ABSTRACT
Since the beginning of Corona Virus Disease (COVID) pandemic, there has been lack of clarity about the management protocols in spite of frequently updated national and international guidelines. Irrational use of unproven therapies has not been helpful in improving treatment outcomes. Early use of high-dose steroids or late use of antiviral medicines might have caused more harm than the benefit. There is also lot of fear about post-COVID fibrosis leading to extended use of steroids and antifibrotics. We reviewed the available COVID guidelines and treatment protocols in the light of scientific evidence generated over last 2 years by a systematic literature search using various databases (PubMed, Google Scholar, MEDLINE, UpToDate, Embase, and Web of Science). This article presents a comprehensive approach to the diagnosis, appropriate investigations, their interpretations, and use of specific therapies according to the stage of disease.
ABSTRACT
Background: There have been scientific papers in the Indian setting that describe demographics, clinical characteristics, hospital course, morbidity, and death in patients with coronavirus disease 2019 (COVID-19);however, they are based on limited numbers of cases. The current study of patients with known outcomes enabled us to acquire a better understanding of the disease process and progression in COVID-19 individuals, as well as correlate the factors affecting the outcome. Method(s): This study was carried out at a COVID-19 tertiary care facility at Dr. D. Y.Patil Medical College, Hospital and Research Centre, Pune. The demographic and clinical information, laboratory parameters of admitted COVID19 patients were collected were subsequently analysed. Categorical variables were analysed using either the chi-square test or Fisher's exact test. The level of significance was set at p<0.05. Result(s): Out of 603, 515 (85.4%) patients were discharged while 88 (15.8%) patients were died. The mean age of dead COVID-19 patients was significantly higher as compared to discharged COVID-19 patients. Serum urea, Serum Creatinine, serum AST, Serum total bilirubin, Serum Conjugated Bilirubin, serum LDH, Serum CRP and Serum Ferritin, Hb, PCV, TLC, neutrophils, eosinophils, basophils, lymphocytes, monocytes, neutrophils to lymphocyte ratio, platelets to lymphocyte ratio, ESR and D-dimer were differ significantly between discharged and dead COVID-19 cases whereas the levels of Serum ALT, Serum ALP, Serum Unconjugated bilirubin, MCV,MCH platelet count, PT and aPTT were remained comparable between discharged and dead COVID-19 cases. Multivariate analysis showed that Serum urea, D-dimer, ESR, NLR, PLR neutrophil and TLC were the significant predictors of COVID-19 death in our study. Conclusion(s): This study revealed that in hospitalised COVID-19 patients, older age, male sex, hypertension, diabetes, serum LDH, and urea levels were strongly linked to an increased risk of mortality. To enhance patient care and results, healthcare professionals should identify these aspects at the time of diagnosis. Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Background: Severe Acute respiratory Syndrome Coronavirus 2 (SARS-Cov-2/COVID 19) infection was firstly described in Wuhan, China during December 2019. Covid 19 patient can present with numerous clinical presentations ranging from Asymptomatic to critical clinical courses. HRCT thorax findings proved to be crucial in assessing the clinical course of patients requiring treatment. Materials And Methods: It was a cross sectional study done in Dr D Y Patil Medical College. Patients >12 years of age who were RT PCR Positive for COVID 19 and met the inclusion criteria were selected for the study. After which they were categorized in to mild moderate category according to guidelines. HRCT was done for all patients and CT severity score was also assessed Results: We evaluated a sample population of 100 patients. The most predominant symptoms in the moderate category were shortness of breath. The most common radiological abnormality noted was Ground glass opacity (50%) with 43patients in mild and 7 patients in moderate category. Lung involvement in mild stage was only 20 to 40% when compared to that of moderate category where the lung involvement was 50 to 60% and this showed statistical significance Conclusion(s): CT scoring could help to identify patient's risk and predict outcome of patient with COVID 19 Pneumonia. The extent of lung involvement is highly correlated with parameters of disease such as clinical staging. Finally, our study strongly supports the use of chest CT in patient with the covid 19 pneumonia, which could be used as a tool for rapid and effective method to evaluate the lung involvement. It can also help in taking clinical decision. Copyright © 2023 Ubiquity Press. All rights reserved.