Characteristics of the COVID-19 patients treated at Gulu Regional Referral Hospital, Northern Uganda: A cross-sectional study
Steven Baguma, Christopher Okot, Nelson Alema Onira, Paska Apiyo, Denis Acullu, Paska Layet, Johnson Nyeko Oloya, Denis Ochula, Pamela Atim, Patrick Odong Olwedo, Francis Pebalo Pebolo, Freddy Wathum Drinkwater Oyat, Janet Oola, Judith Aloyo, Eric Nzirakaindi Ikoona, David Lagoro Kitara
doi:10.21203/rs.3.rs-1193578/v1
Background Coronavirus Disease 2019 (COVID-19) is a severe respiratory disease that results from infection with a new coronavirus (SARS-CoV-2). One of the most critical issues related to the COVID-19 is the high rate of spread, millions of people have been infected around the world, and hundreds of thousands of people have died till now. However, reports from Africa paint a different picture of the SARS-CoV-2 and its effects on the population.
Objectives The objective of this study was to describe the characteristics of the COVID-19 patients treated at the Gulu Regional Referral Hospital and determine factors associated with COVID-19 manifestations, socio-demographic characteristics, and treatment outcomes from March 2020 to October 2021.
Methods A retrospective data abstraction of all COVID-19 hospital admissions registered in the Gulu Health Management Information System (HMIS) database and other tools were conducted. The period of study was March 2020 to October 2021. Data that met the inclusion criteria were consecutively abstracted from the Gulu Hospital HMIS database. A local IRB approved the study. SPSS version 25.0 was used for data analysis, and a p-value of 0.05 was considered signi cant.
Results Data suggests there were three waves of COVID-19 in Uganda. Those with comorbidities, e.g., Diabetes mellitus 38(5.7%), hypertension 83(12.5%), cardiovascular diseases 58(8.7%), HIV and AIDS 61(9.2%), and other comorbidities such as liver cirrhosis and hepatitis B 40(6.0%) were more susceptible and presented with severe forms of the disease. Antibiotics 662(99.7%), steroids 73(11.0%), vitamin C 564(84.9%), Ivermectin 7(1.1%), and Vitamin D 24(3.6%) were the most used medicines for the treatment of COVID-19 patients. Most COVID-19 patients were unvaccinated 661(99.5%). However, the recovery rate was 632(95.2%). The commonest complications were pneumonia 60(9.0%), chronic fatigue 49(7.4%), acute respiratory distress syndrome (ARDS) 37(5.6%), depression 20(3.0%), systemic infections 19(2.9%), nightmares 15(2.3%) and septic shock 8(1.2%). The Adjusted Odds Ratios (AOR) on factors associated with recovery were treated with steroids AOR=138.835 at 95% CI:12.258-1572.50; p<0.000 and Vitamin D AOR=0.016 at 95% CI:1.902-520.98; p=0.016.
Conclusion This study showed successful management of COVID-19 patients in low-resource settings with a recovery rate of 95.2%. The admission pattern suggests Uganda had three waves of COVID-19, contrary to the o cial government position of two. Treatment with steroids and Vitamin D is associated with the recovery of COVID-19 patients. There is a need to conduct more extensive studies on the role played by the two drugs in the successful recovery of COVID-19 patients.
Conclusion This study shows successful management of COVID-19 patients in low resource settings in Gulu Regional Referral Hospital with a recovery rate of 95.2%. The pattern of admission to the Hospital suggests Uganda has experienced three waves of COVID-19, contrary to the o cial government position of two waves. Treatment of COVID-19 patients with steroids and Vitamin D is associated with recovery of COVID 19 patients. However, there is a need for Randomized Controlled Clinical Trials to determine the actual effects of these drugs in the Treatment of COVID-19 infections.
Declarations Ethics approval and consent to participate: The Gulu Regional Referral Hospital Institutional and Ethics Committee approved this study, and all participants consented to the study. In addition, the study was conducted following the relevant institutional guidelines and regulations. Competing interests: All authors declare no con ict of interest. Authors contributions: DLK, ENI, PL, JNO, JA, and FWDO participated in designing the study, SB and DLK were responsible for data abstraction supervision, BS, JA, ENI, and DLK were responsible for data analysis, interpretation, writing, and CO, NAO, WAO, BT, JE, PA, PL, FPP, DA, JNO, FWDO, for revising the manuscript. Principal Investigator: Prof. David Kitara Lagoro This qualitative component will occur at most health facilities and in the nine districts in the Acholi subregion in Northern Uganda. The purpose: Since the outbreak of COVID-19, there..
