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Factors predicting in-hospital all-cause mortality in COVID 19 patients at the Laquintinie Hospital Douala, Cameroon. Travel Med Infect Dis 2022; 47:102292. [PMID: 35307539 PMCID: PMC8930185 DOI: 10.1016/j.tmaid.2022.102292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/23/2022] [Accepted: 02/27/2022] [Indexed: 11/24/2022]
Abstract
Background Despite being a global pandemic, little is known about the factors influencing in-hospital mortality of COVID-19 patients in sub-Saharan Africa. This study aimed to provide data on in-hospital mortality among COVID-19 patients hospitalized in a single large center in Cameroon. Methods A hospital-based prospective follow-up was conducted from March 18 to June 30, 2020, including patients >18 years with positive PCR for SARS-COV-2 on nasopharyngeal swab admitted to the Laquintinie Douala hospital COVID unit. Predictors of in-hospital mortality were assessed using Kaplan Meir survival curves and Weibull regression for the accelerated time failure model. Statistical significance was considered as p < 0.05. Results Overall 712 patients (65,7% men) were included, mean age 52,80 ± 14,09 years. There were 580 (67,8% men) in-hospital patients. The median duration of hospital stay was eight days. The in-hospital mortality was 22.2%. Deceased patients compared to survivors were significantly older, had a higher temperature, respiratory rate, and heart rate, and lowest peripheral oxygen saturation at admission. After adjusting for age, sex, and other clinical patient characteristics, increased heart rate, increased temperature, decreased peripheral oxygen saturation. The critical clinical status was significantly associated with increased in-hospital mortality. In contrast, hospitalization duration greater than eight days and the use of hydroxychloroquine (HCQ) + azithromycin (AZM) therapy was associated with decreased risk of in-hospital mortality. Conclusion One in five hospitalized COVID-19 patients die in a low-middle income setting. Critical clinical status, dyspnea, and increased heart rate were predictors of in-hospital mortality. This study will serve as a prerequisite for more robust subsequent follow-up studies. Also, these results will aid in revising national guidelines for the management of COVID-19 in Cameroon.
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Albanghali M, Alghamdi S, Alzahrani M, Barakat B, Haseeb A, Malik JA, Ahmed S, Anwar S. Clinical Characteristics and Treatment Outcomes of Mild to Moderate Covid-19 Patients in Saudi Arabia: A Single Centre Study. J Infect Public Health 2022; 15:331-337. [PMID: 35151012 PMCID: PMC8812125 DOI: 10.1016/j.jiph.2022.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/29/2022] [Accepted: 02/01/2022] [Indexed: 12/28/2022] Open
Abstract
Objective Since the severity of symptoms affects the treatment option for Coronavirus Disease 2019 (COVID-19) patients, the treatment pattern for mild to moderate non-ICU cases must be evaluated, particularly in the current scenario of mutation and variant strain for effective decision making. Methods The objective of retrospective analysis was to assess clinical and treatment outcomes in mild to moderate symptoms in non-ICU patients with COVID-19 who were admitted to major tertiary care hospitals in Al Baha, Saudi Arabia, between April and August 2020. Results A total of 811 people were admitted for COVID-19 treatment, age ranging from 14 to 66, diabetes mellitus (31%, n = 248) and hypertension (24%, n = 198) were the most common comorbid conditions. The hydroxychloroquine (HCQ) treated group (G1 n = 466) had an MD of 8 and an IQR of 5–13 for time in hospital with a 4.3% mortality rate, while the non-HCQ group (G2 n = 345) had an MD of 6 and an IQR of 3–11 for time in hospital with a 3.2% mortality rate. A combination of antiviral and antibiotic treatment was found to be effective, other most frequent intervention was analgesics 85.7%, anticoagulant 75%, minerals (Zinc 83% and Vit D3 82%). Conclusions The therapy and clinical outcomes from the past will be the guiding factor to treat the COVID variants infection in the future. Patients treated with HCQ had a higher mortality rate, whereas those who were given a non-HCQ combination had a greater clinical outcome profile. Data Availability Data available on request due to ethical restrictions. The anonymized data presented in this study are available on request from the corresponding author. The data are not publicly available to maintain privacy and adhere to guidelines of the ethics protocol.
