Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

Kirenga, Bruce; Muttamba, Winters; Kayongo, Alex; Nsereko, Christopher; Siddharthan, Trishul; Lusiba, John; Mugenyi, Levicatus; Byanyima, Rosemary; Worodria, William; Nakwagala, Fred; Nantanda, Rebecca; Kimuli, Ivan; Katagira, Winceslaus; Bagaya, Bernard Sentalo; Nasinghe, Emmanuel; Aanyu-Tukamuhebwa, Hellen; Amuge, Beatrice; Sekibira, Rogers; Buregyeya, Esther; Kiwanuka, Noah; Muwanga, Moses; Kalungi, Samuel; Joloba, Moses; Kateete, David Patrick; Byarugaba, Baterana; Kamya, Moses R.; Mwebesa, Henry; Bazeyo, William

doi:10.1136/bmjresp-2020-000646

Cited by 51 publications

(86 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is much higher than a case fatality rate of 0·16% in children below 5 years of age in a recent large epidemiological study in Southern India [16]. Several other studies in China [26], Brazil [13,27], Uganda [14], and South Africa [15] have reported COVID-19-related deaths among children under 5 years to be rare. A review of data from US, Korea and Europe early in the epidemic estimated the overall case fatality rate among children (0-19 years old) to be low at 0·03 per 100 000 (44/42 846) [28].…”

Section: Discussionmentioning

confidence: 81%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundData on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020.MethodsThis retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used Cox regression to examine factors associated with mortality.FindingsOf 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had at least one comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5-9; 2% (3/133) for 10-19; 2% (8/638) for 20-29; 3% (26/755) for 30-39; 7% (61/819) for 40-49; 17% (155/941) for 50-59; 22% (132/611) for 60-69; and 34% (96/284) for ≥70. Risk of death was associated with higher age; pre-existing hypertension, cardiac disease, chronic kidney disease or liver disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; and shorter time from symptom onset to admission. Patients <50 years with >1 comorbidity had a nearly six-fold higher risk of death than those without (adjusted hazard ratio 5·50, 95% CI 2·72-11·13; 27% vs 3% mortality).InterpretationOverall mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. However, deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

show abstract

Section: Discussionmentioning

confidence: 81%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…This is much higher than a case fatality rate of 0.16% in children below 5 years of age in a recent large epidemiological study in Southern India [16] . Several other studies in China [29] , Brazil [13 , 30] , Uganda [14] , and South Africa [15] have reported COVID-19-related deaths among children under 5 years to be rare. A review of data from US, Korea and Europe early in the epidemic estimated the overall case fatality rate among children (0–19 years old) to be low at 0.03 per 100 000 (44/42 846) [31] .…”

Section: Discussionmentioning

confidence: 94%

“…However, most cases to date have occurred in low- and middle-income countries (LMIC) [11] , where differences in age distribution, comorbidities, access to quality health services, and other factors, may greatly influence trends regarding severe outcomes, but data are limited [12] , [13] , [14] , [15] , [16] , [17] . Indonesia is the fourth most populous country (population 274 million) and the LMIC that has suffered the highest number of COVID-19 confirmed cases and deaths in Southeast Asia, second only to India in Asia [11] .…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study

Surendra

Elyazar

Djaafara

et al. 2021

The Lancet Regional Health - Western Pacific

146

137

View full text Add to dashboard Cite

Background Data on COVID-19-related mortality and associated factors from low-resource settings are scarce. This study examined clinical characteristics and factors associated with in-hospital mortality of COVID-19 patients in Jakarta, Indonesia, from March 2 to July 31, 2020. Methods This retrospective cohort included all hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals. We extracted demographic and clinical data, including hospital outcomes (discharge or death). We used logistic regression to examine factors associated with mortality. Findings Of 4265 patients with a definitive outcome by July 31, 3768 (88%) were discharged and 497 (12%) died. The median age was 46 years (IQR 32–57), 5% were children, and 31% had >1 comorbidity. Age-specific mortalities were 11% (7/61) for <5 years; 4% (1/23) for 5–9; 2% (3/133) for 10–19; 2% (8/638) for 20–29; 3% (26/755) for 30–39; 7% (61/819) for 40–49; 17% (155/941) for 50–59; 22% (132/611) for 60–69; and 34% (96/284) for ≥70. Risk of death was associated with higher age, male sex; pre-existing hypertension, diabetes, or chronic kidney disease; clinical diagnosis of pneumonia; multiple (>3) symptoms; immediate ICU admission, or intubation. Across all ages, risk of death was higher for patients with >1 comorbidity compared to those without; notably the risk was six-fold increased among patients <50 years (adjusted odds ratio 5.87, 95%CI 3.28–10.52; 27% vs 3% mortality). Interpretation Overall in-hospital mortality was lower than reported in high-income countries, probably due to younger age distribution and fewer comorbidities. Deaths occurred across all ages, with >10% mortality among children <5 years and adults >50 years.

show abstract

“…Clinical outcomes reported in study participants included mortality, severe disease, hospitalization, length of hospitalization, the need for intubation, and development of acute respiratory distress syndrome. In one study, the final clinical outcome of patients was not reported (24).…”

Section: Resultsmentioning

confidence: 99%

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Tipih

Aminake

et al. 2021

mBio

249

175

View full text Add to dashboard Cite

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread across the globe at unprecedented speed and is showing no signs of slowing down. The outbreak of coronavirus disease 2019 (COVID-19) has led to significant health burden in infected patients especially in those with underlying comorbidities. The aim of this study was to evaluate the correlation between comorbidities and their role in the exacerbation of disease in COVID-19 patients leading to fatal outcomes. A systematic review was conducted using data from MEDLINE, Scopus, Web of Science, and EMBASE databases published from 1 December 2019 to 15 September 2020. Fifty-three articles were included in the systematic review. Of those 53 articles, 8 articles were eligible for meta-analysis. Hypertension, obesity, and diabetes mellitus were identified to be the most prevalent comorbidities in COVID-19 patients. Our meta-analysis showed that cancer, chronic kidney diseases, diabetes mellitus, and hypertension were independently associated with mortality in COVID-19 patients. Chronic kidney disease was statistically the most prominent comorbidity leading to death. However, despite having high prevalence, obesity was not associated with mortality in COVID-19 patients. IMPORTANCE COVID-19 has plagued the world since it was first identified in December 2019. Previous systematic reviews and meta-analysis were limited by various factors such as the usage of non-peer reviewed data and were also limited by the lack of clinical data on a global scale. Comorbidities are frequently cited as risk factors for severe COVID-19 outcomes. However, the degree to which specific comorbidities impact the disease is debatable. Our study selection involves a global reach and covers all comorbidities that were reported to be involved in the exacerbation of COVID-19 leading to fatal outcomes, which allows us to identify the specific comorbidities that have higher risk in patients. The study highlights COVID-19 high-risk groups. However, further research should focus on the status of comorbidities and prognosis in COVID-19 patients.

show abstract

Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

Cited by 51 publications

References 22 publications

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: a hospital-based retrospective cohort study

Clinical characteristics and mortality associated with COVID-19 in Jakarta, Indonesia: A hospital-based retrospective cohort study

Comorbidities in SARS-CoV-2 Patients: a Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About