A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study
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. Metho...
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| Veröffentlicht in: | BMC Infectious Diseases 2023, Vol.23 (1) |
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| creator | Anscombe, Catherine Lissauer, Samantha Thole, Herbert Rylance, Jamie Dula, Dingase Menyere, Mavis Kutambe, Belson van der Veer, Charlotte Phiri, Tamara Banda, Ndaziona P Mndolo, Kwazizira S Mponda, Kelvin Phiri, Chimota Mallewa, Jane Nyirenda, Mulinda Katha, Grace Mwandumba, Henry Gordon, Stephen B Jambo, Kondwani C Cornick, Jennifer Feasey, Nicholas Barnes, Kayla G Morton, Ben Ashton, Philip M Kalua, Wezzie Mandala, Peter Katutula, Barbara Ng'oma, Rosaleen Lanken, Steven Phulusa, Jacob Mkandawire, Mercy Kaimba, Sylvester Nthala, Sharon Nsomba, Edna Keyala, Lucy Chinoko, Beatrice Gmeiner, Markus Kaudzu, Vella Freyne, Bridget Swarthout, Todd D Tam, Pui-Ying Iroh Sichone, Simon Ahmadu, Ajisa Stima, Grace Masina, Mazuba Kanjewa, Oscar Nyasulu, Vita Chinyama, End Zuza, Allan Denis, Brigitte Storey, Evance Bondera, Nedson Matchado, Danford Chande, Adams Chingota, Arthur Ntwea, Chimenya Mkandawire, Langford Mhango, Chimwemwe Lakudzala, Agness Chaponda, Mphatso Mwenechanya, Percy Mvaya, Leonard Tembo, Dumizulu Henrion, Marc Y. R Chirombo, James Kambiya, Paul Masesa, Clemens Gondwe, Joel |
| description | 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[TM] 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 < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 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. Keywords: COVID, SARS-CoV-2, ISARIC, Delta, Mortality, LMIC, Malawi, Africa |
| doi_str_mv | 10.1186/s12879-022-07941-y |
| format | Report |
| fullrecord | <record><control><sourceid>gale</sourceid><recordid>TN_cdi_gale_infotracacademiconefile_A736239678</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A736239678</galeid><sourcerecordid>A736239678</sourcerecordid><originalsourceid>FETCH-gale_infotracacademiconefile_A7362396783</originalsourceid><addsrcrecordid>eNqVjUFrAjEUhEOpUKv-AU_vD8TmJctmQ09iW9qDeBHxJs810ZQ1kWRV_Pfdlh56LXOY4YOZYWyMYoJYlU8ZZaUNF1JyoU2B_HbH-lho5FKp4v5PfmCPOX8KgbqSps_WU6jj8UTJ5xggOnDxnMCe_M4efQ1Xutj8jWeL1ccLRwM-wJwauvpnoK6wzTZdqPUxUNMtHWJqIbfn3W3Ieo6abEe_PmCTt9fl7J3vqbEbH1xsE9Wdfo5isM53fKpVKZUpdaX-XfgC4dBP9g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>report</recordtype></control><display><type>report</type><title>A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study</title><source>Springer Nature - Complete Springer Journals</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>PubMed Central Open Access</source><source>Springer Nature OA Free Journals</source><creator>Anscombe, Catherine ; Lissauer, Samantha ; Thole, Herbert ; Rylance, Jamie ; Dula, Dingase ; Menyere, Mavis ; Kutambe, Belson ; van der Veer, Charlotte ; Phiri, Tamara ; Banda, Ndaziona P ; Mndolo, Kwazizira S ; Mponda, Kelvin ; Phiri, Chimota ; Mallewa, Jane ; Nyirenda, Mulinda ; Katha, Grace ; Mwandumba, Henry ; Gordon, Stephen B ; Jambo, Kondwani C ; Cornick, Jennifer ; Feasey, Nicholas ; Barnes, Kayla G ; Morton, Ben ; Ashton, Philip M ; Kalua, Wezzie ; Mandala, Peter ; Katutula, Barbara ; Ng'oma, Rosaleen ; Lanken, Steven ; Phulusa, Jacob ; Mkandawire, Mercy ; Kaimba, Sylvester ; Nthala, Sharon ; Nsomba, Edna ; Keyala, Lucy ; Chinoko, Beatrice ; Gmeiner, Markus ; Kaudzu, Vella ; Freyne, Bridget ; Swarthout, Todd D ; Tam, Pui-Ying Iroh ; Sichone, Simon ; Ahmadu, Ajisa ; Stima, Grace ; Masina, Mazuba ; Kanjewa, Oscar ; Nyasulu, Vita ; Chinyama, End ; Zuza, Allan ; Denis, Brigitte ; Storey, Evance ; Bondera, Nedson ; Matchado, Danford ; Chande, Adams ; Chingota, Arthur ; Ntwea, Chimenya ; Mkandawire, Langford ; Mhango, Chimwemwe ; Lakudzala, Agness ; Chaponda, Mphatso ; Mwenechanya, Percy ; Mvaya, Leonard ; Tembo, Dumizulu ; Henrion, Marc Y. R ; Chirombo, James ; Kambiya, Paul ; Masesa, Clemens ; Gondwe, Joel</creator><creatorcontrib>Anscombe, Catherine ; Lissauer, Samantha ; Thole, Herbert ; Rylance, Jamie ; Dula, Dingase ; Menyere, Mavis ; Kutambe, Belson ; van der Veer, Charlotte ; Phiri, Tamara ; Banda, Ndaziona P ; Mndolo, Kwazizira S ; Mponda, Kelvin ; Phiri, Chimota ; Mallewa, Jane ; Nyirenda, Mulinda ; Katha, Grace ; Mwandumba, Henry ; Gordon, Stephen B ; Jambo, Kondwani C ; Cornick, Jennifer ; Feasey, Nicholas ; Barnes, Kayla G ; Morton, Ben ; Ashton, Philip M ; Kalua, Wezzie ; Mandala, Peter ; Katutula, Barbara ; Ng'oma, Rosaleen ; Lanken, Steven ; Phulusa, Jacob ; Mkandawire, Mercy ; Kaimba, Sylvester ; Nthala, Sharon ; Nsomba, Edna ; Keyala, Lucy ; Chinoko, Beatrice ; Gmeiner, Markus ; Kaudzu, Vella ; Freyne, Bridget ; Swarthout, Todd D ; Tam, Pui-Ying Iroh ; Sichone, Simon ; Ahmadu, Ajisa ; Stima, Grace ; Masina, Mazuba ; Kanjewa, Oscar ; Nyasulu, Vita ; Chinyama, End ; Zuza, Allan ; Denis, Brigitte ; Storey, Evance ; Bondera, Nedson ; Matchado, Danford ; Chande, Adams ; Chingota, Arthur ; Ntwea, Chimenya ; Mkandawire, Langford ; Mhango, Chimwemwe ; Lakudzala, Agness ; Chaponda, Mphatso ; Mwenechanya, Percy ; Mvaya, Leonard ; Tembo, Dumizulu ; Henrion, Marc Y. R ; Chirombo, James ; Kambiya, Paul ; Masesa, Clemens ; Gondwe, Joel</creatorcontrib><description>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[TM] 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 < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 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. Keywords: COVID, SARS-CoV-2, ISARIC, Delta, Mortality, LMIC, Malawi, Africa</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/s12879-022-07941-y</identifier><language>eng</language><publisher>BioMed Central Ltd</publisher><ispartof>BMC Infectious Diseases, 2023, Vol.23 (1)</ispartof><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>776,780,860,4476,27902</link.rule.ids></links><search><creatorcontrib>Anscombe, Catherine</creatorcontrib><creatorcontrib>Lissauer, Samantha</creatorcontrib><creatorcontrib>Thole, Herbert</creatorcontrib><creatorcontrib>Rylance, Jamie</creatorcontrib><creatorcontrib>Dula, Dingase</creatorcontrib><creatorcontrib>Menyere, Mavis</creatorcontrib><creatorcontrib>Kutambe, Belson</creatorcontrib><creatorcontrib>van der Veer, Charlotte</creatorcontrib><creatorcontrib>Phiri, Tamara</creatorcontrib><creatorcontrib>Banda, Ndaziona P</creatorcontrib><creatorcontrib>Mndolo, Kwazizira S</creatorcontrib><creatorcontrib>Mponda, Kelvin</creatorcontrib><creatorcontrib>Phiri, Chimota</creatorcontrib><creatorcontrib>Mallewa, Jane</creatorcontrib><creatorcontrib>Nyirenda, Mulinda</creatorcontrib><creatorcontrib>Katha, Grace</creatorcontrib><creatorcontrib>Mwandumba, Henry</creatorcontrib><creatorcontrib>Gordon, Stephen