Clinical Characteristics of the First 100 COVID-19 Patients Admitted to a Tertiary Hospital in Johannesburg, South Africa

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes, coronavirus disease 2019 (COVID-19), has spread rapidly across the globe resulting in more than 7,000,000 cases and 400,000 deaths worldwide, of which 52,991 cases and 1162 deaths have occurred in South Africa. Objective: To describe the clinical characteristics of the first 100 patients with COVID-19 admitted to a tertiary hospital in Johannesburg, South Africa. Methods: We conducted a single-centre retrospective review of the first 100 patients with reverse transcriptase polymerase chain reaction-confirmed COVID-19 infection admitted to a tertiary academic hospital in Johannesburg, South Africa. Results: The 100 patients were predominantly male (53%), of black ethnicity (79%) and had a median age of 42 years. The most common comorbidities were hypertension (31%), diabetes mellitus (18%) and 47% of the patients had an endomorphic phenotype. Eleven per cent (11%) of our patients were HIV positive. During hospitalisation, 14 patients (14%) required admission to the intensive care unit (ICU). For those patients with an outcome available, the overall mortality rate was 10% (n = 6), and 57% (n = 4/7) for those admitted to the ICU. Mean length of stay for those who had died or had been discharged was 6.8 days. Conclusion: This case series describes clinical characteristics in the first 100 patients with confirmed COVID-19 admitted to a large centre in Johannesburg, South Africa. Our findings are concordant with universally reported data; however, more data is needed on COVID-19 in the South African setting, specifically related to tuberculosis and HIV.

Clinical and epidemiological characteristics of 646 hospitalised SARS-Cov-2 positive patients in Rivers State Nigeria: a prospective observational study

“…[ 8 ] in a study of hospitalised patients in Spain, found that the median age of patients was higher at 64.4 years, with only 4.5% of patients below 29 years and almost half above 70 years. The outcomes from this study validate previous findings from Nigeria and Africa [ 16 - 18 ]; showing younger COVID-19 patients in contrast to findings from Europe, North and South America [ 5 , 7 , 8 ]. Also the findings in this study validate a previous UNICEF report which indicates that there is a higher proportion of COVID-19 in people under 20 years of age in low and middle- income countries (LMICs) in comparison to higher-income countries.…”

“…The age pattern found in this study is close to the findings by Zamparini et al . [ 16 ], in hospitalised patients in South Africa with a median age of 42 years and the majority of the patients between the 18 to 50 year age groups. Bowale et al .…”

Acute Kidney Injury during the COVID-19 Pandemic - Experience from Two Tertiary Centres in South Africa

“…Biochemical parameters were analysed using standard methods by the hospitals' accredited central laboratories. This included creatinine (µmol/L), estimated glomerular filtration rate (mL/min/1.73 m 2 AKI was defined according to Kidney Disease: Improving Global Outcomes [KDIGO] criteria as follows: Stage 1 -increase in serum creatinine by 0.3 mg/dL (26.4 µmol/L) within 48 h or 1.5-1.9 times increase in serum creatinine from baseline within 7 days; Stage 2 -2-2.9 times increase in serum creatinine within 7 days; Stage 3 -3 times or more increase in serum creatinine within 7 days or initiation of KRT. (17) Patients were stratified according to the highest AKI stage attained during their hospital stay.…”

“…At the time of publication the Gauteng Province [GP] and Western Cape [WC] Province had reported a total of 220,365 and 111,060 cases, respectively, and the fatalities in the two provinces were 4260 [GP] and 4196 [WC]. (1,2) The large influx of critically ill patients required considerable resource consideration. Guidelines were developed to assist the selection of patients requiring admission to an intensive care unit [ICU].…”

“…(9-11) A recent systematic review and meta-analysis of 22 observational studies from China and the United States reported on renal complications in 17,391 hospitalized patients with COVID-19. The pooled incidence for AKI (n = 22 studies) was 11.0% (7.4-15.1) with 6.8% (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) requiring kidney replacement therapy [KRT]. Although AKI was the common outcome reported by studies; hyperkalaemia was the most frequent renal complication with an incidence of 12.5%.…”