Dedicated COVID Hospital Research Articles

ENT Manifestations of COVID-19 in a Dedicated Covid Hospital: Prospective Observational Study

Background: The Coronavirus disease (COVID-19) is global challenge to public health. The study investigates all possible manifestations and their prevalence pertaining to ENT in COVID-19 in our cohort.

Severity of respiratory illness among Covid-19-vaccinated and non-vaccinated admitted patients-An observational study from a teaching hospital of Tripura.

To determine the association between vaccination status and mortality among critically ill patients admitted in a dedicated Covid hospital of Tripura who required invasive mechanical ventilation. This study was conducted at a dedicated Covid hospital of Tripura for a period of six months, i.e., from June 2021 to November 2021. A total of 304 patients were enrolled for this study. Baseline epidemiological, radiological data along with other information like heart rate, pulse rate, oxygen saturation (SpO2), etc., were collected through patient record sheet in all cases during hospitalization. Statistical analysis was done by using SPSS 25 version. Admission and mortality rates in hospital and advanced oxygen support like bi-level positive airway pressure (BiPAP), high-flow nasal cannula (HFNOC), and ventilator use incidences were higher in non-vaccinated patients (17.1%) in comparison to double-dose-vaccinated (0.98%) and single-dose (2.3%)-vaccinated patients. This retrospective data analysis of Covid-19 positive patients admitted in the dedicated Covid Hospital of Tripura suggests that severe infection, need for invasive and non-invasive ventilation, and death were significantly less in the vaccinated patients as compared to the vaccine-naive one.

Chest X Ray and C-reactive Protein as Diagnostic Modalities for Monitoring Complications of Mild to Moderate COVID-19 Infections: Experience from a Dedicated COVID Hospital, Kolkata

Introduction: SARS-COV-2 has created havoc during 2019-2021. Diagnosis and managing complications needed both laboratory investigations and imaging modalities.Aims and objectives: To find out the association between socio-demographic and clinical profiles of the studysubjects with their different laboratory investigations and imaging modalities and to compare normal investigations with their gold-standard variants.Materials and Methods: During the first wave of COVID-19, a descriptive, observational, and cross-sectionalstudy was carried out on 120 consecutive samples of mild to moderate COVID patients using a conveniencesampling technique in a COVID indoor ward of Medical College, Kolkata. The semi-structured data collectionform used in the study was predesigned, pretested, face and content validated. SPSS version 25 and Microsoft Excel version 19 was used for data analysis after coding. Ethical approval was taken. (Ref No. MC/KOL/IEC/ Non-Spon/842/11/2020).Results: Old age, uncontrolled diabetes and hypertension, presence of symptoms especially shortness of breath is significantly associated with low levels of SpO2, elevated C reactive protein (CRP) and D-dimer, abnormal Chest X-ray (CXR) and CT Thorax. A Kappa analysis suggested CRP and CXR can also be done instead of D-dimer and CT Thorax respectively, in a COVID patient for monitoring complications.Conclusion: CRP and CXR are cost-effective alternatives and can be used as diagnostic modalities for monitoring of complications of mild to moderate COVID-19 infections.

Retrospective Chart Analysis of Psychiatry Referrals for Hospitalized COVID-19 Patients in a Dedicated COVID Hospital in a Metropolitan City in India

Abstract Background: The COVID-19 pandemic has been associated with multiple psychiatric problems in the general population as well as in those admitted with the infection. Studies done so far have mainly focused on the general population. It is important to address the needs and gaps in mental and psychological aspect of health of patients admitted with the infection to improve their overall prognosis. This study was undertaken with the aim to study the pattern of psychiatric referrals of hospitalized COVID-19 patients and to find out if there is any association between their socio-demographics, severity of COVID-19 infection, inflammatory markers, and co-morbidities. Materials and Methods: A descriptive, retrospective chart analysis of the record of 160 psychiatry referrals for COVID-19 patients seen by the on-call psychiatrist from May 2020 to October 2020 in a tertiary care hospital was undertaken. Sociodemographic data, severity of COVID-19 infection, blood investigation reports, psychiatric symptoms, diagnosis and management were recorded, tabulated, and analyzed using SPSS 20. Results: Referrals were more for individuals having moderate-to-severe COVID-19 infection, in elderly patients and in males. The most common reason for referral was disorientation (27.5%) and insomnia (27.5%), followed by the patient having a preexisting psychiatric illness (15%). The most common psychiatric diagnosis was delirium secondary to general medical condition, (28%), followed by anxiety and depressive spectrum disorders (23.75%). 32.5% of the patients referred had a past history of psychiatric illness, the most common being substance use disorder, followed by major depressive disorder and mixed anxiety depression. With the increase in the age of the individuals, the number of referrals for males was significantly more as compared to females (P = 0.00). No statistically significant association was found between age (P = 0.83), gender (P = 0.99), and psychiatric diagnosis. No significant association was found between the severity of COVID-19 and psychiatric diagnosis (P = 0.69). Conclusion: It is essential to screen for psychiatric disorders in patients admitted for COVID, as it goes a long way in reducing the overall morbidity and improves patient cooperation for various procedures which could be life-saving.

