Control 2023; 12:64. [PMID: 37408082 PMCID: PMC10324105 DOI: 10.1186/s13756-023-01267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES One of the major drivers of the novel coronavirus (SARS-CoV-2) pandemic is community transmission. Nigeria, like other countries globally, took to strict preventive public health measures including good respiratory and hand hygiene, physical distancing, and the use of face mask to control the spread of COVID-19 disease. Furthermore, the government of Lagos State in Nigeria made a pronouncement on the universal use of face mask in the community. While the use of face masks has proven to be an effective barrier to the transmission of respiratory diseases, its use in the community is uncommon. This study assessed the willingness and compliance with wearing face masks for the reduction of the community spread of COVID-19 and identified possible barriers to use of mask among residents in Lagos State. METHODS This was a descriptive cross-sectional study, that surveyed 552 respondents who were adult residents of Lagos State. Data collection was quantitative, using a pretested, interviewer-administered questionnaire, and findings were presented in frequencies and percentages. Pearson's chi-square and logistic regression analyses were used to test the association between variables. The level of significance was set at 5%. RESULTS A majority (75.7%) of the respondents were willing to wear a face mask in public areas but only 21.9% of the respondents were willing to wear a mask at all times. The most identified barriers to wearing mask were discomfort (72.5%) and inconvenience (77.7%). Two-thirds of the respondents reported they were compliant with always wearing a face mask when leaving home. Only 15.0% of the respondents wore the mask continuously and appropriately, covering the nose and mouth. Having a post-secondary education and being older (40 years and above) were found to be positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing masks continuously and appropriately). CONCLUSION Our findings suggest that willingness to wear a face mask influences compliance, and that having a post-secondary education and being older (> 40 years) were positive predictors of both willingness to wear a mask and compliance with universal mask policy (wearing it continuously and correctly). The major barriers to wearing masks were discomfort and inconvenience. Effective risk communication strategies to reach diverse groups for better compliance with public health measures are urgently needed even for the future.
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Affiliation(s)
- Folasade T Ogunsola
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Chioma S Ejekam
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria.
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Igwilo Ugonna
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Oyinlola Oduyebo
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Rita O Oladele
- Department Medical Microbiology, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
| | - Sulaimon A Akanmu
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Idiaraba, Lagos, Nigeria
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Ojo TO, Ojo AO, Ojo OE, Akinwalere BO, Akinwumi AF. Determinants of COVID-19 vaccine uptake among Nigerians: evidence from a cross-sectional national survey. Arch Public Health 2023; 81:95. [PMID: 37237389 DOI: 10.1186/s13690-023-01107-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND COVID-19 ranks as one of the largest public health threats in recent times. It is associated with huge health, economic and social consequences. Although vaccination is an effective control measure, COVID-19 vaccine uptake has been suboptimal in many low/middle income countries. Hence this study assessed the factors influencing COVID-19 vaccine uptake among Nigerian households. DATA AND METHODS This study analyzed secondary data from the COVID-19 High-Frequency Phone Survey of Households that was collected by the National Bureau of Statistics between November 2021 and January 2022. Relevant data were analyzed using descriptive statistical tools and the Multivariate Regression model. RESULTS Out of 2370 respondents, only 32.8% of the respondents were vaccinated against COVID-19. Respondents living in urban areas (34.4%) had a higher level of COVID-19 vaccine uptake relative to those living in rural Nigeria (30.9%). Results from the Multivariate Regression model revealed that adults aged ≥ 60 years (OR 2.20; p = 0.012), respondents with primary (OR 1.72; p = 0.032), secondary (OR 1.77; p = 0.025) and tertiary education (OR 3.03; p < 0.001), respondents with access to health insurance (OR 1.68; p = 0.004), those who obtained vaccine information from health workers (OR 3.92; p < 0.001), the government (OR 3.22; p < 0.001), and the mass media (OR 1.75; p = 0.003) were more likely to be vaccinated. Also, respondents living in North Central (OR 2.02; p < 0.001), North East (OR 1.48; p = 0.039), South West (OR 2.63; p < 0.001), and South South (OR 1.49; p = 0.031) regions had higher odds of being vaccinated. CONCLUSIONS The study recommends increased media campaigns and advocacy for COVID-19 vaccination in the South East and North West regions. Persons with no formal education and younger persons aged 18-29 years should be targeted with COVID-19 vaccine-related information given that they were less likely to be vaccinated. Dissemination of relevant information through government sources, mass media and health workers is encouraged so as to positively influence decisions to receive COVID-19 vaccines among citizens.
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Affiliation(s)
- Temitope Olumuyiwa Ojo
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, +234 8035798224, Nigeria.
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Gebrecherkos T, Challa F, Tasew G, Gessesse Z, Kiros Y, Gebreegziabxier A, Abdulkader M, Desta AA, Atsbaha AH, Tollera G, Abrahim S, Urban BC, Schallig H, Rinke de Wit T, Wolday D. Prognostic Value of C-Reactive Protein in SARS-CoV-2 Infection: A Simplified Biomarker of COVID-19 Severity in Northern Ethiopia. Infect Drug Resist 2023; 16:3019-3028. [PMID: 37215303 PMCID: PMC10199690 DOI: 10.2147/idr.s410053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose To evaluate the role of C-reactive protein (CRP) in predicting severe COVID-19 patients. Methods A prospective observational cohort study was conducted from July 15 to October 28, 2020, at Kuyha COVID-19 isolation and treatment center hospital, Mekelle City, Northern Ethiopia. A total of 670 blood samples were collected serially. SARS-CoV-2 infection was confirmed by RT-PCR from nasopharyngeal swabs and CRP concentration was determined using Cobas Integra 400 Plus (Roche). Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results Overall, COVID-19 patients had significantly elevated CRP at baseline when compared to PCR-negative controls [median 11.1 (IQR: 2.0-127.8) mg/L vs 0.9 (IQR: 0.5-1.9) mg/L; p=0.0004)]. Those with severe COVID-19 clinical presentation had significantly higher median CRP levels compared to those with non-severe cases [166.1 (IQR: 48.6-332.5) mg/L vs 2.4 (IQR: 1.2-7.6) mg/L; p<0.00001)]. Moreover, COVID-19 patients exhibited higher median CRP levels at baseline [58 (IQR: 2.0-127.8) mg/L] that decreased significantly to 2.4 (IQR: 1.4-3.9) mg/L after 40 days after symptom onset (p<0.0001). Performance of CRP levels determined using ROC analysis distinguished severe from non-severe COVID-19 patients, with an AUC value of 0.83 (95% CI: 0.73-0.91; p=0.001; 77.4% sensitivity and 89.4% specificity). In multivariable analysis, CRP levels above 30 mg/L were significantly associated with an increased risk of developing severe COVID-19 for those who have higher ages and comorbidities (ARR 3.99, 95% CI: 1.35-11.82; p=0.013). Conclusion CRP was found to be an independent determinant factor for severe COVID-19 patients. Therefore, CRP levels in COVID-19 patients in African settings may provide a simple, prompt, and inexpensive assessment of the severity status at baseline and monitoring of treatment outcomes.
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Affiliation(s)
- Teklay Gebrecherkos
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
| | - Feyissa Challa
- National Reference Laboratory for Clinical Chemistry, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Department of Bacteriology, Parasitology and Zoonosis, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zekarias Gessesse
- Department of Internal Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Yazezew Kiros
- Department of Internal Medicine, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | | | - Mahmud Abdulkader
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
| | - Abraham Aregay Desta
- Public Health Research and Emergency Management, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Ataklti Hailu Atsbaha
- Department of Microbiology, Tigray Health Research Institute, Mekelle, Tigray, Ethiopia
| | - Getachew Tollera
- Research and Technology Transfer Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abrahim
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Britta C Urban
- Department of Clinical Sciences, Respiratory Clinical Research Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Henk Schallig
- Department of Medical Microbiology and Infection Prevention, Experimental Parasitology Unit, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Tobias Rinke de Wit
- Amsterdam Institute of Global Health and Development, Department of Global Health, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Joep-Lange Institute, Amsterdam, the Netherlands
| | - Dawit Wolday
- Department of Medical Microbiology and Immunology, College of Health Sciences (CHS), Mekelle University (MU), Mekelle, Tigray, Ethiopia
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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12
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Akase IE, Akintan PE, Otrofanowei E, Olopade OB, Olorunfemi G, Opawoye A, Ima-Edomwomyi UE, Akinbolagbe YO, Agabi OP, Nmadu DA, Akinbode GO, Olasope AC, Ogundare A, Bolarinwa AB, Otokiti EO, Enajeroh PJ, Karami M, Esezobor CI, Oshodi Y, Oluwole AA, Adeyemo WL, Bode CO. Clinical predictors of Covid-19 mortality in a tertiary hospital in Lagos, Nigeria: A retrospective cohort study. Niger J Clin Pract 2023; 26:424-431. [PMID: 37203106 DOI: 10.4103/njcp.njcp_454_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Background The predictors of mortality among patients presenting with severe to critical disease in Nigeria are presently unknown. Aim The aim of this study was to identify the predictors of mortality among patients with COVID-19 presenting for admission in a tertiary referral hospital in Lagos, Nigeria. Patients and Methods The study was a retrospective study. Patients' sociodemographics, clinical characteristics, comorbidities, complications, treatment outcomes, and hospital duration were documented. Pearson's Chi-square, Fischer's Exact test, or Student's t-test were used to assess the relationship between the variables and mortality. To compare the survival experience across medical comorbidities, Kaplan Meir plots and life tables were used. Univariable and multivariable Cox-proportional hazard analyses were conducted. Results A total of 734 patients were recruited. Participants' age ranged from five months to 92 years, with a mean ± SD of 47.4 ± 17.2 years, and a male preponderance (58.5% vs. 41.5%). The mortality rate was 9.07 per thousand person-days. About 73.9% (n = 51/69) of the deceased had one or more co-morbidities, compared to 41.6% (252/606) of those discharged. Patients who were older than 50 years, with diabetes mellitus, hypertension, chronic renal illness, and cancer had a statistically significant relationship with mortality. Conclusion These findings call for a more comprehensive approach to the control of non-communicable diseases, the allocation of sufficient resources for ICU care during outbreaks, an improvement in the quality of health care available to Nigerians, and further research into the relationship between obesity and COVID-19 in Nigerians.
