ABSTRACT
Background:Severe acute respiratory syndrome coronavirus-2 is the virus that causes the respiratory illness coronavirus disease-2019 (COVID-19) that has infected millions of people worldwide. It has been reported that by the end of March 2020, this pandemic has affected almost 400 000 people in 168 countries on five continents. Older patients and those with comorbidities present with more severe infection and worse prognosis. Methods:A 52 year old male CML patient with fever and diabetes has reported at the COVID screening area of Silchar Medical College & Hospital (SMCH) for COVID-19 testing. Patient’s nasopharyngeal and oropharyngeal swabs were tak- en for real time-PCR testing. Similar procedure was repeated for follow-up of samples. Results:Patient was confirmed COVID-19 positive by real time-PCR at VRDL, SMCH on 30th March, 2020, this was the first COVID-19 positive case reported from Assam. The patient admitted that he visited the COVID -19 hotspot in New Delhi in the second week of March and developed cough and fever subsequently. He was kept in isolation and under continuous monitoring by physicians. Within 10 days patient’s temperature returned to normal with improvement in symptoms. However, repeated real-time RT-PCR test remained positive for COVID-19 infection till the 35th day of first positive declaration. This case is interesting because the estimated incubation period for COVID -19 infection was thought to be no more than 14 days. However, a retrospective review of the patient’s condition suggested an incuba- tion period of more than 35 days. Conclusions:The clinical and biochemical data of COVID-19 might be partly masked by coexisting CML and prolonged shedding of virus may pose high risk to general population. Therefore individuals who are immunosuppressed must al- ways be vigilant to protect their health, and that vigilance must extend to caregivers, as well.
ABSTRACT
Background:The recent severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) pandemic has struck with the pre-existing HIV pandemic. Information about the frequency and seriousness of COVID-19 infection among immuno- compromised HIV patients is still unclear. To our knowledge till date, clinical data about COVID -19 in HIV infected pa- tients are limited with only few case series. Here, we present cases of two HIV patient with COVID-19 infection admitted at Silchar Medical College & Hospital (SMCH), Silchar, south-eastern Assam, India. Methods:This retrospective study was conducted in VRDL, Silchar Medical College, Silchar among COVID -19 positive patient for the duration of three months from 30th March to 29th June 2020. The aim of the study was to evaluate the scenario of HIV reactive cases among COVID-19 positive population. Results:Between 30th March to 29th June 2020, a total of 727 COVID-19 positive cases were diagnosed at VRDL, SMCH. During these three months only two HIV patients were diagnosed with SARS-COV-2 infection. Patient-1 was 20-year old male (unaware of his HIV status) while Patient-2 was 52 year old army personnel (on ART therapy). In patient-2 HIV was well suppressed with sufficiently high CD4 counts. Fortunately, both the patients were asymptomatic and healthy. The mainstay of treatment given for the patients consisted of hydroxychloroquine, multi-vitamins in addition to the ART drugs (only patient 2). Both patients had stable health conditions, did not have any complications during their entire stay in health care facility for COVID-19. Both were treated and were tested negative by RTPCR within 14-15 days like any other general patient. Conclusions:Although, HIV patients are considered as immunocompromised, but our experience suggests that well con- trolled HIV patients with COVID-19 may have satisfactory prognosis following proper medical care. Further, enlarged cohort studies are needed to better understand risk and clinical course of COVID-19 among HIV-infected people.