Hybrid Learning in Medical Curriculum: Perception of Medical Students of a Dedicated COVID Hospital in Eastern India

Background: In recent years, hybrid education has transformed traditional education. This study aimed toexamine students’ perceptions of the quality of teaching-learning in the hybrid and offline modes of UG medicalcurriculum and to learn how MBBS students perceived the hybrid mode of education.Methods: Using simple random sampling, an institution based descriptive cross-sectional study was carried outbetween November 2022 and January 2023 among 100 MBBS students at the Medical College, Kolkata. Afterreceiving ethical approval, an online interview was carried out utilising a predesigned, pretested, semi-structured,and validated questionnaire via Google forms. Data analysed using MS Excel and SPSS version 25.0.Results: 90% of students believe that traditional offline classes and online learning will coexist as a hybridapproach of instruction. Most students (63%) believed that hybrid programmes can make up for the shortcomingsof completely online or offline courses.Conclusion: The students felt that in the long run, the hybrid approach of teaching should be improved. Theyrecommended making the online and offline modes more integrated, doing offline sessions to clarify questionsabout topics that were taught online, making the lectures more offline format-oriented, and finally, holdingessential lessons offline.

CHEST COMPUTED TOMOGRAPHY SEVERITY SCORING AND ITS RELATION WITH AGE AND GENDER DURING THE SECOND WAVE OF COVID-19 PANDEMIC – A RETROSPECTIVE AND OBSERVATIONAL STUDY

Objective: Our study aimed to assess the lung involvement using computed tomography (CT) severity scores and to determine how age and gender affect the severity of infection during the second wave of COVID-19. Methods: This retrospective and observational study was conducted in a dedicated COVID hospital. A total of 650 positive patients who gave their consent were included in this study. The CT severity score (25 points) was categorized as mild (<7), moderate (7–18), and severe (>18). Results: Patient’s age of 10–86 years with a mean and SD was 47.77±15.21 years, of which 440 were male and 210 were females. Males were more significantly affected than females (p=0.007). The mean±SD of CT severity score was 8.69±6.28, and ranging from 0 to 25. The most affected age group in the second wave of COVID-19 was 41–60 years (275 patients, 42.3%). A significant positive correlation between total CT severity with age, but it was mild (r=0.16, p=0.003). Conclusion: The age range with the highest CT severity score and the majority of men was 41–60 years. In addition, there was a strong association between the severity of the CT and both male gender and age.

Liver function tests at admission as marker of severity and prognosis in COVID-19 patients - A retrospective analysis.

With evolving pandemic, a substantial proportion of patients are presenting with liver dysfunction as an extra-pulmonary manifestation of COVID-19 illness. We planned this study to evaluate the incidence of liver dysfunction in COVID-19 pneumonia and find an association between abnormal liver function and the severity of the disease. We retrospectively analysed the hospital records of 344 patients with moderate to severe COVID-19 illness admitted to a Dedicated COVID Hospital in North India. Out of 344 patients included in the study, 59.9% were males. The abnormal liver functions were present in 78.49% of patients at admission. Mean age of the patient with liver dysfunction was 53.41 ± 15.71 years. The incidence of elevated aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hypoalbuminemia was 82.96%, 74.91%, and 69.7%, respectively, in patients with COVID-19 at admission. A positive correlation was found between the levels of AST, ALT and hypoalbuminemia with severity of disease. Mortality was 33% in patients with liver dysfunction in comparison to 18.9% in patients with normal liver functions. More than 75% of the patient had abnormal liver functions at admission, and mortality was also high in this group. Mortality can be effectively reduced if laboratory parameters such as elevated AST and ALT and hypoalbuminemia are closely monitored at admission and during hospital stay in patients with risk factors like male, age <55 years and HTN.

