Data from much of Africa are still scarce on the clinical characteristics, outcomes of treatment, and factors associated with disease severity and mortality of COVID-19. A cross-sectional study was conducted at Eka Kotebe General Hospital, Ethiopia’s first COVID-19 treatment center. All consecutive symptomatic SARS CoV-2 RT-PCR positive individuals, aged 18 and older, admitted to the hospital between March 13 and September 16, 2020, were included. Of the total 463 cases, 319 (68.9%) were male. The median age was 45 years (interquartile range 32–62). The most common three symptoms were cough (69%), shortness of breath (SOB; 44%), and fatigue (37%). Hypertension was the most prevalent comorbidity, followed by diabetes mellitus. The age groups 40 to 59 and ≥ 60 were more likely to have severe disease compared with those < 40 years of age (adjusted odds ratio [aOR] = 3.45, 95% confidence interval [CI]: 1.88–6.31 and aOR = 3.46, 95% CI: 1.91–6.90, respectively). Other factors associated with disease severity included the presence of any malignancy (aOR = 4.64, 95% CI: 1.32–16.33) and SOB (aOR = 3.83, 95% CI: 2.35–6.25). The age group ≥ 60 was significantly associated with greater in-hospital mortality compared with those < 40 years. In addition, the presence of any malignancy, SOB, and vomiting were associated with higher odds of mortality. In Ethiopia, most COVID-19 patients were male and presented with cough, SOB, and fatigue. Older age, any malignancy, and SOB were associated with disease severity; these factors, in addition to vomiting, also predicted mortality.
Erdheim-Chester disease (ECD) is a rare non-Langerhans cell tumor with histopathology features of foamy histocytes and fibrosis. The disease has varying manifestations from asymptomatic to life-threatening organ involvement including long bones, CNS, lung, heart, and kidneys. On histopathology staining, the cells exhibit CD68 positivity but CD1a and S100 negativity. The prognosis of the patients is poor. ECD poses a diagnostic and therapeutic challenge due to its resemblance to various disorders requiring a multidisciplinary approach. We report a case of a 35-year-old male patient from Ethiopia with literature review, who initially presented with massive chylous ascites and retroperitoneal manifestation but later developed pulmonary and cardiac manifestations. The diagnosis was suggested from an abdominal CT scan with subsequent image-guided biopsy which compartments a diagnosis.
The COVID-19 pandemic is one of the largest health crises that the world has ever seen, infecting forty million people and killing more than 1 million to date. The disease has imposed a significant demand on health care resources due to the increased number and severely ill patients visiting facilities each day. Since there is no effective cure for COVID-19, supportive management with oxygen, steroids, anticoagulation, and prone positioning remains the major interventions. Prone ventilation is known to have a mortality benefit in intubated patients with acute respiratory distress syndrome (ARDS). However, studies on its role in intubated patients with COVID-19 ARDS (CARDS) are very scarce in resource-limited settings like Africa. We describe two patients with CARDS who were successfully treated with invasive mechanical ventilation, prone ventilation, and standard supportive care.
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