ABSTRACT
Objective: The studies describing the clinicoepidemiological features of coronavirus disease-2019 (COVID-19) patients of first wave are available but about second wave, very few studies have documented. This study was aimed to describe the clinicoepidemiological features and the causes of mortality of COVID-19 patients of second wave admitted in our center. Methods: This retrospective, observational, and cross-sectional study was carried out among 200 randomly selected and confirmed COVID-19 indoor patients admitted between April 7, 2021 and July 3, 2021 in Dr. N. D. Desai Hospital, Nadiad. The demographic profile, clinical features, comorbidities, inflammatory markers, and causes of mortality in these patients were analyzed. Results: A total 200 patients of COVID-19 of second wave were analyzed. Majority of them were males (64.5%) and the patients between 18 and 60 years of age constituted 60%. Hypertension (70.93%) and diabetes mellitus (46.51%) were common comorbidities followed by ischemic heart diseases and chronic kidney disease. The most common presenting features were fever (75.7%), cough (68.8%), and shortness of breath (60%). The median duration of hospital stay was 7 days [interquartile range, 4-12]. The patients needed any kind of mode of oxygen therapy were 82.5%. The most common cause of death was cardiac arrest (70.58%) followed by severe acute respiratory distress syndrome (ARDS) (35.29%). Conclusions: In this retrospective study, most patients were young males with the age <60 years. The patients had one or more comorbidities, hypertension being the most common. Inflammatory markers were significantly higher in patients who died in our hospital.
ABSTRACT
Aims & Objectives: The 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV- 2), originated in Wuhan City of Hubei Province of China. In India, first confirmed case of coronavirus disease (COVID-19) was reported on January 30, 2020 and since then the virus has spread across the country. More than 7.9 million cases of COVID-19 and more than 1.19 lakh deaths have been reported in India. The pathobiology of the disease is poorly known, and significant efforts have been made to understand the disease process worldwide. Clinical autopsies are known to have a vital role in developing an understanding of the disease process. The aim of the present study was to evaluate bone marrow findings of COVID-19 by minimally invasive autopsies. Patients/Materials & Methods: This prospective study was conducted at All India Institute of Medical Sciences, Jodhpur. After obtaining approval from Institute's ethics committee and consent from next of kins, minimally invasive autopsies were conducted within an hour after the death. Procedures were done with all biosafety measures. The tissue specimens were kept in neutral buffered formalin for 48 h and then processed with standard biosafety measures. Electronic medical records were reviewed retrospectively and patients' clinical details and results of laboratory investigations were noted. Results: In this prospective study, bone marrow biopsy procedures were done in 37 COVID-19 minimally invasive autopsies. Mean age of these cases was 61.8 years (Range, 28-85 years) and male: female ratio was 2.36. Comorbidities were observed in 25(67.5%) of all cases. Histopathological analysis revealed hypercellular, normocellular and hypocellular marrow in 5, 25 and 5 cases respectively (two biopsies were inadequate). There was marked interstitial prominence of histiocytes in 24(68.5%) cases. Out of these, evidence of haemophagocytosis (Figure 1) was observed in 14(40%) cases, marked increase of haemosiderin laden macrophages in 20(57.1%) cases. There was prominence of plasma cells in 28 (80%) cases. Discussion & Conclusion: Incorporation of minimally invasive autopsies provides an effective method to study the pathological findings in COVID-19 deaths in resource constrained settings. Histopathological findings in bone marrow suggest indirect insult to bone marrow, presumably related to circulatory and/or hyperinflammatory response to viral infections.