Background: In December 2019, a series of unknown origin cases of acute respiratory illness occurred in Wuhan, Hubei Province, China. Although diffuse alveolar damage and acute respiratory failure were the main features of COVID-19, the involvement of other organs needed to be explored. After lung infection, the virus may enter the blood, accumulate in the kidney, and cause damage to resident renal cells. Hence, this study was planned to analyze the potential impact of this pandemic of COVID-19 amongst the chronic kidney disease (CKD) patients.Methods: Cross-sectional observational study was conducted at Seven Hills Dedicated Covid-19 hospital, Andheri, Mumbai. Data was collected from hospital records of CKD patients admitted in the study duration.Results: This study was conducted on 310 patients. Mean age was 53.33+14.21 years, and 191 (61.6%) of patients were male while mean duration of hospitalization was 16.78+10.31. Majority of the patients presented with symptoms like fever 80%, breathlessness 61.3%, and co-morbidities like Diabetes Mellitus 65.5% followed by Hypertension 61.8%. Patients (15.5%) over age of 60 years tested swab report positive for more than 5 times. Recovery rate being 76.1% while mortality rate found to be 23.87%.Conclusions: Early detection and effective intervention may help to reduce deaths among CKD patients with COVID-19.
Context: Coronavirus Disease 2019 (COVID-19) was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020. COVID-19 disproportionately affects patients with pre-existing comorbidities including those undergoing dialysis at intermittent intervals. These patients requiring renal replacement therapy like intermittent hemodialysis have a preponderance to go into severe clinical states. Hence, this study was planned to analyze the outcomes of such patients requiring dialysis and suffering from the COVID-19 disease. Objectives: This study was carried out to compare the outcomes of the COVID-19 patients requiring hemodialysis with those not requiring hemodialysis. Materials and Methods: This cross-sectional observational study was carried out between April 2020 and August 2020 at a dedicated COVID-19 hospital and included COVID-19 patients requiring hemodialysis at the time of admission and an equal number of controls matched for age and sex. Results: The study included 271 COVID-19-positive patients requiring dialysis and 271 COVID-19-positive controls without the requirement of a dialysis matched for age and sex; 10.3% cases needed intensive care. There were 18.8% deaths in cases as opposed to 8.9% among controls. Multivariate analysis showed that advancing age (OR 2.6 in cases and 1.06 in controls) need for intensive care (OR 27.9 in cases and 331 in controls), and diabetes alone and with other comorbidities were significant predictors of mortality. Conclusions: This study showed that the mortality proportions were more in cases as compared to controls; and advancing age, diabetes, and need for intensive care unit (ICU) were significant predictors. The study also highlighted the crisis faced by patients who require dialysis at regular intervals due to this COVID-19 pandemic.
Introduction: The casirivimab and imdevimab antibody cocktail has proven to be extremely effective against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant. Currently, no data on the clinical outcomes of antibody cocktail with the newer omicron form is available. This retrospective study evaluated the effectiveness of casirivimab and imdevimab antibody cocktail in patients infected with SARS-CoV-2 delta and omicron variants. Methodology: Data of 85 patients of age < 60 years, with comorbid conditions and BMI > 25 kg/m2 were identified from a database of 871 patients. Results: Most of the patients in both delta and omicron groups were administered 600 mg casirivimab + 600 mg imdevimab intravenously. SARS-CoV-2 symptoms started resolving from the 3rd day and by the end of the 14th day most patients in both groups did not report any symptoms. There was no significant difference between delta and omicron group with respect to average symptom onset days, number of hospitalized days post cocktail and number of days post cocktail administration to reverse transcription polymerase chain reaction (RT-PCR) negative status. Forty (58%) patients in the delta group and 16 (94%) patients in the omicron group had the high-resolution computed tomography (HRCT) score of zero. No patient required oxygen support during hospitalization and no mortality was reported. Conclusions: There was no difference in effectiveness and safety of casirivimab and imdevimab antibody cocktail in the patients infected with SARS-CoV-2 delta or omicron.