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Affiliation(s)
- I E Akase
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - P E Akintan
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - E Otrofanowei
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O B Olopade
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - G Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - A Opawoye
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - U E Ima-Edomwomyi
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Y O Akinbolagbe
- Department of Pediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - O P Agabi
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - D A Nmadu
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - G O Akinbode
- Department of Surgery, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A C Olasope
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A Ogundare
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - A B Bolarinwa
- Department of Hematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria
| | - E O Otokiti
- Department of Hematology and Blood Transfusion, Lagos University Teaching Hospital, Lagos, Nigeria
| | - P J Enajeroh
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - M Karami
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - C I Esezobor
- Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Y Oshodi
- Department of Psychiatry, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A A Oluwole
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
| | - C O Bode
- Department of Surgery, College of Medicine, University of Lagos, Lagos, Nigeria
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Misganaw S, Eshetu B, Adane A, Solomon T. Predictors of death among severe COVID-19 patients admitted in Hawassa City, Sidama, Southern Ethiopia: Unmatched case-control study. PLoS One 2023; 18:e0282478. [PMID: 36857375 PMCID: PMC9977030 DOI: 10.1371/journal.pone.0282478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
INTRODUCTION Since COVID-19 was announced as a worldwide pandemic, the world has been struggling with this disease. In Ethiopia, there is some information on the epidemiological characteristics of the disease and treatment outcomes of COVID-19 patients. But, there is limited evidence related to predictors of death in COVID-19 patients. OBJECTIVE To assess the predictor of death among severely ill COVID-19 patients admitted in Hawassa city COVID-19 treatment centers. METHODS An institution-based unmatched case-control study was conducted at Hawassa city COVID-19 treatment centers from May 2021 to June 2021. All severe COVID-19-related deaths from May 2020 to May 2021 were included in the case group whereas randomly selected discharged severe COVID-19 patients were included in the control group. Extracted information was entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Multivariable binary logistic regression was run to assess predictors. The result was presented as an adjusted odds ratio with a 95% confidence interval. Variables with a 95% confidence interval which not included one were considered statistically significant. RESULT A total of 372 (124 cases and 248 controls) patients were included in the study. Multivariable analysis revealed age ≥ 65 years (AOR = 2.62, 95% CI = 1.33-5.14), having shortness of breath (AOR = 1.87, 95% CI = 1.02-3.44), fatigue (AOR 1.78, 95% CI = 1.09-2.90), altered consciousness (AOR 3.02, 95% CI = 1.40, 6.49), diabetic Mellitus (AOR = 2.79, 95% CI = 1.16-6.73), chronic cerebrovascular disease (AOR = 2.1, 95% CI = 1.23, 3.88) were found to be predictors of death. CONCLUSION Older age, shortness of breath, fatigue, altered consciousness, and comorbidity were predictors of death in Severe COVID-19 patients.
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Affiliation(s)
- Samuel Misganaw
- Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- * E-mail:
| | - Betelhem Eshetu
- Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Adugnaw Adane
- Department of Human Physiology, Faculty of Medical Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Tarekegn Solomon
- Department of Epidemiology, School of Public Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Adekanmbi O, Ilesanmi O, Idowu O, Esan A, Raji YR, Fowotade A, Ogunlade O, Akere A, Ololade O, Ojifinni K, Akinola O, Orunmuyi A, Eze U, Akinmoladun V, Adeoye A, Adebiyi A, Olapade-Olaopa EO, Otegbayo JA, Osungbade K. Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria. Afr Health Sci 2023; 23:72-82. [PMID: 37545917 PMCID: PMC10398429 DOI: 10.4314/ahs.v23i1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. Objectives To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. Methods A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Results Mean age was 60.9±16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71±22% and 38±11/minute in non-survivors and 90±7% and 31±7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Conclusion Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.
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Affiliation(s)
- Olukemi Adekanmbi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Olayinka Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Olusola Idowu
- Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Anaesthesia, University College Hospital, Ibadan, Nigeria
| | - Arinola Esan
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Yemi R Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olubunmi Ogunlade
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adegboyega Akere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Oluwaseun Ololade
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Kehinde Ojifinni
- Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria
| | - Olurotimi Akinola
- Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria
| | - Akintunde Orunmuyi
- Department of Nuclear Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Uwom Eze
- Department of Pathology, University College Hospital, Ibadan, Nigeria
| | - Victor Akinmoladun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan
| | - Abiodun Adeoye
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Institute of Cardiovascular Disease, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akindele Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - E Oluwabunmi Olapade-Olaopa
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Surgery, University College Hospital, Ibadan, Nigeria
| | - Jesse A Otegbayo
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Kayode Osungbade
- Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan
- Disease Surveillance Unit, University College Hospital, Ibadan, Nigeria
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Adekanmbi O, Alao A, Ibisola B, Odekunle I. A Comparative Analysis of Laboratory Parameters of Hospitalized COVID-19 Patients by Disease Severity and Mortality at a Facility in Ibadan, Nigeria. Niger Med J 2023; 64:243-250. [PMID: 38898975 PMCID: PMC11185805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background COVID-19, which is caused by the SARS-CoV-2 virus, is associated with abnormalities of biochemical parameters. There are indications that some of these biochemical parameters can differ according to the severity of the disease and the outcome of the infection. This study describes and compares laboratory findings among COVID-19 patients hospitalized at a facility in Southwestern Nigeria according to disease severity and mortality. Methodology Records of 223 patients with COVID-19 disease admitted between March 2020 and May 2021 were retrospectively collected. Socio-demographic characteristics, laboratory parameters, and patient outcomes were obtained. Patients were classified according to COVID-19 severity. Laboratory parameters were compared between patients with severe and non-severe disease and between survivors and non-survivors. Results Of the 215 patients with some laboratory data included in the analysis, there were 133 (62%) males, and 56.7% were aged above 60 years. A total of 71.6% had severe COVID-19 and 48.4% died during hospitalization. The severe disease occurred significantly more frequently among non-survivors (P0.01). Higher leukocyte and neutrophil counts, urea levels, D-Dimer, and fasting blood glucose levels occurred significantly more frequently in both severe disease and mortality categories. Additionally, elevated GGT and CRP were significantly more common in those with severe than non-severe disease while lower hemoglobin, hematocrit, albumin, and higher creatinine levels were significantly more common in non-survivors. Conclusion Our study found that certain readily obtainable biochemical parameters occur more frequently with severe disease and/or mortality amongst patients hospitalized with COVID-19 in sub-Saharan Africa and might be useful for prognostication and allocation of resources.
