Pregnant women experience immune system changes to accommodate and tolerate the growing foetus, these changes also increase their susceptibility to viral infections such as SARS-COV-2. COVID-19 in pregnancy increases the likelihood of hospital admission and intensive care compared to non-pregnant women. Early administration of low-dose corticosteroids to patients with acute respiratory distress syndrome can reduce all-cause mortality among such patients. However, during pregnancy, prolonged use of corticosteroids that readily cross the placenta like dexamethasone can negatively impact both the mother and foetus. Evidence is thus needed on the choice, timing, and duration for corticosteroids use among pregnant women with COVID-19. This article aims to provide evidence on corticosteroid use in pregnant women with COVID-19. The RECOVERY trial deduced that low-dose dexamethasone (6 milligrams) reduced mortality by up to one-third among COVID-19 patients on mechanical ventilation and one-fifth among those who received supplemental oxygen. Pregnant women in this trial received either oral prednisolone or intravenous hydrocortisone. Based on the RECOVERY trial findings, the Royal College of Obstetricians and Gynaecologists (RCOG) recommends that pregnant women with moderate-to-severe COVID-19 receive oral prednisolone or intravenous hydrocortisone. However, currently, the World Health Organisation (WHO) does not explicitly specify which corticosteroid to use among pregnant women with moderate-to-severe COVID-19. We also note that there are no published articles on corticosteroid use among pregnant women with severe COVID-19 in Africa.

The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating cell-surface interactions with the extracellular matrix as well as with intracellular signaling molecules. The endothelial glycocalyx that covers the luminal surface mediates the interactions of endothelial cells with materials flowing in the circulating blood, including blood cells. Cardiovascular diseases (CVD) remain a major cause of morbidity and mortality around the world. The cardiovascular risk factors start by causing endothelial cell dysfunction associated with destruction or irregular maintenance of the glycocalyx, which may culminate into a full-blown cardiovascular disease. The endothelial glycocalyx plays a crucial role in shielding the cell from excessive exposure and absorption of excessive salt, which can potentially cause damage to the endothelial cells and underlying tissues of the blood vessels. So, in this mini review/commentary, we delineate and provide a concise summary of the various components of the glycocalyx, their interaction with salt, and subsequent involvement in the cardiovascular disease process. We also highlight the major components of the glycocalyx that could be used as disease biomarkers or as drug targets in the management of cardiovascular diseases.

Hypertension is the leading cause of cardiovascular disease in women, and sub-Saharan African (SSA) countries have some of the highest rates of hypertension in the world. Expanding knowledge of causes, management, and awareness of hypertension and its co-morbidities worldwide is an effective strategy to mitigate its harms, decrease morbidities and mortality, and improve individual quality of life. Hypertensive disorders of pregnancy (HDPs) are a particularly important subset of hypertension, as pregnancy is a major stress test of the cardiovascular system and can be the first instance in which cardiovascular disease is clinically apparent. In SSA, women experience a higher incidence of HDP compared with other African regions. However, the region has yet to adopt treatment and preventative strategies for HDP. This delay stems from insufficient awareness, lack of clinical screening for hypertension, and lack of prevention programs. In this brief literature review, we will address the long-term consequences of hypertension and HDP in women. We evaluate the effects of uncontrolled hypertension in SSA by including research on heart disease, stroke, kidney disease, peripheral arterial disease, and HDP. Limitations exist in the number of studies from SSA; therefore, we will use data from countries across the globe, comparing and contrasting approaches in similar and dissimilar populations. Our review highlights an urgent need to prioritize public health, clinical, and bench research to discover cost-effective preventative and treatment strategies that will improve the lives of women living with hypertension in SSA.

