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Background: Patients with cancer are at a higher risk of getting infected with the severe acute respiratory syndrome coronavirus 2 owing to their immunocompromised state. Providing care to these patients amidst the first wave of the coronavirus disease-2019 (COVID-19) pandemic was extremely challenging. Objective(s): This study was aimed at evaluating the clinical profile and disease-related outcomes of pediatric patients with hematological illnesses and cancer. Material(s) and Method(s): This retrospective study was conducted at a tertiary care center in North India during the first wave of the pandemic from March 2020 to December 2020. Children aged up to 18 years, who were treated for a hematological illness or malignancy or underwent hematopoietic stem cell transplantation (HSCT) and tested positive for COVID-19 regardless of symptoms were included in the study. Baseline demographic data related to the age, diagnosis, treatment status, and chemotherapy protocol used were collected. Outcomes including the cure rates, comorbidities, and sequelae were recorded. Result(s): A total of 650 tests for COVID-19 were performed for 181 children;22 patients were found to be COVID-19 positive. The most common diagnosis was acute leukemia (63.6%). None of the patients developed COVID-19 pneumonia. The majority of patients had asymptomatic infection and were managed at home. Among those with a symptomatic infection, the most common symptoms were fever and cough. A total of 3 (13.6%) patients needed oxygen therapy, one developed multisystem inflammatory syndrome of children leading to cardiogenic shock. Three patients required intensive care or respiratory support;all the patients had favorable clinical outcomes. The median time from the onset of COVID-19 to a negative result on the reverse transcription-polymerase chain reaction test was 21.3 days. Cancer treatment was modified in 15 patients (68.2%). Conclusion(s): Our results suggest that children with hemato-oncological illnesses rarely experience severe COVID-19 disease. The impact of the first wave of COVID-19 primarily manifested as disruptions in the logistic planning and administration of essential treatment to these children rather than COVID-19 sequelae.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.
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Background: Maxillofacial fracture is the most common injury in head and neck trauma patients. The Coronavirus disease 2019 (COVID-19) pandemic affects many sectors including restrictions on community mobility. This study aims to determine the profile of patients with maxillofacial fractures during the COVID-19 pandemic. Methods: This descriptive observational study will evaluate the profile of maxillofacial fracture patients who came to the Emergency Department of Head and Neck Surgery Division of Dr. Soetomo General Hospital Surabaya in 2021. Results: Subjects were grouped by gender, age, month of visit and trauma mechanism. The ratio of prevalence between males and females was 5.7:1. The highest age distribution was in the range of 21-30 years (29.8%). Based on the month, the highest number of patients was in January (19.1%). Traffic accidents are the most frequent mechanism of injury by 85.1%. Isolated maxillofacial fractures occur mostly in the mandible by 47.6% and in multiple maxillofacial fractures on the maxillary bone by 76.9%. Associated trauma was found in 78.7% of the subjects, with the highest pattern being intracranial trauma as much as 34.1%. Conclusion: There was a decreasing incidence of maxillofacial fracture cases in 2021. The highest prevalence was in males and most of the patients were in 21-30 years age group. © 2023, Sanglah General Hospital. All rights reserved.
