Sumary of Africa: High Death Rate in African Covid-19 Intensive Care Units:
- The interim results of an Africa-wide study of hospitalised Covid-19 patients shows that the continent is facing far higher mortality rates in intensive care units than other parts of the world, and that the higher death rates are best explained by scarce resources..
- Covid-19 has produced huge volumes of data in a short period of time, but our knowledge of how the SARS-CoV-2 virus has affected hospitals in Africa, and other countries in which health resources are limited, is scarce..
- The study titled “An African, multi-centre evaluation of patient care and clinical outcomes for patients with COVID-19 infection admitted to high-care or intensive care units”, is awaiting peer review..
- The researchers gathered data of patients with Covid-19 infections admitted to high-care or intensive care units (ICUs) across six African countries..
- The study led by Professor Bruce Biccard from UCT included 1,243 patients in 38 hospitals in Egypt (9), Ethiopia (7), Ghana (2), Libya (7), Nigeria (2) and South Africa (11) between April and early September..
- The study’s aim is to find out how Covid-19 patients admitted to intensive care units are affected by the unit’s resources, comorbidities and critical care intervention..
- 631 of the 1,153 adult patients (55%) that were referred to intensive care or high-care units following suspected or known COVID-19 infection in the hospitals studied died..
- In these hospital ICUs, the mortality rate is between 18 and 29 deaths per 100 admissions higher than in the rest of the world..
- According to the study, this low volume of beds may lead to only very sick patients being admitted to critical care..
- Global studies suggest that 23.2% of patients requiring critical care also require dialysis, which, according to the study, means that twice as many patients in this study may have needed dialysis..
- Similar findings were made with proning (placing patients so that they are lying on their stomachs, which reduces Covid-19 mortality)..
- While proning may seem easy, it’s actually a difficult process for patients in ICU on ventilators and many units may not have had the manpower or confidence to do it..
- The study was able to show with some confidence that certain factors do not explain the higher African death rate..
- These include comorbidities, including hypertension, diabetes, HIV and higher body-mass index (a measure of obesity)..
- Some of these factors are associated with higher Covid-19 mortality, but they do not explain why mortality in African hospitals is higher.) According to its authors this is “the only study from a population with high HIV burden”…