Outcome of COVID-19 infection and the impact of COVID-19 vaccination in chronic kidney disease patients: A single-center study.

Introduction: Chronic kidney disease (CKD) patients have increased vulnerability to infections including Covid-19. There is limited availability of antiviral in CKD patients. All guidelines have prioritized vaccinations for CKD patients. The variability in immunogenic response is multifactorial in CKD group. We have tried to analyze the outcome of Covid-19 infection and the impact of COVID-19 vaccination [COVAXIN / COVISHIELD] in our cohort. Materials Methods and Statistical Analysis: In a retrospective observational study, 73 cases of Covid-19 positive CKD patients were selected, who were managed as per MOFHW guidelines. The data of first laboratory values and radiological findings were evaluated. Their treatment outcome and stay during hospitalization were studied. All data were later analyzed using STATA 16.1 software. Results: In this study, 73 cases of CKD with Covid-19 were included. There were 38 patients who were vaccinated with at least one dose of the Covid-19 vaccine, while there were 35 patients who were unvaccinated. Out of 38 patients, 20 were vaccinated with 2 doses of Covid-19 while 18 received only one dose. The unvaccinated group was having more hypoxia and raised inflammatory markers, and had more lung involvement [i.e. higher CT severity value] [p value for CTSS-0.0765]. There was a higher mortality rate observed in the unvaccinated group [i.e-65.71%] than the vaccinated group [39.47%] [p-value 0.0249]. Dialysis was needed in 57.50% of the study population either due to failure of conservative management for renal failure or due to maintenance dialysis. The mean duration of hospitalization was 11.47 days with a mortality rate of 52% which is much higher than the reported average data in CKD patients. Conclusion: Vaccination seems to be very helpful in combating the adverse effect of Covid-19 in CKD patients. It also reduces mortality significantly in Covid-19 infected CKD patients.

Résumé Introduction: Il existe une différence entre les sexes dans les caractéristiques démographiques, cliniques et les résultats des patients atteints d'IRA associée à une chirurgie cardiaque et vasculaire. Méthodes: Cette étude rétrospective a eu un total de 88 participants pour lesquels les données socio-démographiques, cliniques et de laboratoire (électrolytes sériques, numération globulaire complète, analyse d'urine et volume d'urine, taux de créatinine et de filtration glomérulaire) des participants ont été prises avant et après l'opération. jours 1, 7 et 30. Résultats: Au total, 88 participants (66 hommes et 22 femmes) ont été étudiés. Les maladies des valves cardiaques étaient plus fréquentes chez les femmes que chez les hommes. L'âge moyen des participants était de 65,9 ± 6,9 ans, avec des hommes de 65,1 ± 7,6 ans et des femmes de 68,3 ± 8,4 ans, P = 0,02. Avant la chirurgie, une proportion significativement plus élevée de femmes avaient un dysfonctionnement rénal par rapport aux hommes, P = 0,003. La chirurgie valvulaire et le pontage coronarien étaient les chirurgies les plus courantes. La proportion de chirurgies d'urgence et d'admissions de moins de 7 jours était significativement plus élevée chez les femmes que chez les hommes, P = 0,04 et P = 0,02 respectivement. La récupération complète de l'IRA était significativement plus élevée chez les hommes, car la récupération partielle et la mort étaient significativement plus faibles chez eux, P = 0,02. Sur les 35 (39,8%) qui ont été dialysés, 85,7% se sont complètement rétablis, 5,7% sont devenus dépendants de la dialyse tandis que 8,6% sont décédés. Conclusion: Les hommes atteints d'IRA étaient plus jeunes que les femmes. Les chirurgies valvulaires étaient les plus courantes. Le dysfonctionnement rénal de base et l'âge avancé étaient des facteurs de risque d'IRA. Après l'opération, l'IRA était plus fréquente chez les hommes qui étaient plus susceptibles de récupérer une fonction rénale complète. L'optimisation de la préparation des patients pourrait réduire l'incidence de CVS-AKI. Mots-clés: Chirurgie cardiaque et vasculaire associée insuffisance rénale aiguë, dialyse, récupération de la fonction rénale, chirurgie valvulaire.

