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Mak research raises hope on Covid-19 severity

L-R: Prof William Bazeyo, Prof Barnabas Nawangwe and Dr Bruce Kirenga

L-R: Prof William Bazeyo, Prof Barnabas Nawangwe and Dr Bruce Kirenga

Covid-19 has wreaked havoc globally and claimed hundreds of thousands of lives. In Uganda, the pandemic has so far been managed and we are yet to register any death much as the total cases have risen to 489 by June 2.

However, there is no reason to panic after a study on the first 56 Covid-19 patients led by Makerere University’s lung institute found that show that they were able to recover on supportive care through managing the symptoms and treatment with antibiotics without the need for admission to Intensive care unit (ICU) or ventilation, writes DERRICK KIYONGA

On May 26, the Makerere University Lung Institute released the characteristics and outcomes of initial patients diagnosed and treated with Covid-19 in Uganda. Codenamed COVIDEPI, the six-week study rotated around the behaviour of the Coronavirus and its impact on the lungs.

The research, funded by the Makerere University Research and Innovations Fund (MAKRIF), was a collaboration among various health service providers in the country and was led by Prof William Bazeyo, the Makerere University deputy vice chancellor.

Dr Bruce Kirenga, the institute director, noted that the aim was to prepare study the severity of Covid-19, the patient’s reaction to treatment as well as using the findings to prepare the country to manage other contagious diseases.

“At admission, only two patients met the classification of severe disease. Patients were closely monitored to identify any signs of severe disease. Temperature and oxygen saturation were monitored three times a day,” he said.

“All the patients recovered without the need for admission to intensive care unit (ICU) or ventilation. This is contrary to what has been observed elsewhere, where five per cent of Covid-19 patients required ICU care.”

Kirenga also stressed that the study was not a clinical trial on patients but simply aimed to get pointers of managing Covid-19.

“We wanted to make a comparison of Ugandan patients with those in other countries where Covid-19 is deadly,” he said.

“What we found is that the damage to the body system in Uganda much lower. Covid-19 primarily damages the lungs but we didn’t find any such cases.”

He also pointed out that it was not clear whether the patients had ailments before contracting Covid-19.

“All patients were asymptomatic but some had minor symptoms like a running nose, 28 per cent of them had high blood pressure but this cannot be directly linked to the Covid-19. It could have been anxiety.”

CONCLUSION

The study observed that patients who received the drug hydroxychloroquine, about 50 per cent of the cohort, had shorter time to clinical recovery although this did not reach formal statistical significance.

“In light of the increasing number of cases in the country, these findings help in informing the national preparedness plan for Covid-19,” said Kirenga.

“The number of Covid-19 patients is expected to rise and it is important we build on the successes of the initial group of patients to inform clinical care decisions for the other patients diagnosed.”

RECOMMENDATION

The research advocates for increased testing for Covid-19 since almost half of those confirmed did not have any symptoms and more effort should be taken to make clinical, laboratory and imaging tests available at all Covid-19 treatment centres to support proper grading of disease’s severity.

The study also recommends building capacity to diagnose and treat non-communicable conditions as part of Covid 19 response as well as strengthening monitoring, evaluation and learning as part Covid-19 care.

STITCH IN TIME

Prof Bazeyo noted that the study was mainly meant to help government make appropriate preparations for any form of pandemic.

“This [study] has given us a clue on how to move fast to prepare ourselves in the future and I’m glad the research was done on time without the need to hire foreigners to do it for us,” he said.

“We have done similar research before on pandemics like Ebola, nodding disease and HIV/Aids; so, this one on Covid-19 provides us with linkages of understanding damages of the body system. This means we are building capacity to manage other epidemics.” Dr Kirenga added that both the oldest Covid-19 patient aged 66 years and the heaviest at 145kg managed to recover fully without the need for ventilators.

He, however, said they are still following up on the patients before completely validating their findings.

“None of them has tested positive for Covid-19 but we are keeping the specimens to be used for further studies and analysis. Our research extends to how they will live for the next six months,” he said.

On the other hand, Prof Barnabas Nawangwe, the Makerere University vice chancellor, said that all researchers were Ugandan and no staff got any extra pay to be involved.

“I commend everyone involved in this noble cause to protect the country because it has given us important leads in combatting this pandemic,” he said.

Meanwhile, Makerere has also given out grants worth Shs 6bn to 99 different researchers after approving their proposals on the study of Covid-19.

“The studies revolve around innovation, economic impact, medical impact of Covid-19 and we expect results in six months’ time,” added Nawangwe.

Comments

0 #1 Akao 2020-06-03 18:37
Severe cases of covid 19 in other countries is not comparable to Uganda based on 4 major factors: age, ugandans pop is mostly young.

Chronic illeness, i can assume that most people infected in Uganda do not have chronic illness due to their age. Obesity is major factor in severity of covid 19 which is minimal in Uganda compared to other countries and ofcourse less Ugandans are smokers.

Ministry, media houses and others should concentrate on educating the public about infection control practicess skills instead of this. This is a very basic research not worth wasting space on
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0 #2 Miki 2020-06-03 19:24
Very little is still understood about covid 19. Victims experience it differently - almost not at all for some while others show mild symptoms.

Some have been affected adversely leading to seriously illness ranging from bad respiratory situations, multi-organ failure to widespread clot development in their circulatory system.

The latter end up hospitalized with some needing intensive medical care. Many in this category have died. Some who survive need extensive post hospitalization rehabilitation.

Many people who tested positive cleared the virus with little or no particular medical intervention. So far Uganda has been lucky because the positive cases have been of people who are not sick.

The situation is likely to drastically change when more covid 19 community spread cases occur especially with the end of the lockdown.

Problems multiply when the most vulnerable get in the mix - the old, people with other conditions, and cases from the over crowded areas.
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0 #3 Miki 2020-06-03 20:08
It is commendable that these researchers did something. But so far the findings still seem to be more anecdotal than much else.

The main limitation is the fact that almost all the subjects, on which the research is based, have been postive cases of people not yet sick so to speak.

There are still many unknowns out there about covid19.What should be the proper treatment regimen? For example when should intubation be done if at all?

And if done should it be intubation for ventilation or for tracheotomy for those in severe respiratory distress? The former needing to coma inducing for the duration therefore increasing the risk of secretion evacuation.

The latter while equally invasive does not require coma inducement except for the procedure and easier on secretion evacuation.

Both have high risk for infection. Should anti-coagulant therapy or even shock treatment be standard for all very sick covid patients? What positioning is better for those bed ridden? And many more questions.
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