Epidemiological, clinical Characteristics and mortality of patients Infected with SARS-CoV-2 Admitted of Kinshasa University Hospital, Democratic Republic of the Congo from March 24, 2020 to January 30, 2021: Two waves, two faces?

Mandina, M.; Makulo, j. r.; Wumba, R.; Bepouka, B.; odio, j.; Nkodila, A.; Longokolo, M.; Mayasi, N.; Mangala, D.; Kamwiziku, G.; Longo, A. L.; Mpia, G.; Kokusa, Y.; Keke, H.; Mbula, M.; Situakibanza, H.; Sumaili, E.; Kayembe, J. M.

Abstract Background The objective of our retrospective study was to establish a comparison between the first and the second waves of demographic and clinical characteristics as well as mortality and its determinants. Methods A total of 411 COVID-19 patients were enrolled in Kinshasa University Hospital and categorized into two groups according to the pandemic pattern, demographics, and disease severity. The clinical characteristics were compared according to the two waves. To describe survival from the first day of hospitalization until death, we used Kaplan Meier method. We used the Log Rank test to compare the survival curves between the two waves. The Cox regression was used to identify independent predictors of mortality. Results During the study period, 411 patients with confirmed COVID-19 were admitted to the hospital. The average age of patients in the 2nd wave was higher than in the first wave (between 34.9 and 67.9 years old vs between 58. 42.4 and 73.8 years old, p=0.026). The mean saturation was lower in the first wave than in the second. The death rate of patients in the first wave was higher than in the second wave (p=0.009). Survival was reduced in the first wave compared to the second wave. In the first wave, age over 60 years, respiratory distress, law oxygen saturation (lower than 89%) and severe stage of COVID-19 emerged as factors associated with death, while in the second wave it was mainly respiratory distress, law oxygen saturation (lower than 89%) and severe stage. The predictors of mortality present in both the first and second waves were respiratory distress and severe COVID-19 stage. Conclusion Mortality decreased in the second wave. Age no longer emerged as a factor in mortality in the second wave. Health system strengthening and outreach to those at high risk of mortality should continue to maintain and improve gains. Keywords SARS-COV-2, Democratic Republic of Congo, 2 waves