Anscombe, Catherine, Lissauer, Samantha, Thole, Herbert, Rylance, Jamie, Dula, Dingase, Menyere, Mavis, Kutambe, Belson, van der Veer, Charlotte, Phiri, Tamara, Banda, Ndaziona et al (show 14 more authors)
(2023)
A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study.
BMC INFECTIOUS DISEASES, 23 (1).
79-.
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Abstract
<h4>Background</h4>Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity of data from low-income countries. Our aim was to explore the relationship between viral lineage and patient outcome.<h4>Methods</h4>We enrolled a prospective observational cohort of adult patients hospitalised with PCR-confirmed COVID-19 disease between July 2020 and March 2022 from Blantyre, Malawi, covering four waves of SARS-CoV-2 infections. Clinical and diagnostic data were collected using an adapted ISARIC clinical characterization protocol for COVID-19. SARS-CoV-2 isolates were sequenced using the MinION™ in Blantyre.<h4>Results</h4>We enrolled 314 patients, good quality sequencing data was available for 55 patients. The sequencing data showed that 8 of 11 participants recruited in wave one had B.1 infections, 6/6 in wave two had Beta, 25/26 in wave three had Delta and 11/12 in wave four had Omicron. Patients infected during the Delta and Omicron waves reported fewer underlying chronic conditions and a shorter time to presentation. Significantly fewer patients required oxygen (22.7% [17/75] vs. 58.6% [140/239], p < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 0.001) in the Omicron wave compared with the other waves. Multivariable logistic-regression demonstrated a trend toward increased mortality in the Delta wave (OR 4.99 [95% CI 1.0-25.0 p = 0.05) compared to the first wave of infection.<h4>Conclusions</h4>Our data show that each wave of patients hospitalised with SARS-CoV-2 was infected with a distinct viral variant. The clinical data suggests that patients with severe COVID-19 disease were more likely to die during the Delta wave.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COVID, SARS-CoV-2, ISARIC, Delta, Mortality, LMIC, Malawi, Africa |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 18 Apr 2023 11:43 |
| Last Modified: | 18 Apr 2023 11:43 |
| DOI: | 10.1186/s12879-022-07941-y |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3169659 |
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