Background: A novel corona virus causing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection become a public health emergency of international concern. The infection has increased and caused pandemic. Underlying co-morbidities may worsen the clinical outcome. So, more attention is to be given to COVID patients with co-morbidities. Few studies have been conducted on the prevalence of predominant chronic diseases with COVID-19. Taking into consideration the above factors, a study has been undertaken to assess the prevalence of co-morbidities in a COVID dedicated hospital.Methods: A centre based retrospective study was carried out at a COVID dedicated hospital, Mumbai. All admitted patients of COVID 19 in a COVID dedicated hospital, Mumbai were selected in 4 and half months (19th March 2020 to 31st July 2020) by universal sampling technique. Patients above 20 years were included in the study and patients below 20 years were excluded from the study. Ethics Committee approval taken from an institutional ethics committee.Results: All 6072 patients who were above 20 years were included in the study. Mean age was 48 years and 67.7% were male. The prevalence of various co-morbidities was 25% for hypertension, 22.3% for diabetes mellitus, 5.2% for chronic kidney disease, 1.7% for chronic obstructive pulmonary disease, 0.9% for cerebrovascular disease and 0.3% for one or the other malignancy.Conclusions: It has been concluded that various co-morbidities are present in patients with COVID-19 which may worsen the clinical outcome. So, more attention is to be given to COVID patients with co-morbidities.
Background: The onset of monsoons in Mumbai poses an additional health disease burden in the form of rising vector-borne and water-borne diseases such as dengue, malaria, leptospirosis, hepatitis, typhoid, chikungunya, and acute gastroenteritis. These monsoon-related illnesses are preventable with hygienic and sanitation measures that are likely to have been adopted during COVID-19 pandemic. Aim: To assess the impact of COVID-19 pandemic on the occurrence of monsoon-related diseases in the city of Mumbai and find out determinants of variations if any. Material and Methods: This was a retrospective descriptive study. Universal sampling was done using secondary data collected from the Epidemiological Cell of Municipal Corporation of Greater Mumbai (MCGM). Data mining was performed to obtain the trends of the monsoon-related diseases in Mumbai. Results: COVID-19 pandemic has remarkably affected the city of Mumbai with approximately 3 lakh cases till December 2020. MCGM has taken a lot of efforts resulting in a recovery rate of close to 95% with less than 3% mortality. With the effective use of social behavior change communication, which focused on masks, frequent hand washing, and social distancing, there seems to be a decline in monsoon-related illnesses in the year 2020 as compared to the previous two years of 2018 and 2019. Conclusion: Monsoon-related illnesses are impacted by behavior and lifestyle modifications like hygiene and environmental sanitation practiced during the COVID-19 pandemic. This study highlights the importance of these universal hygienic practices and their utility in the long-term reduction of monsoon-related illnesses.
This case report presents the management of a 69-year-old gentleman with acute coronary syndrome in the setting of an incidentally detected hepatocellular carcinoma with intra-tumoral bleed. Initially, the patient presented with fever, cough, and sudden onset of dyspnea on rest accompanied by angina, after which he was diagnosed with non-ST segment elevated myocardial infarction complicated with congestive cardiac failure. His laboratory and radiological investigations were suggestive of a possible infective etiology which, in an era of COVID-19, was investigated further with a high-resolution CT scan of the chest, which was suggestive of features of pulmonary edema along with an incidental discovery of liver lesions on the abdominal cuts. A further workup with a dedicated triple-phase computed tomography scan abdomen demonstrated features of undiagnosed hepatocellular cancer with intra-tumoral bleeding. Therefore, a mesenteric celiac angiogram followed by trans arterial bland embolization of the bleeding vessel was performed. In the same setting, for the simultaneous management of the acute coronary syndrome, coronary angiography performed revealed a triple vessel disease which was immediately followed by a percutaneous transluminal coronary angioplasty.
Background: India was one of the leaders in terms of COVID-19 cases across year 2020. Hypothyroidism is one of the common morbidities that may influence prognosis of infectious diseases. However, some previously published literature had suggested that hypothyroidism may not be affecting outcomes of COVID-19 disease. Objective of this study was to analyze the outcomes of COVID-19 patients with pre-existing hypothyroidism and further suggesting determinants of worse outcomesMethods: This retrospective cohort study was carried out at one of largest Dedicated COVID-19 Hospital in Mumbai, India. Of the 16306 patients that got admitted at this hospital in year 2020, all those having hypothyroidism were included. Bivariate analysis was performed using Chi-square test and Multivariate analysis was performed using multiple logistic regression.Results: A total of 251 patients were having pre-existing hypothyroidism (1.54%). More females had hypothyroidism (73.7%) while death rate was more in males (26.3%). ICU admissions (27.5%) and death proportions (18.3%) were significantly more in hypothyroidism. Diabetes and hypertension were common concomitant Co-morbidities and odds ratios for death for diabetes group, hypertension group and diabetes+hypertension group were 4.9, 8.1 and 4.4 respectively in comparison to those having exclusive hypothyroidism.Conclusions: This study deals with an important topic of co-existing Hypothyroidism in COVID-19 patients and we can conclude that patients with Hypothyroidism must be considered to be at risk of severe outcomes. Furthermore, age, male gender and presence of concomitant Co-morbidities increase the risk of worse outcome.
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