Clinical characteristics, treatment regimen and duration of hospitalization among COVID-19 patients in Ghana: a retrospective cohort study
Mary Eyram Ashinyo, Vida Duti, Stephen Dajaan Dubik, Kingsley Ebenezer Amegah, Selorm Kutsoati, Ebenezer Oduro-Mensah, Peter Puplampu, Martha Gyansa-Lutterodt, Delese Mimi Darko, Kwame Ohene Buabeng, Anthony Adofo Ashinyo, Anthony Adofo Ofosu, Nyonuku Akosua Baddoo, Samuel Kaba Akoriyea, Francis Ofei, Patrick Kuma-Aboagye
Pan African Medical Journal, doi:10.11604/pamj.supp.2020.37.1.25718
Introduction: COVID-19 is a global pandemic seen in modern times. The clinical characteristics, treatment regimen and duration of hospitalization of COVID-19 patients remain unclear in Ghana. Methods: we retrospectively reviewed the secondary data of 307 discharged COVID-19 patients to characterize their demographics, clinical symptoms, treatment regimen given and duration of hospitalization. Results: the mean age and temperature of the patients were 37.9 years and 36.3°C, respectively. The majority (85.7%) of the cases reviewed were asymptomatic; for those presenting with symptoms, the main ones were cough (50%), fever (29.6%), headache (27.3%), and sore throat (22.7%). Comorbidities were present in 25.1% of the patients; the popularly reported comorbidities were hypertension (71.4%), asthma (7.8%) and diabetes (6.5%). The average duration of hospitalization was 13.8 days, and the duration of hospitalization for patients managed with azithromycin + chloroquine (AZ+CQ) was 10.4 days, followed closely by those managed with hydroxychloroquine (HCQ) only, 11.0 days. There was longer duration of hospitalization among patients who received AZ only compared to patients receiving AZ + CQ (3.24 ± 1.10 days, p=0.037; 95% CI 0.11, 6.37). Linear regression analysis showed that the duration of hospitalization for patients who received AZ only was 2.7 days, which was higher than that of patients who received AZ+CQ and HCQ only (95% CI 0.44, 4.93; p=0.019). Conclusion: in this cohort of COVID-19 patients, the common symptoms were cough, fever, headache, and sore throat. The use of AZ+CQ or HCQ only as a therapy for managing COVID-19 patients shortened the duration of hospitalization.
Competing interests The authors declare no competing interests.
Authors' contributions Authors MEA, VD, SKA and PKA conceived and design the study. Authors SDD, MEA, SK, EOM, PP and MGL collected, analyzed and interpreted the data. Authors DMD, MEA, KOB, AA and AAO wrote the draft manuscript. Authors FO, NAB, SDD did the literature review and discussed the findings of the study. All authors reviewed and approved the final manuscript.
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References
Alsofayan, Althunayyan, Khan, Hakawi, Assiri, Clinical characteristics of COVID-19 in Saudi Arabia: A national retrospective study, J Infect Public Health
Colson, Rolain, Lagier, Brouqui, Raoult, Chloroquine and hydroxychloroquine as available weapons to fight COVID-19, Int J Antimicrob Agents
Feng, Jia, Fang, Richardus, Han et al., Duration of symptom onset to hospital admission and admission to discharge or death in SARS in mainland China: a descriptive study, Trop Med Int Health
Gautret, Lagier, Parola, Meddeb, Mailhe et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents
Geleris, Sun, Platt, Zucker, Baldwin et al., Observational study of hydroxychloroquine in hospitalized patients with COVID-19, N Engl J Med
Goyal, Choi, Pinheiro, Schenck, Chen et al., Clinical characteristics of COVID-19 in New York city, N Engl J Med
Guan, Liang, Zhao, Liang, Chen et al., Comorbidity and its impact on 1590 patients with COVID-19 in China: A Nationwide Analysis, Eur Respir J
Guan, Ni, Hu, Liang, Ou et al., Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Hu, Song, Xu, Chen, Xu, Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China, Sci China Life Sci
Jin, Bai, He, Wu, Liu et al., Gender differences in patients with COVID-19: Focus on severity and mortality, Frontiers in Public Health
Kim, Kim, Ra, Lee, Bae et al., Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19, Clin Microbiol Infect
Koh, Shah, Chua, Gui, Pang, Epidemiological and Clinical Characteristics of Cases During the Early Phase of COVID-19 Pandemic: A Systematic Review and Meta-Analysis, Front Med
Liu, Cao, Xu, Wang, Zhang et al., Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov
Magagnoli, Narendran, Pereira, Cummings, Hardin et al., Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19, Med
Oran, Topol, Prevalence of Asymptomatic SARS-CoV-2 Infection: A Narrative Review, Ann Intern Med
Pastick, Okafor, Wang, Lofgren, Skipper et al., Hydroxychloroquine and chloroquine for treatment of SARS-CoV-2 (COVID-19), InOpen Forum Infectious Diseases
Pubmed|, Scholar, None
Rees, Nightingale, Jafari, Waterlow, Clifford et al., COVID-19 length of hospital stay: a systematic review and data synthesis
Richardson, Hirsch, Narasimhan, Crawford, Mcginn et al., Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients, Clin Microbiol Infect
Rosenberg, Dufort, Udo, Wilberschied, Kumar et al., Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state, JAMA
Thai, Dinh, Hoang, Luu, Hung et al., Factors associated with the duration of hospitalization among COVID-19 patients in Vietnam: A survival analysis, Epidemiol Infect
Tharakan, Nomoto, Miyashita, Ishikawa, Body temperature correlates with mortality in COVID-19 patients, Crit Care
Wang, Hu, Hu, Zhu, Liu et al., Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China, JAMA
Xiong, Tang, Liu, Tu, Tian et al., Clinical characteristics of and medical interventions for COVID-19 in hemodialysis patients in Wuhan, China, J Am Soc Nephrol
Yan, Hua, Feng, Xu, Liang, Clinical characteristics of patients diagnosed with COVID-19 in Beijing, Biosaf Health
Yang, Gui, Xiong, Comparison of clinical characteristics of patients with asymptomatic vs symptomatic coronavirus disease 2019 in Wuhan, China, JAMA Network Open
Yang, Zheng, Gou, Pu, Chen et al., Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis, Int J Infect Dis
Zhao, Xu, Yin, Hu, Xiong et al., Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study, BMC Infect Dis
Zhao, Yu, Zha, Wang, Pang et al., Clinical characteristics and durations of hospitalized patients with COVID-19 in Beijing: a retrospective cohort study
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, The Lancet
Zhu, Ji, Pang, Zhong, Li et al., Clinical characteristics of 3,062 COVID-19 patients: a meta-analysis, J Med Virol