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Background: COVID19 pandemic had affected millions of people worldwide. In contrast with adults, children had milder disease though transmission rate was high. During second wave of COVID 19, more children were affected Aim: To describe and compare the clinical profile of COVID 19 infection in children between the first and second waves. Methods: This was a descriptive cross-sectional study done by retrospective chart analysis. The study population included children from age group 1 month to 12 years admitted with a diagnosis of COVID 19 infection at a tertiary care centre in Kerala. Results: A total of 322 case records were analyzed and 52 were excluded due to incomplete data. Of the 270 records of children, 51(18.9%) were in 1st wave and 219 (81.1%) were in 2nd wave. Among the major clinical symptoms, fever and respiratory complaints were more common. There was significant difference in the mean age of children in 2 waves (2.47 years in 1st wave and 3.70 in second wave, P value 0.023). The proportion of asymptomatic patients were significantly higher during the 1st wave 39 (77%) compared to 2nd wave 98 (45%) with a significant p value of <0.001. Subgroup analysis was done for the presenting symptoms in which gastrointestinal and respiratory symptoms were predominant in the 2nd wave. There was no child mortality during both waves. Conclusion: The study showed significant difference in the presenting symptoms during the 1st and 2nd waves of COVID19 pandemic with higher rate of respiratory and gastrointestinal symptoms during the 2nd wave and more asymptomatic cases during the 1st wave. Since the symptomatology of presentation was evolving, the suspicion of COVID 19 as causative agent for respiratory and gastrointestinal symptoms should remain high. [ FROM AUTHOR] Copyright of Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research) is the property of Journal of Cardiovascular Disease Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Dermatological emergency is defined as any urgent/immediate care. Dermatological conditions compromise about 5-8% of all cases presenting to the emergency department. A grading system can help dermatologist's and allied medical personnel to triage a patient accordingly. Currently no severity grading for dermatological emergencies is available. All patients seen in OPD for dermatological consultations requiring urgent interventions were included. Detailed history and clinical examination were done. Patients were assessed according to the onset, symptoms, distribution, examination, body surface area percentage and mucosal involvement. The severity was graded separately based on comorbidities and systemic involvement. Grade I was no comorbidity or systemic involvement. Grade II was 1 comorbidity or systemic involvement. Grade III was 2 comorbidities or systemic involvement. Grade IV was > 2 comorbidities or multiorgan involvement. Interesting emergency cases observed in Covid period were noted. There were 202 cases, the most common age group was 19-64 (69.8%). Male (49%) and females (51%) had equal preponderance. Most common emergency was acute urticaria with or without angioedema (25.24%). There were 113 (55.94%) inpatients and 89 (44.05%) were outpatients. Acute on chronic onset (34.5%), pain (41.6%), vesicles (30.1%), erosion (23.9%), ulcers (9.7%) and more than 50% body surface area involvement (64.6%) were seen more in admitted cases. Grade I was most common for both comorbidities and systemic involvement. However, grades II, III and IV were higher in admitted cases for both grading systems. The presence of comorbidities and systemic involvement increases the severity of dermatological emergency. Six patients had relapse. Seven patients had methotrexate toxicity. The proposed grading system based on comorbidities and systemic involvement helps to assess the severity of dermatological emergencies.
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Introduction During the coronavirus disease 2019 (COVID-19) pandemic, private hospitals in Mandalay started to manage COVID-19 infections according to national treatment guidelines since February 2021. Variations of clinical characteristics and their outcomes in different surges could be evaluated in the private hospital. This study aimed to assess the clinical profile and outcomes of COVID-19 patients admitted at a private hospital during three surges in Mandalay. Methods This study is a retrospective record review of the case series of COVID-19 patients admitted at City Hospital, Mandalay. The study was conducted from January to December 2022. All of the hospital records of COVID-19 patients admitted during the second wave from February 2020 to 26 May 2021, the third wave from 27 May 2021 to 27 January 2022, and the fourth wave from 28 January to April 2022 were included in the study. Results A total of 1606 admitted cases were included in the study. The mean with standard deviation (SD) of age was 55.7±18.5, and males were 778 (48.4%). The mean duration of hospital stay in days was 10.8±5.94, 10.6±6.11, and 7.3±2.88 in second, third, and fourth waves, respectively. The mean duration of hospital stay was shortened in the fourth wave. Comorbid conditions with hypertension and/or diabetes diseases were mostly observed in three waves of COVID-19 infection. Fever was the most presented symptom in three waves. Cough, sore throat, and rhinorrhea were observed more in the fourth wave compared with previous waves. Complication with pneumonia (71.3%), liver dysfunction (21.0%), acute respiratory distress syndrome (10.0%), thrombocytopenia (6.2%), acute kidney injury (5.5%), bleeding (3.9%), and pulmonary embolism (2.9%) were investigated. Antiviral treatment such as remdesivir or molnupiravir was used more in the patients of third and fourth waves than those of the second wave. Oxygen therapy (59.9%), prone position (35.5%), non-invasive ventilation (9.5%), invasive ventilation (0.5%), inotropes (4.6%), and renal replacement therapy (1.1%) were recorded in serious cases. Only 7.9% and 9.4% died in the hospital in second and third waves. No mortality was observed in the fourth wave. Conclusions The study recommended that COVID-19 patients with comorbid conditions of hypertension or diabetes and ages 65 and older should be taken with intensive care support at the hospital. This study also concluded that a private hospital in Mandalay could tackle with COVID-19 severe cases in line with national treatment guidelines since the second wave and could provide better management in the fourth wave. Antiviral treatment should be used in severe COVID-19 cases for further emergency management. In conclusion, private hospital involvement in the COVID-19 pandemic is supportive of the healthcare provision in Myanmar in an emergency situation.
