CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF COVID-19 PATIENTS IN
LAGOS, NIGERIA: A DESCRIPTIVE STUDY
Ngozi Mirabel Otuonye
1*
, Testimony Jesupamilerin Olumade
2,3*
, Mercy Mayowa Ojetunde
1
,
Susan Abba Holdbrooke
1
, Joy Boluwatife Ayoola
1
, Itse Yusuf Nyam
1
, Bamidele Iwalokun
4
,
Chika Onwuamah
5
, Mabel Uwandu
5
, Babatunde Lawal Salako
7
, Akinola Abayomi
8
, Akin
Osibogun
9,10
, Abimbola Bowale
11
, Bodunrin Osikomaiya
11
, Babafemi Thomas
11
, Bamidele
Mutiu
11
, Nkiruka Nnonyelum Odunukwe
6
.
1- Central Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos.
2- Department of Biological Sciences, Redeemer’s University, Ede, Osun state.
3- African Centre of Excellence for Genomics of Infectious Diseases, Redeemer’s University,
Ede, Osun state.
4- Molecular Biological and Biotechnology Department, Nigerian Institute of Medical Research,
Yaba, Lagos.
5- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba,
Lagos.
6- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos.
7- Administration Department, Nigerian Institute of Medical Research, Yaba, Lagos.
8- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria.
9- College of Medicine University of Lagos, Nigeria
10- Lagos State Primary Health Care Board, Lagos, Nigeria
11- Mainland Infectious Disease Hospital, Yaba, Lagos
* - corresponding authors
Email address: olumadet@run.edu.ng, mnotuonye@gmail.com
Full postal addresses: Department of Biological Sciences, Redeemer’s University, Ede, Osun
state; Central Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos.
Running Head: Clinical and Demographic Characteristics of COVID-19 Patients
Word count: 1608 words
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NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
ABSTRACT
Introduction: COVID-19 is an emerging, rapidly evolving global situation, infecting over 25
million people and causing more than 850,000 deaths. Several signs and symptoms have been
described to be characteristic of the disease. However, there is a dearth of report on the
description of the clinical characteristics of the disease in patients from Nigeria. This study was
designed to provide a description of the clinical and demographic characteristics of COVID-19
patients in Nigeria.
Methods: This study is a case series that includes patients that are evaluated between June and
August 30, 2020, and diagnosed with COVID-19. Patient health records were reviewed and
evaluated to describe the clinical characteristics on presentation.
Results: A total of 154 COVID-19 patients were included in this study, with a mean age (S.D.)
of 46.16 (13.701). Most of the patients survived (mortality rate of 2.6%), and were symptomatic
(89.6%). There were more males (74.7%) than females, and the most common symptoms were
fever, breathing difficulty, dry cough and malaise. Co-morbidities were also present in almost
half of the study participants (49.4%).
Conclusion: This study presents the most extensive description, to date, on the clinical and
demographic characteristics of COVID-19 patients in Nigeria. Males are more likely than
females to be infected with COVID-19 and the most occurring symptoms are fever, breathing
difficulty, malaise, dry cough and chest pain. Old age and the presence of co-morbidities may
also be associated with developing the severe disease.
Key words: COVID-19, SARS-CoV-2, Signs, Symptoms, Nigeria.
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
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INTRODUCTION
COVID-19 is an emerging, rapidly evolving global situation which was first identified in
December 2019, in the Hubei province of Wuhan, China. The disease that has grown into a
pandemic is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)
and has infected more than 25 million people globally, causing the death of more than 850,000
people [1,2]. The distribution of diseases is described in terms of person, place and time or who,
where and when [3]. According to Chan et al. [4] and Andersen et al. [5], the initial outbreak
seemed to be as a result of a zoonotic transmission from bats. However, as the outbreak
continued, it was evident that human to human transmission of the virus via close contact was
also possible through close contact with an infected person and through respiratory droplets,
saliva or discharges from the nose when an infected person coughs or sneezes [6].
The clinical signs and symptoms of COVID-19 ranges in patients ranges from being absent
(asymptomatic infections) to the mild or moderate infection with symptoms such as fever, dry
cough, abdominal pain, fatigue, aches and pains, sore throat, breathing difficulty, diarrhoea,
headache, conjunctivitis, loss of smell and/or taste, skin rash, and so on. Those who develop the
severe disease exhibit more serious symptoms such as acute respiratory distress syndrome
(ARDS), multiple organ failure and ultimately death [6-9]. Treatment remains largely supportive
with the severe cases requiring oxygen supplementation and intensive care [10]. There are no
approved vaccines yet for COVID-19.