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Affiliation(s)
- Olukemi Adekanmbi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adegboyega Alao
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Babalola Ibisola
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
| | - Idowu Odekunle
- Department of Family Medicine, University College Hospital, Ibadan, Ibadan, Nigeria
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Non-Typical Clinical Presentation of COVID-19 Patients in Association with Disease Severity and Length of Hospital Stay. J Pers Med 2023; 13:jpm13010132. [PMID: 36675793 PMCID: PMC9863951 DOI: 10.3390/jpm13010132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND This study aimed to investigate the incidence of non-typical symptoms in ambulatory patients with mild-to-moderate COVID-19 infection and their potential association with disease progression. MATERIALS AND METHODS Data on the symptomatology of COVID-19 patients presenting to the fast-track emergency department were collected between March 2020 and March 2021. Fever, cough, shortness of breath, and fatigue-weakness were defined as "typical" symptoms, whereas all other symptoms such as nasal congestion, rhinorrhea, gastrointestinal symptoms, etc., were defined as "non-typical". RESULTS A total of 570 COVID-19 patients with a mean age of 42.25 years were included, the majority of whom were male (61.3%; N = 349), and were divided according to their symptoms into two groups. The mean length of hospital stay was found to be 9.5 days. A higher proportion of patients without non-typical symptoms were admitted to the hospital (p = 0.001) and the ICU (p = 0.048) as well. No significant differences were observed between non-typical symptoms and outcome (p = 0.685). Patients who did not demonstrate at least one non-typical symptom had an extended length of stay (p = 0.041). No statistically significant differences in length of hospital stay were associated with individual symptoms. CONCLUSION With the possible exception of gastrointestinal symptoms, non-typical symptoms of COVID-19 at baseline appear to predispose to a milder disease.
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Ngere P, Onsongo J, Langat D, Nzioka E, Mudachi F, Kadivane S, Chege B, Kirui E, Were I, Mutiso S, Kibisu A, Ihahi J, Mutethya G, Mochache T, Lokamar P, Boru W, Makayotto L, Okunga E, Ganda N, Haji A, Gathenji C, Kariuki W, Osoro E, Kasera K, Kuria F, Aman R, Nabyonga J, Amoth P. Characterization of COVID-19 cases in the early phase (March to July 2020) of the pandemic in Kenya. J Glob Health 2022; 12:15001. [PMID: 36583253 PMCID: PMC9801068 DOI: 10.7189/jogh.12.15001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Kenya detected the first case of COVID-19 on March 13, 2020, and as of July 30, 2020, 17 975 cases with 285 deaths (case fatality rate (CFR) = 1.6%) had been reported. This study described the cases during the early phase of the pandemic to provide information for monitoring and response planning in the local context. Methods We reviewed COVID-19 case records from isolation centres while considering national representation and the WHO sampling guideline for clinical characterization of the COVID-19 pandemic within a country. Socio-demographic, clinical, and exposure data were summarized using median and mean for continuous variables and proportions for categorical variables. We assigned exposure variables to socio-demographics, exposure, and contact data, while the clinical spectrum was assigned outcome variables and their associations were assessed. Results A total of 2796 case records were reviewed including 2049 (73.3%) male, 852 (30.5%) aged 30-39 years, 2730 (97.6%) Kenyans, 636 (22.7%) transporters, and 743 (26.6%) residents of Nairobi City County. Up to 609 (21.8%) cases had underlying medical conditions, including hypertension (n = 285 (46.8%)), diabetes (n = 211 (34.6%)), and multiple conditions (n = 129 (21.2%)). Out of 1893 (67.7%) cases with likely sources of exposure, 601 (31.8%) were due to international travel. There were 2340 contacts listed for 577 (20.6%) cases, with 632 contacts (27.0%) being traced. The odds of developing COVID-19 symptoms were higher among case who were aged above 60 years (odds ratio (OR) = 1.99, P = 0.007) or had underlying conditions (OR = 2.73, P < 0.001) and lower among transport sector employees (OR = 0.31, P < 0.001). The odds of developing severe COVID-19 disease were higher among cases who had underlying medical conditions (OR = 1.56, P < 0.001) and lower among cases exposed through community gatherings (OR = 0.27, P < 0.001). The odds of survival of cases from COVID-19 disease were higher among transport sector employees (OR = 3.35, P = 0.004); but lower among cases who were aged ≥60 years (OR = 0.58, P = 0.034) and those with underlying conditions (OR = 0.58, P = 0.025). Conclusion The early phase of the COVID-19 pandemic demonstrated a need to target the elderly and comorbid cases with prevention and control strategies while closely monitoring asymptomatic cases.
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Affiliation(s)
- Philip Ngere
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya,Washington State University, Global Health, Kenya
| | | | - Daniel Langat
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Elizabeth Nzioka
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Faith Mudachi
- Department of Promotive and Preventive Health, Ministry of Health, Kenya
| | - Samuel Kadivane
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Bernard Chege
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Elvis Kirui
- National Public Health Laboratory Services, Ministry of Health, Kenya
| | - Ian Were
- Office of the Director General, Ministry of Health, Kenya
| | - Stephen Mutiso
- Department of Promotive and Preventive Health, Ministry of Health, Kenya
| | - Amos Kibisu
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Josephine Ihahi
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Gladys Mutethya
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | | | - Peter Lokamar
- National Public Health Laboratory Services, Ministry of Health, Kenya
| | - Waqo Boru
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya
| | - Lyndah Makayotto
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Emmanuel Okunga
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | | | - Adam Haji
- World Health Organization, Nairobi Kenya
| | | | | | - Eric Osoro
- Washington State University, Global Health, Kenya
| | - Kadondi Kasera
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Francis Kuria
- Directorate of Public Health, Ministry of Health, Kenya
| | - Rashid Aman
- Cabinet Administrative Secretary, Ministry of Health, Kenya
| | | | - Patrick Amoth
- Office of the Director General, Ministry of Health, Kenya
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Bepouka B, Mayasi N, Mandina M, Longokolo M, Odio O, Mangala D, Mbula M, Kayembe JM, Situakibanza H. Risk factors for mortality in COVID-19 patients in sub-Saharan Africa: A systematic review and meta-analysis. PLoS One 2022; 17:e0276008. [PMID: 36251715 PMCID: PMC9576083 DOI: 10.1371/journal.pone.0276008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Aim Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in Africa. In this study, we aimed to summarize the available results on the association between sociodemographic, clinical, biological, and comorbidity factors and the risk of mortality due to COVID-19 in sub-Saharan Africa. Methods We followed the PRISMA checklist (S1 Checklist). We searched PubMed, Google Scholar, and European PMC between January 1, 2020, and September 23, 2021. We included observational studies with Subjects had to be laboratory-confirmed COVID-19 patients; had to report risk factors or predictors of mortality in COVID-19 patients, Studies had to be published in English, include multivariate analysis, and be conducted in the sub-Saharan region. Exclusion criteria included case reports, review articles, commentaries, errata, protocols, abstracts, reports, letters to the editor, and repeat studies. The methodological quality of the studies included in this meta-analysis was assessed using the methodological items for nonrandomized studies (MINORS). Pooled hazard ratios (HR) or odds ratios (OR) and 95% confidence intervals (CI) were calculated separately to identify mortality risk. In addition, publication bias and subgroup analysis were assessed. Results and discussion Twelve studies with a total of 43598 patients met the inclusion criteria. The outcomes of interest were mortality. The results of the analysis showed that the pooled prevalence of mortality in COVID-19 patients was 4.8%. Older people showed an increased risk of mortality from SARS-Cov-2. The pooled hazard ratio (pHR) and odds ratio (pOR) were 9.01 (95% CI; 6.30–11.71) and 1.04 (95% CI; 1.02–1.06), respectively. A significant association was found between COVID-19 mortality and men (pOR = 1.52; 95% CI 1.04–2). In addition, the risk of mortality in patients hospitalized with COVID-19 infection was strongly influenced by chronic kidney disease (CKD), hypertension, severe or critical infection on admission, cough, and dyspnea. The major limitations of the present study are that the data in the meta-analysis came mainly from studies that were published, which may lead to publication bias, and that the causal relationship between risk factors and poor outcome in patients with COVID-19 cannot be confirmed because of the inherent limitations of the observational study. Conclusions Advanced age, male sex, CKD, hypertension, severe or critical condition on admission, cough, and dyspnea are clinical risk factors for fatal outcomes associated with coronavirus. These findings could be used for research, control, and prevention of the disease and could help providers take appropriate measures and improve clinical outcomes in these patients.
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Affiliation(s)
- Ben Bepouka
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
- * E-mail:
| | - Nadine Mayasi
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Madone Mandina
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Murielle Longokolo
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Ossam Odio
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Donat Mangala
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Marcel Mbula
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Jean Marie Kayembe
- Pneumology Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Hippolyte Situakibanza
- Infectious Diseases Unit, Kinshasa University Hospital, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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19
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Marimuthu Y, Kunnavil R, Satyanarayana N, Anil N, Kumar J, Sharma N, Chopra KK, Nagappa B. Clinical presentation and mortality risk factors for COVID-19 among diabetic patients in a tertiary care center in South India. Indian J Tuberc 2022; 69:496-502. [PMID: 36460381 PMCID: PMC8364170 DOI: 10.1016/j.ijtb.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Non-communicable diseases (NCD) like hypertension, diabetes, cardiovascular and cerebrovascular diseases are the most common comorbidities among COVID-19 patients. The clinical presentation and mortality pattern of COVID-19 are different for patients with comorbidities and without comorbidities. OBJECTIVE To determine the clinical presentation of COVID-19 and risk factors for COVID-19 mortality among diabetic patients in a tertiary care hospital in South India. METHODS A record-based cross-sectional study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with the Poisson distribution. Survival curves were made using the Kaplan-Meier method. RESULTS Out of 200 COVID-19 patients with diabetes with a mean (SD) age of 56.1 (11.8) years, 61% were men. The median survival time was slightly lesser in male COVID-19 patients (15 days) as compared to female patients (16 days). The risk of mortality among COVID-19 patients with diabetes is increased for patients who presented with breathlessness (aRR = 4.5 (95% CI: 2.3-8.8)), had positive history of smoking (aRR = 1.9 (95% CI: 1.1-3.8)), who had CKD (aRR = 1.8 (95% CI: 1.1-2.8)) and who had cardiac illness (aRR = 1.6 (95% CI: 0.9-2.7)). CONCLUSION Diabetes patients with COVID-19 need to be given additional care and monitoring especially if they present with breathlessness, positive history of smoking, cardiac illness and, CKD. Public health campaigns and health education activities to control smoking is needed to reduce the COVID-19 mortality in diabetes patients.
