Background There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32–6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48–32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.

BACKGROUND: Drug-resistant TB (DR-TB) remains a significant public health burden and a threat to the progress made in TB control and prevention in sub-Saharan Africa.OBJECTIVE: To determine the risk-predictors of poor treatment outcomes in patients with DR-TB in Uganda.METHODS: We retrospectively reviewed medical records of adult Ugandans who had been treated for DR-TB at Mbarara Regional Referral Hospital (MRRH) in Uganda.RESULTS: Of the 385 files reviewed, 332 (86.2%) met the study inclusion criteria. Of these, 226 (68.1%) were men and 193 (58.1%) were HIV-positive. A total of 73 participants (22.7%) had unfavorable treatment outcomes (treatment failure, loss to follow-up or death). History of cigarette smoking (OR 5.10, 95% CI 2.4–11.4; P < 0.001), age >60 years (OR 6.32, 95% CI 2.2–18.6; P < 0.001), anemia (OR 2.38, 95% CI 1.1–5.3; P = 0.02) and thrombocytopenia (OR 3.60, 95% CI 1.6–8.1; P <  0.001) were independent predictors of unfavorable treatment outcomes.CONCLUSION: There is a high prevalence of unfavorable treatment outcomes among patients with DR-TB. Further research is required to design a prognostic model for DR-TB patients in a resource-limited setting.

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