Commentary: Reducing Covid-19-Related Deaths in Nigeria: More than Ventilators

International Journal of Research and Scientific Innovation (IJRSI) | Volume VII, Issue VI, June 2020 | ISSN 2321–2705

Commentary: Reducing Covid-19-Related Deaths in Nigeria: More than Ventilators

Babatunde B. Osinaike
Department of Anaesthesia, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria

I. INTRODUCTION

In December 2019, a strain of Coronavirus later called Coronavirus disease 2019 (COVID-19), broke out in Wuhan, China [1–3]. COVID-19 mainly affected the respiratory system with some patients rapidly progressing to acute respiratory distress syndrome (ARDS). Some of the patients affected get admitted to the intensive care unit (ICU) and many deaths have been reported. The elderly and those with comorbidities are at highest risk of death. The death appeared to be related to ARDS [4].

In Nigeria, the first case of COVID-19 was reported on February 27 in an Italian expatriate. Since then, the number of cases has progressively increased. Presently, the case fatality in Nigeria is around 3%. Except for the lower case fatality rate of South Africa, 2% the Nigerian figure is much lower than the 6.3%, 5.9%, and 14.3% reported as the global case fatality rate and that of United States of America and United Kingdom respectively [5]. An underestimation of figures from Nigeria is not unlikely because of poor population data base and inadequate coordination between the states and the central government.

II. CLINICAL PRESENTATION

In the report by Wu and McGoogan, among 72,314 COVID-19 cases reported to the Chinese Center for disease Control and Prevention (CCDC), 81% were mild (absent or mild pneumonia), 14% were severe (hypoxia, dyspnea, >50% lung involvement within 24-48 hours), 5% were critical (shock, respiratory failure, multiorgan dysfunction), and 2.3% were fatal[6]. Also, the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) report on COVID-19 [7] published on 6th May 2020 opined that of the 20,276 with a positive history of COVID-19 in their database, 3767(19%) required care in the high dependency unit(HDU) or intensive care unit (ICU).The details of treatment revealed that of the totalpatients,10,281(51%) had oxygen only via nasal or face masks. Non-invasive ventilation, invasive mechanical ventilation and extra-corporal membrane oxygenation (ECMO) were provided for 3039(15%), 2286(11%) and 226(1%) respectively. A treatment outcomes study of the first thirty-two COVID-19 patients managed in Nigeria revealed that most patients had mild to moderate symptoms and none had low oxygen saturation that requiring support in the HDU or ICU[8].

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