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Introduction and aims The demographic and clinical profile and dynamics of real-time polymerase chain reaction (RT-PCR) in coronavirus disease 2019 (COVID-19) patients are not well understood. The study aimed to analyze the demographic, clinical, and RT-PCR profiles of COVID-19 patients. Methodology The study was a retrospective, observational study conducted at a COVID-19 care facility, and the study period was from April 2020 to March 2021. Patients with laboratory-confirmed COVID-19 by real-time polymerase chain reaction (RT-PCR) were enrolled in the study. Patients with incomplete details or with only single PCR tests were excluded. Demographic and clinical details and the results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR collected at different time points were retrieved from the records. The statistical software Minitab version 17.1.0 package (Minitab, LLC, State College, PA, USA) and Rstudio version 1.3.959 (Rstudio, Boston, MA, USA) were used for the statistical analysis. Results The mean duration from symptom onset to the last positive RT-PCR was 14.2 ± 4.2 days. The proportions of positive RT-PCR tests were 100%, 40.6%, 7.5%, and 0% at the end of the first, second, third, and fourth weeks of illness. The median duration of days to first negative RT-PCR in the asymptomatic patients was 8 ± 4 days, and 88.2% of asymptomatic patients were RT-PCR-negative within 14 days. A total of 16 symptomatic patients had prolonged positive test results even after three weeks of symptom onset. Older patients were associated with prolonged RT-PCR positivity. Conclusion This study revealed that the average period of RT-PCR positivity from the onset of symptoms is >2 weeks in symptomatic COVID-19 patients. Prolonged observation in the elderly population and repeat RT-PCR before discharge or discontinuation of quarantine is required.
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Background: Urinary tract infection (UTI) is a common complication in pregnancy. The prevalence varies between countries. This research aims at estimating the prevalence, clinico-bacteriological profile, antibiotic resistance, and risk factor analysis of symptomatic UTI in pregnancy. Method: This is a prospective observational study conducted at the Abdullah Bin Omran Hospital, RAK, UAE, from March 2019 to February 2020. All pregnant women attending the antenatal clinic during this period were given a pre-validated questionnaire for the symptoms of UTI. In symptomatic patients, urine was sent for microscopy, culture, and sensitivity. Women were treated for UTI and were followed up for the rest of the pregnancy. Data analysis was performed by SPSS software version 24 using descriptive statistics and comparisons with significance at a p-value of <0.05. Results: The prevalence of symptomatic UTI was 17.9%. E.coli was the commonest isolate followed by Group B streptococcus. The commonest symptom reported was loin pain and the most common risk factor was diabetes. Women with risk factors are significantly more likely to have culture-positive UTIs. Most of the pathogens were sensitive to cefuroxime and benzyl penicillin. Risk of preterm labor was higher. Conclusions: Regular antenatal care and routine urine testing in all visits are recommended for early detection and treatment of UTI.
