ABSTRACT
Background: Diabetes mellitus significantly increases the severity, risk of hospitalization and mortality in covid19 pneumonia. Methods: A retrospective study was conducted in 248 patients tested positive for covid19 by RTPCR admitted into a tertiary care centre between april 2021 and june 2021 to know the severity assessed by the oxygen requirement and outcome assessed by duration of hospitalization and death rates of covid19 pneumonia in patients with diabetes mellitus. Results: Out of 248 patients, 152 (61.2%) were nondiabetic, 96(38.7%) were diabetic, of which 74 (77%) being previously diagnosed, 22 (22.9%) diagnosed as de novo . Out of 96 diabetics, 24 (25%) were vaccinated with two doses, 20(20.8%) with first dose and 52(54.1%) not vaccinated. Among 96 diabetics, 36 (37.5%) required oxygen, 22 (22.9%) required HFNC support, 19 (19.7%) required NIV support. Among 96 diabetics, 62 (64.5%) were discharged of which 26 (41.9%) required oxygen and death occurred in 34 (35.4%). Out of 34 deaths, 26(76.4%) were not vaccinated and 8 (23.5%) were vaccinated. Conclusion: There is increased severity, mortality and length of hospital stay in patients of covid19 pneumonia with diabetes mellitus. However in vaccinated, risk of mortality is significantly low compared to non-vaccinated patients.
ABSTRACT
Background: Pneumothorax has been noted to be a complication of covid19 pneumonia caused by SARSCOV2 requiring hospitalization and increasing mortality. Case Study: A series of 10 cases of spontaneous pneumothorax in patients with covid19 pneumonia either RTPCR positive or radiological positive admitted into a tertiary care centre from April 2021 to September 2021. Discussion: Of 10 cases of pneumothorax, 8 were confirmed covid19 positive by RTPCR and 2 were radiologically diagnosed based on CT imaging. None of them had previous lung disease, 2 were smokers and 1 had prolonged biomass fuel exposure. 3 of them were kept on NIV support and others required oxygen with facemask. All patients had moderate to severe disease with bilateral GGOs. All of them had acute onset of chest pain, drop in saturation and increased respiratory rate. All the patients were managed with ICD insertion and oxygen supplementation. Out 10 patients, 5 patients had favorable outcome and discharged and death occurred in 5 patients. Conclusion: Acute deterioration in a patient with covid19 pneumonia indicate a pneumothorax which may occur even in the absence of pre-existing lung disease and mechanical ventilation. Early diagnosis and management of this complication is necessary to prevent the risk of mortality.