This study is the first COVID 19 report from Ethiopia. The study describes the demographic, clinical characteristics and treatment outcome of the first 33 cases admitted to Ekka-Kotebe COVID 19 treatment center. Similar to reports from other countries outside China, this study showed that most of the cases in this study either arrived from abroad with the disease 73% (n = 24), or had contact with a person diagnosed to have COVID 19 (9).
Similar to reports from Europe and China, males are more likely to develop the infection (7). The clinical profile of patients in this report range from mild symptom of upper respiratory infection to symptoms of organ damage. The clinical manifestation and disease severity at the time of admission in the literatures vary from country to country. Where cases are identified by community screening, most of the cases are either pre symptomatic or mild form. In countries where large number of people are infected in a short period of time due to delay in introduction of public health preventive measures, screening and diagnosis of COVID is made mostly on symptomatic cases visiting health care facilities. In these areas, patients often times present late after the initial symptom at stage of moderate to severe disease and those with no symptom or mild diseases may not turn to hospitals (11). The reason for more mild cases in this report may be because most of our cases are diagnosed by screening from quarantine where people coming from abroad or those with contact history are kept for two weeks. Like reports from Asia and Europe, the most frequent clinical symptom in our cases is cough, followed by headache and fever. Rare COVID 19 clinical symptoms reported in literatures, like loss of taste and/or smell sensations were reported in four cases in this study (8–11). This indicate the need to look for very rare symptoms and symptoms not yet reported in COVID 19 confirmed cases, in order to increase the accuracy of clinical diagnostic criteria in settings where testing facility is limited.
Even though in this study nearly half of the cases who had organ function tests had abnormal renal and liver function test result, in all except three it resolved completely, showing that laboratory evidence of organ damage alone may not be strong predictor of mortality.
All cases received Chloroquine sulphate, Azithromycin oral treatment, paracetamol for pain and fever. Oxygen therapy by face mask when oxygen saturation drops below 90% and by mechanical ventilator when unable to maintain saturation with low flow oxygen treatment was available for the cases in the center. No antiviral medication, convalescent plasma or any traditional medicine was administered for any of the cases included in this report.
Three patients died in the ICU while being on mechanical ventilator.
The first death was to a 60 years old known diabetic female patient on oral hypoglycemic agent, who had recent travel to France, diagnosed with COVID five days after arrival to Ethiopia, transferred to ICU on second day of admission and was on mechanical ventilator for 5 days before death. Possible cause of death was severe hypoxia secondary to ARDS.
The second death was to a 65 years old hypertensive, male who did not have travel or contact history, diagnosed with COVID 19 while in non COVID hospital for respiratory problem, admitted to Ekka-Kotebe treatment center, transferred to ICU on second day of admission and was on mechanical ventilator for two days before death. Possible cause of death being severe hypoxia.
The third death was to a 65 years old, known diabetic female, who did not have contact or travel history, diagnosed with COVID while being treated in ICU of a non COVID hospital, transferred and admitted to Ekka-kotebe COVID treatment center ICU with the diagnosis of critical COVID 19 and was on mechanical ventilator for three days before death. Possible cause of death is multiple organ damage, ARDS.