B</creatorcontrib><creatorcontrib>Jambo, Kondwani C</creatorcontrib><creatorcontrib>Cornick, Jennifer</creatorcontrib><creatorcontrib>Feasey, Nicholas</creatorcontrib><creatorcontrib>Barnes, Kayla G</creatorcontrib><creatorcontrib>Morton, Ben</creatorcontrib><creatorcontrib>Ashton, Philip M</creatorcontrib><creatorcontrib>Kalua, Wezzie</creatorcontrib><creatorcontrib>Mandala, Peter</creatorcontrib><creatorcontrib>Katutula, Barbara</creatorcontrib><creatorcontrib>Ng'oma, Rosaleen</creatorcontrib><creatorcontrib>Lanken, Steven</creatorcontrib><creatorcontrib>Phulusa, Jacob</creatorcontrib><creatorcontrib>Mkandawire, Mercy</creatorcontrib><creatorcontrib>Kaimba, Sylvester</creatorcontrib><creatorcontrib>Nthala, Sharon</creatorcontrib><creatorcontrib>Nsomba, Edna</creatorcontrib><creatorcontrib>Keyala, Lucy</creatorcontrib><creatorcontrib>Chinoko, Beatrice</creatorcontrib><creatorcontrib>Gmeiner, Markus</creatorcontrib><creatorcontrib>Kaudzu, Vella</creatorcontrib><creatorcontrib>Freyne, Bridget</creatorcontrib><creatorcontrib>Swarthout, Todd D</creatorcontrib><creatorcontrib>Tam, Pui-Ying Iroh</creatorcontrib><creatorcontrib>Sichone, Simon</creatorcontrib><creatorcontrib>Ahmadu, Ajisa</creatorcontrib><creatorcontrib>Stima, Grace</creatorcontrib><creatorcontrib>Masina, Mazuba</creatorcontrib><creatorcontrib>Kanjewa, Oscar</creatorcontrib><creatorcontrib>Nyasulu, Vita</creatorcontrib><creatorcontrib>Chinyama, End</creatorcontrib><creatorcontrib>Zuza, Allan</creatorcontrib><creatorcontrib>Denis, Brigitte</creatorcontrib><creatorcontrib>Storey, Evance</creatorcontrib><creatorcontrib>Bondera, Nedson</creatorcontrib><creatorcontrib>Matchado, Danford</creatorcontrib><creatorcontrib>Chande, Adams</creatorcontrib><creatorcontrib>Chingota, Arthur</creatorcontrib><creatorcontrib>Ntwea, Chimenya</creatorcontrib><creatorcontrib>Mkandawire, Langford</creatorcontrib><creatorcontrib>Mhango, Chimwemwe</creatorcontrib><creatorcontrib>Lakudzala, Agness</creatorcontrib><creatorcontrib>Chaponda, Mphatso</creatorcontrib><creatorcontrib>Mwenechanya, Percy</creatorcontrib><creatorcontrib>Mvaya, Leonard</creatorcontrib><creatorcontrib>Tembo, Dumizulu</creatorcontrib><creatorcontrib>Henrion, Marc Y. R</creatorcontrib><creatorcontrib>Chirombo, James</creatorcontrib><creatorcontrib>Kambiya, Paul</creatorcontrib><creatorcontrib>Masesa, Clemens</creatorcontrib><creatorcontrib>Gondwe, Joel</creatorcontrib><title>A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study</title><title>BMC Infectious Diseases</title><description>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[TM] 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 < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 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. Keywords: COVID, SARS-CoV-2, ISARIC, Delta, Mortality, LMIC, Malawi, Africa</description><issn>1471-2334</issn><issn>1471-2334</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2023</creationdate><recordtype>report</recordtype><sourceid/><recordid>eNqVjUFrAjEUhEOpUKv-AU_vD8TmJctmQ09iW9qDeBHxJs810ZQ1kWRV_Pfdlh56LXOY4YOZYWyMYoJYlU8ZZaUNF1JyoU2B_HbH-lho5FKp4v5PfmCPOX8KgbqSps_WU6jj8UTJ5xggOnDxnMCe_M4efQ1Xutj8jWeL1ccLRwM-wJwauvpnoK6wzTZdqPUxUNMtHWJqIbfn3W3Ieo6abEe_PmCTt9fl7J3vqbEbH1xsE9Wdfo5isM53fKpVKZUpdaX-XfgC4dBP9g</recordid><startdate>20230207</startdate><enddate>20230207</enddate><creator>Anscombe, Catherine</creator><creator>Lissauer, Samantha</creator><creator>Thole, Herbert</creator><creator>Rylance, Jamie</creator><creator>Dula, Dingase</creator><creator>Menyere, Mavis</creator><creator>Kutambe, Belson</creator><creator>van