COVID-19 appropriate health and hygiene practices among food handlers: an experience from therapeutic kitchen of a dedicated COVID hospital of Bhubaneswar, Odisha, India

COVID-19 appropriate health and hygiene practices among food handlers: an experience from therapeutic kitchen of a dedicated COVID hospital of Bhubaneswar, Odisha, India

Burnout in Healthcare Staff due to COVID Pandemic in a Tertiary Care Dedicated COVID Hospital

Objectives To evaluate the socio-demographic profile and burnout among frontline doctors, paramedical, and other supporting staff in dedicated tertiary COVID hospitals. Materials and Methods The samples taken were divided into three groups as follows: Doctors, paramedical staff, and other supporting staff working in a tertiary hospital dedicated to handling the COVID-19 pandemic at SKIMS-MCH Bemina Hospital. Results In this study, a total of 185 participants took part out of which 388 individuals were employed across the medical departments of this hospital. This was an overall response rate of 47.6%. Most participants were in the age group of 31–50 years (48.6%). Males comprised 53.5%, married 66.4%, living with family 82.7%, and as per job description, most responses were from paramedical staff (53.51%). On analysis of the mean ± SD score of burnout across individual socio-demographic variables predominant burnout was seen in paramedical staff (45 ± 5.2) followed by those living with family (42 ± 3.7), married (43 ± 1.2), and those older than 50 years (40 ± 3.9). Conclusion Our study showed that the high prevalence of burnout was among healthcare professionals in the tertiary hospital who were exposed to working and catering large population with serious healthcare and emergency issues caring for patients during the new pandemic. Factors such as female gender, living with family, and older age of healthcare professionals were associated with significant burnout. These findings can help to improve the preparedness for the future.

COVID-19 vaccination status and treatment outcome: An observational study in a dedicated COVID Hospital of North East India

: Vaccination has been recommended to curve the COVID-19 pandemic. Associations of death among COVID-19 patients with their COVID-19 vaccination status and various co-morbidities are ill understood. Tocompare the proportions of death between COVID-19 vaccinated and un-vaccinated and to determine the association of vaccination status and selected co-morbidities with death among COVID-19 patients treated in the DCH of Tripura. : This secondary data based cross-sectional study was conducted in the DCH of Agartala Government Medical College using medical records of 2354 COVID-19 patients treated during second and third quarters of 2021, chosen by simple random sampling. A pre-designed proforma was used to extract data regarding demographics, vaccination status, co-morbidities, vitals, treatment outcome etc. from the case-sheets. Binary regression model was utilized for predicting the probability of death due to COVID-19 using important predictor variables. Majority i.e. 68% patients were aged between 18 to ≤60 yr, 56.7% were male, 38.3% had co-morbidities, 11% received single dose, 9.6% received two doses and 79.4% had no COVID-19 vaccination. Death rate was 5.8% among first dose recipients, 9.3% among second dose recipients and 11.4% among un-vaccinated. Overall death rate was 7.4%. Binary regression model has shown that older age, poor oxygen saturation during hospitalization, chronic kidney disease, hypertension and diabetes mellitus are having significant enhancing effect and vaccination having protective effect upon death. Old age, diabetes mellitus, hypertension and chronic kidney disease have enhancing and vaccination has got protective effect against death due to COVID-19.

Role of Inflammatory Markers in Predicting Severity in COVID-19 Patients at Tertiary Care Hospital, Ujjain (M.P.)

Originating from China in 2019, the novel Coronavirus Disease 2019 (COVID-19) pandemic had badly affected most of the world causing immense morbidity and mortality. The disease in moderate to severe cases was characterized by intense inflammation leading to ARDS and hypercoagulable states leading to thrombo-embolism and mortality. Aim: This study aimed to explore the association of inflammatory biomarkers with COVID-19 disease severity in our hospital which became a dedicated COVID hospital during the pandemic.