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BACKGROUND: In sub-Saharan Africa and particularly in Ghana, there is scarcity of published literature specifically on the impact of DM on outcomes in COVID-19 patients. Based on the difference in genetic makeup and demographic patterns in Africans compared to the Western world and with the rising burden of DM and other non-communicable diseases in Ghana there is a need to define the impact DM has on persons with COVID-19. This would ensure adequate risk stratification and surveillance for such patients as well as appropriate scale up of therapeutic management if needed. AIMS: This single-center study describes the clinical and laboratory profile and outcomes of COVID-19 in-patients with type 2 diabetes mellitus (DM) in Ghana. MATERIALS AND METHODS: Retrospective analysis was undertaken of the medical records of adults with COVID-19 hospitalized at a facility in Ghana from March to October 2020. Clinical, laboratory and radiological data and outcomes were analysed. Comparisons between COVID-19 patients with DM and non-diabetics were done with an independent t-test or a Mann-Whitney test when normality was not attained. Odds ratios (95% CI) were calculated using univariate logistic regression. RESULTS: Out of 175 COVID-19 patients, 64 (36.6%) had DM. Overall mean age was 55.9 ± 18.3 years; DM patients were older compared to non-diabetics (61.1 ± 12.8 vs. 53.0 ± 20.2 years, p = .049). Compared to non-diabetics, diabetics were more likely to have higher blood glucose at presentation, have hypertension, be on angiotensin 2 receptor blockers [OR, 95% CI 3.3 (1.6-6.7)] and angiotensin converting enzyme inhibitors [OR, 95% CI 3.1 (1.3-7.4)]; and be HIV negative (p < .05). Although the values were normal, diabetics had a higher platelet count but decreased lymphocytes, aspartate transaminase and alkaline phosphatase compared to non-diabetics (p < .05). There was no difference in clinical symptoms, severity or mortality between the two groups. DISCUSSION: The clinical profile of patients studied are similar to prior studies. However the outcome of this study showed that DM was not associated with worse clinical severity and in-hospital mortality. This could have been due to majority of DM patients in this study having relatively good blood glucose control on admission. Secondly, DM alone may not be a risk factor for mortality. Rather its concurrent existence with multiple co-morbidities (especially cardiovascular co-morbidities which may predispose to pro-inflammatory and pro-thrombotic states) may be driving the rise in severity and mortality risks reported in other studies. Furthermore, this study was conducted among an African population and Africa has been shown to be generally less severely hit by the COVID-19 pandemic compared to other regions outside the continent. This has been postulated to be due, among other factors, to inherent protective mechanisms in Africans due to early and repeated exposure to parasitic and other organisms resulting in a robust innate immunity. CONCLUSIONS: This study suggested that DM was not associated with more severe clinical symptoms or worse outcomes among hospitalized COVID-19 patients. Despite this, it is important that DM patients adhere to their therapy, observe the COVID-19 containment protocols and are prioritized in the administration of the COVID-19 vaccines. STUDY HIGHLIGHTS: In this retrospective, single-centre study on the clinical and laboratory profile and outcome of hospitalized DM patients with COVID-19, patients with DM did not have a more severe clinical profile or worse outcomes. They were, however, significantly older, more likely to have higher admission blood glucose, have hypertension, be on angiotensin 2 receptor blockers and angiotensin converting enzyme inhibitors; and be HIV negative compared to the cohort without DM. DM patients should be a priority group for the COVID-19 vaccines.
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Objective: A novel coronavirus infection (SARS-CoV-2) pneumonia (COVID-19) has been quickly spreading throughout China and the rest of the world since December 2019. Respiratory tract infections are frequently linked to diabetes mellitus (DM), a different risk factor. This study has reported the clinical presentation and therapeutic outcomes of COVID-19 with diabetes. Method(s): From medical records and histories provided by 72 Covid-19-infected patients with diabetes admitted to the KMCH institute of health sciences and research, Coimbatore, data on demographics, clinical, laboratory, and radiological characteristics as well as treatment outcomes were collected using data collection forms. Real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-CoV RNA was used to screen patients with Covid-19. Result(s): 72 diabetes patients who tested positive for Covid-19 were admitted for this study. SPSS software version 26 was used to evaluate the data that had been collected. Clinical profiles and outcomes of patients with and without diabetes underwent descriptive analysis. Controlled diabetics had a mean plasma glucose of 112.22+/-11.41, while uncontrolled diabetics had a mean plasma glucose of 154.2+/-23.22. Fever was the most prevalent symptom in both managed and uncontrolled diabetes patients (94% and 100%), followed by sore throat (84% and 88%). In patients with uncontrolled diabetes compared to those with controlled diabetes, breathlessness is considerably higher (p<0.05). In the CORADS scoring, 11 of the 34 diabetics with uncontrolled blood sugar levels had CORADS 6 (32.35%), compared to just 2 of the 38 diabetics with regulated blood sugar levels (5.26%), which is considerably higher (p<0.01). In uncontrolled diabetics, the length of hospital stay is much longer (p<0.001). Compared to diabetics with controlled blood sugar, uncontrolled patients SPO2 dramatically dropped (p<0.001). Those with uncontrolled diabetes are more likely to be admitted to the ICU than patients with controlled diabetes (p<0.05). In uncontrolled diabetes compared to controlled patients, the severity was considerably higher (p<0.05). One person who had uncontrolled diabetes died, although no one who had controlled diabetes died. Conclusion(s): Covid 19, persons with uncontrolled diabetes appear to be more likely to sustain lung damage, necessitating admission to the ICU, an extended stay in the hospital, and oxygen assistance throughout the duration of the illness. Copyright © 2023 The Authors. Published by Innovare Academic Sciences Pvt Ltd.
