ABSTRACT
Objective: To evaluate the demographic profile, clinical severity, and outcome of Covid-19 infection in hospitalised vaccinated individuals. Methods: An observational, cross-sectional study was conducted among Covid-19 infected hospitalised patients. Clinicodemographic profile, severity, and outcome of Covid-19 infection among the vaccinated group (VG) were recorded. These patients were also compared with unvaccinated group (UVG) with Covid-19 infection admitted during the study period. Cox proportional hazards models was used to estimate hazard ratios for mortality risk in both groups. Results: Out of 580 participants, 48.2% were vaccinated with either one (71%) or two doses (28.9%). In both, VG and UVG, majority 55.8% belonged to 51-75 years. Males were predominant with 62.9% in both VG and UVGs. Day of illness at admission from symptom onset (DOI), progression of disease, ICU stay, oxygen requirement, mortality was significantly higher in UVG than in VG (p < 0.05). Steroid duration (p < 0.001) and anti-coagulation time (p < 0.001) were significantly higher in UVG than in VG. D dimer levels were significantly higher in UVG than in VG (p < 0.05). Increased age, (p < 0.0004), severity of disease, (p < 0.0052), increased oxygen requirement (p < 0.001), elevated C-reactive protein levels (Moderate: P < 0.0013; Severe P < 0.0082), and elevated IL-6 levels (p < 0.001) were the significant determinants of Covid-19-related mortality in both VG and UVGs. Conclusion: Vaccinated individuals have shown milder severity, had reduced hospital stay and better outcomes as compared to unvaccinated individuals suggesting a potential vaccine efficacy against Covid-19.
ABSTRACT
Aim: The study aims to determine persistent symptoms and effects of COVID-19 infection on the quality of life (QOL) at 1 and 3 months after the acute phase of the disease in mild, moderate and severe cases. Methods: The prospective observational study was conducted among patients with confirmed COVID-19 who had been treated and discharged after hospitalization from February 2021 to June 2021. All patients were interviewed at 1 and 3 months post discharge to assess persisting symptoms and health-related QOL. QOL was assessed using European Quality Of Life 5-Dimensions 3-Levels (EQ-5D-3L) and EuroQol-visual analogue scales (EQ-VAS). Results: In total, 388 out of 479 discharged following COVID-19 infection were included. The median age of patients was 48 years, with 62.6% male predominance. Most of the COVID-19 cases were mild (67.01%). Most common presenting symptom was fever (69.8%). EQ-5D-3L showed that the problems reported at 3-month follow-up were significantly less when compared to 1-month follow-up (p < 0.001), and QOL significantly improved after 3 months in non-intensive care unit (ICU) patients when compared to ICU patients (p = 0.007). The mean EQ-VAS score significantly improved at 3 months when compared to 1 month (80.34 ± 12.77 vs. 91.69 ± 12.34; P < 0.001). The severity of illness was correlated with QOL (p < 0.007). Conclusion: The study results demonstrate ongoing improvement in the QOL and persistent symptoms, while a minority still were symptomatic after 3 months post-COVID-19 illness.
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Aim: To study the clinicodemographic profile, outcomes, and post-COVID change in glycemic control among treated COVID-19-infected patients with poorly controlled or well-controlled diabetes mellitus (DM). Methods: Adult COVID-19-infected patients who tested positive with rapid antigen test or RT-PCR admitted were included in this prospective observational study. Patients were divided into well-controlled and poorly controlled diabetes group based on HbA1c values at admission. Telephonic follow-up and HbA1c estimation was done after three months. Clinical and laboratory investigations performed were compared between both groups. Hazard ratios (HRs) for mortality risk in both well-controlled and poorly controlled COVID-19 patients with DM was done by Cox proportional hazard models. Results: Out of 260 patients, 140 (53.84%) and 120 (46.15%) were poorly and well-controlled diabetics respectively. One hundred sixty-three patients (62.69%) were male, and the mean age was 52.67 ± 15.69 years. Severity, duration of hospital stay, steroid duration, insulin requirement and mean HbA1C, both at admission and after three months, were significantly higher in poorly controlled group than the well-controlled group (P < 0.005). With increase in age, the HR for all-cause mortality increased by 1.15 times (95% CI, 1.05-1.25; P = 0.0025) in well-controlled than poorly controlled group, whereas with increase in FBS at admission, the HR for all-cause mortality increased by 1.03 times in poorly controlled than well-controlled group (95% CI, 1.01-1.06; P = 0.0044). Conclusion: Our results show that well-controlled blood glucose levels or improved glycemic control are associated with a better outcome in patients with COVID-19 and pre-existing type 2 diabetes mellitus.
ABSTRACT
Background: Emergence of variants with specific mutations in key epitopes in the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raises concerns pertinent to its severity. Aims and Objectives: To assess the demographics, clinico-radiological pattern, and outcome of reverse transcription-polymerase chain reaction (RT-PCR) positive isolated coronavirus disease 2019 (COVID-19) patients arrived from the United Kingdom (UK). Materials and Methods: A cross-sectional, observational study was conducted in RT-PCR positive COVID-19 patients arrived from the UK, from December 2020 to February 2021. Nasopharyngeal samples of all patients were sent for whole-genome sequencing of SARS-CoV-2. The aimed parameters were compared between the B.1.17 positive and non-B.1.1.7 groups, among the people, arrived from the UK. All statistical tests with P<0.05 were considered significant. Results: A total of 59 SARS-CoV2 infected patients, who arrived from the UK, were isolated from December 2020 to February 2021 at Telangana Institute of Medical Sciences hospital, Hyderabad, were enrolled in the study. Of these, 27 patients (mean age-31.81±11.28 years) were infected with the B.1.1.7, diagnosed by whole genomic sequencing. Males were predominant in our study. Personal habits such as smoking, alcohol intake were higher among the sequenced group with a significant P<0.05. The most common symptoms observed in the sequenced group were cough (22.22%), sore throat (22.22%), cold (11.11%), fever (11.11%), and in the unsequenced group were cough (22.22%), cold (6.25%), fever (6.25%). In the sequenced group, chest X-ray posteroanterior view was normal in 74%, patchy ground glass opacities was observed in 25.92% patients, whereas in the unsequenced group it was 84.37% and 15.62%, respectively. Asymptomatic patients, observed in the sequenced and unsequenced group were 48.18% and 78.12%, respectively, and symptomatic patients were 51.85% and 21.87%, respectively. We found a statistically significant difference between sequenced and un sequenced patients in the asymptomatic group with a significant P<0.05. In the sequenced and unsequenced group, mild cases were 48.18% and 18.75%, moderate cases were 3.7% and 3.12%, respectively. We found no evidence of an association between disease severity and lineage B.1.17. Conclusion: Our data, within the context and limitations of a real-world study, provide initial reassurance that severity in hospitalized patients with B.1.1.7 is not markedly different from severity in those without B.1.1.7. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)