Epidemiological, clinical Characteristics and mortality of patients Infected with SARS-CoV-2 Admitted to Kinshasa University Hospital (KUH), the Democratic Republic of the Congo from March 24th, 2020, to January 30th, 2021: Two waves, two faces?

  1. Madone Ndona Mandina
  2. Jean-Robert Rissassy Makulo
  3. Roger Di-Mosi Wumba
  4. Ben Bepouka
  5. Jerome Ossam Odio
  6. Aliocha Natuhoyila Nkodila
  7. Murielle Mashi Longokolo
  8. Nadine Ngongo Mayasi
  9. Donatien Mangala
  10. Guyguy Kamwiziku
  11. Auguy Luzayadio Longo
  12. Guillaume Mpia
  13. Yamin Kokusa
  14. Hervé Keke
  15. Marcel Mabimbi Mbula
  16. Hippolyte Nani Tuma Situakibanza
  17. Ernest Kiswaya Sumaili
  18. Jean-Marie Ntumba Kayembe

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Abstract

Context and objective: Like all epidemics, the COVID-19 pandemic occurs in several highly diverse waves. The objective of the present study was to  compare the demographic and clinical characteristics and mortality of patients between the first and second waves of COVID-19. Methods: This was a historical follow-up study conducted at the Kinshasa University Hospital (KUH) between March 2020 and January 2021. We used  the χ² test to compare proportions. Survival was described by the Kaplan Meier method. Cox regression was used to identify independent  predictors of mortality. Results: A total of 411 COVID-19 patients were enrolled. Compared to wave 1 patients, wave 2 patients were significantly  older (52.4 ±17.5 vs. 58.1 ±15.7; p=0.026). The death rate of patients in the first wave was higher than in the second wave (p=0.009). Survival was  more reduced in the first wave compared with the second wave. Predictors of mortality present in both the first and second waves were respiratory  distress and severe COVID-19 stage. Conclusion: The first wave was more lethal than the second wave with respiratory distress and severe COVID-19  stage as independent predictors in both waves. Strengthening the health system and raising awareness of preventive measures including  vaccination should continue to sustain gains.    French title: Caractéristiques épidémiologiques, cliniques et mortalité des patients infectés par le SRAS-CoV-2 admis aux Cliniques Universitaires  de Kinshasa, République démocratique du Congo du 24 mars 2020 au 30 janvier 2021 : Deux vagues, deux visages ? Contexte et objectif: Comme toutes les épidemies, la pandémie à COVID-19 sévit en plusieurs vagues très diversifiées. L’étude a comparé les  caractéristiques démographiques et cliniques ainsi que la mortalité des patients entre la 1ère et la 2ème vague de COVID-19. Méthodes: Il s’agissait  d’une étude de suivi historique réalisée aux Cliniques Universitaires de Kinshasa entre mars 2020 et janvier 2021. Le test de χ² a permis la  comparaison des proportions, et la la survie a été étudiée par la méthode de Kaplan Meier. L’identification dess prédicteurs indépendants de la  mortalité a été déterminée par la régression de Cox. Résultats: Des 411 patients enrôlés, ceux de la 2ème vague étaient beaucoup plus âgés ((58,1 ±15,7 vs 52,4 ±17,5 ; p=0,026). La 1ère vague a été  plus meurtrière que la seconde (p=0,009). La survie était plus réduite dans la première vague par rapport à la seconde. Les facteurs prédictifs de  mortalité présents à la fois dans la première et la deuxième vague étaient la détresse respiratoire et le stade COVID-19 sévère. Conclusion: La 1ère  vague était plus meutrière que la 2ème avec comme prédicteurs indépendants la détresse respiratoire et le stade COVID-19 sévère dans les deux  vagues. Le renforcement du système de santé et la sensibilisation sur les mésures préventives dont la vaccination devraient continuer à maintenir  les gains.

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  1. Version published to 10.4314/aamed.v15i3.5
  2. ScreenIT

    SciScore for 10.1101/2021.09.05.21262678: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: Ethical considerations: The study was approved by the University of Kinshasa School of Public Health’s Ethics Committee (ESP/CE/179/2020).
    Consent: Because of the retrospective nature of the study and the minimal risk posed by it, obtaining informed consent was not considered necessary.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: statistical analysis was performed with SPSS Statistics Software (version 21; IBM, New York, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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:
    Limitations: Our study has some limitations. First, because of the retrospective study design, not all laboratory tests were performed on patients, including d-dimer, IL-6, troponin, lactate dehydrogenase, and serum ferritin. Therefore, their role may be underestimated in predicting in-hospital death. Second, missing data, especially in laboratory parameters, could lead to bias in the final analysis.

    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.
    • Thank you for including a protocol registration statement.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.09.05.21262678v1 on medRxiv