COVID-19 disease and comorbidity: an outcome? A study on Indian population in a COVID care hospital

Background: The world has been severely affected by the novel coronavirus disease (Covid-19). Continuously rising number of cases has put a significant strain on healthcare resources of all countries of the world. Preliminary studies show that people suffering from comorbid conditions are at a relatively higher risk of severe disease and poor outcome.Methods: We studied the risk of ICU admission in 152 Covid-19 positive patients with comorbidity compared to those without comorbid conditions. We studied effect of old age (>65 years), male sex, presence of at least one comorbidity, presence of multiple comorbidities, diabetes mellitus, hypertension, CAD, respiratory disease, neurological disease, skin disease, and hypothyroidism on outcome of coronavirus disease with two tailed Student’s t-test, odds ratio, Chi-square test was used to test significance of results at 95% confidence interval 95% (95% CI). Fisher’s test was also used if one expected value (row total × column total/grand total) was less than 5.Results: In this study, 23 (15.13%) required ICU care. We found higher odds of ICU admission in Covid-19 patients in case of presence of comorbid condition (OR=7.3, 95% CI=2.674, 20.038), diabetes mellitus (OR=2.8, 95% CI=1.035, 8.028), hypertension (OR=1.3, 95% CI=0.396, 4.258), coronary artery disease (OR=2.3, 95% CI=0.430, 12.978) and malignancy (OR=6.5, 95% CI=1.516, 28.54). Case fatality rate (CFR) of those with comorbid conditions was higher (7.55) compared to those without comorbidity (3.03).Conclusions: This study shows that presence of comorbid conditions in Covid-19 positive patients results in significantly higher risk of ICU admission and poor outcome.

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Epidemiological Profile and Clinical Outcome of COVID-19 Patients in a Tertiary Care Hospital, Pune, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/49154.15153 ◽

2021 ◽

Author(s):

Prachi D Sondankar ◽

Shubhangi U Agawane ◽

Abhay B Mane ◽

Parvinder S Chawla

Keyword(s):

Clinical Outcome ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Fatality ◽

High Rate ◽

Care Hospital ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

Epidemiological Profile

Introduction: The COVID-19 caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), has spread throughout the world from its place of origin in Wuhan city of China. From origin in December 2019 till May 2021, this disease affected 222 countries in the world with 152,534,452 confirmed cases. As on May 2021, India is the second worst affected country in the world. Aim: To know the epidemiological profile and clinical outcome of COVID-19 positive patients to help in understanding the disease dynamics. Materials and Methods: It was a cross-sectional, record based study at a tertiary care hospital. All the COVID-19 laboratory confirmed positive patients admitted from 15th June, 2020 to 15th September, 2020 were included in the study. Sample size was 1146. All the required data regarding patients were collected and analysed subsequently with the help of percentages, Z-test for proportion, Chi-square test and Odds ratio. Results: The mean age of the patients was 47.06 ±17.4 years ranging from 1 to 92 years. Males were significantly higher in numbers than females. 30.19% patients had some or other co-morbidities. 89.8% patients were discharged and 9.2% patients died. More number of deaths occurred in higher age group and highest death rate was seen in the patients who had multiple co-morbidities. Conclusion: The study concludes that most of the COVID-19 patients were middle aged and males were significantly more affected than females. Most of the patients were asymptomatic at the time of admission. It can be concluded that maximum patients had favourable clinical outcome as around 90% patients being discharged and case fatality rate was 9.2%. High rate of mortality was significantly associated with higher age and presence of co-morbidities.

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A Synopsis on COVID-19 and Associated Risk Factors: Optimizing Preventive and Clinical Outcomes through Lifestyle Intervention

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.01.art004 ◽

2021 ◽

Vol 9 (1) ◽

pp. 37-44

Author(s):

Abiodun Bamidele Adelowo

Keyword(s):