A STUDY OF LENGTH OF HOSPITAL STAY OF COVID-19 PATIENTS ADMITTED IN A DEDICARED COVID-19 HOSPITAL IN UDAIPUR

Background :- The ongoing coronavirus disease 2019 ( covid-19 ) pandemic has placed an unprecedented strain on indian healthcare systems, with rapidly increasing demand for life-saving equipment and intensive care unit beds. The present study presents an analysis of average length of stay as per different demographic and clinical factors in a dedicated covid hospital. Objectives: 1) To study the clinical and epidemiological prole of Covid 19 patient. 2) To study about relation between patient's length of stay with their clinical characteristics Method: A hospital based Retrospective crosssectional study in which All RTPCR conrmed Cases who got hospitalization and got treated during 19 months(from March 2020 till September 2021)of the rst RTPCR conrmed case in study area. Result: This study reported that out of the total 8027 study population higher proportion of Males that is 5229 (65.14%) were affected as compare to females 2798(34.86%). Mean age of this study population was 53.13 ± 20.13 year, and median age was 39 years. In our study we found that out of total 16.05% severely ill , mild 39.85% and moderate 44.10%. Duration of stay of symptomatic patients was higher 16.14 ± 4.41 days as compare to asymptomatic patients 11.11 ± 3.95 days. Association between duration of stay with symptoms was statistically signicant (p=&lt;0.001). In our study average length of stay for male patients were 15.49±4.32 days and female was 16.08±4.54 days and average length of stay of patients with comorbidity were 17.23±4.57 days and without comorbidity were 13.57±4.08 days. Conclusion: average length of stay was higher in patients with comorbidity and patients who were symptomatic.

An in-depth appraisal of clinico-biochemical and radiological findings of COVID-19 patients during the COVID-19 pandemic in a dedicated COVID Care Hospital in Eastern India and its outcome in relation to the COVAXIN vaccination status: A 2-year study.

COVID-19 pandemic hit Odisha province from April 2020 to December 2020, then from April 2021 to August 2021 and from February 2022 to April 2022 as the first, second, and third waves, respectively, with the most severe form witnessed during the second wave. Kalinga Institute of Medical Sciences hospital in Odisha was declared a Dedicated COVID Hospital (DCH) during those three waves and witnessed 9485 cases of admissions among which there were 1214 deaths. COVAXIN vaccination of the vulnerable population was launched in February 2021 onwards. This study has been done to know the clinic-biochemical profiles, radiologic findings of COVID-19 admitted patients, the predictors of mortality in the second wave, and clinical outcomes in the three waves in relation to COVAXIN vaccination status. This was a serial three-round retrospective study from the electronic medical records using multistage random sampling where we collected and critically analyzed the demographic, and all the relevant possible health data of the cases that consist of 514 cases admitted in three waves. The data from death certificates among the 555 cases in the second wave have been analyzed to conclude predictors of mortality. Mortality increased with age, male gender, comorbidities, and raised C-reactive protein level. High NL ratio, extent of pulmonary involvement. There was a wide variation in incidence and spectrum of illness starting from 79% incidence of mild symptomatic in the initial and third wave, but remained in the range of 35-65% in the second wave, respectively, and the most noticeable symptomatic illness was that of the upper respiratory tract. In fulminant cases, the mode of presentations was severe pneumonia and acute respiratory distress syndrome. Males were more sufferers than females. Children had better outcomes compared to adults. COVID-associated coagulopathy had a normal platelet count. Subsequently, in 2021 year onwards vaccination of the vulnerable population was launched in a phased manner that changed the dynamics of the disease outcome by better survival chances despite intercurrent COVID infection by induction of herd immunity. On the contrary, there was a higher prevalence of serious illness among non-vaccinated individuals. While the cases continued during the second wave of the pandemic, long COVID became a clinical entity of symptomatic that persisted or recurred among the COVID illness recovered cases after reverse transcriptase polymerase chain reaction results for COVID-19 became negative. The symptoms consisted of fatigue, cough, dyspnea as pulmonary manifestations and extra-pulmonary involvement of the cardiac, renal, and central nervous systems and the pulmonary imaging features consisted of interstitial pneumonia, consolidation, cavity pattern, and prone to microbial infection. These events lead to morbidity and admission. Coinciding with the vaccination of all population of Odisha province with the first dose of the vaccine by around the period of the first quarter of 2022, there was a new variant named Omicron responsible in the third wave, in which the majority of the admitted cases had.mild upper respiratory illness. This was not as lethal as its predecessors due to its lower propensity to invade the lungs and blood vessels. Immune dysregulation plays a central role in the pathogenesis of the manifestations. Vaccine-induced protection and the induction of herd immunity played a proactive role in the waning of the severity of clinical presentations.

