Clinical profile and factors associated with COVID-19 in Cameroon: a prospective cohort study

Fouda Mbarga, N.; Epee, E.; Mbarga, M.; Ouamba, J. P.; Nanda, H.; Kengni, A.; Guekeme, J.; Eyong, J.; Tossoukpe, S.; Noumedem Sosso, S.; Ngono Ngono, E.; Bonyomo, L.; Tchatchoua, P.; Vogue, N.; Metomb, S.; Ale, F.; Ousman, M.; Job, D.; Moussi, C.; Tamakloe, M.; Haberer, J. E.; Ndeso Atanga, S.; Halle Ekane, G.; Boum, Y.

Objectives: This study explores the clinical profiles and factors associated with COVID-19 in Cameroon. Research design and methods: In this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk. Results: A total of 323 patients were admitted during the study period; 262 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (77%; N=204) to moderate (15%; N=40) to severe (7%; N=18); the case fatality rate was 1% (N=4). Dysgusia (46%; N=111) and hyposmia/anosmia (39%; N=89) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; N=53), of which hypertension was the most common (20%; N=48). Participation in a mass gathering (OR=5.47; P=0.03) was a risk factor for COVID-19. Age groups 60 to 69 (OR=7.41; P=0.0001), 50 to 59 (OR=4.09; P=0.03), 40 to 49 (OR=4.54; P=0.01), male gender (OR=2.53; P=0.04), diabetes (OR= 4.05; P= 0.01), HIV infection (OR=5.57; P=0.03), lung disease (OR= 6.29; P=0.01), dyspnoea (OR=3.70; P=0.008) and fatigue (OR=3.35; P=0.02) significantly predicted COVID-19 severity. Conclusion: Unlike many high-income settings, most COVID-19 cases in this study were benign with low fatality. Such findings may guide public health decision-making.