Introduction: The COVID-19 pandemic has turned the global health system upside down. Senegal recorded its first case on 2 March 2020. As part of its control strategy, the internal medicine department was set up as an epidemic treatment center (ETC). We report on our experience in the management of patients hospitalized in the said center. Material and Methods: Retrospective and descriptive study with analytical aim carried out at the ETC of the CHU Le Dantec of Dakar during the period from 29 April to 30 October 2020 (1st wave) then from 30 December 2020 to 30 April 2021 (2nd wave). All hospitalized patients who tested positive for RT-PCR were included. Epidemiological, clinical, paraclinical and evolutionary data were collected from a pre-established survey form and analysed using the software. Results: Five hundred and seventy files were collected: 379 patients (66%) in the 1st wave and 191 patients (34%) in the 2nd wave. There were 312 men and 258 women, i.e. a sex ratio of 1.22. The median age was 56 years [1.5 - 100 years]. Two thirds of the patients (66%) were over 50 years of age and 223 patients (39.1%) were over 65 years of age. Community transmission was reported in 72% of cases. The average length of hospital stay was 10 days [1 - 32]. Clinically, the mild form predominated (50.9%); the severe and critical forms were 32.6%. Comorbidity was noted in 68% of patients. The different comorbidities were: hypertension (36.1%), diabetes (28.2%), advanced CKD (9.8%). The case fatality rate was 17.2% with a mean age of 70 years. Conclusion: COVID-19 is responsible for respiratory but also systemic manifestations. This 3rd pandemic particularly affects vulnerable people with a significant morbidity and mortality, thus requiring the implementation of standardized CTE with multidisciplinary teams in the control strategies.
References
[1]
Wong, G., Liu, W., Liu, Y., Zhou, B., Bi, Y. and Gao, G.F. (2015) MERS, SARS and Ebola: The Role of Super-Spreaders in Infectious Disease. Cell Host & Microbe, 18, 398-401. https://doi.org/10.1016/j.chom.2015.09.013
[2]
Zhu, N., Zhang, D., Wang, W., et al. (2020) A Novel Coronavirus from Patients with Pneumonia in China, 2019. The New England Journal of Medicine, 382, 727-723. https://doi.org/10.1056/NEJMoa2001017
[3]
Wu, Y., Ho, W., Huang, Y., et al. (2020) SARS-Cov-2 Is an Appropriate Name for the New Coronavirus. The Lancet, 395, 949-950. https://doi.org/10.1016/S0140-6736(20)30557-2
[4]
Taieb, F., Mbaye, K.F., Tall, B., Lakhe, N.A., Talla, C., et al. (2021) Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Sénégal from March to October. Journal of Clinical Medicine, 10, 2954. https://doi.org/10.3390/jcm10132954
[5]
Wang, D., Hu, B., Hu, C., et al. (2020) Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA, 323, 1061-1069. https://doi.org/10.1001/jama.2020.1585
[6]
Danamou, J., Bangoura, A., Camara, L.M., Camara, D., Traoré, D.A., et al. (2021) Caractéristiques épidémiologiques et cliniques des patients COVID 19 admis en réanimation à l’hôpital Donka de Conakry: Etude descriptive des 140 premiers cas hospitalisés. Anesthésie & Réanimation, 7, 102-109. https://doi.org/10.1016/j.anrea.2021.01.001
[7]
Ketfi, A., Chabati, O., Chemali, S., et al. (2020) Profil clinique, biologique et radiologique des patients Algériens hospitalisés pour COVID-19: Données préliminaires. Pan Africa Medical Journal, 35, 77. https://doi.org/10.11604/pamj.supp.2020.35.2.23807
[8]
Nachega, J.B., Ishoso, D.K., Otoye, J.O., Hermans, M.P., Machekano, R.N., et al. (2020) Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo. American Journal of Tropical Medicine and Hygiene, 103, 2419-2428.
