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Intro: The burden of post-COVID-related morbidity and mortality is significant yet undermined. We studied the morbidity and mortality outcomes of COVID-19 patients with moderate-to-severe diseases by 90-day post-hospitalization. Method(s): This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate to severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID severity category >=5;WHO scale >=5), between January and August 2021. We conducted telephone surveillance for 90 days post-discharge from the hospital, assessing for post- COVID complications and mortality. Relevant clinical data were extracted from medical records. Multiple logistic regression was employed to examine factors associated with post-COVID mortality after index hospitalization. Finding(s): Among 510 patients, 51%(n=260) were male with a mean age of 52.1 (14.65) years. A third had hypertension (39.8%) and diabetes (31.4%). Only 15.5% were partially vaccinated and 4.9% had complete vaccination before hospitalization. Nearly 65% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 25.7% received high flow oxygenation and 10% were mechanically ventilated. Approximately 23.3% (n=119) of patients were admitted to the intensive care unit. By 90-day post-hospitalization, 46% (n=203) reported residual symptoms: lethargy (14.5%), dyspnoea (12.2%), hair loss (7.5%), memory loss (6.3%), depression (3.9%), anxiety (2.7%) and 1.6% required home oxygen supplementation. Forty-four patients (8.5%) were re- hospitalized at least once, with 40.9% due to post-COVID complications. About 87% of patients attended their post-COVID clinic appointment. Nearly 13.5% (n=69) of patients died within 90 days after being discharged from the hospital. Adjusted for gender, comorbids and ventilatory status, age >=60 years (aOR 7.96;95%CI 3.75-16.92;p<0.001), diabetes (aOR 2.30;95%CI 1.12-4.72;p=0.024) and high oxygen requirement (aOR 3.41;95%CI 1.56-7.46;p=0.002), were associated with increased 90-day post-COVID mortality. Conclusion(s): Post-COVID morbidity and mortality are significant among survivors hospitalized for moderate- to-sever disease. Comprehensive care must be addressed to improve the outcomes of post-COVID patients.Copyright © 2023
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Intro: COVID-19 survivors suffer from variable limitations affecting their quality of life. We examined the functional and psychosocial outcomes among COVID-19 patients with moderate-to-severe diseases by three months post-hospitalization. Method(s): This retrospective cohort study included 510 COVID-19 patients admitted to Kepala Batas Hospital with moderate-to-severe diseases, requiring oxygen therapy during hospitalization (Malaysia COVID-19 severity category >=5;WHO scale >=5), between January and August 2021. We followed up with telephone surveillances by 90 days post-discharge from the hospital, assessing their performance in activities of daily living and psychosocial implications. Relevant clinical data were extracted from medical records. We compared patients with low (<10L/ min) versus higher (>=10L/min) oxygen requirements on the patient-reported outcome variables. Finding(s): Among 441 survivors (86.5%), half (n=223, 50.6%) were male, with a relatively young population with a mean age of 50.2 (13.73) years. Only 17.9% were partially vaccinated and 5.7% had complete vaccination before hospitalization. Nearly 70% were supplemented with nasal prong or face mask oxygenation (<10L/ min), 26.1% received high flow oxygenation and 4.1% were mechanically ventilated. By 90-day follow-up, >90% had their functionality returned to baseline before hospitalization. Only 1.6% required home oxygen supplementation. Compared with their baseline functionality, 4.8% were unable to perform basic household chores, 4.1% required assistance in mobilization and 2.5% became fully dependent on caretakers. Among 254 patients returning to work, 98% worked in the same institution but 18.9% required job scope adjustments. About 7.7% experienced post-covid stigma at home and/or work, 3,9% suffered from depression 5.7% became self-isolated and 0.9% had suicidal ideation or attempts. Functional and psychosocial outcomes were similar between patients with low and higher oxygen requirements (all p>0.05). Conclusion(s): Despite fair recovery outcomes reported by survivors with moderate-to-severe disease, a small proportion suffered from significant functional limitations and psychosocial adversity. Post-hospitalization care is essential to screen-detect post-COVID complications and provide timely interventions.Copyright © 2023
