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Mmerem JI, Unigwe US, Iroezindu MO, Chukwu KS, Ezenwosu IL, Okorie GO, Chika-Igwenyi NM, Nwatu CB, Onodugo OD. Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital. Malawi Med J 2023; 35:43-57. [PMID: 38124701 PMCID: PMC10645895 DOI: 10.4314/mmj.v35i1.8] [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: 12/23/2023] Open
Abstract
Background We described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa. Methodology We conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients' medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively. Results Of 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality. Conclusion Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers.
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Affiliation(s)
- Juliet I Mmerem
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Federal Medical Centre, Owerri, Imo State, Nigeria
| | - Uche S Unigwe
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Michael O Iroezindu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Kyrian S Chukwu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Ifeyinwa L Ezenwosu
- Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Geofrey O Okorie
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Enugu State University Teaching Hospital, Parklane, Enugu, Enugu State, Nigeria
| | - Nneka M Chika-Igwenyi
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
- Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - Chidinma B Nwatu
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
| | - Obinna D Onodugo
- Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria
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Khadka N, Shakya S, Khatiwada D, Budhathoki P, Bhattarai TR. Diagnostic Dilemma of Widespread Vesiculobullous Lesions: A Case Report. JNMA J Nepal Med Assoc 2022; 60:86-89. [PMID: 35199670 PMCID: PMC9157670 DOI: 10.31729/jnma.7118] [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] [Received: 10/01/2021] [Accepted: 01/17/2022] [Indexed: 11/02/2022] Open
Abstract
Stevens-Johnson syndrome and toxic epidermal necrolysis represent a spectrum of severe mucocutaneous reactions, while Acute Cutaneous Lupus Erythematosus is a variant of Systemic Lupus Erythematosus. Both are rare conditions, with significant morbidity and mortality; often indistinguishable clinically and pose a diagnostic dilemma for the clinician. We hereby present a unique case of a 17 years old female who presented with widespread vesiculobullous lesions with peeling, desquamation, and crusting of the skin surface, non-scarring alopecia, oral and nasal ulcers, as well as two episodes of generalized tonic-clonic seizures. The patient had a history of intake of itraconazole tablets for a week, 25 days before the disease manifestation.
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Affiliation(s)
- Nisha Khadka
- Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Subij Shakya
- Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | - Dikshya Khatiwada
- Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
| | | | - Tulsi Ram Bhattarai
- Department of Internal Medicine, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal
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