ABSTRACT
Background and aimsPrevalence of diabetes is a vital factor in COVID-19s clinical prognosis. This study aimed to investigate and compare the efficacy of High-flow Nasal Cannula (HFNC) with/without non-rebreather mask (NRM) use on critical COVID-19 patients with/without diabetes. MethodsFor analysis and comparison, epidemiological, biochemical, and clinical data were collected from 240 HFNC ({+/-}NRM) treated severe and critical COVID-19 patients (diabetic = 136; non-diabetic = 104) admitted into ICUs of five hospitals in Chattogram, Bangladesh. Results59.1% of patients with fever had diabetes (p=0.012). ICU stay was longer for diabetic patients (9.06{+/-}5.70) than non-diabetic patients (7.41{+/-}5.11) (p=0.020). Majority of the hypertensive patients were diabetic (68.3%; p<0.001). Majority of diabetic patients (70.4%; p<0.005) had elevated creatinine levels. Partial pressure of oxygen (mmHg) after HFNC (only) administration was significantly (p=0.031) higher in non-diabetic patients (69.30{+/-}23.56) than in diabetic patients (61.50{+/-}14.49). Diabetic (62.64{+/-}13.05) and non-diabetic patients (59.40{+/-}13.22) had almost similar partial pressure of oxygen (mmHg) from HFNC with NRM. Patients with elevated RBS required NRM with HFNC five times (AOR=5.1, 1.2-20.8) higher than others. Besides age, and hypertension were significantly associated with the HFNC+NRM treated diabetic patients. Factors those affected the HFNC only treated patients were fever and impaired glucose tolerance. ConclusionsThe results of this study imply that oxygen supply with HFNC and NRM may be beneficial for the elderly/hypertensive diabetic patients with COVID-19 associated AHRF; and that increased blood glucose level could be a determinant for the need of HFNC + NRM treatment. HighlightsO_LIElderly diabetic patients required both HFNC and NRM to increase oxygen saturation. C_LIO_LIHypertension may be a factor for diabetic patients with COVID-19 requiring HFNC and NRM together. C_LIO_LI HFNC + NRM-combination therapy might be needed when blood glucose levels rise. C_LI
ABSTRACT
IntroductionPeoples all around the world are waiting for vaccination against COVID -19 infection. In Bangladesh, Astra-Zeneca (AZ) vaccine was provided, but patients had infections of SARS-COV-2 even after vaccination. We focused on observing the severity, oxygen requirement and outcome of the COVID-19 infected patients who took the first dose or completed the immunization regimen. MethodsThis is an observational study done among 174 COVID-19 patients from three COVID-19 dedicated hospitals of Chattogram, Bangladesh, who took AZ vaccines 1st dose or completed the schedule. All patients were Real-Time Reverse Transcription Polymerase Chain Reaction (rRT-PCR) positive for COVID-19. Patients were enrolled after receiving written informed consent. Suspected cases or unwilling patients were excluded from the study. Ethical approval was granted by the CMOSH-ERB. SPSS-20 was used to analyze the information gathered. ResultsAmong 174 vaccinated patients, 55(31.61%) completed the vaccination schedule, and 119(68.39%) took their 1st dose of the COVID-19 vaccine. Gender distributions revealed 67(38.5%) female and 107(61.5%) male got the vaccine, and 55 patients completed the full two doses, and 119 patients took the 1st dose. Most of the patients were 40 years and above. In the completed vaccination group, 33(60.0%) out of 55 in and in the first dose vaccinated group, 75(63.0%) out of 119 had a mild COVID-19, and severe and critical cases were found very minimum. Among the patients who have completed the vaccination, 32(58.2%) needed no oxygen, and who was given the first dose, 78(65%) needed no oxygen. No death occurred who completed the vaccine, and 3(2.5%) patients died who took 1st dose of the vaccine. ConclusionVaccine provided in Bangladesh to the people so far seems safe and effective. Severe and critical COVID-19 is low, and the need for oxygen to admitted patients is less, and the death rate is minimal.