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During the coronavirus pandemic 2019 (COVID-19), some studies showed differences in the profile of subjects presenting with acute coronary syndromes as well as in overall mortality due to the delay of presentation and other complications. The purpose of this study was to compare the profile and outcomes, with emphasis on all-cause in-hospital mortality, of ST-elevation myocardial infarction (STEMI) subjects presenting to the emergency department during the pandemic period compared with a control group from the previous year, 2019. The study enrolled 2011 STEMI cases, which were divided into two groups-pre-pandemic (2019-2020) and pandemic period (2020-2022). Hospital admissions for a STEMI diagnosis sharply decreased during the COVID-19 period by 30.26% during the first year and 25.4% in the second year. This trend was paralleled by a significant increase in all-cause in-hospital mortality: 11.5% in the pandemic period versus 8.1% in the previous year. There was a significant association between SARS-CoV-2 positivity and all-cause in-hospital mortality, but no correlation was found between COVID-19 diagnosis and the type of revascularization. However, the profile of subjects presenting with STEMI did not change over time during the pandemic; their demographic and comorbid characteristics remained similar.
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PROBLEM: There are no studies on the association between high blood pressure and COVID-19 in South Kivu. OBJECTIVE: to determine the influence of arterial hypertension on the clinical characteristics and prognosis of COVID-19 patients hospitalized in the city of Bukavu. METHODOLOGY: Between June 2020 and June 2022, an open cohort of hypertensive and non-hypertensive COVID-19 patients admitted to two clinics in the city of Bukavu was formed. The primary endpoint was the occurrence of death. Thus, a prospective modeling of mortality by the Kaplan-Meier estimator was carried out. RESULTS: Among the 178 admissions for COVID-19, 68 (38.2%) patients were hypertensive. Compared to non-hypertensives, hypertensive patients were significantly older [61.0 (56.0-71.0) vs. 48.0 (32.7-64.0); p < 0,0001). During the observation period of 1059 patient-days, the incidence of death (3.2/100 patient-days) was non-significantly higher in hypertensive patients (4.3/100 patient-days) (p = 0.06). On the other hand, the independent predictors of death were Sepsis [adjusted HR = 3.7 (1.5-8.7)], CRP > 100 mg/L [adjusted HR = 3.0 (1.2-7, 0)] and SaO2 < 90 % [adjusted HR = 3.9 (1.3-11.8)]. CONCLUSION: This study shows that hypertension was very common in patients admitted for COVID-19 in the city of Bukavu but did not influence the vital prognosis of the latter, thus confirming the finds of most authors who have addressed the question.
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Background: Three or more waves of COVID 19 pandemic have hit the different parts of world including India very hard, taking toll on the lives of people both in terms of morbidity and mortality. Keeping this in mind, the present study was conducted with an aim to determine the socio-demographic and clinical profile of laboratory confirmed COVID 19 cases and to determine their association with oxygen requirement and outcome of disease at the time of discharge. Methods: The present cross-sectional study was conducted on lab confirmed COVID 19 cases admitted in tertiary care hospital in Jammu from June-July 2021.Data was collected using convenient sampling method. The self-designed questionnaire used for data collection obtained information regarding socio-demographic characteristics of patients as well as clinical features of the disease. Results: Out of total 161 patients studied, 60.8% were males and 39.2% were females. Mean age was 51.2 +/- 17.5 years. Comorbid conditions were present in 37.8% patients, with hypertension being the most common ( 36%). Cough, Fever, breathlessness and myalgia were the main presenting symptoms (90%, 81%, 57.7% and 56% respectively). The variables which were found to have statistically significant association with oxygen requirement and the outcome of disease at the time of discharge were age, gender and presence of co-morbidity (p <0.05). Conclusions: Advancing age, male gender and presence of underlying co-morbidity were found to be significant risk factors for the requirement of oxygen and poor outcome of the disease.
