TY - JOUR
AU - Anscombe, Catherine
AU - Lissauer, Samantha
AU - Thole, Herbert
AU - Rylance, Jamie
AU - Dula, Dingase
AU - Menyere, Mavis
AU - Kutambe, Belson
AU - Van Der Veer, Charlotte
AU - Phiri, Tamara
AU - Banda, Ndaziona P.
AU - Mndolo, Kwazizira S.
AU - Mponda, Kelvin
AU - Phiri, Chimota
AU - Mallewa, Jane
AU - Nyirenda, Mulinda
AU - Katha, Grace
AU - Mwandumba, Henry C.
AU - Gordon, Stephen B.
AU - Jambo, Kondwani C.
AU - Cornick, Jennifer
AU - Feasey, Nicholas
AU - Barnes, Kayla G.
AU - Morton, Ben
AU - Ashton, Philip M.
AU - Blantyre COVID-19 Consortium
PY - 2023
DA - February
TI - A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study
JO - BMC Infectious Diseases
VL - 23
DO - https://doi.org/10.1186/s12879-022-07941-y
AB - Background: Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity of data from low-income countries. Our aim was to explore the relationship between viral lineage and patient outcome. Methods: We enrolled a prospective observational cohort of adult patients hospitalised with PCR-confirmed COVID-19 disease between July 2020 and March 2022 from Blantyre, Malawi, covering four waves of SARS-CoV-2 infections. Clinical and diagnostic data were collected using an adapted ISARIC clinical characterization protocol for COVID-19. SARS-CoV-2 isolates were sequenced using the MinION™ in Blantyre. Results: We enrolled 314 patients, good quality sequencing data was available for 55 patients. The sequencing data showed that 8 of 11 participants recruited in wave one had B.1 infections, 6/6 in wave two had Beta, 25/26 in wave three had Delta and 11/12 in wave four had Omicron. Patients infected during the Delta and Omicron waves reported fewer underlying chronic conditions and a shorter time to presentation. Significantly fewer patients required oxygen (22.7% [17/75] vs. 58.6% [140/239], p &lt; 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p &lt; 0.001) in the Omicron wave compared with the other waves. Multivariable logistic-regression demonstrated a trend toward increased mortality in the Delta wave (OR 4.99 [95% CI 1.0–25.0 p = 0.05) compared to the first wave of infection. Conclusions: Our data show that each wave of patients hospitalised with SARS-CoV-2 was infected with a distinct viral variant. The clinical data suggests that patients with severe COVID-19 disease were more likely to die during the Delta wave.
PB - Springer Nature
UR - https://eprints.gla.ac.uk/291591/
KW - Coronavirus (COVID-19)
ER