ABSTRACT
Introduction: In December 2019, COVID-19 was ?rst identi?ed in Wuhan, China, as a respiratory tract infection causing symptoms, such as fever, chills, dry cough, fatigue, and shortness of breath. The ?rst case in India was reported on 27 January 2020 from Kerala, while the ?rst case in the city where this study was conducted, was reported on 15 March 2020. The study was conducted at a Dedicated COVID Hospital (DCH). We assessed the co-morbidities and other demographic details of COVID positive patients admitted in the ?rst 10 months of the pandemic. Methods: 3187 COVID-19 positive patients admitted in the ?rst wave of COVID-19 from April 2020 to 31 December 2020 were selected, and their demographic details, duration of hospital stay and co-morbidities were studied. Patient details were entered in a spreadsheet and analysis was done using OpenEpi program. Results And Discussion: Of the 3187 patients included in the study, 943 patients died, whereas 2244 patients were discharged from our hospital. Amongst the 943 deaths, 612(65%) were males and 331(35%) were females. The age distribution of the patients who died showed maximum patients in age group of 61-80 years (452 patients, 47.3%). Maximum deaths occurred in September which were 200 (21.20%). When the interval between date of admission and date of death was calculated, it was observed that maximum deaths occurred in the group of 1-5 days (452 deaths, 47.93%). Maximum patients who died had some comorbidity (650, 69%), whereas 293 (31%) patients did not have any comorbidity. Hypertension was the most commonly occurring comorbidity in patients who died, with 108 patients being exclusively hypertensive, and 308 patients having hypertension along with some other comorbidity. Diabetes mellitus (DM) was the second most commonly observed comorbidity in the patients who died, with 86 patients having DM alone, and 245 having DM along with other comorbidities. Amongst the 2244 patients who were discharged, 1354 (60%) were male and 80 (40%) were female. Maximum patients discharged were from the age group of 41-60 years(918 patients, 40.90%). Maximum discharges were done in September (506, 22.54%). When the interval between date of admission and date of discharge was calculated, it was observed that maximum discharges were in the group of 1-10 days (1173 discharges, 52.27%). Maximum patients who were discharged did not have any comorbidity (1548, 69%), whereas 696 (31%) patients had some comorbidity. Hypertension was the most commonly occurring comorbidity in patients who were discharged, with 175 patients being exclusively hypertensive, and 254 patients having hypertension along with some other comorbidity. DM was the second most commonly observed comorbidity in the patients who were discharged, with 127 patients having DM alone, and 236 having DM along with other comorbidities. Conclusion: Some groups appear to be at higher risk of serious disease progression & increased mortality due to COVID-19. In patients without co-morbidities, 69% recovered whereas 31% died, while in patients with co-morbidities, 69% died whereas 31% recovered. Hypertension was most common co-morbidity observed in dead as well as recovered patients followed by DM. Outcome was poorer in patients with chronic kidney disease, cerebrovascular accidents, ischemic heart disease, and cancer. The ratio of discharges & death in ?rst 10 days of hospital stay was 1.7 & in next 10 days (i.e. day 11-20) was 4.5, i.e. outcome was better in the group of 11-20 days stay in the hospital than ?rst 10 days. Most common age group in patients who died was 61-80 years, while most common age group amongst recovered was 41-60 years. Multiple strategies can be devised to speci?cally target these high risk groups to prevent mortality due to COVID-19. Additionally, further studies relating to the pathophysiological processes of COVID-19 especially in high risk groups need to be undertaken which can contribute to development of possible prevention and treatment strategies.
ABSTRACT
Background: Drug utilization studies are crucial and create a positive awareness about proper use of drugs. Analysing the pattern of prescriptions is important in the settings of intensive care units where patients receive multiple antibiotics. The objective of this study was to analyse the use of antibiotics in a Medicine Intensive Care Unit (MICU) of Government Medical College and Hospital, Aurangabad, Maharashtra, India, a tertiary health care centre.Methods: Total 988 number of patients admitted in MICU from January 2017 to June 2018 were enrolled in the study and fulfilling inclusion criteria. Demographic details, disease state and prescription of antibiotic was recorded.Results: Out of 988, n=700 patients received antibiotics. Most common diseases for which patients were admitted in MICU included OP poisoning (24.86%), snake bite (15.14%), bilateral pneumonitis (12.71%), HELLP syndrome (12.14%), and the least common conditions were chronic obstructive pulmonary disease (COPD), meningitis, sepsis with multiple organ dysfunction syndrome (MODS), Guillen barre syndrome (GBS), lung abscess etc., Most common single antibiotic used in the studied cases was ceftriaxone (21.42%) followed by either alone or in combination piperacillin and tazobactam (12.04%), metronidazole (11.85%) etc.Conclusions: Total 700 patients received systemic antibiotics in present study bringing the incidence of systemic antibiotics use in MICU to be 70.85%. Ceftriaxone and combination of piperacillin and tazobactam are most commonly used antibiotics in MICU of the hospital. All patients admitted in this MICU received antibiotics as per the standard protocols of the hospital.