African COVID-19 Critical Care Outcomes Study

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SYNOPSIS

BACKGROUND

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.

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.

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

In patients with suspected or known COVID-19 infection in Africa;

  1. To identify critical care resources associated with survival,
  2. To identify patient comorbidities and other risk factors associated with in-hospital mortality,
  3. To identify in hospital interventions associated with in-hospital survival.

STUDY DESIGN

An African multi-centre 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 primary outcome is in-hospital mortality in adult patients admitted to critical care or high-care units following suspected or known COVID-19 infection in Africa.

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 April to December 2020.

PREPARATORY WORK

This study is built on the successful African Perioperative Research Group (APORG) of over 600 hospitals in over 40 African countries which has successfully conducted the African Surgical Outcomes Study (ASOS).

IMPORTANCE OF THIS STUDY

To decrease the mortality associated with severe COVID-19 infection in Africa, it is important to rapidly establish risk factors for adverse outcomes, and resources potentially associated with survival. The APORG network has the capacity to provide these data timeously.

DOCUMENTS

ACCCOS Protocol

English Protocol

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French Protocol

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ACCCOS CRFs

English CRF

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French CRF

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ACCCOS Definitions

English Definitions

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French Definitions

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