PurposeDuring COVID-19 infection, organ dysfunction such as respiratory failure tends to occur towards the second week of illness; however, in a subset, there may be rapid onset of organ dysfunction as early as symptom onset. We define fulminant onset COVID-19 as rapid onset of organ dysfunction such as acute respiratory failure, acute kidney injury, acute encephalopathy or shock within 4 days of symptom onset. Fulminant onset COVID-19 has not yet been systematically studied. We aimed to identify predictors and prognosis of fulminant onset COVID-19.MethodsThis retrospective study was carried out on patients admitted to a single referral hospital in South India between June 2020 and January 2022. Patients were categorised into fulminant and non-fulminant onset COVID-19. Candidate predictors for fulminant onset were chosen by an intuitive approach and analysed using logistic regression. Then, the outcome of fulminant onset COVID-19 at 30 days was studied.ResultsOut of 2016 patients with confirmed COVID-19, 653 (32.4%) had fulminant onset COVID-19. Age>60 years (a-OR 1.57, 95% CI 1.30 to 1.90, p<0.001), hypertension (a-OR 1.29, 95% CI 1.03 to 1.61, p=0.03) and immune-suppressed state (a-OR 5.62, 95% CI 1.7 to 18.7, p=0.005) were significant predictors of fulminant onset COVID-19. Complete vaccination lowered the odds of fulminant onset COVID-19 significantly (a-OR 0.61, 95% CI 0.43 to 0.85, p=0.004). At 30 days, the fulminant onset COVID-19 group had higher odds of mortality and need for organ support.ConclusionFulminant onset COVID-19 is not uncommon and it carries poor prognosis and deserves recognition as a distinct phenotype of COVID-19.

The present work analysed the fish catches and associated prices of trap fisheries during the regular and COVID-19 lockdown along the Olaikuda fishing village, Palk Bay region. The main target fishery in this region is coral associated fishes. A total of 713 kg of fishes harvested from the trap for eight months of study. The higher and lower average catch was recorded in May and April during 2020 lockdown respectively. But in the regular fishing months, the higher and lower average catch was recorded in July and March 2020 respectively. The total value of harvested fishes during the regular fishing months was ₹ 66,137 and in lockdown months ₹ 54,583 with the cumulative value of ₹ 1,20,720 as against the operation cost of ₹70,750 excluding the cost of craft. Thus, COVID-19 lockdown influenced the price of export quality fishes belonging to the family Scaridae due to which the fishes were sold at lower prices leading to low income of trap fishers. Data on this type of work is not available to compare the present situation. Therefore, long term study will be conducted in different trap fishing areas to compare the catch data along with market value for better understanding.

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