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Affiliation(s)
- Yamini Marimuthu
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, 560010, India
| | - Radhika Kunnavil
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, 560010, India
| | - N. Satyanarayana
- Department of General Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, 560010, India
| | - N.S. Anil
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, 560010, India
| | - Jeetendra Kumar
- ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru, 560010, India
| | - Nandini Sharma
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | | | - Bharathnag Nagappa
- Department of Community Medicine, A.J. Institute of Medical Sciences and Research Centre, Mangalore, India,Corresponding author. Dept. of Community Medicine, A.J. Institute of Medical Sciences and Research Centre, Mangalore, 575004, India. Tel.: +91 8971252949
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20
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Al-Ani RM. Ear, nose, and throat manifestations of COVID-19 and its vaccines. World J Clin Cases 2022; 10:8808-8815. [PMID: 36157654 PMCID: PMC9477042 DOI: 10.12998/wjcc.v10.i25.8808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/01/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease and was designated a pandemic by the World Health Organization (WHO) on March 11, 2020. There are no classical manifestations of the disease. The most prevalent symptoms include fever, cough, dyspnea, myalgia and headache. The main route of transmission of the severe acute respiratory syndrome coronavirus-2 is through the upper respiratory tract. Therefore, it is not strange to find different ear, nose and throat (ENT) symptoms in individuals infected with this virus. Olfactory dysfunction is a common feature of COVID-19; either it is the only presenting symptom or it accompanies other manifestations of the disease. Other otolaryngological features such as sudden sensorineural hearing loss (SSNHL), dysphonia, nasal obstruction, sore throat, etc. are less frequent manifestations of COVID-19. These features, in addition, to being presented early in the disease process, certain long-standing symptoms like parosmia, dysphonia, and persistent deafness, are other characteristics of the disease. Geographical variation in otorhinolaryngological prevalence is another problem with this debilitating disease. Local and systemic adverse effects (local site injection pain, fever, myalgia, headache, and others) of the COVID-19 vaccines are more frequent than otolaryngological side effects (anosmia, hyposmia, Bell’s palsy, SSNHL, etc.). We aimed in this review to summarize the early and persistent ENT symptoms of COVID-19 or after the various COVID-19 vaccines.
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Affiliation(s)
- Raid M Al-Ani
- Department of Surgery/Otolaryngology, University of Anbar, College of Medicine, Ramadi 31001, Anbar, Iraq
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21
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Cyrille TM, Serge SM, Brice TMJ, Alain TNP, Grace N, Joseph F, Achta H, Gisèle N, Julius N, Marcel T, Melissa S, Lucy N, Ronald P, Claire OAM, Walter PYE, Alain EMG, Richard N, Sara E. Clinical presentation of COVID-19 at the time of testing and factors associated with pre-symptomatic cases in Cameroon. IJID REGIONS 2022; 4:33-41. [PMID: 35720960 PMCID: PMC9148624 DOI: 10.1016/j.ijregi.2022.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To describe the clinical features at time of testing and explore factors associated with SARS-CoV-2 infection and pre-symptomatic cases in Cameroon. METHODS Data was collected on people in Cameroon who participated in COVID-19 testing by real-time reverse transcriptase-polymerase chain reaction between 1 March and 5 October 2020. After descriptive analysis, multivariate logistic regression was used to identify factors associated with SARS-CoV-2 infection and pre-symptomatic cases. RESULTS Of 85 206 test participants, 14 863 (17.4%) were infected with SARS-CoV-2. The median age for cases was 38.4 years (interquartile range 29.6-49.4); 6.1% were aged <19 years, and 6.3% were ≥65 years. Of these cases, 46.5% had at least one symptom/sign with a median time from illness onset to testing of 6 days (interquartile range 3-9). Cough (64.2%), headache (46.5%), fatigue/malaise (46.0%), shortness of breath (30.6%) and myalgia/arthralgia (25.6%) were the most commonly observed symptoms/signs. Pre-symptomatic SARS-CoV-2 infection was associated with age <50 years, being male and absence of comorbidities. CONCLUSION This study provides a comprehensive summary of the early clinical profile of SARS-CoV-2 infection during the first wave of COVID-19 in Cameroon, which was dominated by pre-symptomatic illness. These findings would be helpful for SARS-CoV-2 surveillance and control at a regional level.
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Affiliation(s)
| | | | | | | | - Ngondi Grace
- Virology Laboratory, Laquintinie Hospital, Douala, Cameroon
| | - Fokam Joseph
- Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon
| | - Hamadou Achta
- Epidemiology and Public Health Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon
| | | | | | - Tongo Marcel
- Emerging and Reemerging Diseases Research Centre, IMPM, Yaoundé, Cameroon
| | - Sander Melissa
- Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon
| | - Ndip Lucy
- Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon
| | - Perraut Ronald
- Pasteur Centre in Cameroon, Annex of Garoua, Garoua, Cameroon
| | | | | | - Etoundi Mballa Georges Alain
- Public Health Emergency Operations Coordination Centre, Yaoundé, Cameroon
- Department for the Control of Disease, Epidemics, and Pandemics, Ministry of Public Health, Yaoundé, Cameroon
| | - Njouom Richard
- Virology Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon
| | - Eyangoh Sara
- Public Health Emergency Operations Coordination Centre, Yaoundé, Cameroon
- Scientific Department, Pasteur Centre in Cameroon, Yaoundé
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22
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Adejumo OA, Ogunniyan T, Adetola AV, Mba SC, Ogunbayo O, Oladokun OD, Oluwadun OB, Erinoso O, Adesola S, Bowale A. Factors associated with death among hospitalized COVID-19 patients in Lagos State, Nigeria: a retrospective cross-sectional study. Afr Health Sci 2022; 22:486-494. [PMID: 36910372 PMCID: PMC9993304 DOI: 10.4314/ahs.v22i3.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Lagos State has the highest burden of COVID-19 in Nigeria. We assessed associated factors with death from COVID-19 among hospitalized patients in Lagos, Nigeria. Methods A retrospective cross-sectional study was conducted using de-identified records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos State between February 27, 2020, and September 30, 2020. Results A total of 2,858 COVID -19 patients were included in this study. The mean age of the patients was 41.9±15.5 years. A higher proportion of patients were males (65.8%), asymptomatic (55.5%), had no comorbid condition (72.2%) and had the mild disease (73.8%). The case fatality rate was 6.5%. The odds of death from COVID-19 infection increased by 4% with every increase in age (AOR 1.04, 95%CI 1.03-1.05, p<0.001). The chance of dying was 50% fold more among males (AOR 1.5, 95%CI 1.0 - 2.2, p = 0.042), 60% fold more among patients with comorbidity (AOR 1.6, 95%CI 1.3 - 2.4, p = 0.037) and 9 fold more among patients with severe COVID-19 infection (AOR 9.6, 95% CI 4.9 - 19.1, p <0.001). Conclusion The odds of dying was higher among males, the elderly, patients with comorbidity and severe COVID-19.
