ABSTRACT
ObjectivesThis study aims to describe the demographic and clinical profile and ascertain the determinants of outcome among hospitalised COVID-19 adult patients enrolled in the National Clinical Registry for COVID-19 (NCRC). MethodsNCRC is an on-going data collection platform operational in 42 hospitals across India. Data of hospitalized COVID-19 patients enrolled in NCRC between 1st September 2020 to 26th October 2021 were examined. ResultsAnalysis of 29,509 hospitalised, adult COVID-19 patients [mean (SD) age: 51.1 (16.2) year; male: 18752 (63.6%)] showed that 15678 (53.1%) had at least one comorbidity. Among 25715 (87.1%) symptomatic patients, fever was the commonest symptom (72.3%) followed by shortness of breath (48.9%) and dry cough (45.5%). In-hospital mortality was 14.5% (n=3957). Adjusted odds of dying were significantly higher in age-group [≥]60 years, males, with diabetes, chronic kidney diseases, chronic liver disease, malignancy, and tuberculosis, presenting with dyspnea and neurological symptoms. WHO ordinal scale 4 or above at admission carried the highest odds of dying [5.6 (95% CI: 4.6, 7.0)]. Patients receiving one [OR: 0.5 (95% CI: 0.4, 0.7)] or two doses of anti-SARS CoV-2 vaccine [OR: 0.4 (95% CI: 0.3, 0.7)] were protected from in-hospital mortality. ConclusionsWHO ordinal scale at admission is the most important independent predictor for in-hospital death in COVID-19 patients. Anti-SARS-CoV2 vaccination provides significant protection against mortality.
ABSTRACT
Cardiovascular diseases account for almost half of all deaths from noncommunicablediseases, and almost 80% of these deaths occur in low- and middle-incomecountries such as India. The PrePAre (Primary pREvention strategies at thecommunity level to Promote treatment Adherence to pREvent cardiovasculardisease) trial was a primary prevention trial of community health workers aimedat improving adherence to prescribed pharmacological and nonpharmacologicaltherapies in cardiovascular diseases. It was conducted at three geographically,culturally and linguistically diverse sites across India, comprising 28 villages and5699 households. Planning and implementing large-scale community-based trialsis filled with numerous challenges that must be tackled, while keeping in mind thelocal community dynamics. Some of the challenges are especially pronouncedwhen the focus of the activities is on promoting health in communities wheretreating disease is considered a priority rather than maintaining health. This reportexamines the challenges that were encountered while performing the differentphases of the trial, along with the solutions and strategies used to tackle thosedifficulties. We must strive to find feasible and cost-effective solutions to thesechallenges and thereby develop targeted strategies for primary prevention ofcardiovascular diseases in resource-constrained rural settings.
