ABSTRACT
Background: Predicting the severity of COVID-19 infection in advance is the key to success of its treatment outcome. Various scoring systems are used to detect the severity of this disease but this study targets three simple scoring systems based on the vital parameters and basic routine laboratory tests. Aims and Objectives: The aim of the study was to assess the predictability of three scoring systems (Quick sequential organ failure assessment [q SOFA], CURB-65, and Early Warning scoring system) for disease severity at presentation in a rural-based tertiary care center. Material(s) and Method(s): An observational, descriptive, retrospective, and cross-sectional study was conducted at Diamond Harbour Government Medical College Covid Hospital from January 2021 to January 2022 to assess the predictability of q SOFA, CURB-65, and Early Warning scoring system for disease severity at presentation. Result(s): The total number of participants was 561 among total admitted 1367 patients. A short descriptive analysis obtained from the variables to analyze the scorings showed among total sample collected, 57% were male and 43% were female. In this study, 87% of patients were survived and the rest 13% succumbed (death). There is no statistically significant difference in mortality between both genders. Age, pulse rate, and respiratory rate have a significant correlation with the outcome and altered sensorium is also highly associated with mortality. The accuracy was also found to be little higher for National Early Warning score (NEWS) score than CURB-65 scoring and q SOFA scoring (0.919, 0.914 and 0.907). Although all the scoring systems have high sensitivity (>90%) (CURB 65: Most sensitive [0.99]), the specificities of all three scoring systems are below 50%. Among these three-scoring systems, NEWS showed the highest specificity (0.492) than q SOFA (0.423) and CURB 65 (0.394). Conclusion(s): We suggest NEWS score and CURB-65 as a better predictor for in-hospital mortality in COVID-19 patients as it is significantly sensitive and reasonably specific. It can be recommended in less equipped hospitals where only basic laboratory facilities are available. qSOFA can be utilized where no laboratory facility is available like in safe home and isolation centers.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
ABSTRACT
Criteria pollutants such as CO, SO2, NO2, PM10, and PM2.5 were monitored in the Kullu valley, a famous tourist destination in Himachal Pradesh, during the lockdown period of the 2nd wave of COVID-19 pandemic. The Pre-Lockdown Period (PLD) from 1 January to 6 May 2021 is taken here as a reference period, while the period from 7 May to 30 June 2021 is the Lockdown Period (LD). The present study was carried out to assess the anthropogenic impact on gaseous and particulate pollutants. Sulfur dioxide (1 h time average) and carbon monoxide (8 h average) were monitored using Thermo Fisher Scientific Gas Analyzers which uses pulse fluorescence technology and gas filter technology, respectively. While NO2 (24 h average) was analysed by Jacob and Hochessier method, and PM10 (24 h average) and PM2.5 (24 h average) were monitored using gravimetric method. The concentrations of pollutants were further analyzed incorporating mean ± standard error. HYSPLIT model was used to determine back trajectory of long-range transport of air pollutants. The results revealed average concentration of CO 0.59 ± 0.03 ppm in the PLD period, while it decreased to 0.35 ± 0.01 ppm in the LD period indicating how CO is largely influenced by vehicular emissions in the valley. Also, particulate matter such as PM10 and PM2.5 showed a decrease in lockdown period by 65.31% and 52.5%, respectively. The overall air quality was improved in the Kullu valley during lockdown period of the second wave of the COVID-19 pandemic as tourist-related activity and anthropogenic activities were restricted. The MERRA-2 data during the pre-lockdown and the lockdown period was analyzed in ArcGIS 10.8, which indicates almost similar result. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.