Clinical presentation of COVID-19 at the time of testing and factors associated with pre-symptomatic cases in Cameroon

Tejiokem Mathurin Cyrille; Sadeuh-Mba Serge; Tchatchueng Mbougwa Jules Brice; Tagnouokam Ngoupo Paul Alain; Ngondi Grace; Fokam Joseph; Hamadou Achta; Nke Gisèle; Nwobegahay Julius; Tongo Marcel; Sander Melissa; Ndip Lucy; Perraut Ronald; Okomo Assoumou Marie Claire; Pefura Yone Eric Walter; Etoundi Mballa Georges Alain; Njouom Richard; Eyangoh Sara

doi:10.1016/j.ijregi.2022.05.010

Clinical presentation of COVID-19 at the time of testing and factors associated with pre-symptomatic cases in Cameroon

IJID Reg. 2022 Sep:4:33-41. doi: 10.1016/j.ijregi.2022.05.010. Epub 2022 May 29.

Authors

Tejiokem Mathurin Cyrille¹, Sadeuh-Mba Serge², Tchatchueng Mbougwa Jules Brice¹, Tagnouokam Ngoupo Paul Alain², Ngondi Grace³, Fokam Joseph⁴, Hamadou Achta¹, Nke Gisèle⁵, Nwobegahay Julius⁶, Tongo Marcel⁷, Sander Melissa⁸, Ndip Lucy⁹, Perraut Ronald¹⁰, Okomo Assoumou Marie Claire¹¹, Pefura Yone Eric Walter¹², Etoundi Mballa Georges Alain^{13

14}, Njouom Richard², Eyangoh Sara^{13

15}

Affiliations

¹ Epidemiology and Public Health Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon.
² Virology Service, Pasteur Centre in Cameroon, Yaoundé, Cameroon.
³ Virology Laboratory, Laquintinie Hospital, Douala, Cameroon.
⁴ Chantal BIYA International Reference Centre for research on HIV/AIDS prevention and management, Yaoundé, Cameroon.
⁵ Central Hospital of Yaoundé, Cameroon.
⁶ Military Health Research Center, Yaoundé, Cameroon.
⁷ Emerging and Reemerging Diseases Research Centre, IMPM, Yaoundé, Cameroon.
⁸ Tuberculosis Reference Laboratory Bamenda, Bamenda, Cameroon.
⁹ Laboratory of Emerging Infectious Diseases, University of Buea, Buea, Cameroon.
¹⁰ Pasteur Centre in Cameroon, Annex of Garoua, Garoua, Cameroon.
¹¹ National Public Health Laboratory, Yaoundé, Cameroon.
¹² Jamot Hospital, Yaoundé, Cameroon.
¹³ Public Health Emergency Operations Coordination Centre, Yaoundé, Cameroon.
¹⁴ Department for the Control of Disease, Epidemics, and Pandemics, Ministry of Public Health, Yaoundé, Cameroon.
¹⁵ Scientific Department, Pasteur Centre in Cameroon, Yaoundé.

Abstract

Objectives: To describe the clinical features at time of testing and explore factors associated with SARS-CoV-2 infection and pre-symptomatic cases in Cameroon.

Methods: Data was collected on people in Cameroon who participated in COVID-19 testing by real-time reverse transcriptase-polymerase chain reaction between 1 March and 5 October 2020. After descriptive analysis, multivariate logistic regression was used to identify factors associated with SARS-CoV-2 infection and pre-symptomatic cases.

Results: Of 85 206 test participants, 14 863 (17.4%) were infected with SARS-CoV-2. The median age for cases was 38.4 years (interquartile range 29.6-49.4); 6.1% were aged <19 years, and 6.3% were ≥65 years. Of these cases, 46.5% had at least one symptom/sign with a median time from illness onset to testing of 6 days (interquartile range 3-9). Cough (64.2%), headache (46.5%), fatigue/malaise (46.0%), shortness of breath (30.6%) and myalgia/arthralgia (25.6%) were the most commonly observed symptoms/signs. Pre-symptomatic SARS-CoV-2 infection was associated with age <50 years, being male and absence of comorbidities.

Conclusion: This study provides a comprehensive summary of the early clinical profile of SARS-CoV-2 infection during the first wave of COVID-19 in Cameroon, which was dominated by pre-symptomatic illness. These findings would be helpful for SARS-CoV-2 surveillance and control at a regional level.

Keywords: Cameroon; First wave COVID-19; SARS-CoV-2 testing; associated factors; early clinical features; pre-symptomatic.