The first case of COVID-19 in Nigeria was identified on 27th February 2020 in a visiting Italian.
Since then, the epidemic in Nigeria has resulted in more than 54,000 cases and causing more
than 1,000 deaths (mortality rate of 1.85%) as of September 1st, 2020 [11]. More than one-third
(33.5%) of the cases in Nigeria were recorded in Lagos, Nigeria [11]. The epidemic in Nigeria
has resulted in patients presenting with different symptoms and there is scarcity of information
on the description of the clinical characteristics of COVID-19 patients in Nigeria. The only
available study, to the best of our knowledge, describing the clinical characteristics of COVID-
19 patients in Nigeria evaluated the first 32 COVID-19 patients in Nigeria [12]. This study was
designed to provide a larger description of the clinical characteristics of patients presenting to an
isolation centre in Lagos, Nigeria and confirmed to be infected with SARS-CoV-2 by real time
Reverse Transcriptase Polymerase Chain Reaction (RT-PCR).
. CC-BY-NC-ND 4.0 International licenseIt is made available under a
is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.(which was not certified by peer review)preprint
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METHODS
Study Design and Participants
With ethical approval obtained from the Institutional Review Board (IRB) at the Nigerian
Institute of Medical Research (NIMR), Yaba, Lagos, Nigeria, patient data were obtained and
reviewed at the Mainland Infectious Disease Hospital, Yaba. Informed consent was also obtained
from the study participants before their health records were obtained. This study is a case series
that includes patients that are evaluated between June and August 30, 2020, and diagnosed with
COVID-19. The IDIC is a central, comprehensive and integrated healthcare organization
attending to COVID-19 patients in Lagos, the epicentre of the epidemic in Nigeria. All the
patients included in this study were confirmed to have been infected with SARS-CoV-2 by a
positive reverse transcriptase polymerase chain reaction test of nasopharyngeal, throat and blood
samples. Clinical outcomes were also monitored and recorded.
Data Collection and Statistical Analysis
Clinicians and trained research assistants reviewed patient health records retrospectively and
copied them out to a standardized data collection form. Health records copied out include
demographic information, signs and symptoms presented with, co-morbidities, and patient
outcome. A formal sample size was not calculated for this study because the objective of the
study was to describe the clinical characteristics of the patients who had enough information in
their health records for analysis. Records were double entered into the forms before merging to
reduce errors during data entry. Descriptive analyses were performed using Statistical Package
for the Social Science (SPSS) version 25 (IBM, USA).
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RESULTS AND DISCUSSION
With COVID-19 being a novel disease, it is assumed that the immune system is naïve. Hence,
the definition and description of the clinical characteristics after infection with the SARS-CoV-2
is important to foster early detection and control of the spread of the disease.
A total of 154 COVID-19 patients were included in this study. The mean age (Standard
Deviation, [S.D]) of the study participants is 46.16 (13.701). Information about travel history
was not collected because a nationwide lockdown was effected on 30
th
March 2020 [13], and the
study participants presented at the health centre between May and August, a time when
community transmission of SARS-CoV-2 was already established in Nigeria [14]. Hence, it was
assumed that the virus was contracted from other individuals infected with the virus.
Nearly all of the study participants (89.6%) were symptomatic (Table 1). This may explain why
they presented at the health centre. This speaks to the health seeking behaviour of COVID-19
patients as being largely determined by the onset of symptoms. Asymptomatic patients are
almost never aware that they are infected and, hence, do not need medical attention [15]. Four
(2.6%) out of all the 154 patients included in this study died, giving a mortality rate of 2.6%. All
four patients that died had co-morbidities – hypertension, diabetes, Lower Respiratory Tract
Infection (LRTI) and Pneumonia that further complicated the disease.
Table 1: Baseline characteristics of COVID-19 patients at presentation N=154
Baseline Characteristics N (%)
Age
: Mean (S.D) 46.16(13.701)
Range (Minimum – Maximum) 16-83
Gender
: Male 115 (74.7)
Female 39 (85)
Symptomatology:
Asymptomatic 16 (10.4)
Symptomatic 138 (89.6)
Patient Outcome:
Dead
4 (2.6)
Survived 150 (97.4)
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The copyright holder for thisthis version posted September 24, 2020. ; https://doi.org/10.1101/2020.09.15.20195412doi: medRxiv preprint
