Treatment of COVID-19 Patients at a Medical College Hospital in Bangladesh

Bhuyan, Muhammad Ar; Mahtab, Mamun Al; Ashab, Eshita; Haque, Jahirul; Hoque, Syed Md M.; Huq, Akm Faizul; Islam, A. K. M. M.; Choudhury, Nuzhat; Alia, Reema Afroza; Mahtab, Musarrat; Khan, Md. Sakirul Islam; Akbar, Sk. Md. Fazle

doi:10.5005/jp-journals-10018-1317

Cited by 14 publications

(10 citation statements)

References 17 publications

(13 reference statements)

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“…The patients in our study were relatively young with a median age of 31.5 years. This is similar to the data from other South Asian countries [10, 20, 21], but is in contrast to the studies from Italy, UK and USA [13, 14, 19]. This can partly be explained by the fact that the median age of the population in South Asian countries is substantially lower than countries like the US, UK or Italy [22].…”

Section: Discussionsupporting

confidence: 85%

Characteristics and outcomes of hospitalized adults with COVID-19 in Nepal: a multicenter, prospective cohort study

Chaudhary¹,

Singh

Paudel³

et al. 2020

Preprint

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Introduction There is limited data on clinical course and outcomes of hospitalized adults with COVID-19 in Nepal. Thus, it is imperative to characterize the features of this disease in the domestic context. Methodology We identified all adult patients with laboratory-confirmed COVID-19 admitted to five different hospitals in Nepal from June 15 to July 15, 2020. We collected epidemiological, socio-cultural and clinicopathologic data, and stratified the patients based on their symptom status. Results The study included 220 patients with an overall median age of 31.5 (25-37) years, and 181 (82.3%) were males. 159 (72.3%) were asymptomatic, and 163 (74.1%) were imported cases. Of 217 patients with the available data, 110 (50.7%) reported their annual household income less than 2000 US dollars, and 122 (56.2%) practiced Pranayama (yogic rhythmic breathing techniques) regularly. Eight patients (3.6%) required supplemental oxygen and two patients (0.9%) died. None of the patients who practiced Pranayama regularly required supplemental oxygen. Compared to asymptomatic patients, symptomatic patients had greater proportion of females (31.1% vs. 12.6%, p=0.001), imported cases (85.2% vs. 69.8%, p=0.02), illiterates (26.8% vs. 12.1%, p=0.01), alcohol users (43.3% vs. 24.5%, p=0.01), patients feeling stigmatized by society (45.8% vs. 22.6%, p=0.001), and had higher platelet count (253 x 10^9/L vs. 185 x10^9/L, p=0.02). Conclusions Most cases were imported, asymptomatic young males, with very few deaths. Pranayama practice was associated with protection against severe COVID-19, but more data is needed to substantiate this. The association of platelets count with symptom status in the Nepalese population needs further exploration.

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Section: Discussionsupporting

confidence: 85%

Characteristics and outcomes of hospitalized adults with COVID-19 in Nepal: a multicenter, prospective cohort study

Chaudhary¹,

Singh

Paudel³

et al. 2020

Preprint

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“…In our recent case-control study on 37 patients with moderate-to-severe COVID-19 pneumonia, we found that compared to usual daily dose regimen (4 mg) of baricitinib, a single 8 mg oral loading dose-based daily usual dose (4 mg) regimen of baricitinib for 14 days revealed better clinical outcomes, including early normalization of SpO 2 (≥95%) on RA and restoration of normal breathing function [4 (IQR: 4-5)/3 Several studies reported that among the hospital admitted patients with COVID-19, 15.7 to 26.1% cases are severe and often difficult to clinically justify on the basis of abnormal laboratory investigations and CT scan report [16][17][18]. Though, there is no standard antiinflammatory drug therapy for the treatment of severe pneumonia in COVID-19 infection, so early diagnosis and initiation of treatment upon hospital admission with the available drugs may attribute favorable clinical outcome [12,19]. In this study, along with the antiviral and steroid therapy, the anti-inflammatory drug baricitinib was started in both the groups' patients with severe COVID-19 pneumonia within 4 h of hospital admission.…”

