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      Utility of telemedicine in sub‐Saharan Africa during the COVID‐19 pandemic. A rapid review

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          Abstract

          Telemedicine is the use of technology to achieve remote care. This review looks at the utility of telemedicine during the pandemic, period March 2020 to February 2021. Eleven articles met inclusion criteria. There was moderate use of telemedicine in sub‐Sahara Africa during the pandemic, however, there were also some limitations. Benefits of telemedicine include continuing medical service provision, connecting relatives with loved ones in quarantine, education, and awareness of mental health issues, and toxicovigilance and infection control. Challenges to the implementation of telemedicine on the continent were lack of supporting telemedicine framework and policies, digital barriers, and patient and healthcare personnel biases. To address these challenges, this article proposes the development of policy frameworks that fosters telemedicine use by all stakeholders, including medical insurance organizations, the introduction of telemedicine training of medical workers, educational awareness programs for the public, and improvement of digital platforms access and affordability.

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

            Hussin A Rothan, Siddappa Byrareddy (2020)
            Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Person-to-person transmission of COVID-19 infection led to the isolation of patients that were subsequently administered a variety of treatments. Extensive measures to reduce person-to-person transmission of COVID-19 have been implemented to control the current outbreak. Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. In this review, we highlights the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of this fatal disease.
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              COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses

              Muhammad Adnan Shereen, Suliman Khan, Abeer Kazmi … (2020)
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                Author and article information

                Contributors
                Tafadzwa Dzinamarira: u19395419@up.ac.za
                Journal
                Journal ID (nlm-ta): Hum Behav Emerg Technol
                Journal ID (iso-abbrev): Hum Behav Emerg Technol
                Journal ID (doi): 10.1002/(ISSN)2578-1863
                Journal ID (publisher-id): HBE2
                Title: Human Behavior and Emerging Technologies
                Publisher: John Wiley & Sons, Inc. (Hoboken, USA )
                ISSN (Electronic): 2578-1863
                Publication date (Electronic): 02 November 2021
                Publication date PMC-release: 02 November 2021
                Electronic Location Identifier: 10.1002/hbe2.297
                Affiliations
                [ 1 ] Department of Laboratory Diagnostics and Investigative Science, Faculty of Medicine and Health Sciences University of Zimbabwe Harare Zimbabwe
                [ 2 ] School of Public Health University of Western Cape Cape Town South Africa
                [ 3 ] Department of Computer Science, Faculty of Science and Engineering University of Eswatini (formerly Swaziland) Kwaluseni Eswatini
                [ 4 ] ICAP at Columbia University Harare Zimbabwe
                [ 5 ] School of Health Systems & Public Health University of Pretoria Pretoria South Africa
                Author notes
                [*] [* ] Correspondence

                Tafadzwa Dzinamarira, School of Health Systems & Public Health, University of Pretoria, Pretoria, 0002, South Africa.

                Email: u19395419@ 123456up.ac.za

                Article
                Publisher ID: HBE2297
                DOI: 10.1002/hbe2.297
                PMC ID: 8653215
                PubMed ID: 34901772
                SO-VID: 102f9508-f0d4-45a7-afc8-3774331b8408
                Copyright © © 2021 Wiley Periodicals LLC.
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date received : 24 August 2021
                Date accepted : 01 October 2021
                Page count
                Figures: 7, Tables: 2, Pages: 11, Words: 8709
                Categories
                Subject: Review Article
                Subject: Review Articles
                Custom metadata
                source-schema-version-number 2.0
                edited-state corrected-proof
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:08.12.2021

                Keywords: rapid review,telemedicine,utility
                Data availability:
                Keywords: rapid review, telemedicine, utility

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