ABSTRACT
Hospitals across the globe have severe constraints in regard to ICU facilities, beds, and other life support systems. However, in certain situations including natural calamities, epidemics or pandemics, large-scale accidents, and so on, the requirement for ICU beds and resources immediately gets augmented. During such times, there exists an impending need for an optimum apportioning of ICU admissions and resources so that those patients who need critical care are given at the right point of time. The onslaught of COVID-19 pandemic has exuded a high probability of virus transmissions and subsequent complications in patients with co-morbidities and relevant medical issues, resulting in the exploration and investigation of models that could forecast the need for ICU admissions with a higher degree of accuracy. In this research study, a patient's pre-condition dataset will be used that is categorical in nature. Feature selection and extractions are implemented and the modified descriptors are provided as input to the model, for evaluating them based on the metrics namely F1-score, accuracy, specificity, and sensitivity. The prime objective is to build a predictive algorithm that will predict prior to the necessity of ICU admissions based on the patient's comorbidity/ precondition specifically for SARS COV2 infection. © 2022 IEEE.
ABSTRACT
The COVID 19 pandemic has forced us to rethink our management strategies for surgical diseases. Patients with COVID 19 have increased risk of morbidity and mortality after surgical intervention. Emphysematous pyelonephritis (EPN) is often seen in diabetics and can be a life threatening condition. All patients require immediate treatment with antibiotics and close monitoring. Bilateral EPN is a rare entity seen in less than 10% of patients. We present a case of bilateral EPN in a COVID positive patient which was successfully managed conservatively. A 70 year old hypertensive female, presented to us with fever, breathlessness, loss of appetite, generalised weakness requiring oxygen supplementation & was diagnosed with COVID 19. Bilateral EPN (Grade 4) with perinephric collections was found on evaluation for acute kidney injury. She underwent bilateral pig tail insertion followed by bilateral DJ stenting after stabilization. She recovered dramatically, blood parameters improved and was discharged. At 1 year of follow up, patient was doing well. In the present COVID-19 pandemic where case selection for surgical intervention is crucial, we would like to highlight how a conservative approach for even Class 4 EPN is feasible after weighing the risks and benefits of the same. Patients can be spared the immediate morbidity and mortality risks due to surgical intervention during COVID 19 infection. Triaging surgical intervention can also help in better utilization of critical care facilities and man power, both invaluable in the ongoing crisis.