Clinical profile and factors associated with COVID-19 in Yaounde, Cameroon: A prospective cohort study

  1. Nicole Fouda Mbarga
  2. Emilienne Epee
  3. Marcel Mbarga
  4. Patrick Ouamba
  5. Herwin Nanda
  6. Aristide Nkengni
  7. Joseph Guekeme
  8. Justin Eyong
  9. Sylvie Tossoukpe
  10. Sauvia Noumedem Sosso
  11. Engelbert Ngono Ngono
  12. Lazare Mbala Ntsama
  13. Landry Bonyomo
  14. Patrick Tchatchoua
  15. Noel Vogue
  16. Steve Metomb
  17. Franck Ale
  18. Moussa Ousman
  19. Dorian Job
  20. Charlotte Moussi
  21. Modeste Tamakloe
  22. Jessica E. Haberer
  23. Sylvester Ndeso Atanga
  24. Gregory Halle-Ekane
  25. Yap Boum

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Abstract

A year after the COVID-19 pandemic started, there are still few scientific reports on COVID-19 in Africa. This study explores the clinical profiles and factors associated with COVID-19 in Cameroon.

Materials and methods

In this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01 st April and 31 st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk.

Findings

A total of 313 patients were admitted during the study period; 259 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (26.2%; n = 68) to moderate (59%; n = 153) to severe (14.7%; n = 38); the case fatality rate was 1% (n = 4). Dysgusia (46%; n = 119) and hyposmia/anosmia (37.8%; n = 98) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; n = 53), of which hypertension was the most common (18.9%; n = 49). Participation in mass gatherings (Odds Ratio (OR) = 2.37; P = 0.03) and dysgusia (OR = 2.09, P = 0.02) were predictive of diagnosis of COVID-19. Age groups 60 to 69 (OR = 7.41; P = 0.0001), 50 to 59 (OR = 4.09; P = 0.03), 40 to 49 (OR = 4.54; P = 0.01), male gender (OR = 2.53; P = 0.04), diabetes (OR = 4.05; P = 0.01), HIV infection (OR = 5.57; P = 0.03), lung disease (OR = 6.29; P = 0.01), dyspnoea (OR = 3.70; P = 0.008) and fatigue (OR = 3.35; P = 0.02) significantly predicted COVID-19 severity.

Conclusions

Most COVID-19 cases in this study were benign with low fatality. Age (40–70), male gender, HIV infection, lung disease, dyspnoea and fatigue are associated with severe COVID-19. Such findings may guide public health decision-making.

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  1. Version published to 10.1371/journal.pone.0251504
  2. ScreenIT

    SciScore for 10.1101/2021.02.19.21252071: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical oversight: Ethical clearance (Number 2020/09/1294/CE/CNERSH/SP) was sought from the National Ethical Committee of Research for Human Health in Cameroon.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data analysis was performed with STATA version 13 and RStudio Version 1.3.1073 for modelling.
    STATA
    suggested: (Stata, RRID:SCR_012763)
    RStudio
    suggested: (RStudio, RRID:SCR_000432)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Despite its original content, our study has limitations inherent to the observational design. Only 50 suspected cases had no evidence of infection with SARS-CoV2, which might have impacted the multivariable analysis of risk of COVID-19 infection. The study was conducted at a single centre, thus generalisability of findings nationwide might not be accurate. Additionally, conducting rigorous research in a context of a novel pandemic was challenging and missing data was common. For instance, incubation periods were not calculated as only 07% had required data. Moreover, in our setting, laboratory and radiological diagnostics could not be systematically performed for patients. Some critical cases were referred to more sophisticated centres as required and this might in part explain the low CFR obtained at the Djoungolo Hospital. In this study, we described clinical features of COVID-19 infection in a typical COVID-19 treatment centre in Cameroon. The Djoungolo Treatment Centre experienced its highest number of admissions from early May to mid-June. Most patients had a benign form of COVID-19 and the CFR was low (1%). There was a broad range of prevalent symptoms in patients, including olfactory symptoms. The majority of patients admitted had no comorbidity and the commonest comorbidity was hypertension, although it did not predict severity. Mass gathering was a risk factor for COVID-19 infection. Male gender, history of diabetes, history of lung disease, history of HIV infection,...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2021.02.19.21252071v1 on medRxiv