Department of Community Health and Primary Care

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https://ir.unilag.edu.ng/handle/123456789/3605

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Browsing Department of Community Health and Primary Care by Author "Adebayo, B"

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    Open Access
    Clinical presentation, case management and outcomes for the first 32 COVID-19 patients in Nigeria
    (The Pan African Medical Journal, 2020) Bowale, A; Abayomi, A; Idris, J; Omilabu, S; Abdus-Salam, I; Adebayo, B; Opawoye, F; Finnih-Awokoya, O; Zamba, E; Abdur-Razzaq, H; Erinoso, O; Onasanya, T; Ramadan, P; Nyenyi, S; Aniaku, E; Balogun, M; Okunromade, O; Adejumo, O; Adesola, S; Ogunniyan, T; Balogun, M; Osibogun, A
    Introduction: success in curtailing the pandemic coronavirus disease (COVID-19) depends largely on a sound understanding of the epidemiologic and clinical profile of cases in a population as well as the case management approach. This study documents the presenting characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients in Nigeria. Methods: this retrospective study used medical records of the first 32 patients admitted and discharged from the Mainland Hospital, Lagos State, southwest Nigeria between February 27 and April 6, 2020. The outcomes of interest were death, promptness of admission process and duration of hospitalization. Results: the mean age of the patients was 38.1 years (SD: 15.5) and 66% were male. Three-quarters (75%) of the patients presented in moderately severe condition while 16% were asymptomatic. The most common presenting symptoms were fever (59%) and dry cough (44%). The mean time between a positive test result and admission was 1.63 days (SD: 1.31). Almost all (97%) the patients were treated with lopinavir-ritonavir with no recorded death. The median duration of hospital stay was 12 days (IQR: 9-13.5). Conclusion: in this preliminary analysis of the first COVID-19 cases in Nigeria, clinical presentation was mild to moderate with no mortality. Processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.
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    Open Access
    Morbidity and mortality outcomes of COVID-19 patients with and without hypertension in Lagos, Nigeria: a retrospective cohort study.
    (2021) Abayomi, A; Osibogun, A; Kanma-Okafor, O; Idris, J; Bowale, A; Wright, O; Adebayo, B; Balogun, M
    Background: The current pandemic of coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive patients. The morbidity and mortality of the disease among hypertensive patients in Africa have yet to be well described. Methods: In this retrospective cohort study all confirmed COVID-19 adult patients (≥18 years of age) in Lagos between February 27 to July 62,020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying, being discharged after recovery or being evacuated/transferred. Descriptive statistics considered proportions, means and medians. The Chi-square and Fisher’s exact tests were used in determining associations between variables. Kaplan–Meier survival analysis and Cox regression were performed to quantify the risk of worse outcomes among hypertensives with COVID-19 and adjust for confounders. P-value ≤0.05 was considered statistically significant. Results: A total of 2075 adults with COVID-19 were included in this study. The prevalence of hypertension, the most common comorbidity, was 17.8% followed by diabetes (7.2%) and asthma (2.0%). Overall mortality was 4.2% while mortality among the hypertensives was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives and survival rates were significantly lowered by the presence of additional comorbidity to 50% from 91% for those with hypertension alone and from 98% for all other patients (P < 0.001). After adjustment for confounders (age and sex), severe COVID-19and death were higher for hypertensives {severe/critical illness: HR = 2.41, P = 0.001, 95%CI = 1.4–4.0, death: HR = 2.30, P = 0.001, 95%CI = 1.2–4.6, for those with hypertension only} {severe/critical illness: HR = 3.76, P = 0.001, 95%CI = 2.1–6.4, death: crude HR = 6.63, P = 0.001, 95%CI = 3.4–1.6, for those with additional comorbidities}. Hypertension posed an increased risk of severe morbidity (approx. 4-fold) and death (approx. 7-fold) from COVID-19 in the presence of multiple comorbidities. Conclusion: The potential morbidity and mortality risks of hypertension especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension and other comorbidities and prioritizing them for future antiviral interventions.
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    Open Access
    Presenting Symptoms and Predictors of Poor Outcomes Among 2,184 Patients with COVID-19 in Lagos State, Nigeria.
    (Int J Infect Dis, 2020) Abayomi, A; Odukoya, O; Osibogun, A; Wright, O; Adebayo, B; Balogun, M
    Introduction: Lagos state remains the epicentre of COVID-19 in Nigeria. We describe the symptoms and signs of the first 2,184 PCR-confirmed COVID-19 patients admitted at COVID-19 treatment centers in Lagos State. We also assessed the relationship between patients’ presenting symptoms, sociodemographic and clinical characteristics and COVID-19 deaths. Methods: Medical records of PCR-confirmed COVID-19 patients were extracted and analyzed for their symptoms, symptom severity, presence of comorbidities and outcome. Results: The ages of the patients ranged from4 days to 98 years with a mean of43.0(16.0)years.Of the patients who presented with symptoms, cough(19.3%) was the most common presenting symptom. This was followed by fever (13.7%) and difficulty in breathing, (10.9%). The most significant clinical predictor of death was the severity of symptoms and signs at presentation. Difficulty in breathing was the most significant symptom predictor of COVID-19 death (OR:19.26 95% CI 10.95-33.88). The case fatality rate was 4.3%. Conclusion: Primary care physicians and COVID-19 frontline workers should maintain a high index of suspicion and prioritize the care of patients presenting with these symptoms. Community members should be educated on such predictors and ensure that patients with these symptoms seek care early to reduce the risk of deaths associated with COVID-19.