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Background:SARS-Cov-2(covid-19) infection is associated with Systemic Hyercoagulability and Thrombo-Embolic Complications. Anticoagulants play a key role in their management. Despite anticoagulants we have observed five case of RBBB MI in our ICU which co-relates with the thrombotic complication. And hence,Efficacy of the anticoagulants is debatable and requires meticulous APTT monitoring. Efficacy of thrombolysis is also not clear. A current guideline gives more emphasis on PCI over thrombolysis in RBBB MI patients. BUT unfortunate turn of events into catastrophe happened in these cases due to non-feasibility of cathlab interventions in covid-19 pandemic scenario. Material and Methods:This is A case series of five patients that were COVID-19 positive admitted to the ICU and Developed RBBB MI during their ICU stay despite on anticoagulant therapy. Data was collected retrospectively from hospital indoor records. Positive case of COVID-19 was confirmed by RT-PCR assay of nasopharyngeal or oropharyngeal swab specimen. Conclusion:Development of RBBB MI in covid-19 patients on anticoagulants co-relates with the thrombotic complication of SARS-CoV-2 infection and failure of the therapeutic management. PCI can be considered as a gold standard intervention compared to thrombolysis. BUT unfortunate turn of events into catastrophe happened in these cases due to non-feasibility of cathlab interventions in covid-19 pandemic scenario.
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Background:During this long COVID-19 pandemic outbreak, continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) are being widely used to treat of NIV in COVID-19 acute respiratory distress syndrome (ARDS) are lacking, and for this reason it is extremely important to accurately determine the outcomes of this strategy. This study aimed to evaluate clinical data and outcomes of NIV in patients with COVID-19 ARDS.Material And Methods:This is retrospective observation study conducted at government hospital during April 2020 to July 2020. The study was approved by local ethical committee.We analyzed patients with the laboratory confirmed case of COVID-19 infection admitted in intensive care unit who require positive pressure ventilation and perfusion which are not able to maintain on simple O2 masks/ nasal cannula /NRBM. Data related to clinical features and co-morbidities were recorded at admission and clinical laboratory data were recorded at start of NIV and respiratory parameter were recorded at the time of admission, start of NIV and at the time of weaning or shift to invasive ventilation.Result:Out of 119 patients 42 patients were successfully weaned off from non invasive ventilation while remaining were shifted to invasive mechanical ventilation. The patients who were shifted to invasive ventilation were all died. Low P/F ratio, high CRP, high D-dimer, high LDH and high ferritin levels were related to conversion to invasive ventilation and high mortality among the group.Conclusion:Although there is a role for non-invasive respiratory therapies in the context of COVID-19 ARF, more research is still needed to define the balance of benefits and risks to patients. Indirectly, non-invasive respiratory therapies may be of particular benefit in reducing the risks to healthcare workers by obviating the need for intubation, a potentially highly infectious procedure.