ABSTRACT
Objective: To study the epidemiological characteristics of the pandemic by describing the clinical profile of the COVID-19 patients presenting to a super specialty hospital. Methods: This was a descriptive study using medical records of patients who tested positive for SARS-CoV-2 RNA using reverse transcription-polymerase chain reaction between 17th March and 15th January 2021 while maintaining confidentiality. The clinical and demographic data of all the patients were entered in a Microsoft Excel and statistical analysis was done using SPSS 21 software. Regression analysis was performed and a P value < 0.05 was considered to be statistically significant. Results: A total of 3534 patients were enrolled in this study aged 9-96 years. Among patients with symptoms, fever and cough were the most common presenting symptoms, while 5.6% of the patients were asymptomatic. Hypertension was the most common comorbidity (37%), while no comorbidities were present in 43.0% of the participants and this was statistically significant for age (P = 0.000). Among patient outcomes, >50% of patients were in home isolation, while 11% of patients had a fatal outcome. Elder age group had a higher proportion of expiry among outcomes (P <= 0.001). Most patients had a hospital stay of 9-11 days. A total of 63 health workers were included with male: female ratio being 3.5:1. Conclusion: Our study reflects that majority of the positive cases that presented to the hospital had mild/moderate symptoms. We believe that appropriate triaging of patients followed by early institution of medicine and good critical care services may help to control this epidemic.
ABSTRACT
BACKGROUND: Benzodiazepines are currently the most commonly prescribed medication for the treatment of anxiety in older adults, although there is a dearth of good-quality data on this subject. The aim of this review was to systematically review studies examining the efficacy and tolerability of benzodiazepines for the treatment of anxiety disorders among older adults. METHODS: The authors conducted a systematic review, searching PubMed, Ovid MEDLINE, Ovid Embase, Web of Science, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. All searches were limited to English-language articles. The quality of each study was appraised using criteria developed by the Centre for Evidence-Based Medicine for randomized controlled trials. RESULTS: A total of 8,785 citations were retrieved and pooled in EndNote and de-duplicated to 3,753. This set was uploaded to Covidence for screening. Two separate screeners (AG and SAF) evaluated the titles, abstracts, and full text of the eligible articles. Five studies met the inclusion criteria. Across all studies, benzodiazepines were associated with decreased anxiety at the end of the study period. The limited tolerability data show mild adverse effects from the benzodiazepines studied. Limitations of the trials included limited data on the long-term use of benzodiazepines for anxiety and a preponderance of trials examining generalized anxiety disorder, with relatively less data on other anxiety disorders. CONCLUSIONS: Benzodiazepines are effective for treating anxiety disorders in late life, at least in the short term, but more data is needed to establish tolerability and their long-term benefits.
Subject(s)
Anxiety Disorders/drug therapy , Benzodiazepines/therapeutic use , Randomized Controlled Trials as Topic , Aged , Humans , Middle AgedABSTRACT
BACKGROUND: The coronavirus disease (COVID-19) presents across a spectrum of signs and symptoms and shows clinico-epidemiological predilections (elderly, those with comorbidities). Delhi is among the highest burden states in India. OBJECTIVES: To report the case detection trends and clinico-epidemiological profile of patients tested positive at a designated COVID-19 hospital in Delhi in Northern India. METHODS: Using an observational (descriptive design) we analyzed data from the electronic medical records of the hospital. All individuals testing positive for SARS-CoV-2 RNA using reverse transcription polymerase chain reaction (RT-PCR) between 17th March and 07th May 2020 (both dates inclusive) were included. Case detection trend (7-day moving averages) was plotted. Clinico-epidemiological profile of patients was summarized statistically. RESULTS: Total 308 positive cases were enrolled in this study. The median age of participants was 48 years (09-95 years) men (47.9 ± 16.4 years) and women (43.5 ± 14.0 years). Men to women ratio was 3.4:1 with a statistically significant difference (P < 0.001). During the study timeframe, 166 (54.0%) patients had an outcome: 11 (6.6%; 95% CI: 3.4-11.6) expired and 155 recovered (recovery rate: 93.4%; 95% CI: 88.5-96.7). Chance of death was significantly associated with the higher age group (P = 0.005). The commonest clinical symptoms noted were fever (38.9%) and cough (38.6%). Majority (56.6%) had mild to moderate symptoms, 12.6% had severe symptoms and the remaining were asymptomatic (30.8%). 31 patients (26.05%) needed ICU care. Total 119 patients (38.6%) had various preexisting comorbidities, most commonly diabetes mellitus (35.0%) and hypertension (34.0%). However, the comorbidities were not associated with age (P = 1.000). CONCLUSION: Triangulation of data and careful analysis of trends in designated COVID-19 hospitals and other institutional settings may help inform surge preparedness and care provisioning. Stringent containment strategies must continue as the pandemic is intensifying.