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Affiliation(s)
| | | | | | - Sandra Chizoba Mba
- Nigeria Centre for Disease Control. Nigeria Field Epidemiology and Laboratory Training Program Abuja Nigeria
| | | | | | | | - Olufemi Erinoso
- Department of Dentistry, Lagos State University Teaching Hospital Ikeja Lagos Nigeria
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23
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Jo S, Nam HK, Kang H, Cho SI. Associations of symptom combinations with in-hospital mortality of coronavirus disease-2019 patients using South Korean National data. PLoS One 2022; 17:e0273654. [PMID: 36018890 PMCID: PMC9417015 DOI: 10.1371/journal.pone.0273654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 08/11/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND There are various risk factors for death in coronavirus disease-2019 (COVID-19) patients. The effects of symptoms on death have been investigated, but symptoms were considered individually, rather than in combination, as predictors. We examined the effects of symptom combinations on in-hospital mortality. METHODS Data from the Korea Disease Control and Prevention Agency were analyzed. A cohort of 5,153 patients confirmed with COVID-19 in South Korea was followed from hospitalization to death or discharge. An exploratory factor analysis was performed to identify symptom combinations, and the hazard ratios (HRs) of death were estimated using the Cox proportional hazard model. RESULTS Three sets of symptom factors were isolated for symptom combination. Factor 1 symptoms were cold-like symptoms, factor 2 were neurological and gastrointestinal symptoms, and factor 3 were more severe symptoms such as dyspnea and altered state of consciousness. Factor 1 (HR 1.14, 95% confidence interval [95% CI] 1.01-1.30) and factor 3 (HR 1.25, 95% CI 1.19-1.31) were associated with a higher risk for death, and factor 2 with a lower risk (HR 0.71, 95% CI 0.71-0.96). CONCLUSIONS The effect on in-hospital mortality differed according to symptom combination. The results are evidence of the effects of symptoms on COVID-19 mortality and may contribute to lowering the COVID-19 mortality rate. Further study is needed to identify the biological mechanisms underlying the effects of symptom combinations on mortality.
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Affiliation(s)
- Suyoung Jo
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Hee-kyoung Nam
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Heewon Kang
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sung-il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Seoul, Korea
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24
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Sun CY, Chen HP, Kang YN. Associations between pregnancy and symptoms of COVID-19 are worth further analysis. Am J Emerg Med 2022; 61:224-225. [PMID: 35879198 PMCID: PMC9296370 DOI: 10.1016/j.ajem.2022.07.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/10/2022] [Accepted: 07/17/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Chia-Yi Sun
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; International Medical Service Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Hsin-Ping Chen
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Department of Nursing, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-No Kang
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan; Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
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25
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Elugbadebo OO, Baiyewu O. Mild anxiety and depression disorders: Unusual reactions to COVID-19 lockdown in caregivers of older adults attending a psychogeriatric clinic in Southwest Nigeria. Niger Postgrad Med J 2022; 29:13-19. [PMID: 35102945 DOI: 10.4103/npmj.npmj_708_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Many sub-Saharan African countries have fragile healthcare systems and the mental health care of older adults is in a precarious state. The lockdown that accompanied COVID-19 infection was another monumental event. Objective This study examined the effect of the restriction and lockdown on the mental health of the caregivers of older patients attending a psychogeriatric clinic in Ibadan, Nigeria. Materials and Methods We selected 178 dyads of patients and their caregivers. These caregivers were administered a semi-structured questionnaire that collected demographic information and asked questions on effect of COVID-19 on caregiving. In addition, Patient Health Questionnaire-9 and generalised anxiety disorder-7 item scale were administered. Participants were interviewed through telephone. Results One hundred and seventy-eight patients' caregivers' dyads were interviewed. About 62.4% of the caregivers were children of the patients. More importantly, 97.2% and 93.8% had neither depressive nor anxiety symptoms and the caregivers expressed little worry about COVID-19. There was no significant difference in the mean depressive and anxiety scores in caregivers of patients with and without dementia (F = 0.28, P = 0.60). Caregivers who were lesser than 50 years in age had significantly higher mean score compared with those who were 50 years and above (F = 5.54, P = 0.03). Conclusion The rate of anxiety and depressive symptoms was very low in this cohort as the lockdown during the pandemic produced little distress to caregivers including those caring for patients with dementia and cognitive impairment. This is a deviation from reports of some other countries and cultures which described psychological implications of COVID-19 on caregivers as severe.
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Affiliation(s)
| | - Olusegun Baiyewu
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
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26
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Ogboghodo EO, Osaigbovo II, Obaseki DE, Iduitua MTN, Asamah D, Oduware E, Okwara BU. Implementation of a COVID-19 screening tool in a southern Nigerian tertiary health facility. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000578. [PMID: 36962763 PMCID: PMC10021546 DOI: 10.1371/journal.pgph.0000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
Screening for coronavirus disease 2019 (COVID-19) in emergency rooms of health facilities during outbreaks prevents nosocomial transmission. However, effective tools adapted for use in African countries are lacking. This study appraised an indigenous screening and triage tool for COVID-19 deployed at the medical emergency room of a Nigerian tertiary facility and determined the predictors of a positive molecular diagnostic test for COVID-19. A cross-sectional study of all patients seen between May and July 2020 at the Accident and Emergency of the University of Benin Teaching Hospital was conducted. Patients with any one of the inputs- presence of COVID-19 symptoms, history of international travel, age 60 years and above, presence of comorbidities and oxygen saturation < 94%- were stratified as high-risk and subjected to molecular testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Data was obtained from the screening record book patterned after a modified screening tool for COVID-19, deidentified and entered into IBM-SPSS version 25.0. Binary logistic regression was conducted to determine significant predictors of a positive SARS-CoV-2 test. The level of significance was set at p < 0.05. In total, 1,624 patients were screened. Mean age (standard deviation) was 53.9±18.0 years and 651 (40.1%) were 60 years and above. One or more symptoms of COVID-19 were present in 586 (36.1%) patients. Overall, 1,116 (68.7%) patients were designated high risk and tested for SARS-CoV-2, of which 359 (32.2%) were positive. Additional inputs, besides symptoms, increased COVID-19 detection by 108%. Predictors of a positive test were elderly age [AOR = 1.545 (1.127-2.116)], co-morbidity [AOR = 1.811 (1.296-2.530)] and oxygen saturation [AOR = 3.427 (2.595-4.528)]. This protocol using additional inputs such as oxygen saturation improved upon symptoms-based screening for COVID-19. Models incorporating identified predictors will be invaluable in resource limited settings.
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Affiliation(s)
- Esohe O Ogboghodo
- Department of Public Health and Community Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Iriagbonse I Osaigbovo
- Department of Medical Microbiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Darlington E Obaseki
- Chief Medical Director's Office, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Micah T N Iduitua
- Accident and Emergency Department, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Doris Asamah
- Department of Nursing Services, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Emmanuel Oduware
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
| | - Benson U Okwara
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
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Zhabokritsky A, Daneman N, MacPhee S, Estrada-Codecido J, Santoro A, Kit Chan A, Wai-Hei Lam P, Simor A, Allen Leis J, Mubareka S, Andany N. Association between initial symptoms and subsequent hospitalization in outpatients with COVID-19: A cohort study. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:259-268. [PMID: 36338454 PMCID: PMC9629262 DOI: 10.3138/jammi-2021-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/20/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Most individuals with coronavirus disease 2019 (COVID-19) experience mild symptoms and are managed in the outpatient setting. The aim of this study was to determine whether self-reported symptoms at the time of diagnosis can identify patients at risk of clinical deterioration. METHODS This was a retrospective cohort study of 671 outpatients with laboratory-confirmed COVID-19 diagnosed in Toronto between March 1 and October 16, 2020. We examined the association between patients' baseline characteristics and self-reported symptoms at the time of diagnosis and the risk of subsequent hospitalization. RESULTS Of 671 participants, 26 (3.9%) required hospitalization. Individuals aged 65 years or older were more likely to require hospitalization (odds ratio [OR] 5.29, 95% CI 2.19 to 12.77), whereas those without medical comorbidities were unlikely to be hospitalized (OR 0.02, 95% CI 0.00 to 0.17). After adjusting for age and presence of comorbidities, sputum production (adjusted OR [aOR] 5.01, 95% CI 1.97 to 12.75), arthralgias (aOR 4.82, 95% CI 1.85 to 12.53), diarrhea (aOR 4.56, 95% CI 1.82 to 11.42), fever (aOR 3.64, 95% CI 1.50 to 8.82), chills (aOR 3.62, 95% CI 1.54 to 8.50), and fatigue (aOR 2.59, 95% CI 1.04 to 6.47) were associated with subsequent hospitalization. CONCLUSIONS Early assessment of symptoms among outpatients with COVID-19 can help identify individuals at risk of clinical deterioration. Additional studies are needed to determine whether more intense follow-up and early intervention among high-risk individuals can alter the clinical trajectory of and outcomes among outpatients with COVID-19.
