Characterizing the third wave of COVID-19: An analysis from the National Clinical Registry of COVID-19

Background & objectives: Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods: The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results: Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated.Interpretation & conclusions: The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.

Study of liver function tests and spontaneous bacterial peritonitis in a patients of liver cirrhosis

Background: Liver cirrhosis patients are highly susceptible to bacterial infections specially Spontaneous bacterial peritonitis (SBP) which is commonest infection. this study undertaken to understand liver function tests and Spontaneous bacterial peritonitis in patients of liver cirrhosis admitted to tertiary care hospital.Methods: A descriptive cross-sectional study conducted among Liver cirrhosis patients in tertiary care center. Total 100 liver cirrhotic patients were included in present study. All the patients were subjected for biochemical evaluation of Serum albumin and globulin level, Serum bilirubin, SGOT (Serum glutamic oxaloacetic transaminase), SGPT (Serum glutamic pyruvate transaminase) and Ascitic fluid polymorph nuclear neutrophil (PMN) count to diagnose SBP.Results: Spontaneous bacterial peritonitis was present in 12% patients. Relation of Serum bilirubin level and SBP was statistically significant. Relation of serum SGOT, SGPT level and serum globulin between SBP and non-SBP group was statistically non-significant.Conclusions: Liver cirrhosis patients are susceptible for bacterial infections because of defects in various host defense mechanism and hence patients of liver cirrhosis must be screened for spontaneous bacterial peritonitis along with liver function tests.

Study of clinical and laboratory profile of dengue fever in a tertiary care hospital

Background: Dengue fever is one of the most common arboviral mediated outbreaks reported with increased prevalence over the last few years with considerable morbidity and mortality. This study was designed to study the clinical and biochemical parameters in dengue fever patients.Methods: Prospective observational study was undertaken among adult patients in a tertiary care hospital. fifty patients were studied and analysed. All patients who were NS1 (Non-Structural Protein 1) antigen or IgM dengue positive were included in the study. Clinical features, haematological and biochemical parameters were noted.Results: Of the 50 patients studied, majority were males (68%). Fever was the major symptom (100%) followed by Body ache (84%), Headache (64%), Retro-orbital pain (52%), Myalgia (48%), conjunctival injection (40%), Itching (40%), abdominal pain (36%), Bradycardia (34%), Rash (30%), pleural effusion and ascites both seen in (28%). Significant derangements in platelet (76%), leucocyte counts (84%) and serum transaminases (58%) were noted.Conclusions: Fever associated with headache, retroorbital pain, erythematous morbilliform rash, conjunctival injection and itching over palms and soles along with thrombocytopenia, leukopenia, elevated liver transaminases should prompt a clinician on the possibility of dengue infection. Platelet transfusions have little role in management of dengue patients unless patients having active bleeding secondary to thrombocytopenia due to dengue fever.