der Veer, Charlotte</creator><creator>Phiri, Tamara</creator><creator>Banda, Ndaziona P</creator><creator>Mndolo, Kwazizira S</creator><creator>Mponda, Kelvin</creator><creator>Phiri, Chimota</creator><creator>Mallewa, Jane</creator><creator>Nyirenda, Mulinda</creator><creator>Katha, Grace</creator><creator>Mwandumba, Henry</creator><creator>Gordon, Stephen B</creator><creator>Jambo, Kondwani C</creator><creator>Cornick, Jennifer</creator><creator>Feasey, Nicholas</creator><creator>Barnes, Kayla G</creator><creator>Morton, Ben</creator><creator>Ashton, Philip M</creator><creator>Kalua, Wezzie</creator><creator>Mandala, Peter</creator><creator>Katutula, Barbara</creator><creator>Ng'oma, Rosaleen</creator><creator>Lanken, Steven</creator><creator>Phulusa, Jacob</creator><creator>Mkandawire, Mercy</creator><creator>Kaimba, Sylvester</creator><creator>Nthala, Sharon</creator><creator>Nsomba, Edna</creator><creator>Keyala, Lucy</creator><creator>Chinoko, Beatrice</creator><creator>Gmeiner, Markus</creator><creator>Kaudzu, Vella</creator><creator>Freyne, Bridget</creator><creator>Swarthout, Todd D</creator><creator>Tam, Pui-Ying Iroh</creator><creator>Sichone, Simon</creator><creator>Ahmadu, Ajisa</creator><creator>Stima, Grace</creator><creator>Masina, Mazuba</creator><creator>Kanjewa, Oscar</creator><creator>Nyasulu, Vita</creator><creator>Chinyama, End</creator><creator>Zuza, Allan</creator><creator>Denis, Brigitte</creator><creator>Storey, Evance</creator><creator>Bondera, Nedson</creator><creator>Matchado, Danford</creator><creator>Chande, Adams</creator><creator>Chingota, Arthur</creator><creator>Ntwea, Chimenya</creator><creator>Mkandawire, Langford</creator><creator>Mhango, Chimwemwe</creator><creator>Lakudzala, Agness</creator><creator>Chaponda, Mphatso</creator><creator>Mwenechanya, Percy</creator><creator>Mvaya, Leonard</creator><creator>Tembo, Dumizulu</creator><creator>Henrion, Marc Y. R</creator><creator>Chirombo, James</creator><creator>Kambiya, Paul</creator><creator>Masesa, Clemens</creator><creator>Gondwe, Joel</creator><general>BioMed Central Ltd</general><scope/></search><sort><creationdate>20230207</creationdate><title>A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study</title><author>Anscombe, Catherine ; Lissauer, Samantha ; Thole, Herbert ; Rylance, Jamie ; Dula, Dingase ; Menyere, Mavis ; Kutambe, Belson ; van der Veer, Charlotte ; Phiri, Tamara ; Banda, Ndaziona P ; Mndolo, Kwazizira S ; Mponda, Kelvin ; Phiri, Chimota ; Mallewa, Jane ; Nyirenda, Mulinda ; Katha, Grace ; Mwandumba, Henry ; Gordon, Stephen B ; Jambo, Kondwani C ; Cornick, Jennifer ; Feasey, Nicholas ; Barnes, Kayla G ; Morton, Ben ; Ashton, Philip M ; Kalua, Wezzie ; Mandala, Peter ; Katutula, Barbara ; Ng'oma, Rosaleen ; Lanken, Steven ; Phulusa, Jacob ; Mkandawire, Mercy ; Kaimba, Sylvester ; Nthala, Sharon ; Nsomba, Edna ; Keyala, Lucy ; Chinoko, Beatrice ; Gmeiner, Markus ; Kaudzu, Vella ; Freyne, Bridget ; Swarthout, Todd D ; Tam, Pui-Ying Iroh ; Sichone, Simon ; Ahmadu, Ajisa ; Stima, Grace ; Masina, Mazuba ; Kanjewa, Oscar ; Nyasulu, Vita ; Chinyama, End ; Zuza, Allan ; Denis, Brigitte ; Storey, Evance ; Bondera, Nedson ; Matchado, Danford ; Chande, Adams ; Chingota, Arthur ; Ntwea, Chimenya ; Mkandawire, Langford ; Mhango, Chimwemwe ; Lakudzala, Agness ; Chaponda, Mphatso ; Mwenechanya, Percy ; Mvaya, Leonard ; Tembo, Dumizulu ; Henrion, Marc Y. R ; Chirombo, James ; Kambiya, Paul ; Masesa, Clemens ; Gondwe, Joel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-gale_infotracacademiconefile_A7362396783</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2023</creationdate><toplevel>online_resources</toplevel><creatorcontrib>Anscombe, Catherine</creatorcontrib><creatorcontrib>Lissauer, Samantha</creatorcontrib><creatorcontrib>Thole, Herbert</creatorcontrib><creatorcontrib>Rylance, Jamie</creatorcontrib><creatorcontrib>Dula, Dingase</creatorcontrib><creatorcontrib>Menyere, Mavis</creatorcontrib><creatorcontrib>Kutambe, Belson</creatorcontrib><creatorcontrib>van der Veer, Charlotte</creatorcontrib><creatorcontrib>Phiri, Tamara</creatorcontrib><creatorcontrib>Banda, Ndaziona P</creatorcontrib><creatorcontrib>Mndolo, Kwazizira S</creatorcontrib><creatorcontrib>Mponda, Kelvin</creatorcontrib><creatorcontrib>Phiri, Chimota</creatorcontrib><creatorcontrib>Mallewa, Jane</creatorcontrib><creatorcontrib>Nyirenda, Mulinda</creatorcontrib><creatorcontrib>Katha, Grace</creatorcontrib><creatorcontrib>Mwandumba, Henry</creatorcontrib><creatorcontrib>Gordon, Stephen B</creatorcontrib><creatorcontrib>Jambo, Kondwani C</creatorcontrib><creatorcontrib>Cornick, Jennifer</creatorcontrib><creatorcontrib>Feasey, Nicholas</creatorcontrib><creatorcontrib>Barnes, Kayla G</creatorcontrib><creatorcontrib>Morton, Ben</creatorcontrib><creatorcontrib>Ashton, Philip M</creatorcontrib><creatorcontrib>Kalua, Wezzie</creatorcontrib><creatorcontrib>Mandala, Peter</creatorcontrib><creatorcontrib>Katutula, Barbara</creatorcontrib><creatorcontrib>Ng'oma, Rosaleen</creatorcontrib><creatorcontrib>Lanken, Steven</creatorcontrib><creatorcontrib>Phulusa, Jacob</creatorcontrib><creatorcontrib>Mkandawire, Mercy</creatorcontrib><creatorcontrib>Kaimba, Sylvester</creatorcontrib><creatorcontrib>Nthala, Sharon</creatorcontrib><creatorcontrib>Nsomba, Edna</creatorcontrib><creatorcontrib>Keyala, Lucy</creatorcontrib><creatorcontrib>Chinoko, Beatrice</creatorcontrib><creatorcontrib>Gmeiner, Markus</creatorcontrib><creatorcontrib>Kaudzu, Vella</creatorcontrib><creatorcontrib>Freyne, Bridget</creatorcontrib><creatorcontrib>Swarthout, Todd D</creatorcontrib><creatorcontrib>Tam, Pui-Ying Iroh</creatorcontrib><creatorcontrib>Sichone, Simon</creatorcontrib><creatorcontrib>Ahmadu, Ajisa</creatorcontrib><creatorcontrib>Stima, Grace</creatorcontrib><creatorcontrib>Masina, Mazuba</creatorcontrib><creatorcontrib>Kanjewa, Oscar</creatorcontrib><creatorcontrib>Nyasulu, Vita</creatorcontrib><creatorcontrib>Chinyama, End</creatorcontrib><creatorcontrib>Zuza, Allan</creatorcontrib><creatorcontrib>Denis, Brigitte</creatorcontrib><creatorcontrib>Storey, Evance</creatorcontrib><creatorcontrib>Bondera, Nedson</creatorcontrib><creatorcontrib>Matchado, Danford</creatorcontrib><creatorcontrib>Chande, Adams</creatorcontrib><creatorcontrib>Chingota, Arthur</creatorcontrib><creatorcontrib>Ntwea, Chimenya</creatorcontrib><creatorcontrib>Mkandawire, Langford</creatorcontrib><creatorcontrib>Mhango, Chimwemwe</creatorcontrib><creatorcontrib>Lakudzala, Agness</creatorcontrib><creatorcontrib>Chaponda, Mphatso</creatorcontrib><creatorcontrib>Mwenechanya, Percy</creatorcontrib><creatorcontrib>Mvaya, Leonard</creatorcontrib><creatorcontrib>Tembo, Dumizulu</creatorcontrib><creatorcontrib>Henrion, Marc