Risk Factors ◽

Global Economy ◽

Treatment Strategies ◽

Case Fatality ◽

Comorbid Conditions ◽

Middle Income ◽

Lifestyle Choices ◽

The World ◽

Novel Coronavirus ◽

Associated Risk Factors

Since its outbreak in late 2019, Coronavirus Disease 2019 (COVID-19) has been ravaging the health system of most countries of the world. Although many preventive and treatment strategies have been proposed and implemented to combat the disease, these efforts seem to be insufficient, and in some cases ineffective. This is evident by the daily rising global incidence and case fatality of the COVID-19 pandemic. A situation if not mitigated early will likely crumble the global economy and tilt the world to an unprecedented global recession. This challenge demands that researchers and clinicians ask more in-depth questions about the novel coronavirus disease. Aside from age that has been confirmed to be linearly associated, what are the other possible socio-demographic and lifestyle-related risk factors that may be associated with COVID-19? What are the possible factors or comorbid conditions that may worsen clinical progression and determine the clinical outcome in confirmed COVID-19 cases? Does the pre-, peri-, or post-morbid lifestyle choices of people have an impact on COVID-19 preventive and treatment efforts? And how can we use the knowledge of the associated risk factors, comorbid conditions, and lifestyle choices of people to improve preventive efforts and clinical management of COVID-19? Answer to these questions may likely serve as an important guide for policymakers and clinicians in their design and implementation of COVID-19 targeted preventive and treatment policies and programs, especially in Low- and Middle-Income Countries (LMICs). The purpose of this article is to critically review available literature and provide evidence-based recommendations.

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Association and treatment of diabetes in patients affected by Covid-19

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl1.3591 ◽

2020 ◽

Vol 11 (SPL1) ◽

pp. 1198-1201

Author(s):

Syed Yasir Afaque

Keyword(s):

Diabetes Mellitus ◽

Prognostic Value ◽

Heart Diseases ◽

The Novel ◽

The World ◽

Treatment Of Diabetes ◽

Coronavirus Infection ◽

Composite Outcomes ◽

Novel Coronavirus ◽

The Impact

In December 2019, a unique coronavirus infection, SARS-CoV-2, was first identified in the province of Wuhan in China. Since then, it spread rapidly all over the world and has been responsible for a large number of morbidity and mortality among humans. According to a latest study, Diabetes mellitus, heart diseases, Hypertension etc. are being considered important risk factors for the development of this infection and is also associated with unfavorable outcomes in these patients. There is little evidence concerning the trail back of these patients possibly because of a small number of participants and people who experienced primary composite outcomes (such as admission in the ICU, usage of machine-driven ventilation or even fatality of these patients). Until now, there are no academic findings that have proven independent prognostic value of diabetes on death in the novel Coronavirus patients. However, there are several conjectures linking Diabetes with the impact as well as progression of COVID-19 in these patients. The aim of this review is to acknowledge about the association amongst Diabetes and the novel Coronavirus and the result of the infection in such patients.

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Leptospirosis

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.8.3.2016.14148 ◽

2016 ◽

Vol 8 (3) ◽

Author(s):

Novie H. Rampengan

Keyword(s):

Gold Standard ◽

Case Fatality Rate ◽

Severe Disease ◽

Case Fatality ◽

Agglutination Test ◽

Microscopic Agglutination Test ◽

Moderate Risk ◽

Rat Urine ◽

The World ◽

Different Parts

Abstract: Leptospirosis is a zoonotic disease that usually occurs during the flood and is generally transmitted through rat urine. Indonesia is a country with a moderate risk of transmission of leptospirosis. Leptospirosis has a broad manifestation varying from self-limited to severe disease. The gold standard examination of leptospirosis is microscopic agglutination test. Diagnosis is divided into suspected, probable, and confirmed. Treatment consists of antibiotics and supportive agents. Generally, the prognosis is good, albeit, sequelae can occur. Case-fatality rate in different parts of the world ranging from less than 5% to 30%.Keywords: leptospirosis, diagnosis,Abstrak: Leptospirosis merupakan penyakit zoonosis yang umumnya timbul saat banjir dan umumnya ditularkan melalui kencing tikus. Indonesia merupakan negara dengan risiko sedang penularan leptospirosis. Leptospirosis memiliki manifestasi luas dari self limited hingga sakit berat. Pemeriksaan baku emas leptospirosis ialah dengan microscopic agglutination test. Diagnosis dibagi atas suspek, probable, dan konfirmasi. Terapi diberikan medikamentosa dengan antibiotik dan suportif. Prognosis umumnya baik namun bisa juga terjadi gejala sisa. Tingkat fatalitas kasus di berbagai belahan dunia berkisar <5%-30%.Kata kunci: leptospirosis, diagnosis

