To identify rising level of CRP and D-Dimer as a predictor of increased morbidity and mortality in COVID-19 patient-A retrospective study

Aim and objectives: The present study assessed the correlation between rising levels of CRP and D-dimer with morbidity and mortality in adult Covid-19 patients. Materials and method: This retrospective observational study was conducted at Max Super speciality Hospital I.P. Extension, Delhi a tertiary care centre in North India. CRP and D-Dimer values were collected at the time of admission and within 15 days after admission. The statistical analysis was done by independent t-test. Results: The study population consisted of 194 (64.7%) males and 106 (35.3%) females. The mean age of the study population was 56.78±15.42 (28-94) years. The mean age of the non-survivors (58.83±15.64 years) was significantly more than survivors (54.43±14.85 years). The mean CRP and D-DIMER at the time of admission and within 15 days after admission was significantly more among non-survivors compared to survivors. Conclusion: A high CRP and elevated D-Dimer levels among COVID-19 patients predict higher odds of mortality;however, large scale and longer-term studies are needed to validate our findings. The predictive model based upon CRP and D-DIMER levels can help the clinicians to improve individual treatment, make timely clinical decisions, and make optimal use of limited clinical resources.

To Identify Rising Level of CRP and d-Dimer As Predictor of Increased Morbidity and Mortality in Covid-19 Patient. A Retrospective Observational Study

Aim and background: Cytokine storm caused by the release of proinflammatory mediators, e.g., IL-6, TNF-, IL2, IL10, G-CSF, etc., is the hallmark of COVID-19 disease. This cytokine storm is characterized by immuno-thrombomodulation. C-Reactive Protein (CRP) and d-dimer are markers of proinflammatory state, which can also be used as a prognostic marker for the underlying disease processes. Objective: To determine the clinical utility of raised C-reactive protein (CRP) and d-Dimer levels as prognostic markers in patients with the diagnosis of COVID-19. Materials and methods: This retrospective observational study will be conducted at Max Super speciality Hospital I.P. Extension, Delhi after ethical committee clearance. Adult (age > 18 years) patients with confirmed diagnosis of COVID-19 admitted to COVID-ICU between 1st April 2021 till 30th June 2021 will be included and checked for CRP and d-Dimer values retrospectively. Correlation between raised CRP and d-dimer on presentation and rising trend of markers with 28-day mortality, Average length of ICU stay, need for invasive mechanical ventilation, and need for Renal Replacement Therapy will be seen. Results: Results will be shared after the completion of the study.

Psychological assessment and lived experiences of recovered COVID-19 patients who presented for convalescent plasma donation.

BACKGROUND: Increasingly, it has been seen that patients recovering from COVID-19 may face a second battle of coping with its mental health ramifications. These psychological issues can even be experienced by patients who were asymptomatic or had mild to moderate symptoms, potentially impacting their quality of life. METHODOLOGY: This was a prospective observational study to analyse the psychological impact of COVID-19 in recovered patients who presented as prospective convalescent plasma (CP) donors. An interview for the psychological assessment of the prospective donors was carried out. Depression and anxiety in the participants were assessed by HAM-A, and HAM-D scores and Quality of Life were assessed using the WHOQOL-BREF scale. RESULTS: A total of 51 prospective donors were assessed, with a mean age of 34.37 (±9.08) years, with the majority being males (46). No clinically significant depression and anxiety were found on the basis of HAM-D and HAM-A scores. The worst affected quality of life parameter, based on the WHOQOL-BREF scale, was physical quality of life followed by environmental, psychological, and social relationships. Moreover, due to infection, social stigma was experienced by 49.02% of the donors, while 21.97% had anxiety related to convalescent plasma donation as a common livid experience. CONCLUSION: Poor quality of life and social stigma during the recovery phase is prevalent in COVID-19 recovered patients, for which formulation of holistic support strategies are the need of the hour.

Psychosocial difficulties and quality of life in liver transplant recipients during the COVID-19 pandemic

Background: The pandemic of COVID-19 devastated the global community, not only related to illnes but also the other domains i e physical, mental and social aspect too The liver transplant recepients, who supposed to be vulnerable and also need close monitoring as well as support must have been affected The aim of this study was to identify the anxiety, psychosocial difficulties and post-transplant quality of life during the COVID-19 pandemic Methods: A cross-sectional survey was conducted on Liver transplant recipients with informed consent through questionnaire circulated to them The structured questionnaire includes clinical and demographic variables, psychosocial difficulties during COVID-19 pandemic and by using the COVID-19 anxiety scale and Post-Transplant Quality of life questionnaire (pTQOL- 32 item for last 4 weeks) Results: A total of 109 patients completed the study questionnaire The mean age of the participants was 50 49 (± 11 08) years with 88% being males;and a median duration from transplant was 52 37 months The majority had a Live donor liver transplant (79 8%) from a family member Almost all (99 1 %) were on regular follow up and treatment prior to the pandemic Only 57% could able to maintain planned hospital visit, 7 3% couldn't be able to attend the hospital as desired by the treating unit where as 16 5% had fear of COVID-19 infection upon hospital visit and 26 6% opted for tele-consultation during this period Upto 88% could not pursue their regular activities, 39 % could not continue the routine exercise and physiotherapy due to imposed restrictions The economic impact was noted with 3.7% find difficulties for supporting the drug expenses and about 7 3% managed by the immmusuprresants and curtailing the other supportives During this peroid 4 6% had a deranged liver function test requring immeduate attention and 1 patient had COVID-19 The COVID anxiety was not much, but the median psychosocial difficulty score was 18 and mean total pLTQ score was 41 75 (± 33 76) , suggesting the stress of SARS CoV2 on daily life Conclusion: The COVID-19 pandemic had a toll on post liver transplant recepients in terms of significant psychosocial difficulties and poor quality life This in addition to physical and medical conditions needs worth attention Awareness campaigns and comprehensive is an unmet need for a holistic care of this previledged cohort.