[9]
Richardson, S., Hisrch, J.S., Narasimhan, M., Crawford, J.M. and McGinn, T. (2020) Presenting Characteristics, Comorbidities and Outcomes among 5700 Patients Hospitalized with COVID-19 in the New York City Area. JAMA, 323, 2052-2059. https://doi.org/10.1001/jama.2020.6775
[10]
Sixt, T., Moretto, F., Abdallahoui, M., Chavanet, P., Devilliers, H., Catherine, F. and Piroth, L. (2020) 21èmes Journées nationales d’infectiologie. Médecine et maladies infectieuses, 50, S62-S63. https://doi.org/10.1016/j.medmal.2020.06.120
[11]
Guan, W., Ni, Z., Hu, Y., Liang, W., Ou, C., He, J., et al. (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. The New England Journal of Medicine, 382, 1708-1720. https://doi.org/10.1056/NEJMoa2002032
[12]
Wu, C., Chen, X., Cai, Y., et al. (2020) Risk Factors Associated with Acute Respiratory Distress Syndrome and Death in Patients with Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Internal Medicine, 180, 934-943.
[13]
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., et al. (2020) Clinical Features of Patients Infected with 2019 Novel Coronavirus in Wuhan, China. The Lancet, 395, 497-506.
[14]
Li, H., Liu, L., Zhang, D., Xu, J., Dai, H., Tang, N., et al. (2020) SARS-CoV-2 and Viral Sepsis: Observations and Hypotheses. The Lancet, 395, 1517-1520. https://doi.org/10.1016/S0140-6736(20)30920-X
[15]
Plaçais, L. and Richier, Q. (2020) COVID-19: Clinical, Biological and Radiological Characteristics in Adults, Infants and Pregnant Women. An Up-to-Date Review at the Heart of the Pandemic. La Revue de Médecine Interne, 41, 308-318. https://doi.org/10.1016/j.revmed.2020.04.004
[16]
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., et al. (2020) Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology, 77, 683-690. https://doi.org/10.1001/jamaneurol.2020.1127
[17]
Neumann-Podczaska, A., Al-Saad, S.R., Karbowski, L.M., et al. (2020) COVID-19 Clinical Picture in the Elderly Population: A Qualitative Systematic Review. Aging and Disease, 11, 988-1008. https://doi.org/10.14336/AD.2020.0620
[18]
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., et al. (2020) Clinical Course and Risk Factors for Mortality of Adult Inpatients with COVID-19 in Wuhan, China: A Retrospective Cohort Study. The Lancet, 395, 1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
[19]
Li, K., Wu, J., Wu, F., Guo, D., Chen, L., Fang, Z., et al. (2020) The Clinical and Chest CT Features Associated with Severe and Critical COVID-19 Pneumonia. Investigative Radiology, 55, 327-331. https://doi.org/10.1097/RLI.0000000000000672
[20]
Chen, H., Guo, J., Wang, C., Luo, F., Yu, X., Zang, W., et al. (2020) Clinical Characteristics and Intrauterine Vertical Transmission Potential of COVID-19 Infection in Nine Pregnant Women: A Retrospective Review of Medical Records. The Lancet, 395, 809-815. https://doi.org/10.1016/S0140-6736(20)30360-3
[21]
Schwatz, D.A. (2020) An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnant Outcomes. Archives of Pathology & Laboratory Medicine, 144, 799-805. https://doi.org/10.5858/arpa.2020-0901-SA
[22]
Liu, Y., Chen, H., Tang, K. and Guo, Y. (2020) Clinical Manifestations and Outcome of SARS-CoV-2 Infection during Pregnancy. Journal of Infection. https://doi.org/10.1016/j.jinf.2020.02.028
[23]
Bulubas, I., Vogel, T. and Muller, M. (2021) Les facteurs pronostiques dans la Covid-19. NPG Neurologie-Psychiatrie-Geriatrie.