author:"Agyare, Elizabeth" | Pollux - Fachinformationsdienst Politikwissenschaft

Open Access#12022

Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries

Nachega, Jean B; Sam-Agudu, Nadia A; Machekano, Rhoderick N; Rabie, Helena; van der Zalm, Marieke M; Redfern, Andrew; Dramowski, Angela; O'Connell, Natasha

Nachega, Jean B; Sam-Agudu, Nadia A; Machekano, Rhoderick N; Rabie, Helena; van der Zalm, Marieke M; Redfern, Andrew; Dramowski, Angela; O'Connell, Natasha; Pipo, Michel Tshiasuma; Tshilanda, Marc B; Byamungu, Liliane Nsuli; Masekela, Refiloe; Jeena, Prakash Mohan; Pillay, Ashendri; Gachuno, Onesmus W; Kinuthia, John; Ishoso, Daniel Katuashi; Amoako, Emmanuella; Agyare, Elizabeth; Agbeno, Evans K; Martyn-Dickens, Charles; Sylverken, Justice; Enimil, Anthony; Jibril, Aishatu Mohammed; Abdullahi, Asara M; Amadi, Oma; Umar, Umar Mohammed; Sigwadhi, Lovemore Nyasha; Hermans, Michel P; Otokoye, John Otshudiema; Mbala-Kingebeni, Placide; Muyembe-Tamfum, Jean-Jacques; Zumla, Alimuddin; Sewankambo, Nelson K; Aanyu, Hellen Tukamuhebwa; Musoke, Philippa; Suleman, Fatima; Adejumo, Prisca; Noormahomed, Emilia V; Deckelbaum, Richard J; Fowler, Mary Glenn; Tshilolo, Léon; Smith, Gerald; Mills, Edward J; Umar, Lawal W; Siedner, Mark J; Kruger, Mariana; Rosenthal, Philip J; Mellors, John W; Mofenson, Lynne M

Importance: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. Objective: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. Design, Setting, and Participants: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized patients aged 0 to 19 years with SARS-CoV-2 infection. Exposures: Age, sex, preexisting comorbidities, and region of residence. Main Outcomes and Measures: An ordinal primary outcome scale was used comprising 5 categories: (1) hospitalization without oxygen supplementation, (2) hospitalization with oxygen supplementation, (3) ICU admission, (4) invasive mechanical ventilation, and (5) death. The secondary outcome was length of hospital stay. Results: Among 469 hospitalized children and adolescents, the median age was 5.9 years (IQR, 1.6-11.1 years); 245 patients (52.4%) were male, and 115 (24.5%) had comorbidities. A total of 39 patients (8.3%) were from central Africa, 172 (36.7%) from eastern Africa, 208 (44.3%) from southern Africa, and 50 (10.7%) from western Africa. Eighteen patients had suspected (n = 6) or confirmed (n = 12) multisystem inflammatory syndrome in children. Thirty-nine patients (8.3%) died, including 22 of 69 patients (31.9%) who required intensive care unit admission and 4 of 18 patients (22.2%) with suspected or confirmed multisystem inflammatory syndrome in children. Among 468 patients, 418 (89.3%) were discharged, and 16 (3.4%) remained hospitalized. The likelihood of outcomes with higher vs lower severity among children younger than 1 year expressed as adjusted odds ratio (aOR) was 4.89 (95% CI, 1.44-16.61) times higher than that of adolescents aged 15 to 19 years. The presence of hypertension (aOR, ...