Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda
Dr Bruce Kirenga, Winters Muttamba, Alex Kayongo, Christopher Nsereko, Trishul Siddharthan, John Lusiba, Levicatus Mugenyi, Rosemary K Byanyima, William Worodria, Fred Nakwagala, Rebecca Nantanda, Ivan Kimuli, Winceslaus Katagira, Bernard Sentalo Bagaya, Emmanuel Nasinghe, Hellen Aanyu-Tukamuhebwa, Beatrice Amuge, Rogers Sekibira, Esther Buregyeya, Noah Kiwanuka, Moses Muwanga, Samuel Kalungi, Moses Lutaakome Joloba, David Patrick Kateete, Baterana Byarugaba, Moses R Kamya, Henry Mwebesa, William Bazeyo
BMJ Open Respiratory Research, doi:10.1136/bmjresp-2020-000646
Rationale Detailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited. Objective We determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda. Measurements As of the 16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive care, mechanical ventilation or death during hospitalisation.
Main results The median age was 34.2 years; 67.9% were male; and 14.6% were <18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever (21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue (7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and 7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of >130/90 mm Hg, and 27.8% had BP of >140/90 mm Hg. Laboratory derangements were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical recovery was shorter among patients who received HCQ, but this difference did not reach statistical significance. Conclusion Most of the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory not similar to other countries. Outcomes did not differ by HCQ treatment status in line with other concluded studies on the benefit of using HCQ in the treatment of COVID-19.
Competing interests None declared. Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Patient consent for publication Not required. Ethics approval This study was conducted according to the principles of the Declaration of Helsinki and good clinical practice (GCP) as laid down by the ICH topic E6 (Note for Guidance on GCP). The study was approved by the Mulago Hospital Research and Ethics Committee (MHREC 1869). All patients provided written informed consent. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available at Makerere University Lung Institute upon reasonable request. Please contact Dr Bruce Kirenga for data requests. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by-nc/ 4. 0/.
ORCID iD Bruce Kirenga http:// orcid. org/ 0000-0002-2023-2840
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'abstract': '<jats:sec><jats:title>Rationale</jats:title><jats:p>Detailed data on the characteristics and '
'outcomes of patients with COVID-19 in sub-Saharan Africa are '
'limited.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>We determined '
'the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in '
'Uganda.</jats:p></jats:sec><jats:sec><jats:title>Measurements</jats:title><jats:p>As of the '
'16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 '
'received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive '
'care, mechanical ventilation or death during '
'hospitalisation.</jats:p></jats:sec><jats:sec><jats:title>Main '
'results</jats:title><jats:p>The median age was 34.2 years; 67.9% were male; and 14.6% were '
'<18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever '
'(21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue '
'(7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and '
'7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of '
'>130/90\u2009mm Hg, and 27.8% had BP of >140/90\u2009mm Hg. Laboratory derangements '
'were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest '
'X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical '
'recovery was shorter among patients who received HCQ, but this difference did not reach '
'statistical '
'significance.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Most of '
'the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory '
'not similar to other countries. Outcomes did not differ by HCQ treatment status in line with '
'other concluded studies on the benefit of using HCQ in the treatment of '
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