ABSTRACT
INTRODUCTION: India witnessed two distinct COVID-19 waves. We evaluated the clinico-demographic profile of patients infected during first wave (FW) and second wave (SW) in a hospital in north-east India. METHODOLOGY: Patients who tested positive for severe acute respiratory syndrome-coronavirus-2 specific gene by reverse transcriptase polymerase chain reaction across FW and SW were diagnosed as COVID-19 positive. The clinico-demographic data of these positive patients were retrieved from the specimen-referral-form. Vital parameters including respiratory rate, SpO2, data on COVID-19-associated mucormycosis (CAM), COVID-19-associated acute respiratory distress syndrome (CARDS) were obtained from hospital records for in-patients. Patients were categorized based on disease severity. The data obtained in both waves were analyzed comparatively. RESULTS: Out of a total of 119,016 samples tested, 10,164 (8.5%) were SARS-CoV-2 positive (2907 during FW, 7257 during SW). Male predominance was seen across both waves (FW: 68.4%; SW:58.4%), with more children infected during SW. Patients with travel history (24%) and contact with laboratory confirmed cases (61%) were significantly higher during SW relative to FW (10.9% and 42.1% respectively). Healthcare worker infection was higher in SW (5.3%). Symptoms like vomiting [14.8%], diarrhea [10.5%], anosmia [10.4%] and aguesia [9.4%] were more in SW. More patients developed CARDS in SW (6.7%) compared to FW (3.4%) with 85% and 70% patients expiring across FW and SW respectively. No case of CAM is documented in our study. CONCLUSIONS: This was probably the most comprehensive study from north-east India. Industrial oxygen cylinder usage may have been the source of CAM in the rest of the country.
Subject(s)
COVID-19 , Child , Humans , Male , Female , SARS-CoV-2 , Hospitals , India , DemographyABSTRACT
Background and objective The coronavirus disease 2019 (COVID-19) outbreak, which was first detected in Wuhan, China, has turned into a rapidly spreading global healthcare crisis. The clinical and laboratory features of COVID-19 are associated with significant regional variations. In this study, we aimed to describe the clinical and demographic profile of COVID-19 patients from a tertiary care hospital in Northeast India. Materials and methods This was a hospital-based cross-sectional study that included all laboratory-confirmed COVID-19 cases admitted to the institution from 1st July to 31st October 2020. The information was collected on a predesigned proforma, which included patients' demographic profiles, clinical presentations, and outcomes as per treatment by trained doctors. Results The study included 180 laboratory-confirmed COVID-19 cases. A history of contact with laboratory-confirmed COVID-19-affected individuals was found in 92 (51.1%) patients. The median age of the patients was 37.17 years (range: 18-80 years), and there were 104 (57.78%) males in the cohort. Of the total enrolled patients, 102 (56.67%) were asymptomatic from the time of exposure till their admission. The common presenting complaints were fever (n=55, 70.51%), cough (n=42, 53.85%), and shortness of breath (n=32, 42.02%). The case fatality rate among the admitted cases was 15%. Comorbidities were found in 84 (46.67%) patients with the most common one being diabetes mellitus (n=31, 36.9%) followed by hypertension (n=29, 34.52%). Patients with advanced age (more than 60 years) and coexisting comorbidities were at higher risk of progression of disease and death. Conclusion The COVID-19 pandemic is not only a huge burden on healthcare facilities but also a significant cause of disruption in societies globally. The majority of the patients with COVID-19 infection presenting to our hospital were young and asymptomatic. Patients of advanced age with comorbidities were found to have more complications. An analysis of the trends related to COVID-19 in different hospital and institutional settings will help to achieve better preparedness and lead to improved patient care to combat the COVID-19 pandemic in a more efficient manner.
ABSTRACT
Hemophagocytic lymphohistiocytosis (HLH) is a disease that can affect both children and adults. HLH can be categorized as primary or secondary. Secondary HLH (sHLH) may be secondary to various viral infections. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection is a pandemic with multi-system involvement. HLH in COVID-19 positive patients is a recognized entity. However, in post-COVID-19 patients who have recovered and are negative by serological tests and reverse transcription-polymerase chain reaction test may present with sHLH due to dysregulation of the immune system. We highlight this unusual finding of post-COVID-19 sHLH in two cases, who were diagnosed by the new revised H-score.