Official Title
African Covid-19 Critical Care Outcomes Study: An African, Multi-centre Evaluation of Patient Care and Clinical Outcomes for Patients With COVID-19 Admitted to High-care or Intensive Care Units
Brief Summary

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. It is expected that the outcomes will 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).

Detailed Description

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.

It is expected 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 estimated that there are 0.8 (95%
confidence interval 0.3 to 1.45) critical care beds per 100,000 population in Africa. It is
likely that the volume of unplanned admissions associated with COVID-19 will further
adversely affect critical care outcomes in Africa,especially as the ability of healthcare
systems in Africa to adapt and expand during the pandemic to meet the clinical workload is
unknown. Furthermore, the patient outcomes in critical care is poorly documented in this
under-resourced environment.

Most countries in Africa are still in the early phase of the epidemic which provides the
opportunity to study the utilization of critical care resources and their impact on patient
outcomes. It is important therefore to establish what resources, comorbidities and
interventions are potentially associated with either mortality or survival in Africa. Rapid
dissemination of these findings may help inform appropriate resource prioritisation and
utilisation during the COVID-19 pandemic in Africa. These points provide the rationale for
the African Covid-19 Critical Care Outcomes Study (ACCCOS).

Research questions

Primary outcome The primary outcome is in-hospital mortality in adult patients referred to
intensive care or high-care units following suspected or known COVID-19 infection in Africa.

Secondary outcomes To determine the risk factors (resources, comorbidities and interventions)
associated with mortality in adult patients with suspected or known COVID-19 infection in
Africa.

The study is an African national multi-centre prospective observational cohort study of adult
(≥18 years) patients referred to intensive care or high-care units in Africa with suspected
or known COVID-19 infection in Africa. Patient follow up will be for a maximum of 30 days
in-hospital.

This study will run between May to December 2020, with an interim analysis after 250 to 300
deaths registered in the study, or in June or July 2020 if this number of deaths has not been
reported in the study. The reason for the interim analysis, is to potentially provide data
which may be associated with improved outcomes in Africa, in timeous manner for possible
implementation during this COVID-19 pandemic.

Unknown status
Severe Acute Respiratory Syndrome Coronavirus 2
Eligibility Criteria

Inclusion Criteria:

- All consecutive patients at participating centres referred for high-care unit or
intensive care unit admission who have suspected or known COVID-19

Exclusion Criteria:

- None

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
South Africa
Locations

Groote Schuur Hospital
Cape Town, Western Cape, South Africa

Investigator: Margot Flint, PhD
Contact: +2721 4045001
margot.flint@uct.ac.za

Contacts

Bruce M Biccard
+27214045015
bruce.biccard@uct.ac.za

Bruce Biccard, Principal Investigator
University of Cape Town

University of KwaZulu
NCT Number
Keywords
Critical Care, Public Health
MeSH Terms
Severe Acute Respiratory Syndrome