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Introduction/Aim: The COVID-19 Delta strain outbreak in New South Wales resulted in significantly increased hospitalisations for respiratory infection across the state. The most common cause of hospitalisation was hypoxaemia resulting from COVID pneumonitis. We aimed to identify predictors of oxygen requirements and disease trajectory in COVID pneumonitis (predominantly delta strain) from clinical data, laboratory and radiological testing. Method(s): Retrospective cohort study on 194 patients admitted with COVID pneumonitis in the Westmead COVID Respiratory ward from July 2021 to September 2021. We collected patient demographics, Charlson comorbidity index, blood tests on admission, chest X-ray (CXR) findings, and treatments received. Outcomes included peak FiO 2 required to maintain saturations>92%, duration of oxygen therapy, support device used, ICU admission and mortality. Patients were divided into three groups based on highest amount of supplemental oxygen needed to maintain saturations >92%: (i) Mild: no oxygen requirement;(ii) Moderate: FiO 2 up to 36% or nasal prongs 1-4 L and (iii) Severe: FiO 2 > 36%, requiring HFNP, NIV or intubation. We compared continuous data between groups with ANOVA and post-hoc multiple group comparisons with Bonferroni correction, and Chi-square tests for categorical data. Result(s): Mean age was 51.8 years;110 (57.7%) were male and 151 (78%) patients were unvaccinated. Average length of stay was 12.2 days and with mean duration of oxygen use was 8.9 days. Age and Charlson Comorbidity Index were found to be significant predictors of degree of hypoxia, with significant differences between the severity groups. There were significant differences in LDH, neutrophil-lymphocyte ratio, CRP and CXR severity between the three severity groups. Conclusion(s): Age, comorbidities and non-English speaking background were predictors of hypoxemia severity. While various biomarkers demonstrated utility in predicting severity of hypoxia, the strongest predictors in our study were CRP, procalcitonin, LDH, neutrophil-lymphocyte ratio and degree of radiological abnormalities.
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Background: Little is understood about which comorbidities are associated with severe outcomes in children hospitalized with acute COVID-19. Some confusion lies especially for cancer or diabetes. Method(s): Data from 2 multicenter prospective cohort studies of hospitalized children (aged 0-18 years) with confirmed SARS-CoV-2 in Spain and Colombia were combined for this analysis. Data were obtained from 116 hospitals. Outcome was classified as (in decreasing order of severity): death, mechanical ventilation (MV), pediatric intensive care unit (PICU) admission, high flow/CPAP, oxygen therapy with nasal prong (NP) and hospitalization without respiratory support. Risk factors for severity, adjusting for age and gender, were identified using multinominal logistic regression and a backwards selection process. Result(s): A total of 1,753 patients were included, 734 (41.8%) in Spain and 1,019 (58.1%) in Colombia. The most frequent comorbidities were asthma (9.0%), chronic neurological disorder (NRL) (7.4%), immunosuppressive medication (7.2%), malignant neoplasms (5.4%) and chronic lung disease (not asthma) (CLD) (4.5%). Comorbidities associated with the different endpoints are summarized in Figure 1. Asthma was associated with a significantly increased risk of death (OR: 4.17;95%CI 1.34-12.97), MV (OR: 7.94 (3.59-17.56)), PICU admission (OR: 3.37 (1.91- 5.96)), high flow/CPAP (OR: 6.65 (2.69-16.46)), and NP (OR: 3.85 (2.57-5.77)) compared to hospitalization without respiratory support. NRL was associated with increased risk of death (OR: 7.34 (3.01-17.90)), MV (OR: 3.07 (1.20-7.82)) and high flow/CPAP (OR: 4.36 (1.68-11.29)). CLD was associated with increased risk of death (OR: 6.22 [2.28-16.94]) and NP (OR: 3.1 (1.74-5.58)) and in addition, chronic cardiac disease was associated with increased risk of MV (OR: 5.21 (1.76-15.41)) and PICU (OR: 2.78 (1.27-6.08)). Risks of death (OR: 4.49 (2.03-9.05)), MV (OR: 2.97 (1.52-5.81)), PICU (OR: 4.27 (2.89-6.33)), and NP (OR: 4.67 (3.64-5.99)) were higher in the Colombia Cohort. Conclusion(s): Asthma, chronic neurological, cardiac and lung disease;and belonging to the Colombia cohort were consistently associated with multiple severe outcomes of COVID-19. Cancer and diabetes association with selected endpoints rather than with most endpoints may be more related to the baseline disease than with the actual COVID-19.
