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1.
Indian Journal of Hematology and Blood Transfusion ; 37(SUPPL 1):S120-S121, 2021.
Article in English | EMBASE | ID: covidwho-1631896

ABSTRACT

Introduction: COVID-19 pandemic has placed the health systemworldwide in unprecedented stress, therefore, prompt identification and management of patients having severe disease is essential fortriaging of patients at the time of admission.Aims &Objectives: To identify hematological biomarkers ofCOVID-19 disease severity in patients admitted in a tertiary carehospital.Materials &Methods: A retrospective study was conducted over aperiod of 17 months (20th March 2020-19 August 2021) on 7416COVID-19 patients. Patients with cancers, pregnancy and chronichematological diseases were excluded from the study. Patients wereclassified clinically as per severity of disease as non-severe (asymptomatic, mild, moderate) or severe and their hematological parameterswere analyzed.Mann-Whitney test was used to compare between the groups. Optimal predictive cut off points for the variables were defined by receiveroperating characteristic (AUC) curve to dichotomize the variables.Univariate analysis was performed to screen out independent variables to be used in the binary logistic regression (BLR). A p valueof< = 0.05 was considered as statistically significant.Result: Age, duration of hospital stay, RBC count, WBC, Plateletcount, RDW, Neutrophils %, Absolute neutrophil count (ANC),Absolute monocyte count (AMC), NLR, PLR, NMR were statisticallyhigher whereas hemoglobin, hematocrit, MCHC, lymphocyte %,Absolute lymphocyte count (ALC), Eosinophils %, Absolute eosinophil count (AEC), Monocytes %, Basophils %, Absolute Basophilcount (ABC) and Lymphocyte Monocyte ratio (LMR) were lower insevere group. MCV and MCHC were not significant, so wereexcluded from the logistic regression model. All variables were significant in univariate analysis. Age (>42 yrs), duration of hospitalstay (>10 days), RBC count (B 4.33 106/lL),WBC count (> 7.73103/lL), RDW (>14.8%), Neutrophils (>71.7%), Eosinophils(B 0.3%), Monocytes (B 5%), ALC (B 1.01 103/lL), LMR(B 3.125) with adjusted odd ratio of 1.8, 1.5, 1.3,1.3, 1.4, 2.0, 2.1, 1.5,2.0 and 1.3 respectively were found to be significant predictors ofseverity.Conclusions: Age, duration of hospital stay, RBC count, WBC,RDW, Neutrophils %, Eosinophils %, Monocytes %, ALC, LMRshould be assessed and monitor at the earliest to halt unfavorableoutcome of mortality or morbidity.

4.
British Journal of Surgery ; 108(SUPPL 7):vii142, 2021.
Article in English | EMBASE | ID: covidwho-1585098

ABSTRACT

Aim: COVID had an unprecedented effect on the NHS elective surgical care. To overcome the deficit created due to the pandemic, the concept of a 'COVID protected zone' gave birth to the 'hospital within the hospital'. This included 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen and a separated entrance. Of the fundamentals of the model were enhanced infection control and PPE guidance for staff. The aim of our study was to evaluate the recovery of elective activity brought about by this elective centre. Methods: Theatre activity data was collected weekly (7/20 to 1/21) through the business informatics system. This was used to compare the activity achieved during the recovery phase from COVID after the first and subsequent wave. Results: Pre COVID-19, 11 theatres were operating. These managed an average of 263 cases were per week. In the first week of operation of elective centre, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. During the 2nd wave the capacity was reduced to 42% as opposed to 0% during the first wave. This was only possible due to our model elective centre. Conclusion: This model elective centre has enabled elective care to return to above normal levels, with increased efficiencies. This has not only shortened patient waiting times and cleared the back-log but also delivered training to surgical trainees without compromising safety.

5.
British Journal of Surgery ; 108:138-138, 2021.
Article in English | Web of Science | ID: covidwho-1539508
6.
British Journal of Surgery ; 108:1, 2021.
Article in English | Web of Science | ID: covidwho-1539210
7.
British Journal of Surgery ; 108:76-76, 2021.
Article in English | Web of Science | ID: covidwho-1537517
8.
Anesthesia and Analgesia ; 133(3 SUPPL 2):465, 2021.
Article in English | EMBASE | ID: covidwho-1445062

ABSTRACT

Background: Intubation is a highly aerosol generating procedure. Recent airway management guidelines advocate the use of appropriate personal protective equipment, a video laryngoscope and 'intubation box' while intubating a suspected or an infected COVID patient.1 We undertook a study to compare CMAC Videolaryngoscope with Mc Grath Videolaryngoscope for tracheal intubation using an intubation box along with PPE. Methods: The patients were randomly allocated to two groups by computer-generated random numbers, depending upon the Video laryngoscope used: Group C (n=30) where C-MAC VL was used and Group M (n=30) where Mc Grath VL was used. The primary outcome was total time required for successful intubation. The secondary outcomes included number of attempts required, CL grade, POGO score, difficulty faced while using the device and user's preference. Results: The time to intubation was 57.17± 19.98 seconds with C-MAC laryngoscope as compared to 57.93 ± 14.92 seconds with McGrath laryngoscope (p=0.134). The POGO score and CL grade were comparable. Both the devices had a good POGO score. Twelve patients in each group were found to have a CL grade of 1. The time to glottis visualization was more with Mc Grath than with C-MAC although not significant (23.8±14.03 vs 20.10±10.78). Both the devices were easy to use. Conclusions: Both C-MAC and McGrath video laryngoscopes, are equally effective devices for intubation by a donned anaesthesiologist using an intubation box but McGrath with a disposable blade is better suited in these conditions.

9.
British Journal of Surgery ; 108:1, 2021.
Article in English | Web of Science | ID: covidwho-1254465
10.
Indian Journal of Hematology and Blood Transfusion ; 36(1 SUPPL):S129-S130, 2020.
Article in English | EMBASE | ID: covidwho-1092789

ABSTRACT

Aims & Objectives: The present study was undertaken to evaluate prognostic relevance of hematological parameters in COVID-19 infected patients for early identification of critical patients for early management. Patients/Materials & Methods: A retrospective study was conducted over a period of 2 months (01st July 2020 to 1st September 2020) on 912 admitted COVID-19 positive patients. 2 ml venous blood was aseptically collected in EDTA vaccutainer and processed in automated hematology analyser (ADVIA 2120i). Patients with hematological malignancy were excluded from the study. Patients were assigned into three groups according to the severity of disease (mild/asymptomatic, moderate and severe) as well as on the basis of clinical outcome (discharged ordeath). Results: To talleucocyte count, absolute neutrophil count, neutrophillymphocyte ratio, plateletlymphocyte ratio, reddistribution width were significantly higher (p<0.05) is the decreased patients and in severe disease group where as hemoglobin and hematocr it was significant lower in these patients. Lymphopenia was recorded in decreased patient but was not statically significant. Discussion & Conclusion: COVID-19 patients with severe disease and poor outcome showed significant difference in ther outine hematological parameter such as total leucocyte count, absolute neutrophil count, absolute monocyte count, neutrophillymphocyte ratio, plateletlymphocyte ratio, reddistribution width and hematocrit which are readily available and can be helpful in the prediction of COVID-19 patien toutcome.

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