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Respiratory infection
Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda
  1. Bruce Kirenga1,
  2. Winters Muttamba1,
  3. Alex Kayongo1,
  4. Christopher Nsereko2,
  5. Trishul Siddharthan3,
  6. John Lusiba4,
  7. Levicatus Mugenyi1,
  8. Rosemary K Byanyima5,
  9. William Worodria6,
  10. Fred Nakwagala7,
  11. Rebecca Nantanda1,
  12. Ivan Kimuli1,
  13. Winceslaus Katagira1,
  14. Bernard Sentalo Bagaya8,
  15. Emmanuel Nasinghe8,
  16. Hellen Aanyu-Tukamuhebwa9,
  17. Beatrice Amuge10,
  18. Rogers Sekibira1,
  19. Esther Buregyeya11,
  20. Noah Kiwanuka11,
  21. Moses Muwanga12,
  22. Samuel Kalungi13,
  23. Moses Lutaakome Joloba8,
  24. David Patrick Kateete8,
  25. Baterana Byarugaba7,
  26. Moses R Kamya14,
  27. Henry Mwebesa15 and
  28. William Bazeyo16
  1. 1Lung Institute, Makerere University, Kampala, Uganda
  2. 2Dpartment of Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda
  3. 3Pulmonary and Critical Care, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4Uganda Peoples Defense Forces, Uganda Heart Institute Ltd, Kampala, Uganda
  5. 5Department of Radiology, Mulago National Specialised Hospital, Kampala, Uganda
  6. 6Uganda Ministry of Health, Kampala, Uganda
  7. 7Department of Medicine, Mulago National Specialised Hospital, Kampala, Uganda
  8. 8Department of Immunology and Molecular Biology, Makerere University College of Health Sciences, Kampala, Uganda
  9. 9Department of Paediatrics, Mulago National Specialised Hospital, Kampala, Uganda
  10. 10Department of Nursing, Mulago National Specialised Hospital, Kampala, Uganda
  11. 11School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
  12. 12Department of Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda
  13. 13Pathology, Makerere University College of Health Sciences, Kampala, Uganda
  14. 14Medicine, Makerere University College of Health Sciences, Kampala, Uganda
  15. 15Republic of Uganda Ministry of Health, Kampala, Uganda
  16. 16Entebbe Regional Refferal Hospital, Makerere University, Kampala, Uganda
  1. Correspondence to Dr Bruce Kirenga; brucekirenga{at}yahoo.co.uk

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.

  • viral infection
  • respiratory infection
  • clinical epidemiology
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. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2020-000646

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    Footnotes

    • Contributors Conception and design: BK, WM, AK, WW, MLJ, NF, RKB and WB. Analysis and interpretation: LM, RS and NK. Drafting the manuscript for important intellectual content: BK, AK, WM, RN, IK, WK, BSB, EN, HA-T, BA, TS, MM, SK, MLJ, DK, BB, MRK, HM, CN, JL, RKB, EB and WB.

    • Funding This study was sponsored and funded by the Makerere University Research and Innovation Funds, Kampala Uganda.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval This study was conducted according to the principles of the Declaration of Helsinki and good clinical practice (GCP) as laid down by the ICH topic E6 (Note for Guidance on GCP). The study was approved by the Mulago Hospital Research and Ethics Committee (MHREC 1869). All patients provided written informed consent.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available at Makerere University Lung Institute upon reasonable request. Please contact Dr Bruce Kirenga for data requests.