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Introduction/Aim: Medium and long-term impacts of COVID-19 pneumonitis are being increasingly recognised. Our study aimed to evaluate outcomes of hospitalised COVID-19 patients with moderate-to-severe respiratory compromise. Method(s): Patients admitted to a tertiary centre with COVID-19 pneumonitis (March 2020-October 2022) were followed in the Post-COVID Respiratory Clinic at 6-24 weeks. Baseline demographics, admission details, pulmonary function tests (PFTs), and clinic data were collected. Univariable and multivariable logistic regression were performed to investigate for predictors of persisting respiratory symptoms (dyspnoea, cough, chest pain) and functional limitation (self-reported). Result(s): 125 patients (64.8%male, 63.2+/-16.7years, 42.5% former/current smokers, BMI 31.0+/-8.0kg/m2, 49.6% fully vaccinated) with median follow-up time of 85 [interquartile range (IQR) 64-131] days were included. Pre-existing conditions included lung disease (29.6%), immunocompromise (15.2%), diabetes (24.8%) and hypertension (43.6%). 35.2% required ICU care (14.4% mechanical ventilated, 4% ECMO), 44.8% received high flow nasal prong oxygen and/or continuous positive airway pressure (CPAP). At initial clinic follow up, 65.4% had persisting X-ray changes. Mean predicted FEV1, FVC, DLCO were 86.8+/-20.7%, 85.3+/-20.3%, 82.2+/-19.8% respectively. Symptoms included dyspnoea (63.2%), fatigue (24.2%), cognitive dysfunction (12.9%) and musculoskeletal complaints (10.5%). Univariate predictors of continued respiratory and/or functional disability included age [odds ratio (OR) 1.03, 95%confidence interval (CI) 1.01-1.06, p = 0.01), prior lung disease (OR2.98, 95%CI 1.05-8.48, p = 0.04), hypertension OR2.61, 95%CI 1.09-6.22, p = 0.03) and length of hospital stay (LOHS) (OR1.03, 95%CI 1.00-1.07, p = 0.04). On multivariable analysis, only LOHS was independently predictive of continued respiratory and functional limitations (OR1.03, 95%CI 1.00-1.07, p = 0.02). Conclusion(s): Patients recovering from COVID-19 pneumonitis have a large burden of disability at follow-up. Older age, hypertension, lung disease and LOHS are risk factors for delayed recovery.
