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Lung India ; 39(SUPPL 1):S146-S147, 2022.
Article in English | EMBASE | ID: covidwho-1857842


Background: Tuberculosis(TB) is one among the various respiratory pathologies affecting post-covid patients. We intend to describe clinico-radiological characteristics of tuberculosis in post-covid patients. Methods: Retrospective descriptive study, conducted at SDS TRC and RGICD, Bengaluru from May 2020 to November 2021 with inclusion criteria of Tuberculosis with history of COVID in last 6 months. Clinicoradiological characteristics of them were retrieved from medical records section. Results: 13 patients were included in our study. Male predominance (69%), with mean age of 50.7years noted. Patient with co-morbidity were 61.53%, majority were diabetics. 46% severe, 15%moderate covid cases received corticosteroids during covid illness and 38% were mild who didn't receive corticosteroids. Mean duration of TB diagnosis after covid was 2 months. 5 patients were diagnosed as pulmonary tuberculosis with cough, fever, weight loss as presentation, 6 presented with air-leak in which 4 had hydropneumothorax, 2 had pneumothorax with dyspnea as presentation and 2 had pleural effusion. 69% of chest radiograph revealed cavity. Rest showed nodules, consolidation. Bandim-TB score was assigned. 4 were mild and rest 11 were of moderate to severe category. AFB Sputum smear / CBNAAT-positive in 85% cases. Among 2 pleural effusions, pleural fluid CBNAAT was positive in 1 and in other biochemical analysis was suggestive of tuberculosis. 15% were Rifampicin resistant TB. All except 1 were newly diagnosed tuberculosis. 2 patients succumbed to the disease and rest were discharged on appropriate anti-tubercular regimen. Conclusion: Post-covid patients when presents with persistent or worsening respiratory symptoms, tuberculosis should be excluded especially in endemic countries like India.

Journal of SAFOG ; 13(6):396-402, 2021.
Article in English | Scopus | ID: covidwho-1753846


Objective: To compare the maternal and neonatal outcomes, particularly the incidence of preterm birth, and identify their risk among pregnant women who were seropositive or seronegative for SARS-CoV-2, during the pandemic. Method: Pregnant women who got admitted to an urban tertiary care center for delivery during the period August 1, 2020, to October 30, 2020, and consented to participate in the study were recruited and followed up until delivery. Among 230 women, 73 pregnant women who tested positive for SARS-CoV-2 were included in the positive cohort and the remaining in the negative cohort. Demographic details, symptoms at presentation, gestational age, laboratory tests done, and treatment given were noted. The outcome measures studied were the incidence of preterm birth, gestational age at admission and delivery, risk factors for preterm birth (PTB), obstetrics/medical complications, drugs given, mode of delivery, and neonatal outcomes, such as birth weight, Apgar scores at 1 and 5 minutes, neonatal complications, need for NICU admission, and SARS-CoV-2 positivity. Results: Among the 73 SARS-CoV-2 pregnant women, 95% were asymptomatic. The incidence of preterm birth was similar in the SARS-CoV-2-positive and SARS-CoV-2-negative cohorts (20.5 vs 22.5%). There were four SARS-CoV-2-positive babies in the positive cohort and none in the negative cohort. The distribution of known risk factors of preterm births and other maternal and neonatal outcomes were also comparable between the positive and negative cohorts. Conclusion: There is no increase in incidence of preterm births in SARS-CoV-2-positive compared to SARS-CoV-2-negative cohort, during the pandemic. Majority of them have asymptomatic infection, and good pregnancy outcomes can be anticipated. © The Author(s). 2021.

New Armenian Medical Journal ; 15(3):29-38, 2021.
Article in English | Scopus | ID: covidwho-1481616


To assess the association of laboratory biomarkers-serum albumin, C-reactive protein, lactate dehy-drogenase and D-dimer with severity of COVID-19 infections and to know the value of individual parameters in assessing severity of COVID-19 infection A prospective observational study was conducted on COVID-19 patients of age above 18 years, admit-ted to a tertiary care center in coastal part of southern India. The laboratory parameters mentioned, were estimated and compared between groups i.e. severe and non-severe COVID-19. Their cut-off values were detected using the receiver-operator curve. Totally 577 patients with a mean age of 55±16.21 years were included. Among them, 52.3% of the patients suffered from severe COVID-19 infection and 47.6% of the cases had non-severe COVID-19 infection. The median C-reactive protein, median lactate dehydrogenase and median D-dimer levels were significantly higher in patients with severe COVID-19 compared to patients with non-severe COVID-19 (64.93 mg/dL vs. 10.23 mg/dL, (393 U/L vs 249 U/L) and (0.9 µg/mL vs 0.5 µg/mL) respectively. Univariate logistic regression analysis showed that the odd’s ratio of serum albumin, C-reactive protein, lactate dehydrogenase and D-dimer were 0.486 (p≤0.001, 95% CI= 0.361-0.653), 1.005 (p≤0.001, 95% CI=1.003-1.008), 1.005 (p≤0.001, 95% CI=1.004-1.006) and 3.847 (p≤ 0.001, 95% CI=2.702-5.476). Both C-reactive protein and lactate dehydro-genase at a cutoff value of 22.5 mg/dL (0.746AUC) and 331U/L had good sensitivity and specificity in predicting severe COVID-19 infection. Multivariate logistic regression analysis showed that C-reactive protein (OR=1.004, P≤0.001), lactate dehydrogenase (OR=1.005, p≤0.001) and D-dimer (OR=1.208, p≤0.001) were statistically significant independent predictors of severity of COVID-19. The laboratory biomarkers like C-reactive protein, lactate dehydrogenase and D-dimer can be used for predicting severe COVID-19 infections at admission. C-reactive protein, lactate dehydrogenase and D-dimer could be used in differentiating non-severe and severe COVID-19 infections with their cut off values being >22.54 mg/mL, >331 U/L and >0.5 µg/mL respectively. © 2021, Yerevan State Medical University. All rights reserved.

