Clinical outcomes of hospitalised COVID-19 patients at Mthatha Regional Hospital, Eastern Cape, South Africa: A retrospective study

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients.Methods: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape.Results: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients.Conclusion: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients.

Clinical characteristics and outcomes of patients admitted with COVID-19 at a public-sector hospital over the first two waves of SARS-CoV-2 infection in Harare, Zimbabwe: A prospective cohort study

“…Mortality among patients admitted with COVID-19 was 38%, which is comparable with data from other countries in the region [ 26 – 28 ]. Of note, 21% of deaths occurred within 24 hours of admission and may have been avoidable if patients had presented earlier.…”

A single-centred retrospective observational analysis on mortality trends during the COVID-19 pandemic

“…Moderate/severe chest radiograph changes were evident in 278 (90.0%) participants. The median Horowitz Index 8 (ratio of arterial partial pressure of oxygen to fraction of inspired oxygen the patient is receiving: PaO 2 /FiO 2 ) was 125 (IQR: 75–250), with 40.9% of participants having a Horowitz Index 9 less than or equal to 100, indicating severe acute respiratory distress syndrome (ARDS) on presentation. Biochemical derangements included a median urea of 9.4 (IQR: 5.9–17.1), median creatinine of 112 (IQR: 80–208) and a median glomerular filtration rate (GFR) of 47 (IQR: 25–82).…”

Emerging Viral Infections, Hypertension, and Cardiovascular Disease in Sub-Saharan Africa: A Narrative Review

“…Nine further studies reported descriptive statistics on COVID-19 mortality and hypertension or CVD but did not calculate statistics to formally compare groups. 15,24,26,29,35–39…”

“…Ten studies did not calculate statistics to compare those with and without preexisting hypertension or CVD on COVID-19 outcomes. [21][22][23][24][25][26][27][28][29][30]…”

“…34 Nine further studies reported descriptive statistics on COVID-19 mortality and hypertension or CVD but did not calculate statistics to formally compare groups. 15,24,26,29,[35][36][37][38][39] Influence of COVID-19 Infection on CVD Two small studies examined the impact of the COVID-19 pandemic on incident CVD and CVD mortality. 30,40 In an observational comparison of stroke admissions before (n=401) and after (n=431) the COVID-19 pandemic in a hospital in Ghana, the stroke admission rate was +7.5% higher in the COVID-19 era (95% CI, 5.1%-10.5%), but the stroke mortality rate was similar (aOR, 1.2 [95% CI, 0.9-1.7]).…”