BACKGROUND Community acquired pneumonia (CAP) refers to pneumonia contracted by a person with little or no contact with health care system. Severity scores like CURB 65 severity score are useful in estimating the outcome. Hyponatremia is defined as serum sodium level < 135 mEq/L. The incidence of hyponatremia at hospital admission among CAP patients is found to be 28 %and the mechanism behind it has been found to be due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Hence this study is an effort to explore how hyponatremia is associated with severity and outcomes, in hospitalized patients with pneumonia. The purpose of this study was to assess the proportion of hyponatremia in patients with community acquired pneumonia and compare hyponatremia with CURB-65 as an initial screening tool for assessment of severity of CAP. METHODS This is a hospital-based cross-sectional study. 75 community acquired pneumonia patients admitted as inpatients are included in this study. Information is collected and detailed history is taken using pre-formed proforma at the time of admission. Serum sodium levels were measured, after initial assessment of patients. The lab values of serum sodium levels were analysed with the clinical profile and outcome in these study groups. RESULTS In our study, it was observed that as the sodium levels are decreasing, the CURB 65 score increases. Study subjects who had sodium levels < 125 mg/dl, presented with CURB 65 score as 4 (30 %). Inversely, the study subjects with high sodium levels (> 135 mg/dl) had CURB 65 scores as 1 (75 %). The association between sodium levels and CURB 65 score was significant in patients who got discharged but not in patients who expired. CONCLUSIONS Present study of serum sodium levels as biomarkers in CAP showed that hyponatremia carried poor prognosis which correlated with high CURB 65 score. KEYWORDS Sodium, Community Acquired Pneumonia, SIADH, CURB 65, Hyponatremia, COPD
Background: COVID-19 infection, which first reported as a cluster of pneumonia from Wuhan, China, in December 2019, has rapidly emerged as a global pandemic. During the early course of the pandemic. The duration of infectious virus replication is an important factor for clinicians. There is a significant correlation between the duration of SARS-CoV-2 virus clearance and the prognosis of COVID-19. Aims and Objective: To study Duration of viral clearance in COVID 19 patients, admitted in an Indian setting. Materials and Methods: The prospective single-center study considered adults patients of both the gender, diagnosed with COVID-19 infection by RT-PCR technique. Necessary demographic and clinical data were collected and selected subjects were followed-up until discharge or death. Based on the number of days required for viral clearance, the subjects were classified as: group 1: ≤ 14 days, group 2: 15-28 days, and group 3:>28 days. Results: The study included 536 patients it was found that mean duration required for viral clearance was around 8.98±3.54. Mean ages noted for group1, 2 and 3(based on viral clearance) were 37.57±13.65 years, 37.12±13.73 years and 49.50±23.56 years respectively. There was a significant difference between mean age of group 1 and 2, as well as group 1 and 3. Moreover, the distribution of patients across different age group was found to be statistically significant (P<0.05). Significant difference was noted between three groups with respect to the comorbidity status (P<0.0001). The COVID-related symptoms dyspnea and cough were more prominent in group 3 (P<0.05). TLC which is statistically significant (p<0.05), lower the TLC more the duration of viral clearance and more the duration of hospital stay. Conclusion: The mean days of viral clearance noted in COVID subjects is around 8.98±3.54 days. There was a significant difference between mean age of group 1 and 2, as well as group 1 and 3. However, there is no statistically significant correlation between duration of hospital stay and inflammatory markers except TLC which is statistically significant (p<0.05), lower the TLC more the duration of viral clearance and more the duration of hospital stay.
Background: Community acquired pneumonia refers to pneumonia contracted by a person with little or no contact with health care system. Following endotoxemia the number of circulating neutrophils increases while lymphocyte counts decrease. Combining both parameters seems a logical step and the ratio of neutrophil and lymphocyte counts is increasingly used in several clinical circumstances. Initially, this so-called neutrophil-lymphocyte count ratio (NLCR) was studied as an infection marker in ICU patients and found to correlate well with disease severity and outcome, according to APACHE-II and SOFA scores. In the current study, we explored the value of the NLCR in patients admitted with Community acquired pneumonia. Aims and Objectives: 1) To find out the value of Neutrophil-Lymphocyte Count Ratio (NLCR)in Community Acquired Pneumonia (CAP). 2) To study Neutrophil-Lymphocyte Count Ratio (NLCR) as prognostic indicator in Community Acquired Pneumonia (CAP). Materials and Methods: This prospective study was conducted on minimum of 100 patients admitted to hospitals from November 2015 to September 2017 from Bangalore. After admission of cases based on CURB-65 scores, a detailed history and clinical examination was done along with chest x-ray to establish the diagnosis. Before taking into the study all patients had signed the informed consent. Routine haematological investigations done on day 1,3 & 7 were carried out. Serum c-reactive protein levels, Urea nitrogen levels, Sputum for culture and sensitivity and Acid-fast bacilli (AFB) was done on the same day of admission. ANC (Absolute neutrophil count), ALC (Absolute lymphocyte count) and NLCR were calculated. Results: Our study included age groups above 18yrs. Majority of the patients in the study were between 58-67 years (30%) followed by 48-57 years (27%). As the CURB-65 score increased from score 0 to score 4–5, the NLCR consistently increased, while the lymphocyte counts consistently decreased. In patients who died there was a significantly higher NLCR at presentation compared to patients that survived (15.18±3.55 versus 11.73±3.01, p-value,0.003). Conclusion: In our study increased NLCR carried poor prognosis which correlated with high CURB65 score and ICU admission. In patients who died there was a significantly higher NLCR at presentation compared to patients those survived.
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