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Résumé
Objective. The impact of COVID19 on mortality among chronic haemodialysis in Sub-Sahara Africa is unknown. We sought to compare mortality before and during COVID19 in one haemodialysis center in Cameroon. Population and methods. We conducted a retrospective study from 1st January 2018 to 31st April 2021 in the haemodialysis center of the General Hospital of Douala. Data of death patients were recorded and compared before (1st January 2018 - 31st March 2020) and during (1st April 2020 – 30th April 2021).Results. A total of 267 deaths (51.2%) among 522 patients were registered. Most of them were male (n=168,635) with a mean age of 46.7±14.23 years. Annual mortality rate was higher during pandemic (28.63% vs 18.54%, p=0.01) and mortality was elevated among incident patients (40% vs 29.4%, p=0.03). Patients who died during pandemic were older (50.3±12.7 vs 44.5±14.8 years, p=0.002) and COVID19 was the main cause of death during pandemic while catheter sepsis was more common before pandemic. Conclusion. COVID19 is associated with higher mortality in haemodialysis in our setting, especially among incident patients and those older than 50 years.
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##journal.references##
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- Li J, Huang DQ, Zou B, Yang H, Hui WZ, Rui F, Yee NTS, Liu C, Nerurkar SN, Kai JCY, Teng MLP, Li X, Zeng H, Borghi JA, Henry L, Cheung R, Nguyen MH. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021; 93(3):1449-1458.
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- Ashuntantang G, Osafo C, Olowu WA, Arogundade F, Niang A, Porter J, Naicker S, Luyckx VA. Outcomes in adults and children with end-stage Burden of ESRD in sub-Saharan Africa S7 kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Glob Health. 2017; 5: e408-e417.
- Fouda H, Ashuntantang G, Kaze F, Halle MP. La survie en hémodialyse chronique au Cameroun. Pan Afr Med J. 2017; 26:97.
- Fouda H, Halle MP, Mbele CO, Mbatchou BH, Luma HN, Ashuntantang G. Profil épidémiologique et clinique, et survie à 90 jours des patients incidents en hémodialyse chronique au cours de la pandémie à SARS-CoV2 au Cameroun : expérience de l’hôpital général de Douala. Néphrol ther. 2021 ; S1769-7255(21):00001-8.
- Halle MP, Ashuntantang G, Kaze F, Takongue C, Kegne AP. Fatal outcomes among patients on maintenance haemodialysis in sub-Saharan Africa: a 10- year audit from the Douala General Hospital in Cameroon. BMC Nephrol 2016;17:165.
##journal.references##
Africa center of disease control and prevention. Ressources Outbreak brief of COVI19 pandemic. https://africacdc.org/resources/
Li J, Huang DQ, Zou B, Yang H, Hui WZ, Rui F, Yee NTS, Liu C, Nerurkar SN, Kai JCY, Teng MLP, Li X, Zeng H, Borghi JA, Henry L, Cheung R, Nguyen MH. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021; 93(3):1449-1458.
Panagiotou OA, Kosar CM, White EM, Bantis LE, Yang X, Santostefano CM, Feifer RA, Blackman C, Rudolph JL, Gravenstein S, Mor V. Risk Factors Associated With All-Cause 30-Day Mortality in Nursing Home Residents With COVID-19. JAMA Intern Med. 2021; 181(4):439-48.
Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using Open SAFELY. Nature. 2020; 584:430–6.
Zhang L, Hou J, Ma FZ, Li J, Xue S, Xu ZG. The common risk factors for progression and mortality in COVID-19 patients: a meta-analysis. Arch Virol. 2021 ; 2:1–17.
ERA-EDTA Council; ERACODA Working Group. Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA. Nephrol Dial Transplant. 2021 Jan 1;36(1):87-94.
Henry BM, Lippi G. Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. Int Urol Nephrol. 2020;52(6):1193-1194. doi:10.1007/s11255-020-02451-9
Menon T, Gandhi S, Tariq W, Warisha Tariq, Sharma R, Sardar S, Arshad AM, Adhikari R, Ata F, Kataria S, Singh R. Impact of Chronic Kidney Disease on Severity and Mortality in COVID-19 Patients: A Systematic Review and Meta-analysis. Cureus. 2021; 13(4): e14279
Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HH, Mercer SW, Sanderson C, McKee M, Troeger C, Ong KL, Checchi F, Perel P, Joseph S, Gibbs HP, Banerjee A, Eggo RM, Centre for the Mathematical Modelling of Infectious Diseases COVID-19 working group. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study. Lancet Glob Health. 2020; 8:e1003–e1017
Ashuntantang G, Osafo C, Olowu WA, Arogundade F, Niang A, Porter J, Naicker S, Luyckx VA. Outcomes in adults and children with end-stage Burden of ESRD in sub-Saharan Africa S7 kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Glob Health. 2017; 5: e408-e417.
Fouda H, Ashuntantang G, Kaze F, Halle MP. La survie en hémodialyse chronique au Cameroun. Pan Afr Med J. 2017; 26:97.
Fouda H, Halle MP, Mbele CO, Mbatchou BH, Luma HN, Ashuntantang G. Profil épidémiologique et clinique, et survie à 90 jours des patients incidents en hémodialyse chronique au cours de la pandémie à SARS-CoV2 au Cameroun : expérience de l’hôpital général de Douala. Néphrol ther. 2021 ; S1769-7255(21):00001-8.
Halle MP, Ashuntantang G, Kaze F, Takongue C, Kegne AP. Fatal outcomes among patients on maintenance haemodialysis in sub-Saharan Africa: a 10- year audit from the Douala General Hospital in Cameroon. BMC Nephrol 2016;17:165.