ABSTRACT
Background: High number of SARS CoV2 infected patients has overburdened healthcare delivery system, particularly in low-income countries. In the recent past many studies from the developed countries have been published on the prevalence of SARS CoV2 antibodies and the risk factors of COVID 19 in healthcare-workers but little is known from developing countries. Methods: This cross-sectional study was conducted on prevalence of SARS CoV2 antibody and risk factors for seropositivity in HCWs in tertiary care hospitals of Peshawar city, Khyber Pakhtunkhwa province Pakistan. Findings: The overall seroprevalence of SARS CoV2 antibodies was 30.7% (CI, 27.8 to 33.6) in 1011 HCWs. Laboratory technicians had the highest seropositivity (50.0%, CI, 31.8 to 68.1). Risk analysis revealed that wearing face-mask and observing social-distancing within a family could reduce the risk (OR:0.67. p<0.05) and (OR:0.73. p<0.05) while the odds of seropositivity were higher among those attending funeral and visiting local-markets (OR:1.83. p<0.05) and (OR:1.66. p<0.01). In Univariable analysis, being a nursing staff and a paramedical staff led to higher risk of seropositivity (OR:1.58. p< 0.05), (OR:1.79. p< 0.05). Fever (OR:2.36, CI, 1.52 to 3.68) and loss of smell (OR:2.95, CI: 1.46 to 5.98) were significantly associated with increased risk of seropositivity (p<0.01). Among the seropositive HCWs, 165 (53.2%) had no symptoms at all while 145 (46.8%) had one or more symptoms. Interpretation: The high prevalence of SARS CoV2 antibodies in HCWs warrants for better training and use of protective measure to reduce their risk. Early detection of asymptomatic HCWs may be of special importance because they are likely to be potential threat to others during the active phase of viremia. Funding: Prime Foundation Pakistan.
Subject(s)
Viremia , Fever , Severe Acute Respiratory SyndromeABSTRACT
BackgroundAvailable research compared serum biomarkers such as lymphocyte count, C-reactive protein, ferritin, Lactate Dehydrogenase and D-dimers to predict survival in patients with mild, moderate and severe COVID-19. This study aims to compare these biomarkers among survivors and non-survivors of severe COVID-19. MethodsThis was a cross-sectional study based on patient’s data retrieved from Hospital Information System. Sixty-nine patients for whom a record of the biomarkers and survival status was available, were included in the study. For every patient, baseline and peak values were selected for CRP level, serum ferritin level, serum LDH level and serum D-Dimer level. Similarly, baseline and trough levels were selected for lymphocytes. Data were analyzed using SPSS version 21. Mean and standard deviation was used to compare the biomarkers with paired t-test. P value less than 0.05 was taken as significant. ResultsThe mean age of the study population was 55.5±9.1 years and 72.5% were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87 ±8.4 mg/dl, p=0.45) while among the non-survivor, the increase in CRP level was significant (from 16.68± 10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in serum LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while there was a statistically significant increase in serum LDH level in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). Lymphocyte count decreased significantly in both survivors (p=0.001) and non-survivors (p=0.001). There was no statistically significant elevation in serum ferritin among the survivors and non-survivors (p > 0.05). The D-Dimer level increased significantly in both survivors (p=0.01) and non-survivors (p=0.001).Conclusions In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.Trial Registration Not applicable