Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study

May 22, 2021

Bruce M Biccard, Pragasan Dean Gopalan, Malcolm Miller, William Lance Michell, David Thomson, Adesoji Ademuyiwa, Ernest Aniteye, Greg Calligaro, Maman Sani Chaibou, Hailu Tamiru Dhufera, Mohamed Elfagieh, Mahmoud Elfiky, Muhammed Elhadi, Maher Fawzy, David Fredericks, Meseret Gebre, Abebe Genetu Bayih, Anneli Hardy, Ivan Joubert, Fitsum Kifle, Hyla-Louise Kluyts, Kieran Macleod, Zelalem Mekonnen, Mervyn Mer, Atilio Morais, Vanessa Msosa, Wakisa Mulwafu, Andrew Ndonga, Zipporah Ngumi, Akinyinka Omigbodun, Christian Owoo, Fathima Paruk, Jenna Lynn Piercy, Juan Scribante, Yakob Seman, Elliott Taylor, Dawid van Straaten, Mahmoud Elfiky, Maher Fawzy, Ahmed Awad, Hend Hussein, Mahmoud Shaban, Merihan Elbadawy, Ahmed O Elmehrath, Ahmed Cordie, Mohamed Elganainy, Mostafa El-Shazly, Mahmoud Essam, Omar A. Abdelwahab, Aboubakr Ali, Aliae Mohamed Hussein, Emad Zarief kamel, Fatma A. Monib, Islam Ahmed, Mahmoud M. Saad, Mohammed Ali Al-Quossi, Nashwa Rafaat, Islam Galal, Beshoui labib, Dalia Omran Omran, Maher Fawzy, Mahmoud Elfiky, Ahmed Azzam, Mohammed Azab, Ahmed Tawheed, Mahmoud Gamal, Mohamed El Kassas, Aml Azzam, Neama Ahmed, Yasmin NasrEldin, Omar Abdewahab, Mohamed Elganainy, Omar Elmandouh, Hailu Tamiru Dhufera, Meseret MeGebre, Abebe Genetu Bayih, Fitsum Kifle, Zelalem Mekonnen, Yakob Seman, Abebe Addisie, Akine Eshete, Fitsum Kifle, Kokeb Desita, Hiruy Araya, Yared Agidew, Addisu Desalegn Andabo, Emnet Tesfaye, Elias Ali Yesuf, Gelaw Hailemariam, Menbeu Sultan Mohammed, Yemane Gebremedhin, Yoseph Taye, Tamiru Assefa Mebrate, Tirunesh Busha Gemechu, Tigist Tesfaye Bedane, Elias Tewabe Abera, Ayele Teshome, Ernest Aniteye Ernest Aniteye, Christian Owoo Christian Owoo, Alfred Doku, Christian Owoo, Jane Sandra Afriyie-Mensah, Aba Lawson, Christian Owoo, Daniel Akwanfo DYaw Sottie, Emma Addae, Ernest Ofosu-Appiah Ernest, Ofosu-,Appiah, William Obeng William Obeng, Andrew Ndonga, Zipporah Ngumi, Andrew Ndonga, Anne Mugera, Caesar Bitta, Mohamed Elfagieh, Muhammed Elhadi, Mohammed Abdalraheem Huwaysh, Mohammed Mahdi Ali Yahya, Alsnosy Abdullah Khalefa Mohammed, Amrajaa Alsalihin Mohammed Majeed, Amkhatirah Emad Mousay Mohammed, Elsalhein Majeed, Abdurraouf A Abusalama, Ehab Altayr, Taha Abubaker, Akram Mohammed Alkaseek, Butaina Abdulhafith, Zainab Alziyituni, Marwa F Gamra, Mohamed Muftah Anaiba, Samer Khel, Mohammed Abdelkabir, Saedah Abdeewi, Safia Adam, Abdulmueti Alhadi, Ahmed Alsoufi, Muhannad Hassan, Ahmed Msherghi, Ahmad Elmabri Mohammad Bouhuwaish, Vanessa Msosa, Wakisa Mulwafu, Francis Masoo, Singatiya stella Chikumbanje, Delia Mabedi, Atilio Morais, Antonio Carlos, Atilio Morais, Cesaltina Lorenzoni, Jorge Mambo, Isabel Isabel Chissaque, Mouzinho Mouzinho Saide, Maman Sani Chaibou, Maikassoua Mamane, Foumakoye Amadou, Adesoji Ademuyiwa Adesoji