Severe COVID-19 in Uganda across Two Epidemic Phases: A Prospective Cohort Study
Date
2021Author
Bakamutumaho, Barnabas
Cummings, Matthew J.
Owor, Nicholas
Kayiwa, John
Namulondo, Joyce
Byaruhanga, Timothy
Muwanga, Moses
Nsereko, Christopher
Mutonyi, Roselyn
Achan, Josephine
wanyenze, Lucy
Ndazarwe, Alice
Nakanjako, Ruth
Natuhwera, Richard
Nsangi, Annet
Bosa, Henry Kyobe
Ocom, Felix
Kikaire, Bernard
Lutwama, Julius J.
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Among a prospective cohort of children and adults admitted to a national COVID-19 treatment unit in Uganda from March to December 2020, we characterized the epidemiology of and risk factors for severe illness. Across two epidemic phases differentiated by varying levels of community transmission, the proportion of patients admitted with WHO-defined severe COVID-19 ranged from 5% (7/146; 95% CI: 2–10) to 33% (41/124; 95% CI: 25–42); 21% (26/124; 95% CI: 14–29%) of patients admitted during the peak phase received oxygen therapy. Severe COVID-19 was associated with older age, male sex, and longer duration of illness before admission. Coinfection with HIV was not associated with illness severity; malaria or tuberculosis coinfection was rare. No patients died during admission. Despite low mortality, hospital incidence of severe COVID-19 during the first epidemic peak in Uganda was substantial. Improvements in vaccine deployment and acute care capacity, including oxygen delivery, are urgently needed to prevent and manage severe COVID-19 in sub-Saharan Africa.
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- Medical and Health Sciences [2957]