Objectives: Current retrospective study aims to evaluate household Secondary Attack Rate (SAR) of COVID-19 in Gandhinagar (rural) district of Gujarat, India. Methods: Line-listing of 486 laboratory-confirmed patients, tested between 28th March to 2nd July was collected, out of them 80 (15% of overall sample) cases were randomly selected. Demographic, clinical and household details of cases were collected through telephonic interview. During interview 28 more patients were identified from the same household and were added accordingly. So, study included 74 unrelated cluster of households with 74 primary cases and 386 close contacts. Results: SAR in household contacts of COVID-19 in Gandhinagar was 8.8%. Out of 108, 8 patients expired (7.4%), where higher mortality was observed in primary cases (9.5%) as compared to secondary cases (3%). Occupational analysis showed that majority of the secondary cases (88%) were not working and hence had higher contact time with patient. No out-of-pocket expenditure occurred in 94% of the patients, in remaining 6% average expenditure of 1,49,633INR (2027 USD) was recorded. Conclusions: Key observations from the study are 1) SAR of 8.8% is relatively low and hence home isolation of the cases can be continued 2) Primary case is more susceptible to fatal outcome as compared to secondary cases 3) Government has covered huge population of the COVID-19 patients under cost protection. However, more robust studies with larger datasets are needed to further validate the findings.
Rheumatoid arthritis (RA) is a chronic disease related to swelling of joints which lead to restriction in movement due to pain and deformity mainly in feet, ankle, wrist, and fingers. It is an autoimmune disease, and the manifestations caused due to its occurrence are not clearly understood. In today's time, it has been observed that comorbid conditions account for most of the deaths as they influence the outcome of RA and limit therapeutic options. The most common comorbid conditions which are diagnosed in RA patients are generally cardiovascular (CV) abnormalities, several infections, certain mental disorders, and malignancies. Among which CV comorbid diseases are the most common kind relating to disorders of heart and blood vessel that eventually leads to severe conditions such as angina, myocardial infarction, stroke, rheumatic heart disease, and many more. RA affects the quality of life of patients directly or indirectly, but it mainly shows a significant increase in the prevalence of CV diseases. Hence, it is essential to diagnose and understand about the related manifestations when one is suffering from RA. These studies will aid to make better treatment and management strategies. Hence, an attempt has been made in this review article regarding the epidemiology, impact of both diseases and related risk factors. It also gives information in brief about the pathological causes of the comorbidity and summarizes measures that may be used in the prevention and treatment of these conditions.
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