Portable Chest Radiograph: A Boon for Critically Ill Patients With COVID-19 Pneumonia.

In the present study, we evaluated the role of portable chest radiographs in critically ill patients with COVID-19 pneumonia in whom computed tomography (CT) of the chest was not feasible. A retrospective chest X-ray study of patients under investigation for COVID-19 was performed in our dedicated COVID hospital (DCH) during the exponential growth phase of the COVID-19 outbreak (August-October, 2020).A total of 562 on-bed chest radiographs were examined comprising 289 patients (critically ill who couldn't be mobilized for CT) along with positive reverse transcription-polymerase chain reaction (RT-PCR) tests. We categorized each chest radiograph as progressive, with changes, or improvement in appearance for COVID-19, utilizing well-documented COVID-19 imaging patterns. In our study, portable radiographs provided optimum image quality for diagnosing pneumonia, in critically ill patients. Although less informative than CT, nevertheless radiographs detected serious complications like pneumothorax or lung cavitation and estimated the evolution of pneumonia. A portable chest X-ray is a simple but reliable alternative for critically ill SARS-CoV-2 patients who could not undergo chest CT. With the help of portable chest radiographs, we could monitor the severity of the disease as well as different complications with minimal radiation exposure which would help in identifying the prognosis of the patient and thus help in medical management.

Multi-center study to analyse outcome of integrated treatment approach in COVID-19 patients

Background: This study presents the outcome of integrated treatment approach based on government mandated standard allopathic treatment along with alternatives in COVID-19 patients. The aim of our study was to investigate the outcome of treatment strategy, co-morbid status, recovery and mortality rate of COVID-19 patients at Bhaktivedanta Hospital and Research Institute. Methods: Post ethics committee approval for multiple centers, data for 1049 COVID-19 patients (RTPCR confirmed cases) of all age groups and genders which were admitted in a dedicated covid hospital from March 2020 to November 2020 was analysed retrospectively. Results: This study highlights the management of COVID-19 patients with an integrated approach. In our cohort with 36.7%, 44.70 %, 18.58% of mild, moderate and severe cases respectively, mortality rate was only 3.43% of total positive patients admitted at our hospital. Conclusions: We emphasize that even in healthcare facilities with limited resource and poor infrastructure and lack of ICU facilities, clinical observation-based management can help to reduce mortality considerably. Unique features of our study include use of progesterone as an immune modulator, use of dual antiviral agents and use of age-related lower limit of oxygen saturation.

Outcome of intensive care unit admitted COVID-19 patients with co-morbid conditions requiring ventilator support

Background: The characterization of intensive care unit (ICU) admitted COVID-19 patients with co-morbid conditions requiring ventilator support can help investigators worldwide to prepare for emergency situation arising at the time of spread of disease. The objective of our study is to analyse the outcome of ICU admitted COVID-19 patients with co-morbid conditions. Methods: Post ethics committee approval for multiple centers, data of 212 consecutive discharged and death COVID-19 confirmed ICU patients were included and analyzed. These patients of all age groups and genders were admitted in Bhaktivedanta Hospital and Research Institute, Mira Road, Mumbai, Maharashtra, India which is a dedicated COVID hospital from March 2020 to November 2020. Results: Of the total 212 ICU patients, 17 (9%) cases were moderate, 195 (91%) were severe cases as per CT severity score grading, median duration of stay in the hospital was 9 (37%) days. Diabetes mellitus was the leading co-morbid condition with frequency of 27.8% followed by ischemic heart disease (IHD) (5.6%), chronic kidney disease (CKD) (5.1%), asthma (3.77%) and chronic obstructive pulmonary disorder (COPD) (0.94%). Conclusions: Not all patients with co-morbid conditions progress towards poor lung function. IHD is the worst prognostic indicator for progressing towards poor lung function as compared to diabetes, CKD and COPD.

Overview of COVID-19 mortality in Zoram Medical College, Mizoram: A hospital-based study.