Sickle cell disease (SCD) is associated with chronic systemic morbidity that extends beyond acute crises. However, data describing the clinical and laboratory characteristics of adolescents and young adults with SCD at steady state in sub-Saharan Africa are limited. We described clinical and laboratory characteristics of adolescents and young adults with SCD at steady state in Uganda. We conducted a hospital-based cross-sectional study of 60 adolescents and young adults with SCD in steady state at Mulago National Referral Hospital. Descriptive statistics were used to summarize participant characteristics and medication use. The mean age was 16.5 ± 3.3 years, and 34 (56.7%) participants were female. Mean hemoglobin was 9.1 ± 2.2 g/dl. Mean systolic and diastolic blood pressures were 107.9 ± 15.5 mmHg and 60.3 ± 12.6 mmHg, respectively; mean heart rate was 89.5 ± 15.5 beats/min. Fifty-two (86.7%) participants reported using hydroxyurea. These observations show that adolescents and young adults with SCD at steady state exhibit hematologic abnormalities and distinctive hemodynamic profiles that underscore substantial chronic subclinical abnormalities that extend beyond acute complications.

Background: Respiratory syncytial virus (RSV) is an important cause of acute respiratory illness in older adults, yet data from sub-Saharan Africa remain scarce. Understanding prevalence, coinfections, and risk factors in this age group is critical for guiding surveillance and prevention. Methods: We conducted a retrospective cross-sectional study using Uganda’s national influenza-like illness (ILI) and severe acute respiratory infection (SARI) sentinel surveillance data from December 2010 to January 2025. Adults aged ≥65 years with Real time-PCR (RT-PCR) results for RSV, influenza A/B, and SARS-CoV-2 were included. Descriptive analyses summarized period prevalence, clinical characteristics, and temporal trends. Poisson regression with robust variance estimated adjusted prevalence ratios (aPRs) for factors associated with RSV infection and hospitalization. Results: Among 545 illness episodes (mean age 73.2 years; 54.1% female), the period prevalence of RSV across 2010–2025 was 4.8% (95% CI: 3.3–6.9), comparable to influenza A (4.2%) and lower than SARS-CoV-2 (6.4%). Most RSV cases were mono-infections (92.3%), with rare RSV–influenza coinfections (0.4%) and no RSV–SARS-CoV-2 coinfections. Asthma (aPR 6.08, 95% CI: 1.18–31.26, p=0.031) and pneumonia (aPR 2.83, 95% CI: 1.06–7.56, p=0.038) were independent predictors of RSV infection. Hospitalization was strongly associated with asthma (aPR 21.69, 95% CI: 7.50–62.71, p<0.001), pneumonia (aPR 3.80, 95% CI: 1.51–9.56, p=0.005), and heart disease (aPR 3.50, 95% CI: 1.03–11.91, p=0.045). RSV activity showed seasonal peaks in March and June, with a marked decline during 2020–2021 (COVID-19 restrictions) and resurgence thereafter. Conclusions: RSV is a consistent contributor to respiratory illness among older Ugandan adults, with period prevalence estimates similar to influenza A and clinically important associations with asthma and pneumonia. Seasonal peaks during the dry season and post-pandemic resurgence emphasize the need for RSV integration into surveillance and the timely introduction of preventive interventions, including vaccination, in low- and middle-income settings.

Cardiovascular abnormalities contribute to morbidity in sickle cell disease, but data from adolescents and young adults in sub-Saharan Africa are limited. We conducted a hospital-based pilot cross-sectional study among 60 participants aged 13–30 years with homozygous sickle cell disease at steady-state at Mulago National Referral Hospital in Uganda. All participants underwent NT-proBNP measurement, electrocardiography, and transthoracic echocardiography. Forty-seven participants (78.3%) had at least one cardiovascular abnormality, most commonly T-wave abnormalities (46.7%), left ventricular hypertrophy by voltage criteria (30.0%), left ventricular diastolic dysfunction (28.3%), and probable pulmonary hypertension (11.7%). Five participants (8.3%) had NT-proBNP concentrations ≥ 160 pg/mL. Cardiovascular abnormalities were present in 60% of participants with elevated NT-proBNP and 80% with concentrations below the threshold; the adjusted prevalence ratio was 0.75 (95% CI 0.36–1.57). No statistically significant association was detected, but the small number of participants with elevated NT-proBNP resulted in substantial imprecision. Larger longitudinal studies are needed to clarify the relationship between NT-proBNP and specific cardiovascular phenotypes in this population.