Section: Discussionmentioning

confidence: 99%

Impact of high dose of baricitinib in severe COVID-19 pneumonia: a prospective cohort study in Bangladesh

et al. 2021

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Purpose Hyperinflammation in severe COVID-19 infection increases the risk of respiratory failure and one of the cogent reasons of mortality associated with COVID-19. Baricitinib, a janus kinases inhibitor, can potentially suppress inflammatory cascades in severe COVID-19 pneumonia. Methods The objective of this study was to compare the clinical outcomes of high dose of baricitinib with its usual dose in patients with severe COVID-19 pneumonia. This prospective cohort study was conducted on 238 adult patients with severe COVID-19 pneumonia. Eight milligram and 4 mg of baricitinib was given orally to 122 patients in the high dose (HD) group and 116 patients the usual dose (UD) group, respectively daily for 14 days, and clinical outcomes were compared among the groups. Results Blood oxygen saturation level was stabilized (≥94% on room air) earlier in the HD group compared to the UD group [5 (IQR: 4–5)/8 (IQR: 6–9), P < 0.05]. Patients in the HD group required intensive care unit (ICU) and intubation supports more in the UD group than that in patients of the HD group [17.2%/9%, P < 0.05; 11.2%/4.1%, P > 0.05; N = 116/122, respectively]. The 30-day mortality and 60-day rehospitalization rate were higher in the UD group than the HD group [6%/3.3%, P < 0.01; 11.9%/7.6%, P > 0.05; N = 116/122, respectively]. Conclusion The daily high dose of baricitinib in severe COVID-19 results in early stabilization of the respiratory functions, declined requirements of critical care supports, reduced rehospitalization with mortality rate compared to its daily usual dose.

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“…Moreover, a person having multiple comorbidities who have COVID-19 is at greater mortality risk. NCDs, e.g., heart diseases, hypertension, diabetes, chronic obstructive pulmonary diseases, malnutrition, among others, contribute to COVID-19 in Bangladesh ( Al Mahtab et al, 2020 ). In Bangladesh, 48% of males smoke, which is a significant factor for severe COVID-19 by damaging the lungs severely and affecting other parts of the body ( WHO COVID-19 and NCDs, 2020 ).…”

Section: Covid-19 Morbidity Mortality Scenario and Associated Risk Factors In Bangladeshmentioning

confidence: 99%

Global data analysis and risk factors associated with morbidity and mortality of COVID-19

et al. 2022

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This review was focused on global data analysis and risk factors associated with morbidity and mortality of coronavirus disease 2019 from different countries, including Bangladesh, Brazil, China, Central Eastern Europe, Egypt, India, Iran, Pakistan, and South Asia, Africa, Turkey and UAE. Male showed higher confirmed and death cases compared to females in most of the countries. In addition, the case fatality ratio (CFR) for males was higher than for females. This gender variation in COVID-19 cases may be due to males' cultural activities, but similar variations in the number of COVID-19 affected males and females globally. Variations in the immune system can illustrate this divergent risk comparatively higher in males than females. The female immune system may have an edge to detect pathogens slightly earlier. In addition, women show comparatively higher innate and adaptive immune responses than men, which might be explained by the high density of immune-related genes in the X chromosome. Furthermore, SARS-CoV-2 viruses use angiotensin-converting enzyme 2 (ACE2) to enter the host cell, and men contain higher ACE2 than females. Therefore, males may be more vulnerable to COVID-19 than females. In addition, smoking habit also makes men susceptible to COVID-19. Considering the age-wise distribution, children and older adults were less infected than other age groups and the death rate. On the contrary, more death in the older group may be associated with less immune system function. In addition, most of these group have comorbidities like diabetes, high pressure, low lungs and kidney function, and other chronic diseases. Due to the substantial economic losses and the numerous infected people and deaths, research examining the features of the COVID-19 epidemic is essential to gain insight into mitigating its impact in the future and preparedness for any future epidemics.

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Treatment of COVID-19 Patients at a Medical College Hospital in Bangladesh

Cited by 14 publications

References 17 publications

Characteristics and outcomes of hospitalized adults with COVID-19 in Nepal: a multicenter, prospective cohort study

Characteristics and outcomes of hospitalized adults with COVID-19 in Nepal: a multicenter, prospective cohort study

Impact of high dose of baricitinib in severe COVID-19 pneumonia: a prospective cohort study in Bangladesh

Global data analysis and risk factors associated with morbidity and mortality of COVID-19

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