The coronavirus disease 2019 (COVID-19) has claimed close to 2.5 million lives worldwide. But a puzzling question is why the disease has largely skipped Africa. This study aims to directly measure the fatal impact of COVID-19 in the urban African population.

This prospective systematic postmortem surveillance study included a total of 372 deceased people of all ages enrolled within 48 hours of heath. The cause of death was excluded from the eligibility criteria. The primary outcome of the study was postmortem nasopharyngeal swabs tested via reverse transcriptase quantitative polymerase chain reaction (PCR).

Of 372 participants enrolled in the study, PCR results were available for 364. SARS-COV-2 was detected in 58 of them when the recommended cycle threshold value was set to <40 and in 70 participants when the threshold value was extended to any level of PCR detection. Further analysis showed that the median age at death among patients who died from COVID-19 was 48 years. Of 70 people who died of COVID-19, 19 were tested before death. 52 had data on symptoms, and 44 had typical symptoms of COVID-19.

The research concluded that deaths due to COVID-19 in the included population were common; however, fewer people died despite showing symptoms of COVID-19.