ABSTRACT
COVID-19 (Coronavirus infectious disease 2019) denotes an ever changing and varied disease which has crippled the health care systems throughout the world. There have been studies conducted across the globe to establish the important factors for severity and mortality associated with COVID-19. We tried to study the effect of chronic obstructive pulmonary disease (COPD) on the severity as well as outcome of COVID-19. Material and methods: A total of 180 patients with COVID-19 were enrolled in this study and were then screened for history of COPD. There were 49 patients with history of COPD and 131 patients with no history of COPD. Inflammatory markers and HRCT scores were assessed for all the patients and they were followed up to study the outcome. Result: COPD was significantly associated HRCT Score, inflammatory markers and outcome. The mean HRCT Score for patients with COPD was more in COPD group (15.39 +/- 4.65) when compared with Non-COPD group (9.39 +/- 3.98). Mortality was also significantly higher in patients with COPD (67.3%) when compared to the patients without COPD (3.3%). Conclusion: We conclude that COPD is an important factor which has to be considered while treating the patients of COVID-19 especially in the rural India where lockdown restrictions and lack of knowledge have provided hinderance in achieving optimal follow up as there is increased severity and mortality associated with it.
ABSTRACT
Since the December of 2019 there has been an increase in reporting of cerebrovascular events in patients infected with COVID-19. Though it is a common complication which is encountered mostly in the old age it is rare to witness the same in young patient in the absence of prior risk factors. We report a rare case of a young patient with COVID-19 postivie status who presented with a hyper acute infarct in left caudate nucleus, Lenti from nucleus, internal capsule, insular cortex, temporal lobe, parieto-occipital region, focal areas in frontal region and was immediately posted for thrombectomy. The patient improved drastically post procedure. Therefore we highlight the importance of contemplating the differential of stroke induced by COVID-19 even in young patients who present with symptoms consistent with a stroke in the ongoing pandemic.
ABSTRACT
Background: The health services across the world have been deeply impacted by the ongoing COVID-19 pandemic.This meant cutting down resources and manpower away from various health care facilities and severely hampering the functioning of various cancer services across the world.It is, however, important to understand,cancer itself is a life-threatening condition and there is a need to continue running cancer care services,at least for those who needed the most.We present the outcomes of our patients who were treated in the Division of Colorectal and Peritoneal Surgery oncology services during this pandemic. Materials and Methods: Prospective database of surgeries done in the department over a 60-day period between March and May 2020 was analysed.The primary objective of this study was to assess the outcome of the patients undergoing surgery during the study period. Results: A total of 90 patients underwent surgery over a 60-day period from March to May 2020.Out of the 90 surgeries performed,68 (75.6%) were elective surgeries and 22 (24.4%) were emergency surgeries.Majority of the surgeries were laparoscopic procedures accounting for 52 out of the 90 surgeries (57.8%) while open surgeries accounted for the remaining 38 surgeries (42.2%).Robotic surgeries and HIPEC were not performed during this period.Majority of the patients underwent a procedure with a curative intent (71 out of 90, 78.8 %).70% of the cohort were males accounting for 63 out of the 90 patients.Most of the patients were ASA I (56.7 %), while 41.1 % of the patients were ASA 2 with only 2 patients who were ASA 3 being operated in this time frame.36 of the 90 patients had a comorbidity and were actively taking treatment for the same.The median duration of surgery was 240 minutes.The median blood loss was 225 ml. The median post-operative stay was 5 days.The postoperative stay of the laparoscopic group and open surgery group were 4.3 day and 8.3 days respectively.The median post-operative stay in the elective case and emergency cases were 5 days and 6 days respectively.10 patients had a significant post op morbidity (Clavien Dindo Grade III and above) in the post-operative period. Four out of 43 rectal resections had a positive circumferential resection margin which corresponds to 9.3%,which is slightly higher that our institutional rate of below 5%,which probably is attributed to a selection bias of advanced cases during this period Conclusions: The role of minimally invasive surgery (MIS) was initially questioned at the start of the pandemic,however gradually increasing evidence favored MIS as it reduced hospital stay and complication.ERAS also plays an essential role in times like this, where the optimal usage of minimal resources is essential. We embraced these methods to ensure safety of our patients and staff and at the same time provide the highest standards of care.