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Background: Although there are fewer COVID-19 cases in Indonesia, the pandemic is still ongoing. COVID-19 has a significant death rate in Indonesia, but lack of information on the effect of different clinical and demographic factors on COVID-19-related grimness and mortality in Indonesia.Objective: This study examined the clinical profile, treatment, and outcomes of patients with COVID-19 at Lahat Regency Hospital in South Sumatera, Indonesia, to find relevant markers that might be utilized to predict the prognosis of these patients.Methods: This was a retrospective single-center study of all medical record files of confirmed patients with COVID-19 admitted to Lahat Hospital from September 2020 to August 2021 (n = 285). Descriptive statistics, Chi-square, Mann-Whitney, Multiple Logistic Regression, and Cox's proportional hazards model were used for data analyses. Results: This study included 65 non-hospitalized and 220 hospitalized patients. Hospitalized patients were divided into dead and alive groups. The median age was lower in the non-hospitalized group without gender discrimination, and most hospitalized patients had comorbidities. Vital signs and clinical features were significantly different in hospitalized patients compared to non-hospitalized. The survival patients in the hospitalized group showed lower white blood cell (WBC), neutrophil percentages, and neutrophil-lymphocyte ratio (NLR) but higher lymphocyte and eosinophil. Non-survival patients had elevated alanine aminotransferase (ALT), blood urea nitrogen (BUN), creatinine, blood glucose, and potassium. The use of Favipiravir and Remdesivir was significant between the alive and dead groups. The mean hospital stay for all patients was 9.49 +/- 4.77 days, while the median duration of hospital time was 10.73 +/- 4.33 days in the survival group and 5.39 +/- 3.78 days in the non-survival group. Multiple logistic regression analysis determined respiration rate, WBC, and BUN as predictors of survival.Conclusions: Age and comorbidities are significant elements impacting the seriousness of COVID-19. Abnormal signs in laboratory markers can be used as early warning and prognostic signs to prevent severity and death. Potential biomarkers at various degrees in patients with COVID-19 may also aid healthcare professionals in providing precision medicine and nursing.
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Objective: The objective of the study was to find out any peculiarities in the epidemiological and clinical profiles of COVID-19 cases, admitted in the hospital;which may be useful in management of health services in future. Method(s): Retrospective analysis of hospital records of COVID-19 cases admitted from March to May 2021 in our COVID hospital. A total of 1332 hospital case records were analyzed. Result(s): Out of 1332 admitted COVID-19 cases, 50% were in age group 40-60 years. About 60% cases were male. Symptoms were fever (88.29%), sore throat (70.64%), breathlessness (58.84%), loss of smell (58.82%), pain in abdomen (53%), loss of taste (35.29%), and diarrhea (29.43%). Most cases had multiple symptoms. About 60% cases came in serious condition. About 65% cases needed intensive care unit admission. About 50% cases expired. Conclusion(s): Only peculiarity noticed in clinical profile was loss of taste and sense of smell in few cases. Preponderance of males in the age group of 40-60 years and high mortality among the admitted cases was only peculiar epidemiological feature. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
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Background: Due to its physiologic immune suppression, pregnancy is a vulnerable time for severe respiratory infections including COVID-19. However, information regarding the effect of COVID-19 during pregnancy is limited. Objectives: To study the clinical profile of patients suffering from coronavirus disease-2019 (COVID-19) during pregnancy and to evaluate the effect of COVID-19 on maternal, perinatal, and neonatal outcomes. Methodology: This is a cross-sectional observational study over a period of one year from June 2020 to May 2021, in Level-3 Covid facility in Ghaziabad. All pregnant females with confirmed positive for Corona virus infection admitted to the covid ward under the department of Obstetrics & Gynecology were included in the study. Results: A total of 233 pregnant women were included in the study. Maximum patients were from age group 21-30 years (53.2), multigravida (62.7%), and presented in the third trimester (80.7%). On admission, 198 patients (85%) had no covid related symptoms and only three patients had severe symptoms requiring ICU care. Total 102 patients delivered (43.77%), out of whom 40 had a normal vaginal delivery and 62 had a cesarean section. The incidence of preterm birth was 22.5% and maternal death was in three patients (1.3%). Conclusion: The common presentation of COVID-19 during pregnancy is either a mild disease or even asymptomatic. The maternal outcomes observed in late pregnancy and fetal and neonatal outcomes appear good in most cases. Further studies are required to know long-term outcomes and potential intrauterine vertical transmission. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow.
