Mortality rates in serious cases in Africa

The COVID-19 pandemic has severely tested health systems worldwide. Serious cases of the illness have often overwhelmed care services, especially in intensive care units. The average mortality rate is 3%, but large disparities exist between, for example, elderly people with pre-existing medical conditions and young people, and between different countries. It would seem likely that for patients with severe forms of COVID-19 in Africa, where health care systems are less developed than on other continents, survival chances are reduced. However, the outcomes for this category of cases have not been well documented. An African research project (The African COVID-19 Critical Care Outcomes Study) has recently evaluated mortality rates throughout the continent and examined factors contributing to mortality.

The researchers studied 3140 patients admitted to intensive care between May and December 2020 in 64 hospitals across 10 African countries. The patients were all aged above 18 (the average was 56 years old) and 60% were male. The rate of mortality in these patients reached 48%, much higher than rates in other continents (the worldwide average is 32%).

It is true that African countries have fewer intensive care units. In addition, these units are less well equipped than on other continents, and often suffer from shortages of medicines, materials and staff. Hospitals and critical care units are in particularly short supply on the continent of Africa. Many less well-off patients have difficulty accessing care, so the start of their treatment is often delayed. Mortality rates of patients admitted to intensive care are therefore much higher than on other continents. 

The researchers confirmed the worldwide observation that pre-existing conditions such as HIV, diabetes or chronic illnesses of the liver or kidneys are factors that raise mortality rates. On the other hand, they noted that treating patients with steroids does reduce deaths. In addition, and in a departure from other studies, men do not seem to have a greater risk of dying than women.