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Journal of Clinical and Diagnostic Research ; 15(2):4, 2021.
Article in English | Web of Science | ID: covidwho-1129836


Introduction: Novel Coronavirus-2019 (nCoV-2019) is capable of human-to-human transmission and can lead to acute respiratory distress syndrome similar to Middle East Respiratory Syndrome (MERS) due to lung parenchyma destruction. Some patients with COVID-19 consistently demonstrated no hypoxaemia, however, some patients develop sense of difficulty in breathing due to increased airway resistance. Aim: To assess the potential of High Resolution Computed Tomography (HRCT) thorax as an early predictor of hypoxaemia in COVID-19 patients. Materials and Methods: A prospective longitudinal cohort study of 1000 Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 and HRCT thorax positive patients, who were monitored simultaneously for SpO(2) levels, were undertaken. HRCT findings were graded into Computerised Tomography Severity Index (CTSI) and correlated with patient's SpO(2) levels, at the time of scan on admission. Patients, who had normal SpO(2) levels (>= 95%) at the time of initial scan, were monitored upto five days. Pearson's correlation test was used to find correlation between CTSI and SpO(2) levels. Results: In present study group there was male predominance (4:1). Fever was the most common clinical presentation followed by cough. HRCT thorax features were categorised as Typical 769 (76.9%), Indeterminate 176 (17.6%) and atypical 55 (5.5%). 371 (82.8%) patients with SpO(2) >95% were having CTSI between 0-7, similarly 189 (54.4%) patients with SpO(2) 90-94% were having CTSI between 8-15 and 133 (64.8%) patients with SpO(2) <90% were having CTSI between 16-25. So, the present study categorised the patients into three groups-Category 1 (CTSI 0-7), Category 2 (CTSI 8-15) and Category 3 (CTSI 16-25) for better and prompt identification of clinical severity and their management. Majority of patients in CTSI category 1, 2 and 3 were having SpO(2) levels >= 95%, 90-94% and <90%, respectively. Statistical correlation between CTSI and SpO(2) levels at the time of initial scan was significant (Pearson's correlation coefficient (r)=-0.261 and p-value <0.01). Number of patients who developed hypoxaemia (SpO(2) <95%) on follow-up in CTSI Category 1, 2 and 3 were 42 (11.32%), 10 15.87%) and 2 (14.28%), respectively. The association between CTSI and development of hypoxaemia based on follow-up SpO(2) levels was statistically found to be insignificant (chi-square value=1.21, degree of freedom (d.f.) 2 and p-value=0.570). Conclusion: In present study group, a negative correlation was established between CTSI and SpO(2) levels. The association between CTSI and development of hypoxaemia on follow-up SpO(2) monitoring was found to be non-significant statistically. So, HRCT thorax cannot be relied upon as an early predictor of hypoxaemia in COVID-19 patients.

Expert Rev Anti Infect Ther ; 2020.
Article in English | PubMed | ID: covidwho-843154


INTRODUCTION: In December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak occurred and caused the coronavirus disease of 2019 (COVID-19), which affected ~ 190 countries. The World Health Organization (WHO) has declared COVID-19 a pandemic on 11(th) March 2020. AREA COVERED: In the review, a comprehensive analysis of the recent developments of the COVID-19 pandemic has been provided, including the structural characterization of the virus, the current worldwide status of the disease, various detection strategies, drugs recommended for the effective treatment, and progress of vaccine development programs by different countries. This report was constructed by following a systematic literature search of bibliographic databases of published reports of relevance until 1(st) September 2020. EXPERT OPINION: Currently, the countries are opening businesses despite a spike in the number of COVID-19 cases. The pharmaceutical industries are developing clinical diagnostic kits, medicines, and vaccines. They target different approaches, including repurposing the already approved diagnosis and treatment options for similar CoVs. At present, over ~200 vaccine candidates are being developed against COVID-19. Future research may unravel the genetic variations or polymorphisms that dictate these differences in susceptibilities to the disease.