ABSTRACT
Bacillus Calmette-Guerin (BCG) is a vaccine for tuberculosis and is administered at birth in several countries, however there are many countries that have no BCG vaccination policy and coincidently they are worst hit by Covid-19 pandemic in terms of disease severity and mortality.The study was conducted to determine the association between BCG vaccine and COVID-19 severity. Study included total 150 participants visiting Department of Medicine, Mayo Hospital, Lahore, Pakistan. Data regarding BCG vaccination, comorbidity, demographics, disease severity were collected through self-structured questionnaire using non-probability convenient sampling. Prior written informed consents were taken from the participants. Male and female were in equal proportion. 68.6% were married, only 3.9% were smokers. Analysis revealed that only 10 (6.5%) were hypertensive and10 (6.5%) were diabetic. There was no BCG vaccine protection against Covid-19 in the current study. Severity of disease was similar in vaccinated and non-vaccinated patients. But it can not be applicable to whole population. Another fact is that most of Pakistani population is BCG vaccinated due to national policy and coincidently Pakistan suffered less as compared to high hit countries. There maybe some association between BCG vaccination and Covid-19 or some other environmental factor and genetics that need to be explored.
ABSTRACT
Background: COVID-19 is a global pandemic with 12% mortality rate. This pandemic has shattered health care sector of many developed countries across the globe. According to World Health Organization (WHO) India and Pakistan will be badly hit by the pandemic till end of June 2020. Both countries are densely populated and the fragile health sector of these countries is incapable to facilitate of large number of critically ill patients. Data analysis from different studies revealed that Cytokine Storming (CS) is main cause of COVID-19 related respiratory, renal, cardiac and neural complications in critically ill patients. Objectives: The aim of this review is to highlight the significance of CS in management of COVID-19 infection, Methods: Literature from previous studies was collected to suggest the possible diagnostic testing as well as strategies to manage these patients. Mesh terms such as Corona, COVID-19, Cytokine storming, Wuhan, Pandemic were applied on PUBMED as well as google to search for the latest published articles. Reports and newpapers were also considered as this is an ongoing pandemic and there is scarcity of knowledge and information in this regard. Results: IL6 and TNF alpha blockers are helpful in regulating the uncontrolled immune response due to CS. Levels of different substances like ferritin, Cytokine Reactive Proteins and D-dimer can be helpful in early detection of these complications. Conclusions: The early dctcction of CS can be used for selection of appropriate treatment, reduction in burden on Intensive Care Units (ICU) and ultimately saving many lives.