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Affiliation(s)
| | - Nick Daneman
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Scott MacPhee
- Department of Nursing, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jose Estrada-Codecido
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Aimee Santoro
- Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Adrienne Kit Chan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Philip Wai-Hei Lam
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Simor
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jerome Allen Leis
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Samira Mubareka
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Nisha Andany
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Modelling the effect of Covid-19 mortality on the economy of Nigeria. RESEARCH IN GLOBALIZATION 2021; 3:100050. [PMCID: PMC8711248 DOI: 10.1016/j.resglo.2021.100050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 06/15/2023]
Abstract
Objectives This paper is aimed at modelling the effect of COVID-19 mortality per population (CMP), a proxy for COVID-19 on the Gross Domestics Product (GDP) per capita per COVID-19 cases (RGDPC), a proxy for the economic wellbeing of a nation. Methods Nine models divided into three groups (Gaussian polynomial, other non-linear, and Gamma generalized polynomial models) were fitted for RGDPC data on CMP, collected from 1st June to 31st December 2020. Results The result showed that the gamma cubic model was selected as the best model out of the 9 competing models to predict the economic wellbeing of Nigeria. Predictions were made for the whole day in the year 2021. Conclusion It is therefore concluded that there is a non-linear relationship between COVID-19 mortality and the economic wellbeing of Nigerians. Thus, COVID-19 mortality has an adverse effect on the wellbeing of Nigerians. The economic wellbeing of Nigerians can be improved if COVID-19 mortality is stopped.
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Adejumo OA, Ogunniyan T, Adesola S, Gordon I, Oluwadun OB, Oladokun OD, Abdulsalam IA, Falana AA, Anderson OS, Anumah A, Dawodu OT, Owuna HJ, Osoba EG, Disu AOA, Adetola AV, Oloniniyi NB, Fadoju PK, Ogunsanya AO, Osundaro OA, Bowale A. Clinical presentation of COVID-19-positive and -negative patients in Lagos Nigeria: A comparative study. Niger Postgrad Med J 2021; 28:75-80. [PMID: 34494591 DOI: 10.4103/npmj.npmj_547_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background A lot has been documented about the pathophysiology and clinical presentation of coronavirus disease 2019 (COVID-19). We compared the clinical features of real-time reverse transcriptase polymerase-chain-reaction (RT-PCR) confirmed COVID-19 positive and negative patients admitted in Lagos State. Methods Medical records of all patients admitted in 15 isolation centres across Lagos state between 27th February 2020 and 30th September 2020, were abstracted and reviewed. We compared the clinical features, co-morbidities and clinical outcomes of COVID-19 positive and negative patients. Results A total of 3157 records of patients admitted in 15 isolation centres in Lagos State were reviewed of which 302 (9.6%) tested negative to RT-PCR COVID-19. There was no gender difference between COVID-19 positive and negative patients (P = 0.687). The average age of the negative patients was higher (46.8 ± 18.3 years) than positive patients (41.9 ± 15.5 years) (P < 0.001). A higher proportion of the COVID-19 negative patients had co-morbidity (38.1% vs. 27.8%), were symptomatic (67.5% vs. 44.6%) and higher mortality (21.9% vs. 6.6%) than positive patients (P < 0.001). The percentages with hypertension (26.2% vs. 21.0%, P = 0.038), diabetes (17.2% vs. 9.4%, P < 0.001), cardiovascular disease (2.3% vs. 0.9%, P < 0.029) and cancer (2.3% vs. 0.5%, P < 0.002) were more among patients without COVID-19. More patients without COVID-19 presented with fever (36.1% vs. 18.8%), cough (33.7% vs. 23.1%) and breathlessness (40.8% vs. 16.1%) than the positive patients (P < 0.001). Conclusion Anosmia and dysgeusia were strongly associated with COVID-19. Clinical decision-making should only be used to prioritise testing and isolation of patients suspected to have COVID-19, especially in settings with limited access to diagnostic kits.
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Affiliation(s)
| | | | | | - Igbodo Gordon
- Nigeria Centre for Disease Control, Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
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Mbagwu JPC, Olajugba JO, James-Okoro PP, Blessing O. Clinical progression of patients with COVID-19 in Lagos State, Nigeria. TRANSLATIONAL MEDICINE COMMUNICATIONS 2021; 6:20. [PMID: 34514172 PMCID: PMC8418277 DOI: 10.1186/s41231-021-00099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The majority of COVID-19 research has been devoted to characterizing the epidemiology and early clinical aspects of the virus. In Lagos, Nigeria, we looked at the temporal progression of COVID-19 patients. We included 1337 confirmed COVID-19 cases in our study from February 27th to March 27th 2020. Of the 1337 patients enrolled, the median age was 50 years old, and 800 (59.83%) were male while 537 (40.16%) were female. METHOD In symptomatic patients, the time from the beginning of signs to admission was 4 (2-7) days. Fever occurred in 217 (16.2%) while cough occurred in 211(15.78%) patients respectively. Patients were given 5-6 treatment, including nutrition support, supplementary oxygen, and antiviral medicines (e.g., Remdesivir, dexamethasone) in a limited percentage of cases. The assessed median period of infection in all patients was 10 days after the start of symptoms (95 confidential intervals [CIs]: 8-11 days). The duration of fever was slightly longer in patients admitted to intensive care units (ICU) than in those who were not (31 days versus 9 days, respectively, P < 0.003). RESULTS On day 7 after the onset of symptoms, radiological deterioration of the original picture was found in 500 (37.39%) patients. On day 13, 154 of these patients (94.5%) showed signs of radiological improvement. The average time it took for upper respiratory tract samples to test negative for reverse transcriptase PCR was 10 days (90 percent confidence interval: 10-12 days). Virus clearance was more significant in ICU patients than in non-ICU patients (P < 0.003). CONCLUSIONS Community members should continue to adhere to the recommended methods of preventing the spread of COVID-19 infection and patients should seek care early to reduce the risk of mortality associated with the infection as rapidly as possible.
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Affiliation(s)
- JP. C. Mbagwu
- Department of Physics, Faculty of Physical Science, Imo State University, Owerri, Nigeria
| | - J. O. Olajugba
- College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Obidike Blessing
- Department of Chemistry, Faculty of Physical Science, Imo State University, Owerri, Nigeria
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Elimian KO, Aderinola O, Gibson J, Myles P, Ochu CL, King C, Okwor T, Gaudenzi G, Olayinka A, Zaiyad HG, Ohonsi C, Ebhodaghe B, Dan-Nwafor C, Nwachukwu W, Abdus-Salam IA, Akande OW, Falodun O, Arinze C, Ezeokafor C, Jafiya A, Ojimba A, Aremu JT, Joseph E, Bowale A, Mutiu B, Saka B, Jinadu A, Hamza K, Ibeh C, Bello S, Asuzu M, Mba N, Oladejo J, Ilori E, Alfvén T, Igumbor E, Ihekweazu C. Assessing the capacity of symptom scores to predict COVID-19 positivity in Nigeria: a national derivation and validation cohort study. BMJ Open 2021; 11:e049699. [PMID: 34479936 PMCID: PMC8421116 DOI: 10.1136/bmjopen-2021-049699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study aimed to develop and validate a symptom prediction tool for COVID-19 test positivity in Nigeria. DESIGN Predictive modelling study. SETTING All Nigeria States and the Federal Capital Territory. PARTICIPANTS A cohort of 43 221 individuals within the national COVID-19 surveillance dataset from 27 February to 27 August 2020. Complete dataset was randomly split into two equal halves: derivation and validation datasets. Using the derivation dataset (n=21 477), backward multivariable logistic regression approach was used to identify symptoms positively associated with COVID-19 positivity (by real-time PCR) in children (≤17 years), adults (18-64 years) and elderly (≥65 years) patients separately. OUTCOME MEASURES Weighted statistical and clinical scores based on beta regression coefficients and clinicians' judgements, respectively. Using the validation dataset (n=21 744), area under the receiver operating characteristic curve (AUROC) values were used to assess the predictive capacity of individual symptoms, unweighted score and the two weighted scores. RESULTS Overall, 27.6% of children (4415/15 988), 34.6% of adults (9154/26 441) and 40.0% of elderly (317/792) that had been tested were positive for COVID-19. Best individual symptom predictor of COVID-19 positivity was loss of smell in children (AUROC 0.56, 95% CI 0.55 to 0.56), either fever or cough in adults (AUROC 0.57, 95% CI 0.56 to 0.58) and difficulty in breathing in the elderly (AUROC 0.53, 95% CI 0.48 to 0.58) patients. In children, adults and the elderly patients, all scoring approaches showed similar predictive performance. CONCLUSIONS The predictive capacity of various symptom scores for COVID-19 positivity was poor overall. However, the findings could serve as an advocacy tool for more investments in resources for capacity strengthening of molecular testing for COVID-19 in Nigeria.
