Background: In this study authors retrospectively analyzed the record of 102 patients with confirmed COVID-19 infection to determine factors associated with severity of disease. Methods: Clinical, biochemical, radiological and hematological profiles of 102 patients with confirmed SARS-CoV-2 RNA testing were obtained and analyzed. Results: A total of 102 patients were enrolled, with median age of patients of 32.5 years (range 10-85 years), of which 83.3% (85/102) were asymptomatic and 16.67% (17/102) symptomatic. Eighteen (17.6%) patients had co-existing illnesses. Clinical spectrum among COVID-19 patients varied from being asymptomatic to having symptoms like fever, dry cough, breathlessness with few progressing to respiratory failure and multi-organ failure. In our study, 97.05% (99/102) recovered while 2.94% (3/102) died. Mean age, total leucocyte count (TLC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) of severely ill patients were significantly higher than those of patients with non-severe illness.Conclusions: Elevated NLR, TLC, PLR, LDH and lymphopenia were seen in the symptomatic patients especially manifesting severe disease. Early intervention and periodic monitoring of these parameters in patients, especially with severe disease may help in improving disease outcome.
Introduction: As the coronavirus disease 2019 (COVID-19) pandemic continues
to spread on an unprecedented scale from around the world, we described our
experience in treating early COVID-19 cases in India. Materials and Methods: An
observational study of COVID-19 patients admitted to a tertiary care centre in
North India between 2 March–4 April 2020 was performed. The clinical,
epidemiological, laboratory, treatment and outcome data of patients were
evaluated. Results: A total of 75 patients were treated and 56 (74.66%) were men.
The clinical spectrum of COVID-19 ranged from asymptomatic to acute respiratory
distress syndrome (ARDS). Fever (85.36%) was the most common symptom followed
by cough (56.09%) and dyspnoea (19.51%). Findings from hemogram analysis
showed that 32%, 21.33% and 18.67% of patients had lymphopaenia, eosinopenia
and thrombocytopaenia, respectively. Inflammatory markers such as C-reactive
protein, D-dimer, ferritin, fibrin degradation product and interleukin-6 were
significantly elevated (P <0.05) in patients who required oxygen therapy than those
who did not require it, suggesting the potential role such markers could play in
predicting prognosis in patients. Mean hospital stay was 9.2 days and 72 (96%)
patients made a complete recovery, but 3 (4%) patients demised after progressing
to ARDS. Conclusion: The clinical and epidemiological spectrum of COVID-19 has
jeopardised the health system in India. Without a proven therapy to combat this
pandemic and with no sight of vaccines in the near future, a preventive strategy
should be adopted to contain the spread of this infectious disease.
Key words: Acute respiratory distress syndrome, Cytokine release syndrome,
Interleukin-6, Lopinavir-ritonavir, Lymphopaenia
Background:
Stress hyperglycemia is a common phenomenon in patients presenting
with acute myocardial infarction (MI). We aim to evaluate the association of stress hyperglycemia
at the time of hospital presentation and adverse cardiac events in myocardial infarction during the
course of hospital stay.
Methods:
Subjects with age ≥18 years with acute MI were recruited on hospital admission and categorized based on admission blood glucose (<180 and ≥180 mg/dl, 50 patients in each group). Both
groups were compared for clinical outcomes, adverse cardiac events and mortality. We also compared the adverse cardiac outcomes based on HbA1c levels (<6% and ≥6%).
Results:
Patients with high blood glucose on admission (stress hyperglycemia) had significant increased incidences of severe heart failure (Killip class 3 and 4), arrythmias, cardiogenic shock and
mortality (p value = 0.001, 0.004, 0.044, and 0.008 respectively). There was no significant association between adverse cardiac events and HbA1c levels (heart failure 18.8% vs. 25%, p value =
0.609 and mortality 16.7% vs. 17.3%, p value = 0.856).
Conclusions:
Stress hyperglycemia is significantly associated with adverse clinical outcomes in patients with MI irrespective of previous diabetic history or glycemic control. Clinicians should be
vigilant for admission blood glucose while treating MI patients.
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