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Factors Related to Symptoms in Patients Suspect Covid-19 in The Public Health Center Kebayoran Baru in March – June 2020

Muhammadiyah International Public Health and Medicine Proceeding ◽

10.53947/miphmp.v1i1.150 ◽

2021 ◽

Vol 1 (1) ◽

pp. 907-922

Author(s):

Tri Wahyuni ◽

Suherman Suherman ◽

Nazarwin Saputra ◽

Istianah Surury

Keyword(s):

Diabetes Mellitus ◽

Heart Disease ◽

Health Center ◽

Community Health Center ◽

High Mobility ◽

Secondary Data ◽

Chi Square ◽

Cross Sectional ◽

The World ◽

The Government

The world is undergoing the new pandemic named COVID-19 of early 2020 announced in China and all over the world and infect more than 10 million people in the world (incidence rate 1.3). Indonesia has the number of cases 28.818 per June 04, 2020, with a CFR of 6%, the highest in Southeast Asia. Besides confirming the case, the suspect like ODP, PDP, and OTG should also be monitored. Although the number of cases and suspects in the Kebayoran Baru district is not the highest in South Jakarta, as the center of South Jakarta where many offices and high mobility, and the population is not as much as another district, so the possible transmission of COVID-19 in Kebayoran Baru still high. To find out the relationship between age, sex, comorbid hypertension, diabetes mellitus, and heart disease with the severity of symptoms in COVID-19 suspect of Kebayoran Baru district March – June 2020. The design of this study used cross-sectional secondary data of COVID-19 suspect monitoring in Community Health Center Kebayoran Baru. Analysis with chi-square 0.005. Statistical results of COVID-19 suspects in the Kebayoran Baru district are 44% having symptoms. The research suggests that a significant relationship between age, hypertension comorbid, diabetes mellitus comorbid, and heart disease with the symptoms. While sex has no significant relation with symptoms. The government should have more attention to protect people that having comorbid such as hypertension, diabetes mellitus, or heart disease.

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2019 Novel Coronavirus (COVID-19) pneumonia: an unusual lung ultrasound presentation.

10.21203/rs.3.rs-25490/v1 ◽

2020 ◽

Author(s):

Letizia Consoli ◽

Vittorio Bendotti ◽

Sara Cicchinelli ◽

Federico Gaioni ◽

Paola Prandolini ◽

...

Keyword(s):

Case Fatality Rate ◽

Lung Ultrasound ◽

Case Fatality ◽

Ground Glass Opacity ◽

Public Health Emergency ◽

Fatality Rate ◽

Chest Computed Tomography ◽

Ultrasound Findings ◽

The World ◽

Novel Coronavirus

Abstract In December 2019, a novel coronavirus (SARS-Cov-2) was first reported in Wuhan, China, and rapidly spread around the world, leading to an international emerging public health emergency. As reported from Chinese experiences, approximately 20% of patients had a severe course, requiring intensive care, with an overall case fatality rate of 2.3%. In diagnosis, chest computed tomography most commonly showed ground-glass opacity with or without consolidative patterns.Herein we report a case of a patient affected by COVID-19 pneumonia referred in the emergency department of our institution on 4 April 2020 with peculiar lung ultrasound findings.

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Comparison of Predictors of Mortality between Young and Elder Covid-19 Patients Admitted in Covid-19 Designated Tertiary Care Hospital

Healthline ◽

10.51957/healthline_197_2020 ◽

2021 ◽

Vol 12 (1) ◽

pp. 46-54

Author(s):

Sonal Shah ◽

Manisha Kapdi ◽

Jyoti Vora ◽

Kuldeep Joshi ◽

Pratik Patel ◽

...

