Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

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

doi:10.1136/bmjresp-2020-000646

Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

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 KiwanukaMoses Muwanga, Samuel Kalungi, Moses Lutaakome Joloba, David Patrick Kateete, Baterana Byarugaba, Moses R Kamya, Henry Mwebesa, William Bazeyo

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Abstract

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.

Original language	English
Article number	e000646
Number of pages	12
Journal	BMJ Open Respiratory Research
Volume	7
Issue number	1
DOIs	https://doi.org/10.1136/bmjresp-2020-000646
Publication status	Published - 7 Sept 2020

Keywords

Adult
Age factors
Betacoronavirus
Body mass index
COVID-19
Cohort studies
Coronavirus infections/epidemiology
Enzyme Inhibitors/therapeutic use
Female
Hospital mortality
Hospitalization
Humans
Hydroxychloroquine/therapeutic use
Male
Middle aged
Pandemics
Pneumonia, viral/epidemiology
Prospective studies
Respiration, artificial/statistics & numerical data
SARS-CoV-2
Severity of illness index
Sex factors
Treatment outcome
Uganda/epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Kirenga_2020_BMJOpen_characteristics-outcomes_CC
Copyright © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ 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.
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Kirenga, B., Muttamba, W., Kayongo, A., Nsereko, C., Siddharthan, T., Lusiba, J., Mugenyi, L., Byanyima, R. K., Worodria, W., Nakwagala, F., Nantanda, R., Kimuli, I., Katagira, W., Bagaya, B. S., Nasinghe, E., Aanyu-Tukamuhebwa, H., Amuge, B., Sekibira, R., Buregyeya, E., ... Bazeyo, W. (2020). Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda. BMJ Open Respiratory Research, 7(1), Article e000646. https://doi.org/10.1136/bmjresp-2020-000646

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title = "Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda",

abstract = "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.",

keywords = "Adult, Age factors, Betacoronavirus, Body mass index, COVID-19, Cohort studies, Coronavirus infections/epidemiology, Enzyme Inhibitors/therapeutic use, Female, Hospital mortality, Hospitalization, Humans, Hydroxychloroquine/therapeutic use, Male, Middle aged, Pandemics, Pneumonia, viral/epidemiology, Prospective studies, Respiration, artificial/statistics & numerical data, SARS-CoV-2, Severity of illness index, Sex factors, Treatment outcome, Uganda/epidemiology",

author = "Bruce Kirenga and Winters Muttamba and Alex Kayongo and Christopher Nsereko and Trishul Siddharthan and John Lusiba and Levicatus Mugenyi and Byanyima, {Rosemary K} and William Worodria and Fred Nakwagala and Rebecca Nantanda and Ivan Kimuli and Winceslaus Katagira and Bagaya, {Bernard Sentalo} and Emmanuel Nasinghe and Hellen Aanyu-Tukamuhebwa and Beatrice Amuge and Rogers Sekibira and Esther Buregyeya and Noah Kiwanuka and Moses Muwanga and Samuel Kalungi and Joloba, {Moses Lutaakome} and Kateete, {David Patrick} and Baterana Byarugaba and Kamya, {Moses R} and Henry Mwebesa and William Bazeyo",

note = "{\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2020",

month = sep,

day = "7",

doi = "10.1136/bmjresp-2020-000646",

language = "English",

volume = "7",

journal = "BMJ Open Respiratory Research",

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Kirenga, B, Muttamba, W, Kayongo, A, Nsereko, C, Siddharthan, T, Lusiba, J, Mugenyi, L, Byanyima, RK, Worodria, W, Nakwagala, F, Nantanda, R, Kimuli, I, Katagira, W, Bagaya, BS, Nasinghe, E, Aanyu-Tukamuhebwa, H, Amuge, B, Sekibira, R, Buregyeya, E, Kiwanuka, N, Muwanga, M, Kalungi, S, Joloba, ML, Kateete, DP, Byarugaba, B, Kamya, MR, Mwebesa, H & Bazeyo, W 2020, 'Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda', BMJ Open Respiratory Research, vol. 7, no. 1, e000646. https://doi.org/10.1136/bmjresp-2020-000646

TY - JOUR

T1 - Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

AU - Kirenga, Bruce

AU - Muttamba, Winters

AU - Kayongo, Alex

AU - Nsereko, Christopher

AU - Siddharthan, Trishul

AU - Lusiba, John

AU - Mugenyi, Levicatus

AU - Byanyima, Rosemary K

AU - Worodria, William

AU - Nakwagala, Fred

AU - Nantanda, Rebecca

AU - Kimuli, Ivan

AU - Katagira, Winceslaus

AU - Bagaya, Bernard Sentalo

AU - Nasinghe, Emmanuel

AU - Aanyu-Tukamuhebwa, Hellen

AU - Amuge, Beatrice

AU - Sekibira, Rogers

AU - Buregyeya, Esther

AU - Kiwanuka, Noah

AU - Muwanga, Moses

AU - Kalungi, Samuel

AU - Joloba, Moses Lutaakome

AU - Kateete, David Patrick

AU - Byarugaba, Baterana

AU - Kamya, Moses R

AU - Mwebesa, Henry

AU - Bazeyo, William

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/9/7

Y1 - 2020/9/7

N2 - 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.

AB - 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.

KW - Adult

KW - Age factors

KW - Betacoronavirus

KW - Body mass index

KW - COVID-19

KW - Cohort studies

KW - Coronavirus infections/epidemiology

KW - Enzyme Inhibitors/therapeutic use

KW - Female

KW - Hospital mortality

KW - Hospitalization

KW - Humans

KW - Hydroxychloroquine/therapeutic use

KW - Male

KW - Middle aged

KW - Pandemics

KW - Pneumonia, viral/epidemiology

KW - Prospective studies

KW - Respiration, artificial/statistics & numerical data

KW - SARS-CoV-2

KW - Severity of illness index

KW - Sex factors

KW - Treatment outcome

KW - Uganda/epidemiology

U2 - 10.1136/bmjresp-2020-000646

DO - 10.1136/bmjresp-2020-000646

M3 - Article

C2 - 32900781

SN - 2052-4439

VL - 7

JO - BMJ Open Respiratory Research

JF - BMJ Open Respiratory Research

IS - 1

M1 - e000646

ER -

Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

Abstract

Keywords

UN SDGs

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