Observational studyBMJ open2021
Evaluation of patient characteristics, management and outcomes for COVID-19 at district hospitals in the Western Cape, South Africa: descriptive observational study.
Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression.Scientific reports · 2023Pooled it
- Evaluating the Impact of the COVID-19 Pandemic on Accessing HIV Services in South Africa: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Asthma and COVID-19 risk: a systematic review and meta-analysis.The European respiratory journal · 2022Pooled it
- Impact of the COVID-19 pandemic on quality of life of adults with diabetes in rural Uganda: a cross-sectional survey.International health · 2026Article
- Post-discharge mortality among SARS-CoV-2-infected adult patients with severe acute respiratory infection in Bangladesh (2020-2023): burden, clinical characteristics, and associated risk factors.Tropical medicine and health · 2026Article
- Factors predicting the outcome of patients admitted with COVID-19 infection at Pietersburg Hospital, Polokwane, Limpopo province.Southern African journal of infectious diseases · 2026Article
- Impact of COVID-19 on nurse outcomes in the private sector of South Africa: a cross-sectional study.BMC nursing · 2024Article
- The role of community health workers in non-communicable diseases in Cape Town, South Africa: descriptive exploratory qualitative study.BMC primary care · 2024Article
- Clinical and epidemiological risk factors associated with hospitalization and mortality rate of COVID-19 patients in Banja Luka County: A retrospective observational cohort study on 40,000 patients.Journal of family medicine and primary care · 2024Article
- Diabetes mellitus in sub-saharan Africa during the COVID-19 pandemic: A scoping review.PloS one · 2024Article
- Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemic.African health sciences · 2023Article
- External validation of triage tools for adults with suspected COVID-19 in a middle-income setting: an observational cohort study.Emergency medicine journal : EMJ · 2023Observational
- Piloting of virtual group education for diabetes in Cape Town: An exploratory qualitative study.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- COVID-19 severity and in-hospital mortality in an area with high HIV prevalence.Southern African journal of HIV medicine · 2023Article
- A point-prevalence study of body mass indices in HIV-positive and HIV-negative patients admitted to hospital with COVID-19 in South Africa.African journal of thoracic and critical care medicine · 2023Article
- COVID-19 preparedness and response in rural and remote areas: A scoping review.PLOS global public health · 2023Article
- Article
- LMIC-PRIEST: Derivation and validation of a clinical severity score for acutely ill adults with suspected COVID-19 in a middle-income setting.medRxiv : the preprint server for health sciences · 2022Article
- Evaluating the Implementation of the GREAT4Diabetes WhatsApp Chatbot to Educate People With Type 2 Diabetes During the COVID-19 Pandemic: Convergent Mixed Methods Study.JMIR diabetes · 2022Article
- Virtual healthcare services and digital health technologies deployed during coronavirus disease 2019 (COVID-19) pandemic in South Africa: a systematic review.Global health journal (Amsterdam, Netherlands) · 2022Review
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the characteristics, clinical management and outcomes of patients with COVID-19 at district hospitals.
designA descriptive observational cross-sectional study.
settingDistrict 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.
participantsAll 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.
results1376 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.
conclusionDistrict 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.
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