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Introduction: Coronavirus Disease-2019 (COVID-19) can affect multiple system of body including eye. In eye, it can cause mild conjunctivitis, posterior segment involvement, neurosensory involvement and lethal opportunistic infection like mucormycosis. Associated co-morbidities, severity of COVID-19 infection and corticosteroids used in its management can affect ophthalmic involvement. Aim(s): To determine the frequency and various types of ophthalmic manifestation of patients with COVID-19. Material(s) and Method(s): This prospective observational study was conducted on indoor patients of Shree Krishna Hospital, a rural, tertiary care hospital affiliated with Pramukh Swami Medical College, Karansad, Gujarat, India, from 1st May 2021 to 1st January 2022. Second wave of COVID-19 was from 13th March 2021 to 19th June 2021. Patients' demographic data, details of COVID-19 infection severity score, oxygen requirement, use of corticosteroids, history of various co-morbidities and stages of Rhino-Orbital-Cerebral Mucormycosis (ROCM) (if present) were noted. Bedside ophthalmic examination was done with torch light, fluorescent strip, cobalt blue light of direct ophthalmoscope and fundus examination with indirect ophthalmoscopy under institutional COVID-19 guidelines. Descriptive Statistics {Mean, (SD), Frequency, (%)} were used for analysis of the collected data. Result(s): Out of 649 COVID-19 patients, 368 were male and 281 were female with mean age of 52.58 (+/-15.38) years. All over prevalence of ophthalmic manifestations was 9.86% (n=64 out of 649 patients). A total of 63 patients (9.71%) did not require any oxygen supplement, 352 patients (54.24%) required nasal prongs, 201 patients (30.97%) required non invasive ventilator support and 33 patients (5.08%) required mechanical ventilation. The 378 patients (58.24%) received cortico-steroids in oral or intravenous form. A total of 325 patients (50.1%) had diabetes,267 patients (41.1%) had hypertension, 29 patients (4.5%) had chronic kidney disease and 15 patients (2.3%) had thyroid disease. A total of 52 patients (8.01%) had conjunctivitis. Mean age of patients with conjunctivitis was 50.04 (+/-15.28) with male preponderance (n=30, 57.7%). Most common systemic presentation was fever (n=29,55.8%). Patients with conjunctivitis had high D-dimer (>500 ng/mL) (n=42;80.8%) and C-Reactive Protein (CRP) values (>3 mg/L) (n=39;75%). A total of 144 patients (22.2%) were vaccinated with COVID-19 vaccine first dose while ten patients (19.23%) out of 52 patients having conjunctivitis were vaccinated. Out of 649 patients, prevalence of ROCM was 1.85% (n=12) with mean age 58.58 years (+/-9.71 years) and male preponderance (n=8, 66.66%). Nine out of twelve patients had high blood sugar levels (mean level 340 mg/ dL) at the time of admission. Out of twelve, eight patients had received corticosteroids for management of COVID-19 infection. Six patients of ROCM (50%) did not require any oxygen support while two patient (16.7%) required nasal prongs for mean 7.50 days and four patient (33.3%) required non invasive ventilator support for mean 7.33 days (+/-2.5 days). One patient had stage 2C disease, one had stage 3B, five patients had stage 3C while five patients had stage 4C disease. Conclusion(s): Ocular manifestations of COVID-19 range from conjunctivitis to ROCM. Conjunctivitis has mild and self-limited course while ROCM is sight threatening and life-threatening condition, if not treated appropriately.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
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Background: Coronavirus disease 2019 (COVID-19) is currently spreading fast around the world. The rate of acute kidney damage (AKI) in patients hospitalized with Covid-19, as well as the outcomes related with it, are unknown. The goal of this study was to see if having acute kidney damage (AKI) increased the risk of severe infection and death in COVID-19 patients. It also described the symptoms, risk factors, and outcomes of AKI in Covid-19 patients. Material(s) and Method(s): We undertook a retrospective cohort from June 2020 and March 2021 to examine the connection between AKI and patient outcomes COVID-19. Result(s): The most common comorbid condition was hypertension and diabetes followed by chronic kidney disease and ischemic heart disease. Most of the patients who required low dose oxygen with nasal prongs, face masks, or rebreathing masks were in control groups (76.2% vs. 50.6%;p <.001). More patients in AKI group needed non-invasive ventilation and invasive mechanical ventilation compared to control group (33.8% vs. 19.9%;p .001, 15.6% vs. 3.9%;p <.001 respectively. Patients in the AKI group had higher levels of C-reactive protein, lactate dehydrogenase, D-dimer, and serum. Of 145 patients who developed AKI, 29 (20%) needed hemodialysis. Of 29 patients who needed hemodialysis, 18 (62%) expired. A higher number of patients in the control group were discharged than patients in the AKI group (82.1% vs. 56.9%;p <.001). One hundred five patients were expired, with higher mortality in the AKI group (41.7% vs. 12.4%;p <.001). Conclusion(s): COVID-19 patients admitted to the hospital, AKI is associated with a shockingly high fatality rate.Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Background: Covid-19 infection appeared as rapidly spreading cases of acute respiratory disease in Wuhan city of China that became pandemic. It was brought to the notice of WHO on December 31, 2019. Diabetes mellitus is one of the biggest health problems and fast growing emergencies of the 21st century. Diabetic patients with who got infected with Covid-19 have more chance of in hospital treatment need, intensive care unit care requirement, intubation and death. Objective(s): The objective of this study was to know the severity and mortality of covid-19 in patients with diabetes mellitus. Study Design: This was a descriptive case series study. Study Setting: It was done in the Covid-19 isolation and ICU unit of Ayub Teaching Hospital Abbottabad from May 2020 to October 2021. Method(s): Using non-probability consecutive sampling, 189 diabetic patients were enrolled. Sample included all covid-19 patients having diabetes that received indoor treatment during this period. All patients from both genders with age > 18 years were included. Patients with malignancy or on immunosuppressants for more than 1 month were excluded. Patients who were maintaining oxygen saturation at room air/facemask/nasal prongs were labelled as having non-severe disease while patient who needed CPAP or assisted ventilation were labelled as having severe covid-19 disease. All patients who died during admission were documented as covid-19 related mortality. Patients were labelled as diabetic who were known diabetic and taking diabetes treatment. Data was collected on a structured pro forma. Statistical program SPSS version 16.0 was used for the analysis of data. Result(s): In this study, mean age was 61.29 +/- 11.73 years. There were 40.2% male and 59.8% female patients. 86.2% patients were not-vaccinated, 3.7% patients were partially vaccinated and 10.1% patients were fully vaccinated. Hypertension was most common comorbidity (42.3%) and only CKD was significantly associated with increased mortality. 43.92%patients had non-severe illness while 56.08% patients had severe illness. The overall mortality of illness was 48.15% while it was 84.9% in patients with severe illness. Practical implication: These published publications provide a variety of various estimations and impact amounts due to the numerous different study designs and demographics. A comprehensive and methodical study is required because of the unpredictability of the situation. So that we conducted this study to assess the severity and mortality of covid-19 in patients with diabetes mellitus Conclusion(s): Our study concluded that severity and mortality of covid-19 was high in diabetic patients with high fasting & random sugar levels, pack smoking years and low oxygen saturation. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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SESSION TITLE: Respiratory Care: Oxygen, Rehabilitation, and Inhalers SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: INTRODUCTION: Oxygen is life saving if administered properly. Low and middle income countries recently faced a acute oxygen shortage during covid surge. We aim to study the oxygen requirement and its administration in patients with acute respiratory failure requiring oxygen therapy. AIMS AND OBJECTIVES: 1. To study the oxygen requirement and its utilization in patients with acute respiratory failure 2. To study the effectiveness of oxygen saving protocols and its impact on healthcare delivery METHODS: Sample size: 50 patients with acute respiratory failure INCLUSION CRITERIA: 1. Patients aged 20 years and above 2. Patients with acute respiratory failure 3. Patients requiring oxygen EXCLUSION CRITERIA: 1.Patients unable to consent 2.Patients requiring NIV 3.Patients with poisoning METHODOLOGY: We developed a protocol according to which ROX index of each patient was calculated and suitable interface like nasal prongs, face mask, NRB mask etc were used. Oxygenation was delivered with the target oxygen saturation of 92% and above. Also the oxygen delivery system was checked for potential leakage. RESULTS: 1. 80% of the oxygen delivery lines had a minute leakage and were a source of oxygen wastage 2. 92% patients just removed the oxygen mask for drinking water, eating, etc without turning off the valve 3. Night nursing staff was a bit careless and never cared to check for oxygen leakage from mask in night shifts. It accounted for approximately 24% of total leakage per patient 4. 56% of patients were not aware of proper usage of nasal prongs 5. Unavailability of liquid oxygen storage facilities in hospitals was a cause of delayed supply of oxygen during the crises CONCLUSIONS: Liquid medical oxygen is a life saving in patients of acute respiratory failure. However proper supply, storage facilities and usage protocols have to be followed rigorously to avoid acute shortages. CLINICAL IMPLICATIONS: Oxygen if used properly is a live saving measure in patients of respiratory failure. DISCLOSURES: No relevant relationships by Sarang Patil