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Affiliation(s)
- Kelly Osezele Elimian
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Jack Gibson
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Puja Myles
- Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | | | - Carina King
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tochi Okwor
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Giulia Gaudenzi
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | | | | | | | - Oluwatosin Wuraola Akande
- Nigeria Centre for Disease Control, Abuja, Nigeria
- Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | | | | | | | | | | - Emmanuel Joseph
- Kaduna State Infectious Disease Control Center Community Medicine, Kaduna, Nigeria
| | | | | | - Babatunde Saka
- Lagos State Government Ministry of Health, Ikeja, Nigeria
| | | | - Khadeejah Hamza
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Christian Ibeh
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Shaibu Bello
- Department of Medical Education, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Michael Asuzu
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Nwando Mba
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - John Oladejo
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Elsie Ilori
- Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ehimario Igumbor
- Nigeria Centre for Disease Control, Abuja, Nigeria
- School of Public Health, University of the Western Cape, Bellville, South Africa
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Bahloul M, Kharrat S, Chtara K, Hafdhi M, Turki O, Baccouche N, Ammar R, Kallel N, Hsairi M, Chakroun-Walha O, Hamida CB, Chelly H, Mahfoudh KB, Karoui A, Karray H, Rekik N, Bouaziz M. Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia. Acute Crit Care 2021; 37:84-93. [PMID: 34380191 PMCID: PMC8918704 DOI: 10.4266/acc.2021.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Nozha Kallel
- Department of Radiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Majdi Hsairi
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Chakroun-Walha
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | | | - Abelhamid Karoui
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hela Karray
- Department of Microbiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Noureddine Rekik
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Ogoina D, James HI, Ogoinja SZ. Post-Discharge Symptoms among Hospitalized COVID-19 Patients in Nigeria: A Single-Center Study. Am J Trop Med Hyg 2021; 105:731-736. [PMID: 34270448 PMCID: PMC8592373 DOI: 10.4269/ajtmh.21-0509] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
There is a paucity of studies on post-acute COVID-19 syndrome (PCS) among hospitalized COVID-19 survivors from Nigeria. We describe the frequency, types, and duration of post-discharge symptoms suggestive of PCS among previously hospitalized COVID-19 patients in a treatment center in Nigeria. We conducted a retrospective review of admission and post-discharge follow-up medical records of COVID-19 survivors admitted between April and December 2020. A standardized checklist was used to document post-discharge symptoms. PCS was defined as persisting or new post-discharge symptoms lasting at least 3 weeks after initial COVID-19 symptoms. The relationship between study variables and development of PCS was ascertained by univariate analysis. Thirty of 51 previously hospitalized COVID-19 patients (median age, 46 years; male, 66.7%) were studied. Seventeen (56.7%) of the 30 patients developed features suggestive of PCS. Approximately three post-discharge symptoms were reported per patient over a follow-up period of ranging from 3 weeks to 9 months after initial COVID-19 symptoms. Cough, fatigue, and dyspnea were the most common post-discharge symptoms reported. A few patients had symptoms suggestive of thrombosis and COVID-19 reinfection. Among all study variables, baseline COVID-19 severity was the only significant variable associated with the development of PCS. PCS is common in our setting and is characterized by multisystemic signs and symptoms that require vigilance by clinicians for appropriate diagnosis and treatment. Long-term multicenter prospective studies are needed to characterize fully the burden of PCS among COVID-19 survivors in Nigeria.
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Affiliation(s)
- Dimie Ogoina
- 1Department of Internal Medicine, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
| | - Hendris Izibewule James
- 1Department of Internal Medicine, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
| | - Stanley Zikeyi Ogoinja
- 2Department of Radiology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State, Nigeria
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Abayomi A, Balogun MR, Bankole M, Banke-Thomas A, Mutiu B, Olawepo J, Senjobi M, Odukoya O, Aladetuyi L, Ejekam C, Folarin A, Emmanuel M, Amodu F, Ologun A, Olusanya A, Bakare M, Alabi A, Abdus-Salam I, Erinosho E, Bowale A, Omilabu S, Saka B, Osibogun A, Wright O, Idris J, Ogunsola F. From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria. Global Health 2021; 17:79. [PMID: 34243790 PMCID: PMC8267235 DOI: 10.1186/s12992-021-00728-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/28/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response. DISCUSSION Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment. CONCLUSION Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.
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Affiliation(s)
- Akin Abayomi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | | | - Munir Bankole
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Bamidele Mutiu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - John Olawepo
- School of Public Health, University of Nevada, Las Vegas, USA
| | - Morakinyo Senjobi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Lanre Aladetuyi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | | | - Akinsanya Folarin
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Madonna Emmanuel
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Funke Amodu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Adesoji Ologun
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abosede Olusanya
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Moses Bakare
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abiodun Alabi
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Ismail Abdus-Salam
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Eniola Erinosho
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Abimbola Bowale
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
| | - Sunday Omilabu
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
- Global Emerging Pathogens Treatment Consortium, Lagos, Nigeria
| | - Akin Osibogun
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
- College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Ololade Wright
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Jide Idris
- Lagos State Ministry of Health/Lagos Incident Management Command System, Lagos, Nigeria
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Marimuthu Y, Kunnavil R, Anil NS, Nagaraja SB, Satyanarayana N, Kumar J, Ramya B. Clinical profile and risk factors for mortality among COVID-19 inpatients at a tertiary care centre in Bengaluru, India. Monaldi Arch Chest Dis 2021; 91. [PMID: 34006039 DOI: 10.4081/monaldi.2021.1724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/21/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is an emerging viral disease affecting more than 200 countries worldwide and it present with varied clinical profile throughout the world. Without effective drugs to cure COVID-19, early identification and control of risk factors are important measures to combat COVID-19. This study was conducted to determine the clinical profile and risk factors associated with mortality among COVID-19 patients in a tertiary care hospital in South India. This record-based longitudinal study was conducted by reviewing the case records of COVID-19 patients admitted for treatment from June 2020 to September 2020 in a tertiary care centre in South India. The clinical details, discharge/death details, were collected and entered in MS Excel. Potential risk factors for COVID-19 mortality were analysed using univariate binomial logistic regression, generalized linear models (GLM) with Poisson distribution. Survival curves were made using the Kaplan-Meier method. Log-rank test was used to test the equality of survivor functions between the groups. Out of 854 COVID-19 patients, 56.6% were men and the mean (standard deviation) age was 45.3(17.2) years. The median survival time was significantly lesser in male COVID-19 patients (16 days) as compared to female patients (20 days). Increasing age, male gender, patients presenting with symptoms of fever, cough, breathlessness, smoking, alcohol consumption, comorbidities were significantly associated with mortality among COVID-19 patients. Patients with older age, male gender, breathlessness, fever, cough, smoking and alcohol and comorbidities need careful observation and early intervention. Public health campaigns aimed at reducing the prevalence of risk factors like diabetes, hypertension, smoking and alcohol use are also needed.
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Affiliation(s)
- Yamini Marimuthu
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru .
| | - Radhika Kunnavil
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru .
| | - N S Anil
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru .
| | - Sharath Burugina Nagaraja
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru .
| | - N Satyanarayana
- Department of General Medicine, ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru.
| | - Jeetendra Kumar
- ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru.
| | - Bojja Ramya
- ESIC Medical College & Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bengaluru.
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Abraha HE, Gessesse Z, Gebrecherkos T, Kebede Y, Weldegiargis AW, Tequare MH, Welderufael AL, Zenebe D, Gebremariam AG, Dawit TC, Gebremedhin DW, de Wit TR, Wolday D. Clinical features and risk factors associated with morbidity and mortality among patients with COVID-19 in northern Ethiopia. Int J Infect Dis 2021; 105:776-783. [PMID: 33741488 PMCID: PMC7962557 DOI: 10.1016/j.ijid.2021.03.037] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/27/2021] [Accepted: 03/10/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To describe the clinical features and assess the determinants of severity and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) from a unique setting in Ethiopia. METHODS Consecutive patients admitted to a COVID-19 isolation and treatment centre were included in this study. The overall clinical spectrum of COVID-19, and factors associated with risk of severe COVID-19 and in-hospital mortality were analysed. RESULTS Of 2617 quarantined patients, three-quarters (n = 1935, 74%) were asymptomatic and only 114 (4.4%) presented with severe COVID-19. Common characteristics among the 682 symptomatic patients were cough (n = 354, 50.6%), myalgia (n = 212, 31.1%), headache (n = 196, 28.7%), fever (n = 161, 23.6%), dyspnoea (n = 111, 16.3%), anosmia and/or dysgeusia (n = 90, 13.2%), sore throat (n = 87, 12.8%) and chest pain (n = 77, 11.3%). Factors associated with severe COVID-19 were older age [adjusted relative risk (aRR) 1.78, 95% confidence interval (CI) 1.61-1.97; P < 0.0001], diabetes (aRR 2.00, 95% CI 1.20-3.32; P = 0.007), cardiovascular disease (aRR 2.53, 95% CI 1.53-4.17; P < 0.0001), malignancy (aRR 4.57, 95% CI 1.62-12.87; P = 0.004), surgery/trauma (aRR 23.98, 95% CI 10.35-55.57; P < 0.0001) and human immunodeficiency virus infection (aRR 4.24, 95% CI 1.55-11.61; P = 005). Factors associated with risk of in-hospital mortality included older age (aRR 2.37, 95% CI 1.90-2.95; P < 0.001), malignancy (aRR 6.73, 95% CI 1.50-30.16; P = 0.013) and surgery/trauma (aRR 59.52, 95% CI 12.90-274.68; P < 0.0001). CONCLUSIONS A significant proportion of cases of COVID-19 were asymptomatic, and key comorbid conditions increased the risk of severe COVID-19 and in-hospital mortality. These findings could help in the design of appropriate management strategies for patients.