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Fatality ◽

Care Facility ◽

Health Care Facility ◽

Care Hospital ◽

Chi Square ◽

Neutrophil Lymphocyte Ratio ◽

Predictors Of Mortality ◽

Co Morbidity

Background: The outbreak of Covid-19 has led to a health emergency and economic crisis worldwide. Mortality in productive age further worsens the crisis, so it is important to understand reasons for death in productive age group. Objective: To identify predictors of mortality and to compare the intensity of rise in inflammatory markers of amongst young Covid-19 decedents in comparison with elder Covid-19 decedents. Method: Record based study of Covid-19 infected admitted patients was conducted in tertiary care hospital. Information of all (n=3131, 209 deceased and 2922 recovered patients) Covid-19 positive patient assessed . Their clinico epidemiological markers were compared between younger (18-45 years) decedents in comparision with elder decedents (>45 years). Mann–Whitney U-test and the Chi-square test for significance were used. Bivariate Multiple logistic regression was used to identify predictors in younger and elder decedents. Results: Case Fatality Rate (CFR) in Covid-19 infected patients was 2.4% and 9.7% amongst younger and elder group respectively. (OR 8.83 : 95% CI 5.9-13.2; p < 0.001). Biomarkers were raised and similar in both groups except Neutrophil Lymphocyte Ratio (NLR) was significantly higher in elder decedent while LDH was significantly higher in younger decedents. Conclusions: Males had higher CFR than females after 45 years of age, which was due to co-morbidity. Reaching late to the health care facility and high LDH were predictors in younger decedent, while male gender, co morbidities and high NLR were more important predictors in elder group.

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SURVEILLANCE OF MORTALITY: FROM A TERTIARY CARE TEACHING HOSPITAL OF EASTERN INDIA IN PERSONS WITH AND WITHOUT DIABETES MELLITUS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i6.17430 ◽

2017 ◽

Vol 10 (6) ◽

pp. 87

Author(s):

Shobhitendu Kabi ◽

Shrikant Kumar Dhar ◽

Baikuntha Nath Panda ◽

Chandan Das ◽

Kamal Kant Jena ◽

...

Keyword(s):

Diabetes Mellitus ◽

Cause Of Death ◽

Teaching Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Eastern India ◽

Mortality Pattern ◽

Tertiary Care Teaching Hospital ◽

Care Teaching ◽

The World

Objective: There is abundant knowledge about the gravity of global load of diabetes mellitus (DM). There are conflicting reports on the cause of death from different parts of the world. In India, there are not enough studies to establish the cause of death in DM. To find out the mortality pattern in DM and non-DM (NDM) in a tertiary care teaching hospital in Eastern India.Methods: Retrospective analysis of in-hospital mortality in a tertiary care hospital in Eastern India, from January 2012 to December 2015.Results: There were a total of 1590 deaths of which 442 were having DM and 1148 did not have DM (NDM). Mean age of death for nondiabetics was 66.4 years (M:F = 67.5:65.3) and that for diabetics were 62.7 years (M:F = 63.5:60.04) which was not statistically significant (p=0.9) though diabetics died younger by 4 years. On analyzing the specific cause of death, coronary artery disease (CAD) was 14.71% in DM and 1.57% in NDM (p=0.0001). Chronic kidney disease (CKD) was 18.55% in DM and 1.92% in NDM (p=0.0001). Congestive heart failure was 7.27% in DM and 1.83% in NDM (p=0.0001). CVA was 13.57% in DM and 1.66% in NDM (p=0.0001). Infection was the most common cause of death (39.37%) in DM, but in NDM also this was quite high 34.41% (p=0.21). The death due to CVA in DM was more in hemorrhage as compared to ischemic (p=0.00001).Conclusion: We found causes of death in DM were an infection, CKD, CAD, CVA, and CHF in descending order in this part of the world. The diabetes patients had lesser hospital stay than nondiabetes patients (p=0.009).

