Critically ill COVID-19 patients in Africa: it is time for quality registry data

Document Type



Anaesthesiology (East Africa)


The African COVID-19 Critical Care Outcomes Study (ACCCOS) Investigators are to be commended for providing the first multinational study reporting epidemiological, management, and outcome data of critically ill COVID-19 patients in Africa. 1 However, this important effort lags behind other international cohorts in timing and included less than half of the countries expected by the study investigators. 1 2

During this period of accelerated COVID-19 research in low-income and middle-income countries (LMICs), 3 it is important to understand barriers to data acquisition, often attributed to research infrastructure limitations.

Critical care registries provide real-time, low-cost epidemiological, management, and outcome data. Although registry output has historically been low in the hierarchy of evidence, 4 methodological improvements, international harmonisation efforts, and widespread implementation in LMICs are underway, providing robust data for pandemic preparedness, reporting, and response.

Crit Care Africa, funded by UK Research and Innovation, and a sibling of the ten-country Wellcome-funded Asia network, 5 is one such initiative that has built a federated network of high-quality registries of intensive care units across the continent. The network uses a setting-adapted data platform and a Common Data Model, enabling local research priorities and seamless data sharing with the WHO–International Severe Acute Respiratory and Emerging Infection Consortium pandemic protocol ( appendix ). Informed by this model, a similar network has been implemented across nine African countries: Kenya, Uganda, South Africa, Namibia, Mozambique, Ethiopia, Ghana, Sierra Leone, and Cameroon.

Functionality, rather than limitation of resources, was raised by the ACCCOS findings. Critical care registries in LMICs have the potential to provide quality data in resource-limited environments, overcoming some of the limitations faced by the ACCCOS.