Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis

Skrip, Laura; Derra, Karim; Kaboré, Mikaïla; Noori, Navideh; Gansané, Adama; Valéa, Innocent; Tinto, Halidou; Brice, Bicaba W.; Gordon, Mollie M. Van; Hagedorn, Brittany; Hien, Hervé; Althouse, Benjamin M.; Wenger, E. A.

doi:10.1016/j.ijid.2020.09.1432

Cited by 28 publications

(17 citation statements)

References 26 publications

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“…Since the outbreak of the SARS-CoV-2/COVID-19 viral pandemic, confirmed disease cases with severe complications, and especially mortality rate, have shown a strong age dependency in most countries with adequate disease reporting, showing significantly fewer severe cases in younger compared with older individuals ( Figure 1 a) [1] , [2] . Developing nations in Africa, despite reported earlier mortality, also match this pattern, such as in sub-Saharan Africa and South Africa [2] , [3] . Moreover, younger individuals appear less susceptible to infection or might lack symptoms, raising concern for epidemic asymptomatic viral spread.…”

Section: Introductionmentioning

confidence: 94%

Diabetes, inflammation, and the adiponectin paradox: Therapeutic targets in SARS-CoV-2

Ho¹,

Ali²,

Takamatsu

et al. 2021

Drug Discovery Today

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Section: Introductionmentioning

confidence: 94%

Diabetes, inflammation, and the adiponectin paradox: Therapeutic targets in SARS-CoV-2

Ho¹,

Ali²,

Takamatsu

et al. 2021

Drug Discovery Today

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“…If effective in any group of hospitalized patients, CCP will have immense impact on health care resources and public health during this ongoing pandemic ( 74 ). CCP is rapidly available compared with other pharmaceuticals or vaccines and may be a more feasible option in surge conditions and/or resource-limited settings ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…In early case series, CCP-treated patients exhibited viral clearance and reductions in inflammatory markers ( 15 – 19 ). Observational studies comparing CCP-treated patients to retrospective controls showed a reduction in mortality in nonintubated patients and/or those transfused within 72 hours of hospitalization with high-titer CCP ( 20 – 24 ). Analysis of a subset of more than 3000 CCP recipients in an open-label study found a dose response whereby nonintubated patients who received high-titer CCP had lower mortality than those who received low-titer CCP ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

Treatment of Severe COVID-19 with Convalescent Plasma in Bronx, NYC

Yoon¹,

Bartash²,

Gendlina³

et al. 2021

JCI Insight

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Convalescent plasma with severe acute respiratory disease coronavirus 2 (SARS-CoV-2) antibodies (CCP) may hold promise as a treatment for coronavirus disease 2019 (COVID-19). We compared the mortality and clinical outcome of patients with COVID-19 who received 200 mL of CCP with a spike protein IgG titer ≥ 1:2430 (median 1:47,385) within 72 hours of admission with propensity score–matched controls cared for at a medical center in the Bronx, between April 13 and May 4, 2020. Matching criteria for controls were age, sex, body mass index, race, ethnicity, comorbidities, week of admission, oxygen requirement, D-dimer, lymphocyte counts, corticosteroid use, and anticoagulation use. There was no difference in mortality or oxygenation between CCP recipients and controls at day 28. When stratified by age, compared with matched controls, CCP recipients less than 65 years had 4-fold lower risk of mortality and 4-fold lower risk of deterioration in oxygenation or mortality at day 28. For CCP recipients, pretransfusion spike protein IgG, IgM, and IgA titers were associated with mortality at day 28 in univariate analyses. No adverse effects of CCP were observed. Our results suggest CCP may be beneficial for hospitalized patients less than 65 years, but data from controlled trials are needed to validate this finding and establish the effect of aging on CCP efficacy.

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“…In Western countries, stroke ranks among the most frequent causes of non-COVID excess deaths [ 71 , 72 ], paralleled by a decrease of 39% in the number of patients asking for assistance at emergency stroke departments for acute stroke during COVID-19 [ 73 ]. In SSA countries such as Burkina Faso, many of the COVID-19 patients who died did not seek care at all, and hypertension and diabetes, main risk factors for stroke, were often reported as underlying conditions [ 74 ].…”

Section: Disruption Of Care Under Covid-19 Pandemic In Sub-saharanmentioning

confidence: 99%

Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

Leone

Ciccacci

Orlando

et al. 2021

IJERPH

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Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy−related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. The vast majority of the 38 million people living with HIV/AIDS are in SSA, and the burden of neurological disorders in SSA parallels that of HIV/AIDS. Local healthcare systems are weak. Many standalone HIV health centres have become a platform with combined treatment for both HIV and noncommunicable diseases (NCDs), as advised by the United Nations. The COVID-19 pandemic is overwhelming the fragile health systems in SSA, and it is feared it will provoke an upsurge of excess deaths due to the disruption of care for chronic diseases such as HIV, TB, hypertension, diabetes, and cerebrovascular disorders. Disease Relief through Excellent and Advanced Means (DREAM) is a health programme active since 2002 to prevent and treat HIV/AIDS and related disorders in 10 SSA countries. DREAM is scaling up management of NCDs, including neurologic disorders such as stroke and epilepsy. We described challenges and solutions to address disruption and excess deaths from these diseases during the ongoing COVID-19 pandemic.

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Clinical management and mortality among COVID-19 cases in sub-Saharan Africa: A retrospective study from Burkina Faso and simulated case analysis

Cited by 28 publications

References 26 publications

Diabetes, inflammation, and the adiponectin paradox: Therapeutic targets in SARS-CoV-2

Diabetes, inflammation, and the adiponectin paradox: Therapeutic targets in SARS-CoV-2

Treatment of Severe COVID-19 with Convalescent Plasma in Bronx, NYC

Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

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