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A comparison of COVID-19, SARS and MERS

PeerJ ◽

10.7717/peerj.9725 ◽

2020 ◽

Vol 8 ◽

pp. e9725 ◽

Cited By ~ 3

Author(s):

Tingting Hu ◽

Ying Liu ◽

Mingyi Zhao ◽

Quan Zhuang ◽

Linyong Xu ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Case Fatality ◽

Hubei Province ◽

World Health ◽

Atypical Pneumonia ◽

Organization Studies ◽

Optimal Method ◽

The World ◽

Novel Coronavirus ◽

Health Organization

In mid-December 2019, a novel atypical pneumonia broke out in Wuhan, Hubei Province, China and was caused by a newly identified coronavirus, initially termed 2019 Novel Coronavirus and subsequently severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 19 May 2020, a total of 4,731,458 individuals were reported as infected with SARS-CoV-2 among 213 countries, areas or territories with recorded cases, and the overall case-fatality rate was 6.6% (316,169 deaths among 4,731,458 recorded cases), according to the World Health Organization. Studies have shown that SARS-CoV-2 is notably similar to (severe acute respiratory syndrome coronavirus) SARS-CoV that emerged in 2002–2003 and Middle East respiratory syndrome coronavirus (MERS-CoV) that spread during 2012, and these viruses all contributed to global pandemics. The ability of SARS-CoV-2 to rapidly spread a pneumonia-like disease from Hubei Province, China, throughout the world has provoked widespread concern. The main symptoms of coronavirus disease 2019 (COVID-19) include fever, cough, myalgia, fatigue and lower respiratory signs. At present, nucleic acid tests are widely recommended as the optimal method for detecting SARS-CoV-2. However, obstacles remain, including the global shortage of testing kits and the presentation of false negatives. Experts suggest that almost everyone in China is susceptible to SARS-CoV-2 infection, and to date, there are no effective treatments. In light of the references published, this review demonstrates the biological features, spread, diagnosis and treatment of SARS-CoV-2 as a whole and aims to analyse the similarities and differences among SARS-CoV-2, SARS-CoV and MERS-CoV to provide new ideas and suggestions for prevention, diagnosis and clinical treatment.

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Analysis of SARS-CoV-2 genomes from across Africa reveals potentially clinically relevant mutations

10.1101/2020.09.08.287201 ◽

2020 ◽

Author(s):

Modeline N. Longjohn ◽

Olivia S. Egbule ◽

Samuel O. Danso ◽

Eugene E. Akujuru ◽

Victor T. Ibubeleye ◽

...

Keyword(s):

Vaccine Coverage ◽

Phylogenetic Analyses ◽

Severe Disease ◽

Case Fatality ◽

Climatic Conditions ◽

Etiologic Agent ◽

World Health ◽

Sequence Alignments ◽

Novel Coronavirus ◽

Health Organization

AbstractSARS-CoV-2 is a betacoronavirus, the etiologic agent of the novel Coronavirus disease 2019 (COVID-19). The World Health Organization officially declared COVID-19 as a pandemic in March 2020 after the outbreak in Wuhan, China, in late 2019. Across the continents and specifically in Africa, all index cases were travel-related. Understanding how the virus’s transportation across continents and different climatic conditions affect the genetic composition and the consequent effects on transmissibility, infectivity, and virulence of the virus is critical. Thus, it is crucial to compare COVID-19 genome sequences from the African continent with sequences from selected COVID-19 hotspots/countries in Asia, Europe, North and South America and Oceania.To identify possible distinguishing mutations in the African SARS-CoV-2 genomes compared to those from these selected countries, we conducted in silico analyses and comparisons. Complete African SARS-CoV-2 genomes deposited in GISAID and NCBI databases as of June 2020 were downloaded and aligned with genomes from Wuhan, China and other SARS-CoV-2 hotspots. Using phylogenetic analysis and amino acid sequence alignments of the spike and replicase (NSP12) proteins, we searched for possible vaccine coverage targets or potential therapeutic agents. Identity plots for the alignments were created with BioEdit software and the phylogenetic analyses with the MEGA X software.Our results showed mutations in the spike and replicate proteins of the SARS-Cov-2 virus. Phylogenetic tree analyses demonstrated variability across the various regions/countries in Africa as there were different clades in the viral proteins. However, a substantial proportion of these mutations (90%) were similar to those described in all the other settings, including the Wuhan strain. There were, however, novel mutations in the genomes of the circulating strains of the virus in African. To the best of our knowledge, this is the first study reporting these findings from Africa. However, these findings’ implications on symptomatic or asymptomatic manifestations, progression to severe disease and case fatality for those affected, and the cross efficacy of vaccines developed from other settings when applied in Africa are unknown.

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