Ademuyiwa, Akinyinka Omigbodun Akinyinka Omigbodun, Ademola Adeyeye, Akinola Akinmade, Yakubu Momohsani, John Bamigboye, Donald Orshio, Erdoo Suckie Isamade, Henry Embu, Samuel Nuhu, Samuel Ojiakor, Ahmed Nuhu, Adeola Fowotade, Arinola Sanusi, Babatunde Osinaike, Olusola Idowu, Abdullahi Oteikwu Amali, Sanusi Ibrahim, Adamu Abba Adamu, Ibrahim Kida, Job Otokwala, Mahmoud Essam, Olubusola Alagbe-Briggs, Sylvanus Ojum, Fathima Paruk Fathima Paruk, Juan Scribante Juan Scribante, Aurence Mdladla, Tebogo Mabotja, Ria Naidoo, Roel Matos-Puig, Arisha Ramkillawan, Michelle Smith, Christel Arnold-Day, David Thomson, Greg Calligaro, Ivan Joubert, Jagga Jagga, Jenna Piercy, Lance Michell, Liam Devenish, Malcolm Miller, Nicole Fernandes, Dean Gopalan, Santosh Pershad, Nicola Grabowski, Mapule Rammego, Sabelo Zwane, Masikhanyise Elizabeth Dhlamini, Matthew Neuhoff, Tobisa Fodo, Anthony Usenbo, Busisiwe Mrara, Freddy Kabambi, Estie Cloete, Leonel De Caires, Roger Dickerson, Candice Louw, Alida Theron, Ryan Herselman, Jannes Badenhorst, Godfrey Moletsane, Helene Loots, Fathima Paruk, Julian Chausse, Matthew Neuhoff, Melinda Sebastian, Nicola Grabowski, Paul Rheeder, Wesley van Hougenhouck-Tulleken, Carin Snyman, Durotolu Adeleke, Jovan Esterhuizen, Leoni de Man, Matema Mosola, Pieter van der Linde, Reinier Swart, Shaun Maasdorp, Tina Martins, Veneshree Govender.

Lancet

The African COVID-19 Critical Care Outcomes Study (ACCCOS) was developed to determine which resources, patient comorbidities, and critical care interventions were associated with mortality or survival in study participants. Eligible participants for this prospective, observational cohort study included adults who were referred to intensive care or high-care units with suspected or confirmed COVID-19 in 10 participating African countries. The primary outcome was the in-hospital mortality after 30 days. Out of the 3140 patients that participated, 2995 were confirmed positive for COVID; the in-hospital mortality after 30 days was 48.2%. The most common comorbidities were increasing age, hypertension, diabetes, HIV/AIDS, coronary artery disease, and chronic kidney disease. There was an excess mortality of 11-23 deaths per 100 patients in Africa when compared to the global rate, with critical care in-hospital mortality higher in African countries. The scarcity of critical care resources, inadequate critical care beds, and under-resourced critical care facilities (inability to provide dialysis, proning, ECMO) likely contributed to this reported increased rate.

Biccard BM, Dean Gopalan P, Miller M, et al. Patient care and clinical outcomes for patients with COVID-19 infection admitted to African high-care or intensive care units (ACCCOS): a multicentre, prospective, observational cohort study. 2021 DOI:10.1016/S0140-6736(21)00441-4.

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