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Affiliation(s)
| | | | | | - Yazezew Kebede
- Mekelle University College of Health Sciences, Mekelle, Ethiopia
| | | | | | | | - Dawit Zenebe
- Mekelle University College of Health Sciences, Mekelle, Ethiopia
| | | | | | | | - Tobias Rinke de Wit
- Amsterdam Institute for Global Health and Development, Academic Medical Centre, University of Amsterdam, The Netherlands
| | - Dawit Wolday
- Mekelle University College of Health Sciences, Mekelle, Ethiopia.
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Osikomaiya B, Erinoso O, Wright KO, Odusola AO, Thomas B, Adeyemi O, Bowale A, Adejumo O, Falana A, Abdus-Salam I, Ogboye O, Osibogun A, Abayomi A. 'Long COVID': persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria. BMC Infect Dis 2021; 21:304. [PMID: 33765941 PMCID: PMC7993075 DOI: 10.1186/s12879-020-05716-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Coronavirus disease once thought to be a respiratory infection is now recognised as a multi-system disease affecting the respiratory, cardiovascular, gastrointestinal, neurological, immune, and hematopoietic systems. An emerging body of evidence suggests the persistence of COVID-19 symptoms of varying patterns among some survivors. This study aimed to describe persistent symptoms in COVID-19 survivors and investigate possible risk factors for these persistent symptoms. METHODS The study used a retrospective study design. The study population comprised of discharged COVID-19 patients. Demographic information, days since discharge, comorbidities, and persistent COVID-19 like symptoms were assessed in patients attending the COVID-19 outpatient clinic in Lagos State. Statistical analysis was done using STATA 15.0 software (StataCorp Texas) with significance placed at p-value < 0.05. RESULTS A total of 274 patients were enrolled in the study. A majority were within the age group > 35 to ≤49 years (38.3%), and male (66.1%). More than one-third (40.9%) had persistent COVID-19 symptoms after discharge, and 19.7% had more than three persistent COVID-like symptoms. The most persistent COVID-like symptoms experienced were easy fatigability (12.8%), headaches (12.8%), and chest pain (9.8%). Symptomatic COVID-19 disease with moderate severity compared to mild severity was a predictor of persistent COVID-like symptoms after discharge (p < 0.05). CONCLUSION Findings from this study suggests that patients who recovered from COVID-19 disease may still experience COVID-19 like symptoms, particularly fatigue and headaches. Therefore, careful monitoring should be in place after discharge to help mitigate the effects of these symptoms and improve the quality of life of COVID-19 survivors.
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Affiliation(s)
| | - Olufemi Erinoso
- Lagos State University Teaching Hospital, Lagos, Lagos State, Nigeria.
| | | | | | | | | | | | | | | | | | | | - Akin Osibogun
- College of Medicine, University of Lagos, Lagos, Nigeria
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38
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Osibogun A, Balogun M, Abayomi A, Idris J, Kuyinu Y, Odukoya O, Wright O, Adeseun R, Mutiu B, Saka B, Osa N, Lajide D, Abdus-Salam I, Osikomaiya B, Onasanya O, Adebayo B, Oshodi Y, Adesola S, Adejumo O, Erinoso O, Abdur-Razzaq H, Bowale A, Akinroye K. Outcomes of COVID-19 patients with comorbidities in southwest Nigeria. PLoS One 2021; 16:e0248281. [PMID: 33720975 PMCID: PMC7959379 DOI: 10.1371/journal.pone.0248281] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. METHODS This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. RESULTS Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33-55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22-4.01), diabetes (OR: 3.69, 95% CI: 1.99-6.85), renal disease (OR: 12.53, 95%CI: 1.97-79.56), cancer (OR: 14.12, 95% CI: 2.03-98.19) and HIV (OR: 1.77-84.15]. CONCLUSION Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.
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Affiliation(s)
- Akin Osibogun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Akin Abayomi
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
- Lagos State Ministry of Health, Lagos, Nigeria
| | - Jide Idris
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Yetunde Kuyinu
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine University of Lagos, Lagos, Nigeria
| | - Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Remi Adeseun
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bamidele Mutiu
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Babatunde Saka
- Lagos State Biosafety and Biosecurity Governing Council, Lagos, Nigeria
| | - Nike Osa
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Dayo Lajide
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Ismael Abdus-Salam
- Lagos State COVID-19 Incident Command System/Emergency Operation Centre, Lagos, Nigeria
| | - Bodunrin Osikomaiya
- Lagos State Blood Transfusion Service, Lagos State Ministry of Health, Lagos, Nigeria
| | | | - Bisola Adebayo
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Lagos, Nigeria
| | - Yewande Oshodi
- Department of Psychiatry, College of Medicine University of Lagos, Lagos, Nigeria
| | | | | | - Olufemi Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Nigeria
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39
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Osibogun A. The resilience of microbes – Man's great enemies. JOURNAL OF CLINICAL SCIENCES 2021. [DOI: 10.4103/jcls.jcls_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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40
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Leulseged TW, Hassen IS, Maru EH, Zewsde WC, Chamiso NW, Bayisa AB, Abebe DS, Ayele BT, Yegle KT, Edo MG, Gurara EK, Damete DD, Tolera YA. Characteristics and outcome profile of hospitalized African patients with COVID-19: The Ethiopian context. PLoS One 2021; 16:e0259454. [PMID: 34752481 PMCID: PMC8577729 DOI: 10.1371/journal.pone.0259454] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/19/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic seems to have a different picture in Africa; the first case was identified in the continent after it had already caused a significant loss to the rest of the world and the reported number of cases and mortality rate has been low. Understanding the characteristics and outcome of the pandemic in the African setup is therefore crucial. AIM To assess the characteristics and outcome of Patients with COVID-19 and to identify determinants of the disease outcome among patients admitted to Millennium COVID-19 Care Center in Ethiopia. METHODS A prospective cohort study was conducted among 1345 consecutively admitted RT-PCR confirmed Patients with COVID-19 from July to September, 2020. Frequency tables, KM plots, median survival times and Log-rank test were used to describe the data and compare survival distribution between groups. Cox proportional hazard survival model was used to identify determinants of time to clinical recovery and the independent variables, where adjusted hazard ratio, P-value and 95% CI for adjusted hazard ratio were used for testing significance and interpretation of results. Binary logistic regression model was used to assess the presence of a statistically significant association between disease outcome and the independent variables, where adjusted odds ratio, P-value and 95% CI for adjusted odds ratio were used for testing significance and interpretation of results. RESULTS Among the study population, 71 (5.3%) died, 72 (5.4%) were transferred and the rest 1202 (89.4%) were clinically improved. The median time to clinical recovery was 14 days. On the multivariable Cox proportional hazard model; temperature (AHR = 1.135, 95% CI = 1.011, 1.274, p-value = 0.032), COVID-19 severity (AHR = 0.660, 95% CI = 0.501, 0.869, p-value = 0.003), and cough (AHR = 0.705, 95% CI = 0.519, 0.959, p-value = 0.026) were found to be significant determinants of time to clinical recovery. On the binary logistic regression, the following factors were found to be significantly associated with disease outcome; SPO2 (AOR = 0.302, 95% CI = 0.193, 0.474, p-value = 0.0001), shortness of breath (AOR = 0.354, 95% CI = 0.213, 0.590, p-value = 0.0001) and diabetes mellitus (AOR = 0.549, 95% CI = 0.337, 0.894, p-value = 0.016). CONCLUSIONS The average duration of time to clinical recovery was 14 days and 89.4% of the patients achieved clinical recovery. The mortality rate of the studied population is lower than reports from other countries including those in Africa. Having severe COVID-19 disease severity and presenting with cough were found to be associated with delayed clinical recovery of the disease. On the other hand, being hyperthermic is associated with shorter disease duration (faster time to clinical recovery). In addition, lower oxygen saturation, subjective complaint of shortness of breath and being diabetic were associated with unfavorable disease outcome. Therefore, patients with these factors should be followed cautiously for a better outcome.
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Affiliation(s)
- Tigist W. Leulseged
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- * E-mail:
| | - Ishmael S. Hassen
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Endalkachew H. Maru
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wuletaw C. Zewsde
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Negat W. Chamiso
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Abdi B. Bayisa
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Daniel S. Abebe
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Birhanu T. Ayele
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Kalkidan T. Yegle
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mesay G. Edo
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Eyosyas K. Gurara
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Dereje D. Damete
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Yared A. Tolera
- Millennium COVID-19 Care Center, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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