Observational studyBMC infectious diseases2023
A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study.
Observational study in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 19 citations in OpenAlex.
- Efficacy of typhoid conjugate vaccine: final analysis of a 4-year, phase 3, randomised controlled trial in Malawian children.Lancet (London, England) · 2024Trial
- Describing a National Chatbot Deployed by the Ministry of Health in Malawi During the COVID-19 Pandemic: Retrospective Data Analysis.Journal of medical Internet research · 2026Article
- Can Malawi afford to lose? The definitive cost of 'brain drain' and 'brain waste' in its essential medical laboratory workforce.African journal of laboratory medicine · 2026Article
- Distribution ofPathogens (Basel, Switzerland) · 2025Article
- Rethinking the evidence on COVID-19 in Africa.The Lancet. Infectious diseases · 2025Review
- COVID-19 severity and vaccine effectiveness in Malawi: A test-negative case-control study.Journal of public health in Africa · 2025Article
- Cross-Section of Neurological Manifestations Among SARS-CoV-2 Omicron Subvariants-Single-Center Study.Brain sciences · 2024Article
- Longevity of hybrid immunity against SARS-CoV-2 in adults vaccinated with an adenovirus-based COVID-19 vaccine.BMC infectious diseases · 2024Article
- Managing and treating COVID-19 in patients with hematological malignancies: a narrative review and expert insights.Clinical and experimental medicine · 2024Review
- Surprising Gendered Age Differences in Rural Malawians' Early COVID-19 Pandemic Prevention Efforts.The journals of gerontology. Series B, Psychological sciences and social sciences · 2024Article
- Insights into COVID-19 data collection and management in Malawi: exploring processes, perceptions, and data discrepancies.Wellcome open research · 2024Article
- Controlling the first wave of the COVID-19 pandemic in Malawi: Results from a multi-round study.PLOS global public health · 2024Article
- Uptake of COVID-19 vaccine and associated factors among Health Care Workers at Queen Elizabeth Central Hospital in Malawi: A cross-section study.PLOS global public health · 2024Article
- Utilizing river and wastewater as a SARS-CoV-2 surveillance tool in settings with limited formal sewage systems.Nature communications · 2023Article
- Effects of COVID-19 on Maternal and Neonatal Outcomes and Access to Antenatal and Postnatal Care, Malawi.Emerging infectious diseases · 2023Article
- Omicron B.1.1.529 variant infections associated with severe disease are uncommon in a COVID-19 under-vaccinated, high SARS-CoV-2 seroprevalence population in Malawi.EClinicalMedicine · 2023Article
- Article
- Impact on the Clinical Evolution of Patients with COVID-19 Pneumonia and the Participation of theInternational journal of molecular sciences · 2022Article
- The Impact of Demographic, Clinical Characteristics and the Various COVID-19 Variant Types on All-Cause Mortality: A Case-Series Retrospective Study.Diseases (Basel, Switzerland) · 2022Article
- Health behavior and social crisis in the era of COVID-19 in Malawi: A decolonizing approach to a qualitative study.Nursing outlookArticle
Corrections and comments
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Authors and funding
25 authors at 8 institutions in 3 countries.
Funding
Abstract
backgroundCompared 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.
methodsWe 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.
resultsWe 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.
conclusionsOur 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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.