African critical care registry network for pandemic surveillance, clinical management and research

Our group of LMIC based co-investigators and project partners from established critical care and pandemic networks aims to address the knowledge gaps that exist regarding the natural history and clinical course of COVID-19 related critical illness in seven African countries. In achieving this aim, we will address operational gaps in pandemic responsiveness by establishing a network with the infrastructure to identify optimal strategies for supportive care and interventions for the same patients.The aim will be achieved by 3 activities. 1. Implementing a setting-adapted (International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Clinical Characterisation Protocol (CCP) compliant critical care registry. The near-real time registry with integrated ISARIC tier 0-2 CCP and capacity for clinical research will be implemented in 35 critical care sites in seven countries building on the methods used in the Wellcome-supported nine country Critical Care Asia (CCA) network. Registry data output will include epidemiology, quality of care processes, risk stratification and outcomes. A comprehensive national service evaluation of critical care services and an EARL evaluation will also be conducted. 2. Identifying stakeholder research priorities to optimise critical care processes and outcomes leveraging activity 1 data. We will facilitate Audit & Feedback workshops and research prioritisation exercises for site stakeholders (inc. public) using Activity 1 output to determine priorities for optimising COVID-19 clinical management and pandemic responsiveness, especially for the critically ill, obstetric and surgical populations. 3. Recruiting sites to registry enabled clinical trials.We will facilitate sites to participate in registry-enabled clinical trials mentored by our group and project partners. The registry infrastructure and specific data will optimise sampling strategies, patient recruitment and study monitoring.