Department of Medicine, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities
Department of Medicine, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities
Freedom Gumedze
Department of Statistical Sciences, University of Cape Town
Daniel Mutithu
Cape Heart Institute, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities
Marguerite Adriaanse
Department of Medicine, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities
Daniel Egan
Department of Medicine, University of Cape Town
Simthandile Mazondwa
Department of Medicine, University of Cape Town
Rochelle Walters
Department of Medicine, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities
Lambert Tetteh Appiah
Department of Medicine, Kwame Nkrumah University of Science & Technology (KNUST) and Komfo Anokye Teaching Hospital, Kumasi
Francisca Inofomoh
Internal Medicine Department, Olabisi Onabanjo University Teaching Hospital
Okechukwu Ogah
Department of Medicine, College of Medicine, University of Ibadan, and University College Hospital Ibadan
Olukemi Adekanmbi
Department of Medicine, University College Hospital Ibadan
Fastone Goma
Centre for Primary Care Research, Levy Mwanawasa University Teaching Hospital, Lusaka
Elijah Ogola
The Mombasa Hospital
Kieran Mwazo
Department of Medicine, Coast General Teaching and Referral Hospital, Mombasa
Ahmed Suliman
Faculty of Medicine, University of Khartoum
Kavita Singh
Public Health Foundation of India, Gurugram, Haryana and Centre for Chronic Disease Control, New Delhi, IN; Heidelberg Institute of Global Health, University of Heidelberg
Lana Raspail
World Heart Federation, Geneva
Dorairaj Prabhakaran
Public Health Foundation India and Centre for Chronic Disease Control, IN; World Heart Federation, CH; London School of Hygiene & Tropical Medicine
Pablo Perel
Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, GB; World Heart Federation
Karen Sliwa
Cape Heart Institute, Department of Medicine & Cardiology, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa; World Heart Federation
Ntobeko A. B. Ntusi
Department of Medicine, University of Cape Town; UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases; ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, ZA; World Heart Federation
Background: COVID-19 cardiovascular research from Africa is limited. This study describes cardiovascular risk factors, manifestations, and outcomes of patients hospitalised with COVID-19 in the African region, with an overarching goal to investigate whether important differences exist between African and other populations, which may inform health policies. Methods: A multinational prospective cohort study was conducted on adults hospitalised with confirmed COVID-19, consecutively admitted to 40 hospitals across 23 countries, 6 of which were African countries. Of the 5,313 participants enrolled globally, 948 were from African sites (n = 9). Data on demographics, pre-existing conditions, clinical outcomes in hospital (major adverse cardiovascular events (MACE), renal failure, neurological events, pulmonary outcomes, and death), 30-day vitality status and re-hospitalization were assessed, comparing African to non-African participants. Results: Access to specialist care at African sites was significantly lower than the global average (71% vs. 95%), as were ICU admissions (19.4% vs. 34.0%) and COVID-19 vaccination rates (0.6% vs. 7.4%). The African cohort was slightly younger than the non-African cohort (55.0 vs. 57.5 years), with higher rates of hypertension (48.8% vs. 46.9%), HIV (5.9% vs. 0.3%), and Tuberculosis (3.6% vs. 0.3%). In African sites, a higher proportion of patients suffered cardiac arrest (7.5% vs. 5.1%) and acute kidney injury (12.7% vs. 7.2%), with acute kidney injury (AKI) appearing to be one of the strongest predictors of MACE and death in African populations compared to other populations. The overall mortality rate was significantly higher among African participants (18.2% vs. 14.2%). Conclusions: Overall, hospitalised African patients with COVID-19 had a higher mortality despite a lower mean age, contradicting literature that had previously reported a lower mortality attributed to COVID-19 in Africa. African sites had lower COVID-19 vaccination rates and higher AKI rates, which were positively associated with increased mortality. In conclusion, African patients were hospitalized with more severe COVID-19 cases and had poorer outcomes.
