Which South Africans are more likely to die from COVID-19

Health Minister Zweli Mkhize has issued a statement detailing the country’s data on the spread and danger of COVID-19 to the local populace.

South Africa currently has 151,209 recorded cases of COVID-19, with a total of 2,657 deaths and 73,543 recoveries to date.

“The world has experienced six months of COVID-19, and in our case, we are beginning the fourth month,” Mkhize said.

“Clinical and epidemiological knowledge around this disease has developed at an unprecedented rate and a vaccine has already ascended to human trial phase.”

“This is how determined we are, collectively, to beat this virus and minimise its impact on us as humanity,” he said.

In his statement, Mkhize cited data published by the National Institute for Communicable Diseases (NICD) which tracked 10,700 COVID-19 hospital admissions across the country from 5 March to 21 June 2020.

This data details which South Africans are more vulnerable to severe COVID-19 cases, as well as the comorbidities which are present in a significant number of recorded deaths locally.

The key findings of the NICD’s report included the identification of the following risk factors for in-hospital mortality among South Africans:

  • Older age groups
  • Hypertension
  • Chronic cardiac disease
  • Chronic renal disease
  • Malignancy
  • HIV
  • Obesity

The data found that of the 7,324 COVID-19 patients who had recorded in-hospital outcomes (died or discharged), 1,515 died, which equates to an in-hospital case fatality ratio of 21%.

Hypertension was a significantly common comorbidity among patients who were hospitalised due to COVID-19, with 59% of the 5,836 patients with comorbid conditions presenting with hypertension.

48% of these patients had diabetes, 19% had HIV, and 14% had either an active case or a history of tuberculosis.

Obesity, while not consistently recorded for all reported COVID-19 admissions, was noted by clinicians as a risk factor in 297 (3%) patients.

Of the 10,700 admissions, 3,260 (31%) patients were in hospital at the time of the report, 5,925 (55%) patients were discharged alive or transferred out, and 1,515 (14%) patients had died.

Symptoms and complications

Mkhize noted that there is still uncertainty over how long the virus may be able to transmit from infected people, as well as how long it may survive on surfaces.

He said that presentations of COVID-19 have ranged from asymptomatic to severe illness and death in South Africa, with symptoms developing between two days and two weeks after exposure to the virus.

These symptoms can include the following:

  • Fever
  • Cough
  • Sore throat
  • Loss of taste and smell
  • Nasal congestion
  • Conjunctivitis
  • Nausea
  • Vomiting
  • Diarrhoea

He added that the virus can progress to cause lower respiratory tract infection, resulting in pneumonia and its complications.

One serious complication of COVID-19 is Acute Respiratory Distress Syndrome (ARDS), where the patient’s lungs become stiff and difficult to ventilate.

“It is for this reason that ARDS is associated with a high mortality rate,” Mkhize said.

“Added to this, some reports from Italy seem to suggest there is an atypical form of ARDS in patients with COVID-19, leading to much higher oxygen requirements.”

He added that the use of dexamethasone for the treatment of severely ill patients and the avoidance of invasive ventilation strategies have aided the recovery of severely ill patients.

“We soon expect the Ministerial Advisory Committee on COVID-19 to issue advisories on the use of high flow oxygen for patients who are very ill but can be managed without intubation and ventilation,” Mkhize said.

Now read: South Africa may implement localised lockdown due to surge in COVID-19 cases

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Which South Africans are more likely to die from COVID-19