ABSTRACT
Introduction: The aim of the study is to determine the patient's outcome and mortality rate of COVID-19 patients requiring hemodialysis in Anwar Khan Modern Medical College & Hospital. Method(s): Retrospective cohort study of medical record of patients with COVID-19 hospitalized at Anwar Khan Modern Medical College & Hospital during the months of September 2020 to January 2021. The dependent variable was in patient's outcome and mortality rate and independent variables included clinical conditions, physical examination results, oxygen requirements, diagnosis, clinical features, and complications. Result(s): Total 98 patients were included. Among them 97 patients were treated with hemodialysis and 1 was pre-dialysis patient. Median age was 59 years and 52 (53.06%) were male and 46 (46.94%) were female. The most frequent comorbidities were chronic kidney disease (CKD), hypertension (HTN), and diabetes mellitus (DM). Patients were diagnosed with different clinical manifestation when they arrived at hospital. Major manifestations were cough, breathlessness, fatigue, fever and body ache. The patients showed some other complications including fluctuated blood pressure (50.1%), vomiting (19.38%), shivering (37.76%), chest pain (16.33%).Treatment was given according to WHO and Bangladesh Government Covid-19 treatment guideline. We observed lower mortality rate. 11 (11.23%) patients died during this observation period. Mortality rate of male patients were 7(7.14%) and female patient were 4(4.08%). Another 87(88.79%) patients were alive according to the observations. Conclusion(s): We found low mortality rate in our cohort study. Dead patients had severe clinical manifestations and complications i.e. DM, HTN, CKD with cough, breathlessness and fatigue. Close monitoring, guideline medication and patient care reduces mortality. No conflict of interestCopyright © 2023
ABSTRACT
Introduction: Thromboembolic manifestations is a common phenomenon in patients affected by Corona virus (SARS CoV-2). Recent studies have shown that patients with Acute Renal Failure are also at a greater risk of venous and arterial thromboembolism, 15-30% in ICU, 7% inpatient care. However, frequently unjudicial use of anticoagulant may develop severe life-threatening hematoma. In our Hospital settings we had a dedicated COVID Unit with Hemodialysis facility. Our Nephrology department had managed 381 patients being COVID positive along with renal impairment from March 2020 to January 2022. Among these patients, four patients developed spontaneous non traumatic hematoma in unusual sites. On admission all the patients received treatment according to our national guidelines for Covid-19. Method(s): It is a retrospective analysis in a single-centered hospital. Four cases with confirmed COVID-19 with acute kidney injury and on anticoagulant therapy had developed sudden concealed bleeding. These patients had no previous history of anticoagulant therapy before admission. Case 1: Developed hemorrhage in Right lower anterior paramedian deep parietal wall of abdomen, Case 2: Had hematoma in retroperitoneal space and in lower third of Iliopsoas, Case 3: Developed hemorrhage in left cerebral hemisphere, Case 4: Had Intramuscular Hematoma in left rectus abdominis. Out of these four patients two of them required Hemodialysis and one of them went into shock. Result(s): All patients included were male. The mean age was 57+/-19.64 years. All the four patients were initially managed conservatively with keen monitoring and with proper volume resuscitation, blood transfusion and discontinuation of the anticoagulants. Three of the patients survived with conservative management and one patient died due to sudden massive cardiac arrest. Conclusion(s): The use of therapeutic anticoagulant can increases the risk of bleeding in atypical sites and may exhibit higher patient death with COVID-19 if not identified at early stage. So a risk-benefit ratio of usage of anticoagulants should be kept in mind and further clinical trials needed to justify its random use in COVID-19. No conflict of interestCopyright © 2023