Burkholderia cepacia infection associated with sickle cell disease: An uncommon entity.

Burkholderia, a multidrug-resistant Gram-negative bacteria, is an uncommon cause of infection mostly in immunocompromised patients with a clinical profile very similar to tuberculosis. The most common conditions associated with this organism are cystic fibrosis and chronic granulomatous diseases. Bacteremia with it occurs in patients who are chronically ill and associated with significant morbidity and mortality. We are reporting here a case of perisplenic intra-abdominal abscess caused by Burkholderia cepacia in a patient with sickle cell disease (SCD).

Post-COVID-19 Assessment of Physical, Psychological, and Socio-Economic Impact on a General Population of Patients From Odisha, India.

AIM:  This prospective cross-sectional study evaluated the physical, psychological, and socioeconomic impacts of post-COVID-19 conditions (PCC) in a generalized population from Odisha, India. MATERIALS AND METHODS:  The study protocol and clinical record form (CRF) were approved by the Institutional Ethics Committee. Those above 18 years and of all genders who had recovered in the last six months, whether hospitalized or not hospitalized after the COVID-19 diagnosis, were included in our study. RESULTS:  A total of 198 persons with a median age of 41 years (18-87 years) were enrolled at the post-Covid clinic. For COVID-19 management, 91 persons (46%) were hospitalized, and the remaining 107 (54%) were non-hospitalized. Five dominant clusters of physical symptoms were present - fatigue (82.8%), cough (54%), breathing difficulty (54%), pain in the body (53%), and sleeplessness (51%). The psychological issues faced were fear (41.6%), worry (40.4%), depression (31.8%), and anger (30.3%). The median monthly income in Indian Rupees (INR) for pre-Covid versus post-Covid was 30,000 versus 25,000, effectively a loss of 16.6% in the family income. Adverse impacts on health and economic conditions were observed in 31.3% and 20.7%, respectively. CONCLUSION: Post-Covid clinics can be a resource-appropriate health system approach for nearly 20% of the pandemic survivors with a low gross domestic product (GDP) per capita.

Supervised hospital based pulmonary rehabilitation outcome in long COVID-experience from a tertiary care hospital.

Introduction: Some patients suffer from various multisystem symptoms even after active process of COVID-19 illness has settled lasting more than four weeks called as long COVID. Pulmonary rehabilitation therapy is the proposed option in those patients. This study aims to study the impact of pulmonary rehabilitation on outcome of long COVID patients through improvement in mMRC dyspnea scale, oxygen saturation, cough score, six-minute walk distance and biomarkers of inflammation. Materials and Methods: A retrospective observational study was carried out from the data of electronic medical records among 71 Long COVID patients. Parameters like Spo2, MMRC scale, cough score, six-minute walking distance along with blood levels of D-dimer, C-reactive protein (CRP), leucocyte count at the time of admission and after three weeks of pulmonary rehabilitation were collected. The outcome among the patients was divided into full recovery and partial recovery group. Statistical analysis was done using SPSS software version 19.0. Result: Among 71 cases in our study 60 (84.50%) where male with mean age was 52.7 ± 13.23 years. Biomarkers like CRP and d-Dimer were elevated in 68 (95.7%) and 48 (67.6%) patients, respectively, at the time of admission. After 3 weeks of pulmonary rehabilitation mean SPO2, cough score, 6MWD showed significant improvement and normalization of biomarkers in recovered group of 61 out of 71 which was statistically significant. Conclusion: Significant improvement of oxygen saturation, mMRC grade, cough score, six-minute walk distance and normalization of biomarkers were marked following pulmonary rehabilitation. Thus, pulmonary rehabilitation therapy should be offered to all long COVID cases.