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Background and Objectives: Multisystem inflammatory syndrome (MIS-C) is a SARS-COV-2 infection-associated dreaded clinical sequelae in pediatric patients. Its epidemiology is complex and differs from severe acute COVID-19 infection in children. The present case-series report describes the various clinical features, laboratory markers, and interventions among 222 pediatric patients from one of the states in India with the highest prevalence of COVID-19 infection. Methods: An observational study was conducted at one of the tertiary healthcare institutes in the western region of Maharashtra state of India. Twenty-two children were hospitalized with diagnosed MIS-C, aged from 2 months to 18 years, from January to June 2021. Demographic and clinical characteristics and diagnostic and treatment parameters were collected from each subject. Statistical Package for Social Sciences version 21 software was used as a data analysis tool. Results: Clinical assessment revealed high-grade fever, non-purulent conjunctivitis, and abdominal complaints, which were the leading presentations of MIS-C. In inflammatory markers, serum IL-6 levels and D-dimer levels took a longer duration for normalization in the severe MIS-C group. Almost half of the mild-moderate MIS-C patients were managed with only systemic corticosteroids. All remaining patients recovered with the dual therapy of intravenous immunoglobulins (2 g/kg) and systemic corticosteroids with an improved clinical and biological response. Conclusions: The present clinical case-series report concluded that almost all MIS-C cases have a favorable prognosis with dual therapy of corticosteroids and immunoglobulins. With the principle of early diagnosis and prompt treatment, it is possible to manage patients without any critical support. However, long-term follow-up studies of these cases are warranted to validate the clinical approach. © 2022 Medical Journal of Dr. D.Y. Patil Vidyapeeth ;Published by Wolters Kluwer - Medknow.
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Background: COVID-19 is a pandemic spread all over the world. This disease has imposed a huge burden on health resources. Evaluation of clinical profiles of such patients can help in understanding and managing the pandemic more efficiently. Method(s): This was a cross sectional observational study of 100 diagnosed COVID-19 patients admitted to JIIU's, IIMSR, from April to June 2021. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab rt-PCR based testing. Result(s): The mean age of the population was 45 years with a male predominance (72% patients). All the patients (100 %) were symptomatic, with fever being the most common symptom (85%), followed by cough (62%). Conclusion(s): Severity based approach to COVID -19 infections, with defined criteria and treatment guidelines will help in judicious utilization of health-care resources. Copyright © 2022 Ubiquity Press. All rights reserved.
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Background Since the onset of the Covid-19 pandemic, several studies have been conducted around the world in an attempt to understand this heterogeneous and unpredictable disease and to prevent related death. It was therefore necessary to study the associated risk factors of Covid-19-related mortality. Objectives The aim of this study was to describe the clinical profile and to identify the factors associated with mortality of patients with Covid-19 in Morocco. Methods We performed a mixed cohort study (retrospective and prospective) of 615 in-patients with Covid-19 disease, enrolled between August 2020 and October 2021. We followed the cohort throughout the hospitalization until discharge and 30 days thereafter. Results The median age was 64 years old; 62.1% of the patients were male. The mean time from symptom onset to hospitalization was 8.5 days (±4.67), and 68.1% of patients had comorbidities. On admission, the most common symptoms were dyspnea (82.2%), cough (80.3%), and fever (76.8%). The main follow-up complication was secondary infection (56.9%). Based on univariate analysis, male gender (p<0.008 and brut relative risk {bRR}=1.57), advanced age (p<0.001), lung involvement (p<0.001), lymphopenia (p<0.001 and bRR=2.32), D-dimers of >500 µg/l (p<0.007 and bRR=2.47), C-reactive protein (CRP) of >130 mg/l (p<0.001 and bRR=2.45), elevated creatinine (p<0.013 and bRR=1.61), lactate dehydrogenase (LDH) of >500 U/l (p<0.001 and bRR=7.16), receiving corticosteroids (p<0.001 and bRR=5.08), invasive ventilation (p<0.001 and bRR=30.10), the stay in the resuscitation unit (p<0.001 and bRR=13.37), and acute respiratory distress syndrome (ARDS) (p<0.001 and bRR=10.98) were associated with a higher risk of death. In the opposite, receiving azithromycin and hydroxychloroquine (p<0.001 and bRR=0.28) and pre-admission anticoagulants (p<0.005 and bRR=0.46) was associated with a lower risk of mortality. Multivariate regression analysis showed that age of >60 years (p<0.001 and adjusted odds ratio {aOR}=4.90), the use of invasive ventilation (p<0.001 and aOR=9.60), the stay in the resuscitation unit (p<0.001 and aOR=5.09), and acute respiratory distress syndrome (p<0.001 and aOR=6.49) were independent predictors of Covid-19 mortality. Conclusion In this cohort study focusing on Covid-19 in-patient's mortality, we found that age of >60 years, the use of invasive ventilation, the stay in the resuscitation unit, and acute respiratory distress syndrome were independent predictors of Covid-19 mortality. The results of this study can be used to improve knowledge for better clinical management of Covid-19 in-patients.
