Demographic and Clinical Characteristics Associated With Severity, Clinical Outcomes, and Mortality of COVID-19 Infection in Gabon

Iroungou, Berthe Amélie; Mangouka, Laurette Guignali; Bivigou-Mboumba, Berthold; Moussavou-Boundzanga, Pamela; Obame-Nkoghe, Judicaël; Nzigou Boucka, Farrel; Mouinga-Ondeme, Augustin; Aghokeng, Avelin Fobang; Tchoua, Romain; Pineau, Pascal; Nzenze, Jean Raymond

IMPORTANCE: Since the emergence of COVID-19 in central China, sub-Saharan African countries, with the exception of South Africa, have been relatively spared during the COVID-19 pandemic. Consequently, few descriptive studies from this region are available. OBJECTIVE: To describe the clinical characteristics and outcomes of patients with COVID-19 infection in Gabon, from March to June 2020. DESIGN, SETTING, AND PARTICIPANTS: A single-center, cross-sectional study of 837 patients with COVID-19 was conducted from March to June 2020 in the Armed Forces Hospital in Libreville, Gabon. MAIN OUTCOMES AND MEASURES: Demographic and clinical characteristics and imaging findings of hospitalized patients with COVID-19. RESULTS: Of the 837 patients enrolled, 572 (68.3%) were men, and 264 (31.5%) were women (male to female ratio, 2:1); the median (interquartile range [IQR]) age was 35 (30-45) years (mean [SD] age, 38.0 [12.2] years. The mortality rate associated with COVID-19 was low (1.4%). Of these 837 patients, 524 (62.6%) were categorized as having no symptoms, 282 (33.7%) as having mild symptoms, and 31 (3.7%) as having severe symptoms. Patients with severe symptoms were older (mean [SD] age, 46.1 [14.7] years) than patients with mild symptoms (mean [SD] age, 41.3 [12.5] years) and those with no symptoms (mean [SD] age, 35.7 [11.3] years) (Kruskal-Wallis χ(2)(2) = 53.5; P < .001). History of diabetes was the principal risk factor associated with both severe symptoms in 5 of 31 patients (16.1%) and mild symptoms in 11 of 282 (3.9%) compared with no symptoms in 5 of 524 (0.9%) (Pearson χ(2)(2) = 30.9; P < .001). Patients with severe symptoms and a fatal outcome were older (mean [SD] age, 53.4 [15.1] years) than survivors (mean [SD] age, 41.5 [12.9] years) (t(20.83) = 2.2; P = .03). CONCLUSIONS AND RELEVANCE: In this single-center, cross-sectional study in Libreville, Gabon, the mortality rate associated with COVID-19 infection from March to June 2020 was low, and patients who died of COVID-19 infection were younger on average than reported elsewhere, possibly reflecting a smaller elderly population in Gabon.