ABSTRACT
Objective: To assess the impact of age on outcome of COVID-19 patients at a tertiary care hospital. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital Malir, Karachi, from Apr to Jun 2020. Methodology: This was a retrospective cross sectional study conducted at Combined Military Hospital Malir Karachi. About 120 positive cases of SARS COV-2 were studied, including males and females. Age range was 21-85 years. Patients were divided into groups according to age, group A (21-40 years), group B (41-55 years), group C (56-85 years). Presenting complaints and associated co morbidities were also analyzed. Mild cases were managed conservatively. Moderate to severe oxygen dependent cases were managed in intensive care units. Results: The mean age of patients was 40.24 years with 16.25 ± SD. Co-morbidities were noted in 67 (55.83%) patients, highest in group C, hypertension being the most common. Ten patients could not survive, due respiratory failure complicated by adult respiratory distress syndrome (ARDS). Bilateral infiltrates >50% observed in (14%) out of (n=120) patients. One hundred and ten patients were discharged with uneventful recovery. Conclusion: Mortality was highest among elderly patients with comorbidities. Therefore, international standing operative measures (SOPs) to be followed. Meticulous monitoring of vital signs and oxygen saturation in mild cases is the bare mini-mum requirement and timely appropriate treatment escalation of moderate to severe cases in intensive care units is the key to success. © 2021, Army Medical College. All rights reserved.
ABSTRACT
Objective: To determine the effectiveness of therapeutic plasma exchange (TPE) in management of critically ill Covid-19 patients Materials and Methods: In this study non-randomized controlled trial, a total of 47 patients were included after thorough screening of the admitted patients in Covid ITC CMH, Multan from July-2020 to May-2021.Single administration of TPE was done to determine the results. The parameters assessed in this study included the efficacy of TPE in terms of improvement of critical end points such as Norepinephrine dose to maintain MAP of more than 65mmHg, 6-hour balance of fluid, MAP, CRP (C reactive protein), WBC count (white blood cell), platelets, INR (international normalized ratio), IL-6. Results: The variations before and after TPE in clinical and biochemical parameters shown in table. II. In clinical parameters and in gas exchange parameters no significant difference was found. Inflammatory biomarkers, before and after TPE, the parameters had not significant different, (p>0.005). The differences before and after TPE between acid base balance, cytokines and vasoactive substances were also statistically insignificant, (p>0.005). Conclusion: Even though there is evidence of slight improvement in clinical endpoints of Covid-19 patients with TPE, overall efficacy of TPE is still a question that needs an answer as no significant improvement could be seen in outcome values after TPE.