American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277450


Introduction: Coronavirus disease 2019 (COVID-19) was first reported in the Houston city area in the first week of March 2020. Soon hospitals in the city were overrun with COVID-19 patients. By October, COVID-19 had resulted in 216,025 deaths in the US1. Older patients and Hispanic, American Indian/Alaskan Natives, Black, and Asian patients have experienced the highest excessive deaths1. The aim of our research was to study the factors associated with mortality among COVID-19 patients. Methods: The study was conducted on patients at a large university-affiliated multi-hospital system. The study used data from electronic medical records with an inpatient admission from March-October 2020 and a confirmed diagnosis of COVID-19. The data included demographic information, prescreening information, length of stay, discharge disposition, diagnoses and comorbidity, respiratory support, medications, and laboratory test results. The dependent variable in all analyses was defined as a discharge disposition of in-hospital death or hospice. Unadjusted logistic regression analyses were carried out on all variables, and a multivariable logistic regression model was built using variables that lowered the Akaike information criterion. Laboratory values missing at random were imputed by multiple imputations using chained equations. Results: There were 8,341 inpatients admissions, of whom 1,139 died or received hospice. The median age was 72 years among dead/hospice patients and 55 years among patients discharged alive (p<0.01). Death/hospice was higher among men (15% of all men vs. 12% of all women) and people who were Asian (20%), White (15%), and African American (12%). 10% of Hispanics and 13% of Non-Hispanic died or received hospice. The multivariable logistic regression model showed that receiving mechanical ventilation (OR 19.171), Non-invasive ventilation, using non-rebreather masks, high flow nasal cannula, ICU admission had higher odds of death/hospice. Increase in age, Charlson comorbidity index of 2 &3, and receiving convalescent plasma also had higher odds of death/hospice. Not receiving supplemental oxygen and increase in the anticoagulants administration days reduced the likelihood of death/hospice. Among laboratory values, an increase in the initial lactic acid, blood urea nitrogen, total bilirubin, and alkaline phosphatase were associated with higher death/hospice odds. Conclusion: COVID-19 mortality has decreased over time due to a better understanding of managing the patients. This study highlights the most important predictors of mortality, which must be followed up by future studies. (Table Presented).

American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277424


Introduction: There has been a rush to find a cure for Coronavirus disease 2019 (COVID-19) since the early days of the pandemic. Drugs such as Hydroxychloroquine used to treat malaria, and autoimmune disorders received a lot of media attention and an emergency use authorization by FDA early on, which was withdrawn in June 2020. The aim of this study was to assess the trends of medication use among COVID-19 patients. Methods: The study was conducted at a large university-affiliated hospital system. The study collected data from electronic medical records on all COVID-19 patients from March-November 2020. Data was also collected on medication usage for all patients in 2019. The association of death/hospice with each medication usage among inpatient COVID-19 patients was assessed using unadjusted logistic regression analyses. Results: Among all COVID-19 inpatient admissions, up to 50% of all hospitalized patients received Hydroxychloroquine and 7% overall during the study period. Hydroxychloroquine was not associated with death/hospice in inpatient COVID-19 patients. The use of Hydroxychloroquine was higher in the initial months of the pandemic coinciding with initial recommendations and increased news media coverage. On March 20, the Food and Drug Administration (FDA) gave Hydroxychloroquine an emergency use authorization (EUA). In March, Hydroxychloroquine was given to 50% of COVID-19 patients. As more evidence was published, the use of Hydroxychloroquine declined in April, and by April 24, the FDA issued a warning against the use of Hydroxychloroquine. Utilization had dropped to 32% of hospitalized patients. By June 15, the FDA had rescinded the EUA given to Hydroxychloroquine with utilization less than 2% by June 1 in hospitalized patients. Conclusion: In the time of rapid nontraditional communication of disease therapies, Hydroxychloroquine utilization in COVID-19 may have demonstrated most rapid implementation and de-implementation of any intervention in modern medicine. (Table Presented).