Management of COVID-19 Infection in a Context of Countries with Limited Resources: Case of the University Hospital Center of Renaissance (UHCR) in N’Djamena, Chad

Abstract

Introduction: The aim of this study was to describe the clinical characteristics of patients admitted for Covid-19 in the department of Covid-19 of the University Hospital Center of Renaissance (UHCR) of N’Djamena in Chad. The pandemic of the sickness of Covid-19 constitutes a real public health problem in the world since its appearance in December 2019. Materials and Methods: This was an observational, transversal and descriptive study carried out from 19 March 2020 to 19 November 2021. All patients diagnosed with Covid-19, confirmed at least either by RT-PCR or chest computed tomography (CT) were included. The healing was defined through the disappearance of clinical signs and two negative RT-PCRs at 72 hours intervals. Results: Our study included 825 patients of which 613 (74.34%) men (sex ratio 2.9). Age Medium for patients was 50 ± 4 years with extreme ranging from 19 to 84 years old. Six hundred and thirty-three (76.70%) patients came directly from their residences. Respectively 82 and 71 were transferred from the provincial hospital of Farcha (9.9%) and from a private health structure (8.7%). Three hundred and thirteen patients had at least a comorbidity especially arterial hypertension (n = 173; 21%); the diabetes (n = 156; 19.7%); chronic renal failure (n = 28; 3.5%); heart disease (n =27; 3.3%) and obesity (n= 14; 1.6%), HIV infection (n = 9; 1.09%). five hundred and seventy-two (61.12%) patients performed the CT and all the RT-PCR. Four hundred and ninety-two patients (59.60%) presented severe forms of the disease, 160 (19.40%) were critical and 124 (15.10%) were moderates. The hospital lethality was 16.24% (n = 134). The treatment consisted in the administration of Hydroxychloroquine-Azythromycin in 99.4% of cases (n = 813) and by covid-organics in 0.6% of cases (n = 5). Conclusion: The infected patients with Covid-19 were admitted with the advance stage of the disease. Lethality was associate with the presence of comorbidities. The sensitization of the population on the importance of vaccination, barrier measures and recourse to care are necessary.