Original Research

Experiencing COVID-19 at a large district level hospital in Cape Town: A retrospective analysis of the first wave

Nadè Claassen, Gerhard van Wyk, Sanet van Staden, Michiel M.D. Basson
Southern African Journal of Infectious Diseases | Vol 37, No 1 | a317 | DOI: https://doi.org/10.4102/sajid.v37i1.317 | © 2022 Nadi Claassen, Gerhard Van Wyk, Sanet Van Staden, De Vries Michiel Matthys Basson | This work is licensed under CC Attribution 4.0
Submitted: 25 July 2021 | Published: 29 March 2022

About the author(s)

Nadè Claassen, Department of Internal Medicine, Karl Bremer Hospital, Cape Town, South Africa
Gerhard van Wyk, Department of Internal Medicine, Karl Bremer Hospital, Cape Town, South Africa
Sanet van Staden, Department of Internal Medicine, Karl Bremer Hospital, Cape Town, South Africa
Michiel M.D. Basson, Department of Internal Medicine, Karl Bremer Hospital, Cape Town, South Africa


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Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic in tertiary hospitals from South Africa and world wide have been well described, but limited data are published on the findings. This article aimed to describe patients admitted to a large district hospital in Cape Town, South Africa, during the first wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infections. To compare the clinical features and further investigate survivors and deceased COVID-19 patients.

Methods: A single centre retrospective review of clinical records and laboratory data of patients admitted with a positive SARS-CoV-2 polymerase chain reaction (PCR) from April 2020 to August 2020.

Results: A total of 568 patients with a positive SARS-CoV-2 PCR were admitted to the study centre for one night or longer and of these patients 154 (27%) died of COVID-19. The median age of patients who died of COVID-19 was 66 years and 53 years for survivors. Hypertension, diabetes mellitus and obesity were the commonest comorbidities in patients who survived and died of COVID-19. There were no major differences when comparing the severity of infiltrates on chest X-rays (CXR) of COVID-19 survivors with deceased patients. More than half (58%) of deceased patients died within 3 days following admission to hospital. A substantial number of patients who died of COVID-19 had associated acute kidney injury (n = 79, 51%).

Conclusion: Acute kidney injury had a high prevalence amongst patients who died of COVID-19. Delays in transfer to intensive care unit (ICU), limited ICU capacity and disease severity contributed to a substantial number of patients dying within 3 days of admission.


Keywords

COVID-19; mortality; comorbidities; admissions; first wave of infections; district level hospital; diabetes; hypertension

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