Mizoram is a small state in the northeastern part of India and recorded its first case of coronavirus disease 2019 (COVID-19) on March 24, 2020. The first registered death because of COVID-19 in the state was on October 28, 2020 at Zoram Medical College (ZMC), which is a dedicated COVID hospital in Mizoram. COVID-19 cases from different districts in the state were referred to ZMC according to severity of symptoms. NCDIR-ICMR e-Mortality Cell was first started as a project at ZMC in 2019. Since then, all hospital deaths are recorded using a structured questionnaire developed by NCDIR which has also strengthened the data for COVID-19 mortality statistics in the state. The objective of this study is to determine the association of in-hospital COVID-19 mortality in relation to age, sex, vaccine status, and underlying co-morbidities and highlight the utility of ICMR-NCDIR e-Mortality software in the hospital. Data on COVID-19-associated deaths from October 2020 to October 2021 at ZMC were collected from the hospital e-Mortality software and Medical Records Department (MRD). This includes patients' demographic characteristics including age, sex, vaccination status, and underlying co-morbidities if any. Appropriate statistical analysis was performed to evaluate the correlation between variables. From October 2020 to October 2021, a total of 324 deaths related to COVID-19 was recorded at ZMC, Mizoram. The majority of the deaths were distributed in the age group 65 years and above and accounts for 49.1% in all age groups. Out of the total deaths, 64.2% (208) were males and 81.48% had an associated underlying co-morbidity besides COVID-19. The most common co-morbidities were hypertension, type 2 diabetes mellitus, cancer, and chronic obstructive pulmonary disease. More than half, 59.6%, had no vaccination history, and all the cases had no history of taking a booster vaccination dose. A statistically significant correlation between delay in time to admission and length of hospital stay (p = 0.017) was also seen. COVID-19 is more severe in the older age group above 65 years of age and in males, particularly in the presence of underlying co-morbidities. Mortality was also higher in patients with no history of vaccination as compared with patients vaccinated. Also, delay in hospital admission increases the length of hospital stay and mortality.

Variation in biochemical parameters in COVID-19 patients admitted at a tertiary care dedicated COVID hospital: A prospective study.

COVID-19 infection has a myriad of presentation. Rural India and other developing nations are relatively resource poor, not having access to modern specialized investigations. In this study, we tried to evaluate only biochemical parameters in predicting the severity of the infection. The aim of this study was to find a cost-effective means to predict the clinical course at the time of admission and thereby to reduce mortality and, if possible, morbidity by timely intervention. All COVID-19-positive cases admitted at our hospital from March 21 to December 31, 2020, were recruited in this study. The same acted as sham control at recovery. We observed a significant difference in biochemical parameters at the time of admission and discharge, between mild/moderate disease and severe disease. We found slightly deranged liver function tests at admission, which becomes normal at the time of discharge. Urea, C-reactive protein (CRP), procalcitonin, lactate dehydrogenase, and ferritin concentrations in severe/critical patients were significantly higher than that in the mild/moderate group. Receiver operating characteristic curves were plotted to predict the severity on the basis of biochemical parameters independently, of the patients based on these values. We proposed cutoff values of certain biochemical parameters, which will help in judging the severity of the infection at admission. We developed a predictive model with a significant predictive capability for CRP and ferritin values, using normal available biochemical parameters, routinely done in resource-poor centers. Clinicians working in resource-poor situations will be benefitted by having an idea of the severity of the disease. Timely intervention will reduce mortality and severe morbidity.

Perinatal Outcome in Maternal COVID-19 infection at a Tertiary care Institute- A cross Sectional Study.

