A BSTRACT Background: Andaman and Nicobar Islands, a Union Territory of India is Tropical Island, has better air quality and since its specific geographic location that may have an impact on the clinical and pathological features. So, this study is intended to describe the clinical and pathological features of COVID-19 infection and its association with the severity of the disease among adult COVID-19 patients. Material and Method: A cross-sectional study done retrospectively among 100 adult COVID-19 RT PCR positive in Tertiary Hospital, tropical Islands by reviewing medical records. The clinical, laboratory parameters were assessed. Results: In the study 65% of the population were male, and 55% of COVID-19 cases were between the age group of 25 to 50 years of age. At presentation, 96% had respiratory symptoms, 91% had fever, 33% had gastrointestinal symptoms, 10% had musculoskeletal symptoms, and 6% have a history of contact with COVID-19 positive patients. The severe COVID-19 patients had longer duration of fever ( P -value 0.041), duration of cough ( P 0.016), duration of breathlessness ( P 0.002), high pulse rate ( P = 0.031) at presentation, had high neutrophil/lymphocyte ratio ( P = 0.001), high neutrophil count ( P < 0.001), low lymphocyte count ( P < 0.001), high CRP ( P < 0.001), and high D-dimer ( P < 0.001) at presentation. Conclusion: Severe COVID-19 patients at presentation had longer duration of fever, cough, and breathlessness, hence should seek early medical care. Lab parameters is a great tool in the assessment of patient who can go to have severe disease and thus help in formulating Guidelines.
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