Y. R</creatorcontrib><creatorcontrib>Chirombo, James</creatorcontrib><creatorcontrib>Kambiya, Paul</creatorcontrib><creatorcontrib>Masesa, Clemens</creatorcontrib><creatorcontrib>Gondwe, Joel</creatorcontrib></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anscombe, Catherine</au><au>Lissauer, Samantha</au><au>Thole, Herbert</au><au>Rylance, Jamie</au><au>Dula, Dingase</au><au>Menyere, Mavis</au><au>Kutambe, Belson</au><au>van der Veer, Charlotte</au><au>Phiri, Tamara</au><au>Banda, Ndaziona P</au><au>Mndolo, Kwazizira S</au><au>Mponda, Kelvin</au><au>Phiri, Chimota</au><au>Mallewa, Jane</au><au>Nyirenda, Mulinda</au><au>Katha, Grace</au><au>Mwandumba, Henry</au><au>Gordon, Stephen B</au><au>Jambo, Kondwani C</au><au>Cornick, Jennifer</au><au>Feasey, Nicholas</au><au>Barnes, Kayla G</au><au>Morton, Ben</au><au>Ashton, Philip M</au><au>Kalua, Wezzie</au><au>Mandala, Peter</au><au>Katutula, Barbara</au><au>Ng'oma, Rosaleen</au><au>Lanken, Steven</au><au>Phulusa, Jacob</au><au>Mkandawire, Mercy</au><au>Kaimba, Sylvester</au><au>Nthala, Sharon</au><au>Nsomba, Edna</au><au>Keyala, Lucy</au><au>Chinoko, Beatrice</au><au>Gmeiner, Markus</au><au>Kaudzu, Vella</au><au>Freyne, Bridget</au><au>Swarthout, Todd D</au><au>Tam, Pui-Ying Iroh</au><au>Sichone, Simon</au><au>Ahmadu, Ajisa</au><au>Stima, Grace</au><au>Masina, Mazuba</au><au>Kanjewa, Oscar</au><au>Nyasulu, Vita</au><au>Chinyama, End</au><au>Zuza, Allan</au><au>Denis, Brigitte</au><au>Storey, Evance</au><au>Bondera, Nedson</au><au>Matchado, Danford</au><au>Chande, Adams</au><au>Chingota, Arthur</au><au>Ntwea, Chimenya</au><au>Mkandawire, Langford</au><au>Mhango, Chimwemwe</au><au>Lakudzala, Agness</au><au>Chaponda, Mphatso</au><au>Mwenechanya, Percy</au><au>Mvaya, Leonard</au><au>Tembo, Dumizulu</au><au>Henrion, Marc Y. R</au><au>Chirombo, James</au><au>Kambiya, Paul</au><au>Masesa, Clemens</au><au>Gondwe, Joel</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study</atitle><jtitle>BMC Infectious Diseases</jtitle><date>2023-02-07</date><risdate>2023</risdate><volume>23</volume><issue>1</issue><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>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[TM] 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 < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 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. Keywords: COVID, SARS-CoV-2, ISARIC, Delta, Mortality, LMIC, Malawi, Africa</abstract><pub>BioMed Central Ltd</pub><doi>10.1186/s12879-022-07941-y</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1471-2334 |
| ispartof | BMC Infectious Diseases, 2023, Vol.23 (1) |
| issn | 1471-2334 1471-2334 |
| language | eng |
| recordid | cdi_gale_infotracacademiconefile_A736239678 |
| source | Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Springer Nature OA Free Journals |
| title | A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study |
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