Virus World

The mortality rate among patients in the Democratic Republic of the Congo with severe or critical cases of COVID-19 is nearly 50%, according to a study in The American Journal of Tropical Medicine and Hygiene. The study was the first to explore the clinical characteristics and outcome management of COVID-19 patients in an African country. Jean Nachega, MD, PhD, MPH, FRCP, FAAS, associate professor of epidemiology, infectious diseases and microbiology at University of Pittsburgh and adjunct professor of medicine at Stellenbosch University in Cape Town, and colleagues conducted a retrospective cohort study using data from the Democratic Republic of the Congo (DRC) health ministry’s COVID-19 database that was collected between March 10, 2020, and July 31, 2020. The study included data from 766 patients with COVID-19 admitted to the seven largest health facilities in Kinshasa.

“Whilst it is generally thought that COVID-19 in Africa causes lower mortality rates than in Western countries, COVID-19 is an important disease and does cause mortality in elderly adults with comorbidities,” Sir Alimuddin Zumla, KBE, FRCP, FRCPath, FRSB, senior co-author and professor of infectious diseases and international health at University College London, told Healio. “Physicians should not become complacent.” Among the patients in the study, overall hospital mortality was 13.2% (95% CI, 10.9-15.8), with a higher rate of mortality among patients with severe and critical disease than those with mild or moderate disease (45% vs. 2.6%; P < .001). According to the study, 34.6% of patients had at least one comorbidity and 48.5% had more than one. The most common comorbidities were hypertension (25.4%) and diabetes (14%). Of the patients who died, four were children. “One surprising finding was the high COVID-19 death rate among young patients”— 11.8% among patients aged 20 years or younger — “when compared to the United States, where hospitalization rates and death rates in children and adolescents with COVID-19 are lower than those in adults,” Nachega, told Healio.

Published in American J. Topical Medicine and Hygiene (Oct. 2, 2020):

https://doi.org/10.4269/ajtmh.20-1240

As many as 190,000 people across Africa could die in the first year of the coronavirus pandemic if crucial containment measures fail, the World Health Organization (WHO) warns. The new research also predicts a prolonged outbreak over a few years. "It likely will smoulder in transmission hot spots," says WHO Africa head Matshidiso Moeti. This patchier and slower pattern of transmission sets Africa apart from other regions, WHO experts say.

Other factors taken into account are the region's younger populations who have "benefitted from the control of communicable diseases such as HIV and tuberculosis", as well as lower mortality rates. The WHO's warning comes as Africa's most populous nation, Nigeria, plus others including South Africa and Ivory Coast, have begun relaxing some of their lockdown measures. 

The study finds that between 29 million and 44 million people in the WHO African region could get infected in the first year of the pandemic. Between 83,000 and 190,000 could die in the same period, it warns. The estimates are based on prediction modelling, and focus on 47 countries in the WHO African region with a combined population of one billion - Egypt, Libya, Tunisia, Morocco, Eritrea, Sudan, Somalia and Djibouti are not included.