ABSTRACT
INTRODUCTION@#As the coronavirus disease 2019 (COVID-19) pandemic continues to spread on an unprecedented scale from around the world, we described our experience in treating early COVID-19 cases in India.@*MATERIALS AND METHODS@#An observational study of COVID-19 patients admitted to a tertiary care centre in North India between 2 March-4 April 2020 was performed. The clinical, epidemiological, laboratory, treatment and outcome data of patients were evaluated.@*RESULTS@#A total of 75 patients were treated and 56 (74.66%) were men. The clinical spectrum of COVID-19 ranged from asymptomatic to acute respiratory distress syndrome (ARDS). Fever (85.36%) was the most common symptom followed by cough (56.09%) and dyspnoea (19.51%). Findings from hemogram analysis showed that 32%, 21.33% and 18.67% of patients had lymphopaenia, eosinopenia and thrombocytopaenia, respectively. Inflammatory markers such as C-reactive protein, D-dimer, ferritin, fibrin degradation product and interleukin-6 were significantly elevated ( <0.05) in patients who required oxygen therapy than those who did not require it, suggesting the potential role such markers could play in predicting prognosis in patients. Mean hospital stay was 9.2 days and 72 (96%) patients made a complete recovery, but 3 (4%) patients demised after progressing to ARDS.@*CONCLUSION@#The clinical and epidemiological spectrum of COVID-19 has jeopardised the health system in India. Without a proven therapy to combat this pandemic and with no sight of vaccines in the near future, a preventive strategy should be adopted to contain the spread of this infectious disease.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Betacoronavirus , Coronavirus Infections , Diagnosis , Epidemiology , Therapeutics , Hospitalization , India , Outcome and Process Assessment, Health Care , Oxygen Inhalation Therapy , Pandemics , Pneumonia, Viral , Diagnosis , Epidemiology , Therapeutics , Symptom Assessment , Tertiary Care CentersABSTRACT
Introduction: Diabetic nephropathy is a microvascular complication and is the leading cause of diabetes related morbidity, mortality and important cause of end-stage kidney disease. Both microalbuminuria and macroalbuminuria are associated with increased risk of cardiovascular disease. Evidence has been accumulating from clinical trials that assessing the levels of apolipoprotein B (ApoB), a constituent of atherogenic lipoproteins: ApoA1, a component of anti-atherogenic high density lipoprotein (HDL) cholesterol; and the ApoB/ApoA1 ratio will provide better prediction of future cardiovascular events than measuring serum low-density lipoprotein (LDL)-cholesterol levels. There is paucity of published data linking ApoB/ApoA1 ratio to diabetic nephropathy especially from developing countries, hence this study was carried out. Materials and Methods: The present study was conducted in the Department of Medicine, CSM Medical University, Lucknow between August 2009 and July 2010. Patients with type 2 Diabetes Mellitus (DM) attending the Diabetic and Medical Out-Patient clinics or who were admitted to the medical wards of Gandhi Memorial and Association Hospital CSM University, Lucknow were included. One hundred patients were enrolled; 64 of those were cases (Micro- and Macroalbuminuria groups) and 36 without nephropathy (Normoalbuminuria) were controls. The cut-off value for higher ApoB/ApoA1 ratio for male was 0.97 and for female was 0.86. Results: Older age, durations and control of DM were significantly correlated with degree of albuminuria. Fifty-six patients (56%) had raised ApoB/ApoA1 ratio, 19.4% in the Normoalbuminuria group (n=7/36), 71.4% in the Microalbuminuria group (n=30/42), and 86.4% in the Macroalbuminuria group (n=19/22). There were no statistical differences in the mean total cholesterol, HDL, LDL, triglycerides among the groups. Conclusion: In our study higher ApoB/ApoA1 ratio was significantly correlated with diabetic nephropathy.