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Introduction: Severe acute respiratory syndrome by coronavirus 2 (SARS-CoV-2) pandemic first time started from Wuhan in China in December 2019, the World Health Organization on February 11, 2020, officially named this infection, coronavirus disease 2019 (COVID-19) and the virus as SARS-CoV-2. Clinical assessment is indispensable, but laboratory markers, or biomarkers, can provide additional, objective information which can significantly impact many components of patient care. There are several studies and meta-analyses that showed the relation between potential biomarkers to outcomes like mortality, need for ICU admission, mechanical ventilation, and duration of hospital stay. However, the temporal variation of biomarkers along the course of the illness is important to ascertain disease progression and therapeutic response. Objective of study: 1. Trends of blood biomarkers in critically ill patients require prolonged hospitalization. 2. Relation between temporal variation in blood biomarker and course of illness. Materials and methods: This was a retrospective hospitalbased observational study, conducted between 1st May and 30 June, 2021, we included all adult patients aged >18 years with RTPCR or antigen positive COVID-19 infections, admitted in intensive care unit for at least 30 days, and discharged from the hospital. All patients admitted to our institute are investigated and treated as per the COVID treatment protocol of our institute. Blood biomarkers such as C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), and D-dimer level tested at various intervals during hospitalisation details were noted along with clinical severity. To look for a trend, we took four levels of blood biomarkers at an interval of 10 days and compared then mean value (Day 1-5, Day 10-15, Day 20-25, and Day 30-35). Clinical severity is measured on basis of type of respiratory support like mechanical ventilation, non-invasive ventilation, oxygen through a non-reservoir mask or simple face mask or nasal prong. Results: Total nine patients (six males and three females) were discharged from Intensive care after >30 days of hospitalisation. Among CRP, LDH, ferritin, and D-dimer, only LDH fall and below the baseline level at the time of discharge (Table 1). Other markers have a wide fluctuation in their level and found either similar or higher levels at discharge compared to baseline level. D-dimer found to be increased during the course of illness and raised from the baseline level of 2.1-7.7 at the time of discharge. Wide fluctuation in their level found for CRP followed by LDH and lowest for ferritin during hospitalisation. CRP and ferritin initially fall around day 10 of ICU while LDH increased during the same period (Fig. 1). Out of nine patients, seven patients were on NIV support, one patient on HFNC, and one patient on a simple face mask. Even after 30 days of hospitalisation, one patient was on NRM support, five patients require oxygen through a face mask, and one patient was through nasal prong (Table 1). Conclusion: There is no association between temporal variation in blood biomarkers with the clinical course of COVID-19 disease. Among CRP, LDH, ferritin, and D-dimer, LDH is most closely associated with the clinical course of the disease.
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Rationale: New effective treatments are urgently needed for patients hospitalized with COVID-19, due to lower respiratory tract illness caused by the SARS-CoV-2 virus. SARS-CoV-2 suppresses production of interferon-beta (IFN-β), a naturally occurring protein and key driver of innate antiviral immunity, to evade host immune responses. Patients with severe disease have reduced ability to generate a primary interferon response in the lungs because of genetic, comorbid and/or autoantibody host responses. In vitro, IFN-β has potent antiviral activity against SARS-CoV-2, including known variants of concern. SNG001 is an IFN-β-1a nebulizer solution administered directly into the lungs to boost IFN-β levels at the site of infection. In trials of patients with chronic respiratory diseases and viral infections, SNG001 was well tolerated and improved lung function, providing the rationale to treat patients with COVID-19, at risk of progressing to severe disease. In a phase 2 trial, non-ventilated hospitalized patients with COVID-19 receiving SNG001 were more than twice as likely to recover to “no limitation of activities” and experienced significantly reduced