ABSTRACT
The similarities and differences between the mortality patterns of the two waves in India remain largely unknown. This was a retrospective study of medical records conducted in the COVID data center of our hospital This study analyzed data of patients who died in the month of August, 2020 to October 2020 (one month before and after the peak of first wave i.e., 16th September, 2020) and April 2021 to June 2021 (one month before and after the peak of second wave i.e., 6th May, 2021), corresponding to an equal part of the pandemic during first (2020) and second (2021) wave. Out of 1893 patients in the study, 764 patients were admitted during the first wave and 1129 patients during the second wave of pandemic. In total, 420 patients died during the entire study period. Of those, 147 (35%) deaths occurred during the first wave and 273 (65%) during the second wave, reflecting a case fatality rate (CFR) of 19.2% during the first wave and a CFR of 24.18%. There were no significant differences in the age group, gender, presenting complaints, duration of stay and comorbidities. However, the deceased COVID-19 patients had an increase in case fatality rate, average duration of symptoms from onset to hospital admission (DOSHA) and a major shift from MODS to ARDS being the cause of death during the second wave of pandemic. This study demonstrates increased CFR, average DOSHA and a paradigm shift to ARDS as cause of mortality during the second peak of the pandemic. It is necessary to remain vigilant of newer COVID-19 variants of concern, follow COVID-19 appropriate behaviors and keep emphasizing on care of high-risk groups including patients with comorbidities and elderly population to prevent mortality.
Subject(s)
COVID-19 , Respiratory Distress Syndrome , Adult , Aged , Humans , India/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2 , Tertiary Care CentersABSTRACT
Abstract There has been a significant reduction of elective surgeries including creation of arteriovenous fistulas (AVF) during the ongoing pandemic by the surgeons. Here, we report the retrospective observational data of AVF creation by nephrologists in a single center, during a period of 8?months. A total of 376 fistulae were created in 310 patients. Patients were followed up at 2, 6, and 12?weeks. Twenty-eight patients required fistula creation twice, 16 patients thrice, and two patients underwent fistula creation four times. Of the total, 259 (68.8%) fistulae were radio-cephalic while 99 (26.3%) and 18 (4.79%) were brachio-cephalic and brachio-basilic, respectively. A total of 207 (67%) patients were already on hemodialysis whereas 103 (33%) were planned for elective initiation after fistula maturation. Of the 211 (69%) patients who completed 3?months of follow-up, 31 (15%) expired and 7 (3.3%) were lost to follow-up. Primary failure was observed in 70 (33.2%) fistulae. Fifteen (7.1%) patients were noted to be COVID positive during the follow-up. A total of 279 (90%) patients were alive at last follow-up. Amongst 20 dialysis staffs with 10 nephrologists, only two have developed COVID. Both were having mild illness and recovered completely. This study demonstrates that AVF creation can be performed safely with careful screening and by using adequate personal protective equipment.
ABSTRACT
Coronavirus disease-2019 (COVID-19) is showing a wide spectrum of ocular manifestations. They are creeping from vision sparing to irreversible visual loss as a result of its thromboembolic events. Hypercoagulability associated with COVID-19 is also called "sepsis-induced coagulopathy" and may predispose to thromboembolic phenomenon that decides the morbidity and mortality of this pandemic. A 37-year-old man presented with no perception of light in the left eye with optic atrophy and macular pucker on fundus examination. Visual evoked potential showed extinguished P 100 wave. His past medical history revealed severe pneumonia secondary to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV 2) infection about 3 months back.
Subject(s)
COVID-19 , Cavernous Sinus Thrombosis , Adult , Evoked Potentials, Visual , Humans , Male , Pandemics , SARS-CoV-2Subject(s)
COVID-19/therapy , Respiration, Artificial/methods , Respiratory Distress Syndrome/therapy , Respiratory Mechanics , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/physiopathology , Cohort Studies , Early Medical Intervention , Female , Humans , Intubation, Intratracheal , Lung Compliance , Male , Middle Aged , Respiratory Distress Syndrome/mortality , Respiratory Distress Syndrome/physiopathology , Retrospective Studies , SARS-CoV-2 , Time FactorsABSTRACT
Otolaryngologists around the world are amongst the front-line fighters against the pandemic coronavirus disease (COVID-19). As knowledge about the disease epidemiology and clinical profile is rapidly evolving, we are still not sure about many different aspects of the disease transmission and presentation. Otolaryngologists regularly deal with the upper aerodigestive tract, which is the portal of transmission and site of multiplication of the virus. There is a substantial risk of getting infected and transmitting the disease further. We discuss the various recommendations pertaining to the emergency and elective procedures in otolaryngology, and head and neck surgeries in these difficult times, so as to sensitise the clinicians while dealing with such cases, till the pandemic is under control and things get back to normal.