References
Ali, Role of vitamin D in preventing COVID-19 infection, progression, and severity, Journal of Infection and Public Health
Annex, Informed Consent Title: Characterization of COVID-19 patients admitted at Gulu Regional Referral Hospital
Ayugi, Ndagijimana, Luyima, Kitara, Breast cancer awareness and downstaging practices among adult women in the Gulu City Main Market, Northern Uganda: A cross-sectional study,
doi:10.21203/rs.3.rs-1136303/v1
Covid, Severe outcomes among patients with coronavirus disease 2019 (COVID-19)-United States
Dr, Arwinyo, Gulu Regional Referral hospital on 0782047694
El, Anti-HCV, nucleotide inhibitors, repurposing against COVID-19, Life Sci
Fadel, Morrison, Vahia, short-course corticosteroids in hospitalized patients with COVID-19, Clin Infect Dis,
doi:10.1093/cid/ciaa601
Gao, Tian, Yang, Breakthrough Chloroquine phosphate has shown apparent e cacy in the treatment of COVID-19 associated pneumonia in clinical studies, Biosci Trends
Garg, Kim, Whitaker, Hospitalization rates and characteristics of patients hospitalized with laboratorycon rmed coronavirus disease 2019 -COVID-NET, 14 States, MMWR Morb Mortal Wkly Rep
Guan, Ni, Hu, Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Kirenga, Muttamba, Kayongo, Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda, BMJ Open Resp Res,
doi:10.1136/bmjresp-2020-000646
Lagoro Kitara, Ikoona, COVID-19 pandemic, Uganda's Story, Pan Afr Med J
Lagoro Kitara, Ikoona, Proposed strategies for easing COVID-19 lockdown measures in Africa, Pan Afr Med J
Lagoro Kitara, Karlsson, The effects of economic stress and urbanization on driving behaviors of Boda-boda drivers and accidents in Gulu, Northern Uganda: a qualitative view of drivers, Pan Afr Med J,
doi:10.11604/pamj.2020.36.47.21382
Li, Lu, Zhang, Clinical observation and management of COVID-19 patients, Emerg Microbes Infect
Mez, Daneshvar, Kiernan, Clinicopathological evaluation of chronic traumatic encephalopathy in American football players, JAMA
Petrov, Welford, Nikolay, John Degroote, Devlin et al., The second wave of the COVID-19 pandemic in the Arctic: regional and temporal dynamics, International Journal of Circumpolar Health,
doi:10.1080/22423982.2021.1925446
Prof, David Kitara Lagoro, None
Udugama, Kadhiresan, Kozlowski, Diagnosing COVID-19: the disease and tools for detection, ACS Nano
Wang, Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China, JAMA
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention, JAMA
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' <jats:p>Background\n'
'\n'
'Coronavirus Disease 2019 (COVID-19) is a severe respiratory disease that results from '
'infection with a new coronavirus (SARS-CoV-2). One of the most critical issues related to the '
'COVID-19 is the high rate of spread, millions of people have been infected around the world, '
'and hundreds of thousands of people have died till now. However, reports from Africa paint a '
'different picture of the SARS-CoV-2 and its effects on the population.\n'
'Objectives\n'
'\n'
'The objective of this study was to describe the characteristics of the COVID-19 patients '
'treated at the Gulu Regional Referral Hospital and determine factors associated with COVID-19 '
'manifestations, socio-demographic characteristics, and treatment outcomes from March 2020 to '
'October 2021.\n'
'Methods\n'
'\n'
'A retrospective data abstraction of all COVID-19 hospital admissions registered in the Gulu '
'Health Management Information System (HMIS) database and other tools were conducted. The '
'period of study was March 2020 to October 2021. Data that met the inclusion criteria were '
'consecutively abstracted from the Gulu Hospital HMIS database. A local IRB approved the '
'study. SPSS version 25.0 was used for data analysis, and a p-value of 0.05 was considered '
'significant.\n'
'Results\n'
'\n'
'Data suggests there were three waves of COVID-19 in Uganda. Those with comorbidities, e.g., '
'Diabetes mellitus 38(5.7%), hypertension 83(12.5%), cardiovascular diseases 58(8.7%), HIV and '
'AIDS 61(9.2%), and other comorbidities such as liver cirrhosis and hepatitis B 40(6.0%) were '
'more susceptible and presented with severe forms of the disease. Antibiotics 662(99.7%), '
'steroids 73(11.0%), vitamin C 564(84.9%), Ivermectin 7(1.1%), and Vitamin D 24(3.6%) were the '
'most used medicines for the treatment of COVID-19 patients. Most COVID-19 patients were '
'unvaccinated 661(99.5%). However, the recovery rate was 632(95.2%). The commonest '
'complications were pneumonia 60(9.0%), chronic fatigue 49(7.4%), acute respiratory distress '
'syndrome (ARDS) 37(5.6%), depression 20(3.0%), systemic infections 19(2.9%), nightmares '
'15(2.3%) and septic shock 8(1.2%). The Adjusted Odds Ratios (AOR) on factors associated with '
'recovery were treated with steroids AOR=138.835 at 95% CI:12.258-1572.50; p<0.000 and '
'Vitamin D AOR=0.016 at 95% CI:1.902-520.98; p=0.016.\n'
'Conclusion\n'
'\n'
'This study showed successful management of COVID-19 patients in low-resource settings with a '
'recovery rate of 95.2%. The admission pattern suggests Uganda had three waves of COVID-19, '
'contrary to the official government position of two. Treatment with steroids and Vitamin D is '
'associated with the recovery of COVID-19 patients. There is a need to conduct more extensive '
'studies on the role played by the two drugs in the successful recovery of COVID-19 '
'patients.</jats:p>',
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