Mortality rate among DRC patients with severe or critical COVID-19 close to 50%
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.
Nachega said one of the study’s limitations was that it was underpowered to investigate the effect of tuberculosis and HIV on COVID-19 because of low numbers of participants with TB or HIV.
“Further research is required to better define the epidemiology and factors affecting COVID-19 outcomes and the relationships between the overlapping epidemics of COVID-19, HIV, TB and malaria among both young and older populations in Africa,” Nachega said. “However, our study’s small number of children and the possibility of unmeasured confounding factors, such as scope of pediatric intensive care, preclude concrete conclusions about excess COVID-19-related mortality among children in this setting.”