Objectives: The present study is aimed at estimating patient ow dynamical parameters and requirement of hospital beds. Secondly, the effects of age and gender on parameters were evaluated. Patients and Methods: In this retrospective cohort study, 987 COVID-19 patients were enrolled from SMS Medical College, Jaipur (Rajasthan, India). The survival analysis was carried out from 29 Feb to 19 May 2020 for two hazards-'Hazard 1' was hospital discharge and 'Hazard 2' was hospital death. The starting point for survival analysis of the two hazards was considered to be hospital admission. The survival curves were estimated and additional effects of age and gender were evaluated using Cox proportional hazard regression analysis. Results: The Kaplan Meier estimates of lengths of hospital stay (Median =10 days, IQR =10 days) and median survival rate (more than 60 days due to large amount of censored data) were obtained. The Cox Model for 'Hazard 1' showed no signi cant effect of age and gender on duration of hospital stay. Similarly, the Cox Model 2 showed no signi cant difference of gender on survival rate. The case fatality rate 8.1 % , recovery rate 78.8% , mortality rate 0.10 per 100 person-days and hospital admission rate 0.35 per 10 5 person-days were estimated. Conclusion : The study estimates hospital bed requirement based on patient ow dynamic parameters. Furthermore, study concludes that average length of hospital stay were similar for patients of both genders and all age groups.
Summary Between September 2012 and January 20, 2017, the World Health Organization (WHO) received reports from 27 countries of 1879 laboratory-confirmed cases in humans of the Middle East respiratory syndrome (MERS) caused by infection with the MERS coronavirus (MERS-CoV) and at least 659 related deaths. Cases of MERS-CoV infection continue to occur, including sporadic zoonotic infections in humans across the Arabian Peninsula, occasional importations and associated clusters in other regions, and outbreaks of nonsustained human-to-human transmission in health care settings. Dromedary camels are considered to be the most likely source of animal-to-human transmission. MERS-CoV enters host cells after binding the dipeptidyl peptidase 4 (DPP-4) receptor and the carcinoembryonic antigen–related cell-adhesion molecule 5 (CEACAM5) cofactor ligand, and it replicates efficiently in the human respiratory epithelium. Illness begins after an incubation period of 2 to 14 days and frequently results in hypoxemic respiratory failure and the need for multiorgan support. However, asymptomatic and mild cases also occur. Real-time reverse-transcription–polymerase-chain-reaction (RT-PCR) testing of respiratory secretions is the mainstay for diagnosis, and samples from the lower respiratory tract have the greatest yield among seriously ill patients. There is no antiviral therapy of proven efficacy, and thus treatment remains largely supportive; potential vaccines are at an early developmental stage. There are multiple gaps in knowledge regarding the evolution and transmission of the virus, disease pathogenesis, treatment, and prospects for a vaccine. The ongoing occurrence of MERS in humans and the associated high mortality call for a continued collaborative approach toward gaining a better understanding of the infection both in humans and in animals. MERS-CoV was first identified in September 20121 in a patient from Saudi Arabia who had hypoxemic respiratory failure and multiorgan illness. Subsequent cases have included infections in humans across the Arabian Peninsula, occasional importations and associated clusters in other regions, and outbreaks of nonsustained human-to-human transmission in health care settings (Fig. 1).
T h e n e w e ng l a n d j o u r na l o f m e dic i n e
Patients with EVD presented with evidence of dehydration associated with vomiting and severe diarrhea. Despite attempts at volume repletion, antimicrobial therapy, and limited laboratory services, the rate of death was 43%.
Efficacy testing will be challenging because of the small pool of donors with sufficiently high antibody titers.
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