How Nigeria’s first 32 coronavirus patients were treated — Report

Almost 97 per cent of the first set of COVID-19 patients in Lagos State were treated with lopinavir-ritonavir with no recorded death, a new report has shown.

Lopinavir-ritonavir is an anti-retrovial drug used in the treatment of HIV and some forms of cancer.

The review was done by experts at Mainland Hospital, Yaba, the first hospital designated for the management of COVID-19 cases in Lagos.

The retrospective study, since published in the Pan African Medical Journal, examined the treatment of the first 32 patients who tested positive for COVID-19 in the state.

The report relied on medical records of the 32 patients admitted and discharged from the hospital between February 27 and April 6.

The outcomes of interest were death, promptness of admission process, and duration of hospitalisation.

According to the findings, many of the patients were admitted promptly to the health facilities within 48 hours after testing positive.

The report suggested the early presentation of cases to the facility influenced the outcome of treatment and also reduced the stay in hospital and mortality rate.

It said the preliminary analyses of the first COVID-19 cases in Nigeria, showed clinical presentation was mild to moderate with no mortality.

The experts said processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.

Global scourge

The novel coronavirus that emerged in December 2019 in China has infected over 4.9 million people with over 323,000 deaths as of Tuesday.

Nigeria recorded its first case on February 27 in an Italian businessman who had flown into the country.

Within some weeks, cases increased sporadically in the state and country with Lagos currently the epicentre of the pandemic in the country with over 2,000 cases.

The report showed that the median duration of hospital stay was 12 days.

“Three-quarters, 75 per cent, of the patients presented in moderately severe condition while 16 per cent, were asymptomatic,” it said.

According to the report, the most common symptoms among the patients were fever (59 per cent) and dry cough (44 per cent). Loss of smell and loss of taste were also reported by about 19 per cent of the patients.

Treatment

According to the report, almost all (97 per cent) of the patients were treated with lopinavir-ritonavir. Only one patient (3 per cent) was treated with chloroquine phosphate. Also, no death was reported among the cases.

“Although fever was the commonest symptom in our study, it did not occur in over a third of cases,” it stated.

With this finding, the researchers suggested that undue emphasis should not be placed on temperature checks as a form of screening for COVID-19. It also suggested that loss of taste and smell be added as symptoms to look out for.

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While other researches are being conducted worldwide to understand the behaviour of the new virus and its treatment, the report established that lopinavir-ritonavir could have some prospects in the treatment of Covid-19.

However, the report established that the current evidence of the benefit of using antiretrovirals to treat COVID-19 is of low certainty because of important limitations in previous studies.

“Specifically, lopinavir-ritonavir, which was the treatment majorly used in our study, has shown to have no benefit over standard care in hospitalized patients with severe COVID-19 in one randomized clinical trial,” it said.

As such, the researchers recommended that the effectiveness of the use of the antiretroviral medication in the Nigerian environment should be subjected to further robust and well-conducted research with a larger sample.