Dataset Information

Evaluation of patient characteristics, management and outcomes for COVID-19 at district hospitals in the Western Cape, South Africa: descriptive observational study.

ABSTRACT:

Objectives

To describe the characteristics, clinical management and outcomes of patients with COVID-19 at district hospitals.

Design

A descriptive observational cross-sectional study.

Setting

District hospitals (4 in metro and 4 in rural health services) in the Western Cape, South Africa. District hospitals were small (<150 beds) and led by family physicians.

Participants

All patients who presented to the hospitals' emergency centre and who tested positive for COVID-19 between March and June 2020.

Primary and secondary outcome measures

Source of referral, presenting symptoms, demographics, comorbidities, clinical assessment and management, laboratory turnaround time, clinical outcomes, factors related to mortality, length of stay and location.

Results

1376 patients (73.9% metro, 26.1% rural). Mean age 46.3 years (SD 16.3), 58.5% females. The majority were self-referred (71%) and had comorbidities (67%): hypertension (41%), type 2 diabetes (25%), HIV (14%) and overweight/obesity (19%). Assessment of COVID-19 was mild (49%), moderate (18%) and severe (24%). Test turnaround time (median 3.0 days (IQR 2.0-5.0 days)) was longer than length of stay (median 2.0 day (IQR 2.0-3.0)). The most common treatment was oxygen (41%) and only 0.8% were intubated and ventilated. Overall mortality was 11%. Most were discharged home (60%) and only 9% transferred to higher levels of care. Increasing age (OR 1.06 (95% CI 1.04 to 1.07)), male (OR 2.02 (95% CI 1.37 to 2.98)), overweight/obesity (OR 1.58 (95% CI 1.02 to 2.46)), type 2 diabetes (OR 1.84 (95% CI 1.24 to 2.73)), HIV (OR 3.41 (95% CI 2.06 to 5.65)), chronic kidney disease (OR 5.16 (95% CI 2.82 to 9.43)) were significantly linked with mortality (p<0.05). Pulmonary diseases (tuberculosis (TB), asthma, chronic obstructive pulmonary disease, post-TB structural lung disease) were not associated with increased mortality.

Conclusion

District hospitals supported primary care and shielded tertiary hospitals. Patients had high levels of comorbidities and similar clinical pictures to that reported elsewhere. Most patients were treated as people under investigation. Mortality was comparable to similar settings and risk factors identified.

SUBMITTER: Mash RJ

PROVIDER: S-EPMC7839306 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Evaluation of patient characteristics, management and outcomes for COVID-19 at district hospitals in the Western Cape, South Africa: descriptive observational study.

Mash Robert James RJ Presence-Vollenhoven Mellisa M Adeniji Adeloye A Christoffels Renaldo R Doubell Karlien K Eksteen Lawson L Hendrikse Amee A Hutton Lauren L Jenkins Louis L Kapp Paul P Lombard Annie A Marais Heleen H Rossouw Liezel L Stuve Katrin K Ugoagwu Abi A Williams Beverley B

BMJ open 20210126 1

<h4>Objectives</h4>To describe the characteristics, clinical management and outcomes of patients with COVID-19 at district hospitals.<h4>Design</h4>A descriptive observational cross-sectional study.<h4>Setting</h4>District hospitals (4 in metro and 4 in rural health services) in the Western Cape, South Africa. District hospitals were small (<150 beds) and led by family physicians.<h4>Participants</h4>All patients who presented to the hospitals' emergency centre and who tested positive for COVID- ...[more]

PMID: 33500292

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Dataset Information

Evaluation of patient characteristics, management and outcomes for COVID-19 at district hospitals in the Western Cape, South Africa: descriptive observational study.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusion

Publications

Evaluation of patient characteristics, management and outcomes for COVID-19 at district hospitals in the Western Cape, South Africa: descriptive observational study.

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