breathlessness over the treatment period versus those receiving placebo. These encouraging results with inhaled IFN-β supported progression of SNG001 into a phase 3 trial in patients hospitalized due to COVID-19 (SPRINTER). Methods: Adults (≥18 years) hospitalized with COVID-19, requiring supplemental oxygen via nasal prongs or mask were randomized to receive SNG001 or placebo (1:1) by inhalation once daily for 14 days, in addition to standard-of-care treatment. Efficacy was assessed in the intention-to-treat population by change in clinical condition using the WHO 9-point Ordinal Scale for Clinical Improvement (OSCI;Table). Primary endpoints: time to hospital discharge (OSCI ≤2) and time to recovery to “no limitation of activities” (OSCI ≤1). Key secondary endpoints: progression to severe disease or death (OSCI ≥5), progression to intubation or death (OSCI ≥6), and death. Cox proportional hazards modeling was used to evaluate primary endpoints. Key secondary endpoints were analyzed using logistic regression. Results: Between January and November 2021, 623 patients were randomized to treatment. Preliminary, blinded data show that median duration of symptoms was 9 days;22% (135/623) of patients were partially/fully vaccinated;median duration of hospital stay was 7 days;84% (525/623) of patients were discharged by Day 35;13% (80/623) progressed to severe disease or died within 35 days;and 5% (31/623) died within 35 days. Conclusions: Recruitment into the SPRINTER trial was completed in November 2021. Unblinded efficacy and safety results (expected Q1 2022) will be presented. (Table Presented).
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Background: COVID-19 is an emerging infectious disease, caused by a novel coronavirus, named SARS-CoV-2. It emerged in Wuhan city, Hubei province, China in December 2019. Convalescent plasma (CP) has been used in a number of emerging infections for which there are no proven antivirals, including SARS, MERS, and Ebola virus disease (EVD). It may also be a potentially effective treatment strategy for COVID-19 disease before COVID-19 vaccinations was introduced. In this case report, we described a case of a 59 years old lady with no known medical illness or no known drug allergies and she was diagnosed with Covid-19 with Class 4A (requiring nasal prong) on 8/10/2020, her oxygen saturation was 96% under nasal prong. During her initial admission, she was given favipravir and interferon as alternative treatment for Covid-19. Unfortunately, at 3rd day of illness, her oxygen level deteriorated to 94% under nasal prong (72% from arterial blood gas) thus, she was transferred to intensive care unit for non-invasive ventilation support. The next day, she was intubated as her condition worsen. On 5th day of illness, she was transfused with convalescent plasma and subsequently extubated as she improved clinically. Aims: To evaluate the effectiveness of convalescent plasma in treating a case of category 5 Covid-19 patient at Hospital Tuanku Ja'afar. Methods: The data regarding the patient's clinical information was retrospectively collected from the patient case notes and the laboratory information system. Results: Other than clinically improved, we noted the CT value from tracheal aspirate PCR prior to the transfusion was 24.60 while the CT value 48 h post transfusion showed 31.62. This showed that the patient had clinical improvement post convalescent plasma transfusion. Summary/Conclusions: Convalescent plasma should be considered in treatment of Covid-19.
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The outbreak of the SARS CoV2 ’Coronavirus pandemic’ is believed to have originated in Wuhan in 2019 as a zoonotic spread from bats to humans. It is a highly communicable infection-causing rapid human to human transmission of the virus by virtue of its infectious and pleomorphic nature. The virus has affected millions of people worldwide, with numbers still rising with each passing day. Depleting oxygen saturation levels is amongst the prime concerns in the majority of infected patients. Nasal prongs, face masks, mechanical ventilation and extracorporeal membrane (ECMO) are the commonly used modes of oxygen delivery in such patients. These methods though mostly successful, at times fail to restore the depleting oxygen levels to normal. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% O2 in a special chamber whose pressure is maintained at a level greater than 1 ATP. The main purpose for raising the pressure within the chamber is that as the atmospheric pressure increases, the saturation levels of oxygen in the blood also increase, which eventually result in increased overall tissue oxygenation. This article provides a systematic and wholesome review on the basic principle of hyperbaric oxygen therapy, its effects on the body at a microscopic and macroscopic level, its various uses and its suitability as an adjuvant for the treatment of select COVID-19 infected patients.