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Affiliation(s)
- Mohammad Albanghali
- Department of Public Health, Faculty of Applied Medical Sciences, Al Baha University, Al Baha, Saudi Arabia
| | - Saleh Alghamdi
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha, Saudi Arabia
| | - Mohammed Alzahrani
- Pharmaceutical Care Department, King Fahad Hospital, Al Baha, Saudi Arabia
| | - Bassant Barakat
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha, Saudi Arabia
| | - Abdul Haseeb
- Department of Clinical pharmacy, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Jonaid Ahmad Malik
- Department of Biomedical Engineering, Indian Institute of Technology Ropar, Rupnagar, India
| | - Sakeel Ahmed
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Ahmedabad, India
| | - Sirajudheen Anwar
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail, Saudi Arabia.
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Deng J, Zhou F, Heybati K, Ali S, Zuo QK, Hou W, Dhivagaran T, Ramaraju HB, Chang O, Wong CY, Silver Z. Efficacy of chloroquine and hydroxychloroquine for the treatment of hospitalized COVID-19 patients: a meta-analysis. Future Virol 2021; 17:10.2217/fvl-2021-0119. [PMID: 34887938 PMCID: PMC8647998 DOI: 10.2217/fvl-2021-0119] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/11/2021] [Indexed: 02/06/2023]
Abstract
Aims: To evaluate the efficacy and safety of hydroxychloroquine/chloroquine, with or without azithromycin, in treating hospitalized COVID-19 patients. Materials & methods: Data from randomized and observational studies were included in a random-effects meta-analysis. Primary outcomes included time to negative conversion of SARS-CoV-2 tests, length of stay, mortality, incidence of mechanical ventilation, time to normalization of body temperature, incidence of adverse events and incidence of QT prolongations. Results: Fifty-one studies (n = 61,221) were included. Hydroxychloroquine/chloroquine showed no efficacy in all primary efficacy outcomes, but was associated with increased odds of QT prolongations. Conclusion: Due to a lack of efficacy and increased odds of cardiac adverse events, hydroxychloroquine/chloroquine should not be used for treating hospitalized COVID-19 patients.
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Affiliation(s)
- Jiawen Deng
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Fangwen Zhou
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Kiyan Heybati
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Mayo Clinic Alix School of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
| | - Saif Ali
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Qi Kang Zuo
- Department of Anesthesiology, Rutgers, New Jersey Medical School, 185 S Orange Ave, Newark, NJ 07103, USA
- Faculty of Science, McGill University, 845 Sherbrooke St W, Montreal, QC, H3A 0G5, Canada
| | - Wenteng Hou
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Thanansayan Dhivagaran
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Integrated Biomedical Engineering & Health Sciences Program (iBioMed), McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | | | - Oswin Chang
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Chi Yi Wong
- Faculty of Health Sciences, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Zachary Silver
- Faculty of Science, Carleton University, 1125 Colonel By Dr, Ottawa, ON, K1S 5B6, Canada
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Alghamdi S. Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study. Saudi Pharm J 2021; 29:1096-1101. [PMID: 34366685 PMCID: PMC8332927 DOI: 10.1016/j.jsps.2021.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 08/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is limited information describing the presenting features and treatment outcomes of intensive care unit (ICU) patients with coronavirus disease 2019 (COVID-19) in Saudi Arabia. OBJECTIVE To investigates the clinical, epidemiological, laboratory, radiological, vital signs and treatment characteristics/outcomes of severe (ICU) COVID-19 patients in Albaha region, Saudi Arabia. METHODS A retrospective cohort study was conducted from 01 April 2020 to 31 August 2020 involving files review of 171 patients admitted to the ICU of a COVID-19 treatment centre as a result of severe symptoms. RESULTS Around a third of the ICU patients admitted were over 66 years of age, 59.6% males, 45% diabetics, 39% hypertensive, 25.7% smokers. Patients had symptoms such as 79% fever, 78% cough, 75% headache, 59% sore throat, 57% runny nose, and 75% cough. More than half of the patients had <90% oxygen saturation. Bilateral infiltration was present in about 43% of patients. 85.4% lymphopenia, and 70.8% D-dimer (>0.5 u/ml) were the most significant laboratory results. The median stay in the hospital ranged from 4 to 15.6 days, and the ICU time ranged from 4 to 12.7 days. Approximately 29% of patients received antiviral, antimalarial, and antibiotic treatment, while 27.5% of patients received antibiotics and antimalarial therapy alone. Incorporating hydroxychloroquine in treatment protocols did not improve patients' outcomes. CONCLUSIONS Older age and cardio-metabolic comorbidities increase the risks of sever COVID-19. Different treatment protocols fail to improve mortality rates and urgent efforts are required to prevent the disease and reduce its severity.
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Affiliation(s)
- Saleh Alghamdi
- Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Albaha University, Albaha, Saudi Arabia
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