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Introduction Despite the availability of a vaccine and extensive vaccination, breakthrough infections are commonly noted, which is jeopardizing the vaccine-based protection against COVID-19. The present study aims to evaluate COVID-19 breakthrough infections and to compare the clinical profile and outcomes of the vaccinated and unvaccinated populations. Methods A retrospective observational study was conducted for two months (March-April 2021), and all cases reported during the study period were included in the study. Socio-demographic details, COVID-19 profiles, clinical outcomes, vaccination statuses, and types of vaccine were collected from the patients. Further, COVID-19-positive samples were screened for lineages using next-generation sequencing (NGS). Results Of the total 103 patients included in the study, 79 (76.7%) were symptomatic and 24 (23.3%) were asymptomatic. Only 32% were vaccinated and 68% were unvaccinated. 29.2% were hospitalized due to COVID-19 and all of them were unvaccinated. The mortality among hospitalized patients was extremely high (60%). The time to positivity after complete vaccination was noted to be 37.09±23.74 days. The unvaccinated study participants showed lower Cycle threshold (Ct) values (E Gene/N Gene: 17.38±4.53) as compared to the vaccinated people (E Gene/N Gene: 22±4.25). The Delta (B. 1.1. 629) (76.7%) was the predominant variant among the study population followed by AY.4 (20.4%) and Kappa (2.9%) variants. Conclusion Although the vaccination does not restrict/avoid infection, it appears to protect the vaccinated people from severe forms of COVID-19. Also, the higher Ct values among vaccinated people indicate that the viral load among such people may be lower and, therefore, minimizes viral transmission.
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Introduction The coronavirus disease (COVID-19) pandemic has incurred high costs for the entire planet. The complex interactions between the host, virus, and environment have resulted in various clinical outcomes. It is crucial to comprehend sickness severity and outcome predictors to provide early preventative measures for a better outcome. The current study aimed to determine the association of clinical and inflammatory profiles with the outcome of COVID-19 infection in patients admitted to the intensive care unit. Methods This retrospective study was done in patients admitted to intensive care units for COVID-19 with a positive reverse transcriptase polymerase chain reaction (RTPCR) assay. A total of 125 patients above 18 years were included in the study. The patient's age, gender, and co-morbidities like type 2 diabetes mellitus, hypertension, respiratory illness, and coronary artery disease were noted. The patient's symptomatology, vital signs, oxygen saturation (Spo2), need for inotropes, and non-invasive positive pressure ventilator support (NIPPV) were observed. Computed tomography severity score (CTSS) and hematological and inflammatory parameters at the time of admission were noticed. Patient's management and treatment outcomes as survivors and non-survivors were noted. Results The mean age was significantly greater in non-survivors. The common symptoms were fever, respiratory distress, cough, muscle pain, and sore throat. The leucocyte count, C-reactive protein (CRP), urea, creatinine, interleukin-6 (IL-6), and lactate dehydrogenase (LDH) were greater, and platelet counts were lower significantly in the non-survivors group. On multivariable logistic regression, CT severity score, NIPPV, and IL-6 had an odds ratio of 1.17, 0.052, and 1.03, respectively. IL-6 had a sensitivity of 81.5% and a specificity of 81.8% with a cut-off value of 37.5. Conclusion Vigilant monitoring of leucocyte count, CRP, urea, creatinine, IL-6, LDH, platelet count, and CT severity score is essential for managing COVID-19 infection. IL-6 was found to be a significant marker as a predictor of outcome in our study.