Introduction: Coronavirus Disease-19 (COVID-19) pandemic is posing a challenge not only with sheer number of people infected but also with the large number of patients with persistent symptoms of COVID-19 infection. A proper understanding of the magnitude and associated factors of persistent COVID-19 symptoms will go a long way in planning treatment and control strategies. Aim: To determine the proportion of patients who have persistent symptoms post acute COVID-19 infection and to determine the factors associated with it, among those who have been discharged from Government Medical College, Thrissur, Kerala, India. Materials and Methods: The current cross-sectional study was conducted among 335 patients who were admitted and discharged with COVID-19 infection in Government Medical College, Thrissur, Kerala, a tertiary care institution in southern India between December 2020 and February 2021. They were contacted through a telephonic interview 28 days from symptom onset through a semi-structured interview schedule. The questions included basic demographic details, symptomatology at admission, persistent symptoms at 28 days after onset and other clinical details including comorbidities. For defining post COVID-19 symptom persistence National Institute for Health and Care (NICE) guidelines were used. Association between persistent symptoms and selected factors was done by Chi-square test. Results: Out of the 335 patients, the persistence of symptoms of COVID-19 infection after 28 days of symptom onset was 221 (66%) (CI 60.7-79.8). Persistence of two or more COVID-19 symptoms after 28 days of onset was seen in 120 (35.8%). The most common persistent symptoms among the patients were fatigue in 109 (32.5%) of people followed by dyspnoea in 77 (23%), cough in 45 (13.4%) and myalgia in 37 (11%) patients. Highest persistence was seen in Category C patients where symptoms were persisting in 75%. Persistence was also higher in those with Diabetes Mellitus (DM), those who received oxygen support and those who were in Intensive Care Unit (ICU) or on ventilator and the association was statistically significant (p-value <0.05). Conclusion: The study shows that two-third of patients still continues to have persistent symptoms even after 28 days of symptom onset. Health systems should be prepared to face the consequences of morbidities caused by post COVID-19 syndrome.
A 42-year-old male developed hemorrhagic bullae and erosions while in alcohol induced coma. The lesions were limited to areas of the body in prolonged contact with the ground in the comatose state. He developed rhabdomyolysis, progressing to acute renal failure (ARF). Histopathological examination of the skin showed spongiosis, intraepidermal vesicles, and necrosis of eccrine sweat glands with denudation of secretory epithelial lining cells. With supportive treatment and hemodialysis, the patient recovered in 3 weeks time. This is the first reported case of bullous lesions and sweat gland necrosis occurring in alcohol-induced coma complicated by rhabdomyolysis and ARF.
Introduction: Coronavirus Disease 2019 (COVID-19) is rapidly spreading in India and all over the world. Being at the frontline in the battle against COVID-19, Health Care Workers (HCWs) are among the greatest groups at risk of COVID-19 infection. Therefore, it is very important to study the risk and sources of infection and clinical outcome of HCWs. Aim: To study the clinico-epidemiological profile and outcome of COVID-19 positive HCWs in Government Medical College Thrissur, Kerala, India. Materials and Methods: This was a hospital based cross-sectional study conducted during the time period from February 2020 to December 2020. A semi-structured telephonic interview schedule and hospital based records were used to collect the demographic, epidemiological and clinical information of 235 COVID-19 positive HCWs. Proportions along with 95% Confidence Interval was used to express the results. Results: Among 235 COVID-19 positive HCWs, 51% were either nurses or auxiliary nursing staff. Non-COVID-19 areas had 31.9% infections, while 17.1% of infections occured in COVID-19 areas. Around 57% acquired infection from health care settings. Common symptoms were fever (67.2%), myalgia (40.4%) and headache (39.6%). Around 21.3% subjects remained asymptomatic. Hand hygiene compliance was 96.6%. Among positive HCWs, 57% used N95 mask, 52.8% used gloves, 49.8% used apron and 48.9% used face shield in the hospital. Only 0.85% required Intensive Care Unit (ICU) admission. No mortality was reported in the present study. Conclusion: There is a considerable risk for COVID-19 infection among HCWs in hospital settings especially from non-COVID-19 areas. Present study findings show the risk of exposure and need of infection control measures even outside the health care settings. Early identification and isolation of cases is very important. This study will be useful for policy makers in planning control strategies and preventing COVID-19 infections among HCWs.
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