Study the co-relation between SpO2 and radiological and biochemical markers with the severity and outcome in geriatric Covid-19 patients

Background: Pandemics are natural calamities, which humans have been encountering since time im-memorial. The world has witnessed and endured several pandemics like from Justinian Plague to Spanish Flu. The 21st century has already witnessed three major pandemics like Severe Acute Respiratory Syndrome in 2002, Middle East Respiratory syndrome in 2012 and at present COVID?19. The first case of COVID?19 was reported in Wuhan, Hubein Province in Dec 2019. The first case of COVID?19 was reported in Kerala on 30th January 2020. COVID?19 virus is a single stranded RNA Virus and resembles SARS -2 virus and hence the name SARS -COV 2. There has been a report of around 34 million cases with 1 million deaths. Majority of the deaths occur in the elderly population as they have immunosenescence and multiple comorbidities. Hence a study aiming at analysis of correlation between SpO2, radiological and biochemical markers is essential in management of COVID 19 in elderly. Aims & Objectives: To study the correlation between SpO2 and radiological features in X ray and CT Chest and biochemical markers with the severity and outcome in geriatric patients. Study Period: April 2020 to September 2020, Duration: 6 months. Study Centre: Chengalpattu Medical College, Tamilnadu. Inclusion Criteria: RT PCR positive Covid 19 patients more than 60 years of age. Exclusion Criteria: Covid 19 patients less than 60 years, RT PCR Negative patients. Materials and Methods: Retrospective analysis of records of 300 Covid 19 patients, aged more than 60 years hospitalized in Chengalpattu Medical College during April to September 2020 was done and biochemical parameters mentioned below were corelated with features in CXR and CT Chest RTPCR positive spo2 and analysis with severity of disease and outcome was done. Results and Discussion: On retrospective analysis of records of elderly Covid 19 patients, it was observed that the elderly could be graded as mild, moderate and severe based on clinical criteria. Radiological parameters co-relating in the same group classified as mild, moderate and severe could be derived and could be used for assessment of patients. Similarly, it was observed that the biochemical parameters of D? Dimer, C reactive protein, Neutrophil Lymphocyte Ratio correlated most significantly in that order with the clinical severity of disease and hence could be used as useful tools for assessment of severity of patients and the ranges corelating withseverity could be derived. Conclusion: Analyzing SpO2, radiological features, biochemical parameters individually and in combination with clinical severity and outcome in elderly patients helps in deriving biochemical and radiological parameters to predict severity which in turn helps in a holistic approach and right management at the right time preventing or reducing mortality due to Covid 19 in the elderly.

Prevalence and risk factors for respiratory morbidity, among high school students of South India.

Background: The prevalence of asthma and other respiratory diseases among children and adolescents has been on the rise in recent years and this can affect the quality of life and scholastic performance of school students. Therefore, it is essential to find out the actual prevalence of respiratory morbidity among high school students so that we can plan early interventions against this problem. Methods: A cross sectional study was conducted among the students from classes 8 to 10, from a public school in Pathanamthitta district of Kerala state, using a modified American Thoracic Society Questionnaire (ATS-DLD-78-A) to assess respiratory symptoms among general population. Results: The prevalence of cough was 40.8% (95% CI 34.8% to 46.9%) and that of wheeze was found to be 19.6% (95% CI 15.1% to 24.9%). Among the possible risk factors for developing respiratory diseases, it was found that only family history of respiratory problems had a significant association with symptoms of respiratory disease (P = 0.002). Conclusion: The very high prevalence of respiratory symptoms in the study may be due to the fact that the study was conducted during the rainy season in which there is a higher incidence of respiratory infections. But these findings point towards the need to conduct more comprehensive and objective studies on the subject.