Almost all the COVID-19 patients admitted to the Mainland Hospital, an infectious facility at Yaba, Lagos, were treated with Lopinavir-Ritonavir, according to a research on the clinical presentation, case management and outcomes for the first 32 COVID-19 patients in Nigeria.
Lopinavir/Ritonavir is a fixed dose combination medication for the treatment and prevention of HIV/AIDS.
It combines Lopinavir with a low dose of Ritonavir., and it is generally recommended for use with other anti-retrovirals.
The study, conducted by a 22-man team of researchers in Lagos State, was published in the Pan Africa Medical Journal.
Led by the Medical Director at the Mainland Hospital, Yaba, Dr. Abimbola Bowale, the study involved the first 32 patients admitted and discharged from the hospital between February 27 and April 6, 2020.
The hospital is the first of five facilities in Lagos designated (as of the time of the study) to isolate and treat COVID-19 patients, being the foremost public infectious disease hospital in the state, with funding support from the World Health Organisation and the United States Agency for International Development.
It has a 115-bed admission facility, with a female to male bed space ratio of 30:70, a dedicated biosafety laboratory, emergency operations centre and a biosecurity unit.
Data for the study was obtained on patients’ exposure history, clinical symptoms and signs, treatment modalities and outcomes, as can be easily done today with software solutions like ems charting software it similar ones available in the market .
The outcomes of interest were death, promptness of admission process and duration of hospitalisation.
The study shows that three-quarters (75 percent) of the patients presented in moderately severe condition, while 16 percent were asymptomatic and no patient presented in critical condition.
“Severity of condition of patients upon presentation at the hospital was based on clinical symptoms and the need for oxygen and ventilation.
“A patient that was asymptomatic at presentation was classified as ‘mild,’ while a patient was classified as ‘moderate’ if they presented with fever, cough, respiratory rate <30 breaths per minutes and peripheral capillary oxygen saturation (spO2) >90 percent for adults and >92 percent for children,” the researchers say.
The study also revealed that the common symptoms of the patients were fever (59 percent) and dry cough (44 percent).
Anosmia (loss of smell) and ageusia (loss of taste) were experienced by an equal proportion of patients (19 percent respectively).
The researchers said, “Upon admission, almost all (97 percent) the patients were treated with Lopinavir-Ritonavir.
“Only one patient (three percent) was treated with chloroquine phosphate.
“No death was reported among the cases.
“Prior to discharge, the median interval between the first and second negative tests was three days, with a range of 1-11 days.
“The hospital stay for the patients was between six and 24 days, with a median duration of 12 days.”
Speaking with PUNCH HealthWise, the corresponding author of the study and an ex-CMD of LUTH, Prof. Akin Osibogun, said the study was to present the signs and symptoms patients present in this environment and to see whether it is different from other environments, so that it will be easier for people to make the diagnosis and issues to look for in this environment.
“The study is to also look at how we managed and treated the first 32 patients, so that other states can learn from our treatment experience.
“That is not the end of it, because we will follow up with other studies to look at other treatment modalities and see whether we can bring down the duration of hospitalisation and see whether other drugs can do better than the other drugs that we are using now,” Osibogun said.
He added that they were planning some clinical trials in which there will be a comparison of other treatments and methods to see whether the patients can stay for a shorter period in the hospital.
“Of course, you know that the length of hospitalisation has implications for the patients and they will like to be back at home as soon as possible and the longer they stay in the hospital, the more expenses for the government because the government is currently paying for everything.
“So, research is continuing, but we just thought we should share this experience, particularly as regards the common symptoms to look out for so that it will be easier for health workers to make the diagnosis and to share our experience with treatments and the outcome with the patients.”