The African Covid-19 critical care outcomes study (ACCCOS)

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Date
2020-10-08
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Kamuzu University of Health Sciences
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TYPE OF STUDY Multi-centre prospective observational cohort study. PROBLEM The infectious disease COVID-19, caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has been declared a pandemic and an international healthcare emergency by the World Health Organization (WHO). It has spread across the globe, overwhelming healthcare systems by causing high rates of critical illness. Mortality from COVID-19 exceeds 4%, with older people with comorbidities being extremely vulnerable. It is expected that between 50-80% of the world’s population may contract SARS-CoV-2 over the next two years. In Africa there is a limited workforce and there are limited intensive care facilities and critical care resources across to provide sufficient care. It is important therefore to establish what resources, comorbidities and interventions are potentially associated with either mortality or survival in patients with COVID-19 who are referred for critical care in Africa. Rapid dissemination of these findings may help mitigate mortality from COVID-19 in critical care patients in Africa. These points provide the rationale for the African COVID-19 Critical Care Outcomes Study (ACCCOS). STUDY OBJECTIVES The main objectives of this study are to identify critical care resources associated with survival, identify patient comorbidities and other risk factors associated with in-hospital mortality and to identify in hospital interventions associated with in-hospital survival in patients with suspected or known COVID-19 in Africa. METHODS An African multi-centre retrospective and prospective observational cohort study of adult (≥18 years) patients referred to critical care or high-care units with suspected or known COVID-19 infection. Patient follow up will be for a maximum of 30 days in-hospital. The intention is to provide a representative sample of the mortality and the risk factors associated with mortality in adult patients with suspected or known COVID-19 referred for critical care in Africa. This study will run between Aprils to December 2020. EXPECTED FINDINGS AND DISSEMINATION We expect the outcomes to be potentially worse in Africa, because firstly, there is a limited workforce, and secondly there are limited intensive care facilities and critical care resources across Africa to provide sufficient care. A report of the research findings will be submitted to the College of Medicine Research and Ethics Committee, the College of Medicine Library, the Health Sciences research committee, the University research and publication committee, the Lancet Commission and the Ministry of Health.
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