'American Society of Tropical Medicine and Hygiene'
Doi
Abstract
CITATION: Nachega, J. B. et al. 2020. Clinical characteristics and outcomes of patients hospitalized for COVID-19 in Africa : early insights from the Democratic Republic of the Congo. American Journal of Tropical Medicine and Hygiene, 103(6):2419–2428, doi:10.4269/ajtmh.20-1240.The original publication is available at https://www.ajtmh.orgENGLISH ABSTRACT: Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a
retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven
hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days
(primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median
(interquartile range [IQR]) age of 46 (34–58) years. One hundred ninety-one (25%) patients had severe/critical disease
requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged
within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI: 10.9–15.8), and almost 50% among those in
the ICU. Independent risk factors for death were age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI: 1.85–23.64),
40–59 years (aHR = 4.45, 95% CI: 1.83–10.79), and ³ 60 years (aHR = 13.63, 95% CI: 5.70–32.60) compared with those
aged 20–39 years, with obesity (aHR = 2.30, 95% CI: 1.24–4.27), and with chronic kidney disease (aHR = 5.33, 95% CI:
1.85–15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical
improvement (adjusted odds ratio [aOR] = 1.53, 95% CI: 0.88–2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI:
0.35–1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high
mortality among patients aged < 20 years and with severe/critical disease is of great concern, and requires further
research for confirmation and targeted interventions.https://www.ajtmh.org/view/journals/tpmd/103/6/article-p2419.xmlPublisher's versio