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Advances in Respiratory Medicine ; 90(3):193-201, 2022.
Article in English | Web of Science | ID: covidwho-1997991

ABSTRACT

Introduction: This retrospective observational study has been designed to identify clinical characteristics, treatment outcomes and factors associated with severe illness in 813 COVID-19 patients hospitalised in an Indian tertiary care hospital. Material and methods: This was a retrospective analysis of patient admitted between 1st July to 15th Aug 2020 with COVID-19 infections. Logistic regression was performed to explore the association of clinical characteristics and laboratory parameters with the risk of severe disease and mortality. The statistical significance level was set at 0.05 (two-tailed). Results: Out of 813 study patients, 630 (77.50%) patients were categorised with mild to moderate while 183 (22.50%) patients as severe Covid infection. Mortality was significantly higher in severe Covid patients as compared to mild moderate cases (66.21% vs. 10.31%. p<0.0001. Patients with severe infection were significantly more likely to have diabetes hypertension, chronic kidney disease (CKD) and had significantly higher Neutrophil count, serum creatinine, C-reactive protein (CRP), ferritin, D-Dimer and decreased haemoglobin, lymphocyte and serum calcium than patients with mild-moderate infection. In Multivariate analysis, age more than 60 years [AOR: 2.114, 95% CI (1.05-4.254), 0.036], NLR more than 3.3 [AOR: 1.082, 95% CI (1.030-1.137), 0.002] and D-Dimer >1 mu g/mL [AOR: 2.999 (1.464-6.146), 0.003] were found significantly associated with severe disease (p < 0.05). Factors associated with mortality were age more than 60 years, presence of breathlessness, severe disease or presence of chronic kidney disease. Conclusions: Factors like elderly age (age > 60 years), elevated NRL, CRP, D-Dimer and serum ferritin were associated with significantly higher risk to develop severe COVID-19 infections. Elderly, and patients with CKD were associated with worse outcome.

2.
Indian Journal of Transplantation ; 15(2):131-133, 2021.
Article in English | Web of Science | ID: covidwho-1332217

ABSTRACT

The National Organ and Tissue Transplant Organization (NOTTO) has previously published transplant-specific guidelines with reference to COVID-19.([1]) The mortality is higher in dialysis patients with COVID-19 (12%-30%) than posttransplant COVID-19 patients (11.3%) and both are higher than the general population (<2%) in India.([2-5]) With the resumption of the kidney transplant program in various parts of India, new issues are expected to occur. There is uncertainty, regarding the safety of performing kidney,([ 6-8]) liver,([9-12]) and lunge([13]) transplantation in a recipient recently recovered from COVID-19. At present, we have limited evidence-based information about safety and feasibility of kidney transplantation from living donors, who have recovered from COVID-19.([4]) Recently, Indian Multi-center cohort studies have reported successful kidney transplantation in recipients from living donors with a previous diagnosis of COVID-19.([15, 16])

4.
Indian Journal of Transplantation ; 14(4):363-365, 2020.
Article in English | EMBASE | ID: covidwho-1024731

ABSTRACT

Among coronavirus disease 2019 (COVID-19) pandemic, endemic infections also peak in India during this monsoon. Kidney transplant recipients are at higher risk of contracting infections with increased morbidity and mortality. Co-infection of COVID-19 with other infections is apprehended with more unfavorable outcome. We report a case of young renal allograft recipient with co-infection of COVID-19 and dengue fever presenting with acute graft dysfunction. Apart from supportive treatment and reduction in immunosuppressants, the patient was managed with dexamethasone, remdesivir, and heparin. The patient responded to the treatment and graft dysfunction improved on conservative management. This case emphasizes the need to consider endemic diseases also during workup of COVID-19 patients and shows that co-infections even with acute graft dysfunction can also have favorable prognosis. This case also points out the difficulties faced in managing immunosuppressants due to fear of acute graft rejection.

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