Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations. Methods We describe the clinical characteristics of all consecutive COVID-19 positive patients (n = 215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. Results The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p < 0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p < 0.001) and respiratory diseases (group 2: 38 vs group 1: 25%, p = 0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p = 0.03), frailty (OR 5.1; p < 0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p = 0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients. Conclusion Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.Methods We describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (group 1: alive or group 2: deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) curves were generated by following the outcome in all patients until 12 May 2020. Results The median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (group 2: 63 vs group 1: 37%, p<0.001), with a higher prevalence of cardiovascular disease (group 2: 58 vs group 1: 33%, p<0.001) and respiratory diseases (group 2: 38 vs group 1: 25 %, p=0.03). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were significant predictors of inpatient mortality. KM curves showed a significantly shorter survival time in the frail older patients. Conclusion Older age and frailty are chief risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.

Background: A wide range of medications are now available for the treatment of asthma, and selection of optimal treatment is essential. Aims and Objective: To evaluate the drug-prescribing trend of antiasthmatic drug in a tertiary-care hospital. Materials and Methods: The prescription data from 130 patients with asthmapatients were studied using a prescription auditing pro forma. Data were recorded from the patients attending the outpatient department of Hi-Tech Medical College and Hospital from February to July 2014. Verbal consent was taken from the patients before filling the pro forma. Results: During the study, 130 patients were monitored but only 100 prescriptions were included for data analysis as per the inclusion and exclusion criteria. Demographic analysis of data revealed that there were 66% men and 34% women in the study. The study showed that maximum patients with asthma belonged to 30-40 years age group. The results of this study showed that most of the patients received combination therapy as compared with individual therapy. Majority of the patients received combination therapy of beta 2 agonists and glucocorticoids via inhalational routes; 34% of the prescribed drugs are from the essential drug lists. Average drugs per prescription were 5.16, and 54% of the patients received more than four drugs. About 60% drugs were given by inhalation route, followed by oral route (38%). Conclusion: There is need to encourage the physician to use the treatment guidelines while managing patients with asthma. In conclusion, National Asthma Education program would benefit as an initial step to improve asthma knowledge and increase awareness in the medical community on current treatment practice.

The coronavirus disease (COVID-19) has challenged health professions and systems, and developed different speeds of reaction and types of response around the world. Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract, and to a lesser extent, the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The role of dental professionals in preventing the transmission of COVID-19 is critically important. While all routine dental care has been suspended in countries experiencing COVID-19, the need for organized urgent care delivered by teams provided with appropriate personal protective equipment has become a priority. Dental professionals can also contribute to medical care. Major and rapid reorganization of both clinical and support services is not simple. Dental professionals considered a moral duty to reduce routine care due to fear of spreading COVID-19 among their patients, but were understandably concerned about financial consequences. Amidst the explosion of information available online and through social media, it is difficult to identify reliable research evidence and guidance; therefore, moral decisions must be made.

Background There is a need for more observational studies across different clinical settings to better understand the epidemiology of the novel COVID-19 infection. Evidence on clinical characteristics of COVID-19 infection is scarce in secondary care settings in Western populations.MethodsWe describe the clinical characteristics of all consecutive COVID-19 positive patients (n=215) admitted to the acute medical unit at Fairfield General Hospital (secondary care setting) between 23 March 2020 and 30 April 2020 based on the outcome at discharge (alive or deceased). We investigated the risk factors that were associated with mortality using binary logistic regression analysis. Kaplan-Meir (KM) charts were generated by following the outcome in all patients until 12 May 2020. ResultsThe median age of our cohort was 74 years with a predominance of Caucasians (87.4%) and males (62%). Of the 215 patients, 86 (40%) died. A higher proportion of patients who died were frail (63 vs 37%, p<0.001), with a higher prevalence of cardiovascular disease (50 vs 33%, p<0.001) and respiratory diseases (38 vs 25 %, p=0.034). In the multivariate logistic regression models, older age (odds ratio (OR) 1.03; p=0.03), frailty (OR 5.1; p<0.001) and lower estimated glomerular filtration rate (eGFR) on admission (OR 0.98; p=0.01) were strong and independent predictors of inpatient mortality. KM charts showed a clear difference in survival outcome in the frail older patients. ConclusionOlder age and frailty are strong and independent risk factors associated with mortality in COVID-19 patients hospitalised to an acute medical unit at secondary care level. A holistic approach by incorporating these factors is warranted in the management of patients with COVID-19 infection.