Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study

African, Covid-Critical Care Outcomes Study Investigators

doi:10.1016/s0140-6736(21)00441-4

Cited by 154 publications

(146 citation statements)

References 27 publications

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“…Other reasons may feature more prominently in LMICs. For example, reported COVID-19 cases and deaths have been consistently lower in most LMICs relative to higher-income countries 16 – 18 . If individuals feel the risk of disease is less severe, they may be less willing to accept any perceived risks of vaccination 19 .…”

Section: Mainmentioning

confidence: 99%

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Arce

Warren

Meriggi

et al. 2021

Nat Med

831

716

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Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.

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Section: Mainmentioning

confidence: 99%

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

Arce

Warren

Meriggi

et al. 2021

Nat Med

831

716

View full text Add to dashboard Cite

show abstract

“…Nevertheless, rapid mortality assessments for COVID-19 that is underway in some countries [35][36][37][38] could reveal a more complete picture. Expectedly, due to weak health systems, recent data show that Africa has a higher mortality in those with critical COVID-19 illness than elsewhere, with a mortality rate of 48.2% compared with a global average of 31.5% [39].…”

Section: Introductionmentioning

confidence: 99%

What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus?

Wamai

Hirsch

Damme

et al. 2021

IJERPH

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The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases.

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“…This has been attributed to the burden of underlying comorbidities and resource deficits. 8 Reports globally have indicated that increasing age, [9][10][11] comorbidities (cardiovascular disease, diabetes) 9,12,13 and obesity 14,15 are all associated with adverse outcomes. In addition, certain demographic characteristics [10][11][12]16 and laboratory parameters [17][18][19] have also been associated with the severe form of COVID-19 and increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Mortality Among Hospitalized Adults with COVID-19 Pneumonia at a Private Tertiary Hospital in Tanzania: A Retrospective Cohort Study

Kassam¹,

Aghan²,

Aziz³

et al. 2021

IJGM

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Background:The emergence of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There has been paucity of data for hospitalized African patients suffering from COVID-19. This study aimed to identify factors associated with in-hospital mortality in patients suffering from COVID-19 in Tanzania. Methods: This was a single center, retrospective, observational cohort study in adult patients hospitalized with confirmed COVID-19 infection. Demographics, clinical pattern, laboratory and radiological investigations associated with increased odds of mortality were analyzed. Results: Of the 157 patients, 107 (68.1%) patients survived and 50 (31.8%) died. Mortality was highest in patients suffering with severe (26%) and critical (68%) forms of the disease. The median age of the cohort was 52 years (IQR 42-61), majority of patients were male (86%) and of African origin (46%), who presented with fever (69%), cough (62%) and difficulty in breathing (43%). Factors that were associated with mortality among our cohort were advanced age (OR 1.07, 95% CI 1.03-1.11), being overweight and obese (OR 9.44, 95% CI 2.71-41.0), suffering with severe form of the disease (OR 4.77, 95% CI 1.18-25.0) and being admitted to the HDU and ICU (OR 6.68, 95% CI 2.06-24.6). Conclusion:The overall in-hospital mortality was 31.8%. Older age, obesity, the severe form of the disease and admission to the ICU and HDU were major risk factors associated with in-hospital mortality.

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Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study

Cited by 154 publications

References 27 publications

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries

What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus?

Factors Associated with Mortality Among Hospitalized Adults with COVID-19 Pneumonia at a Private Tertiary Hospital in Tanzania: A Retrospective Cohort Study

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