COVID 19 pandemic is one of the biggest challenge to health system of developing as well as developed countries. Because of the novelty of the virus, limited data were available regarding perinatal outcome. The objective of this study is to find out the perinatal outcome in COVID-19 infected mothers who delivered during COVID Pandemic. A cross sectional study was carried out at PCMC'S Post-Graduate Institute and YCM Hospital Pune (Maharashtra) from 1 May 2020 to 31 October 2021 which was a dedicated COVID hospital during COVID pandemic. A total of 362 maternity patients (including 5 twin pregnancies) having COVID 19 infection who gave birth to 367 Newborns were studied. Maternal COVID -19 infection was diagnosed either by RTPCR test or Rapid Antigen test. Demographic variables, maternal symptoms, labour and neonatal outcome were recorded. RT PCR of neonates at birth was performed. Data was analyzed statistically by using Epi Info Software. To analyze the perinatal outcome among COVID-19 infected mothers who delivered during Covid pandemic. Study was conducted with the primary objective to analyze the labour outcome, maternal symptoms and secondarily to study maternal demographic profile and to compare disease severity during 1st and 2nd wave of COVID and to detect possibility of vertical transmission of COVID-19 in neonates of covid positive mothers. 74.2% patients from young reproductive age (21-30 years age) were affected. All socioeconomic classes were affected. 61% patients were multigravida. Normal BMI was noted in 49.8%. 28.2% deliveries were preterm. Caesarean section rate was 50.5%. Following obstetric high risk factors were noted-anaemia in 34.2% followed by previous LSCS in 26.2% cases and preeclampsia in 18.7%Overall 54.6% patients were asymptomatic while 45.4% were symptomatic. Symptomatology between 1st and 2nd wave showed statistical significance (p value < .05%) for mild, moderate and severe symptoms. Myalgia, cough, fever and fatigue were common presenting symptoms. 14% patients required ICU/HDU care. HDU/ICU requirement showed statistical significance (p value < .05) between 1st and 2nd wave. Overall maternal mortality was 1.1% (4 maternal deaths in 2nd wave) with no mortality in 1st wave.96.4% were live births. Birth weight was more than 2.5kg in 62% cases and 21.3% cases required NICU. Vertical transmission of COVID was seen in 1.1% cases. Pregnant patients with moderate and severe disease are at higher risk of perinatal complications. ICU/HDU management with multidisciplinary management may reduce morbidity and mortality. Neonatal affection due to COVID may not be severe but may increase prematurity due to iatrogenic intervention.

Cardiopulmonary long-term effects in patients after hospitalization due to COVID-19 infection

Abstract Background Multiple studies have described acute effects of the Covid-19 infection on the heart, but little is known about the long-term cardiac and pulmonary effects and complications after recovery. The aim of this analysis was to deliver a comprehensive report of symptoms and possible long-term impairments after hospitalization because of Covid-19 infection as well as to try to identify predictors for Long-Covid. Methods This was a prospective, multicenter registry study. Patients with verified Covid-19 infection, who were treated as in-patients at our dedicated Covid hospital (Clinic Favoriten), have been included in this study. In all patients, testing was performed approximately 6 months post discharge. During the study visit the following tests and investigations were performed: detailed patient history and clinical examination, transthoracic echocardiography, electrocardiography, cardiac magnetic resonance imaging (MRI), chest computed tomography (CT) scan, lung function test and a comprehensive list of laboratory parameters including cardiac bio markers. Results Between July 2020 and October 2021, 150 patients were recruited. Sixty patients (40%) were female and the average age was 53.5±14.5 years. Of all patients, 92% had been admitted to our general ward and 8% had a severe course of disease, requiring admission to our intensive care unit. Six months after discharge the majority of patients still experienced symptoms and 75% fulfilled the criteria for Long-Covid. Only 24% were completely asymptomatic (figure 1). Echocardiography detected reduced global longitudinal strain (GLS) in 11%. Cardiac MRI revealed pericardial effusion in 18%. Furthermore, cardiac MRI showed signs of former peri- or myocarditis in 4%. Pulmonary CT scans identified post-infectious residues, such as bilateral ground glass opacities and fibrosis in 22%. Exertional dyspnea was associated with either reduced forced vital capacity measured during pulmonary function tests in 11%, with reduced GLS and/or diastolic dysfunction, thus providing evidence for a cardiac and/or pulmonary cause. Independent predictors for Long-Covid were markers of a more severe disease course like length of in-hospital stay, admission to an intensive care unit, type of ventilation as well as higher NT-proBNP and/or troponin levels. Conclusion Even 6 months after recovery from Covid-19 infection, the majority of previously hospitalized patients still suffer from at least one symptom, such as chronic fatigue and/or exertional dyspnea. While there was no association between fatigue and cardiopulmonary abnormalities, impaired lung function, reduced GLS and/or diastolic dysfunction were significantly more prevalent in patients presenting with exertional dyspnea. On chest CT approximately one fifth of all patients showed post infectious changes in chest CT including evidence for myo- and pericarditis as well as accumulation of pericardial effusions. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Major fund