Profile Of COVID-19 Patients Research Articles

Profile of COVID-19 Patients at Arifin Achmad Hospital, Riau Province Between January 2021 and June 2021

Profile of COVID-19 Patients at Arifin Achmad Hospital, Riau Province Between January 2021 and June 2021

DIABETES MELLITUS IN COVID-19; A HOSPITAL-BASED LONGITUDINAL ANALYTICAL STUDY

Objectives: The aim of the study was (1) to assess and compare the profile of COVID-19 patients with diabetes and without diabetes and (2) to determine the outcome of COVID-19 patients with diabetes mellitus. Methods: A hospital-based longitudinal analytical study was conducted on a total of 2000 patients in Bengaluru during the study period from August 2020 to July 2021. The patients fulfilling the inclusion criteria were enrolled for the study after obtaining informed consent. Patients were divided into diabetic and non-diabetic groups and inflammatory markers were compared between these two groups and outcome of these patients was noted. Results: Of the 2000 COVID-19 patients included, 358 were diabetics in this study. Mean age of non-diabetic patients was 41.71 (±15.37) years and diabetic patients were 54.37 (±11.95) years. The inflammatory markers such as Lactate Dehydrogenase (LDH), Ferritin, C-Reactive Protein (CRP), and Neutrophil-Lymphocyte ratio (NLR) were significantly high in patients with diabetes compared to the non-diabetic patients with COVID-19 (p<0.05). Conclusion: This study shows that diabetes is a major risk factor and contributes to the severity and mortality of patients with COVID-19. Our recommendations are for the strict glycemic control in patients affected by COVID-19 during treatment for the same.

Clinical characteristics based homeopathic Remedy Profiling of COVID-19 Patients: A Retrospective Cohort Study

Objective: The objective of the study was to recognize core symptoms associated with COVID-19 positivity, its impact on mental health of patients and to identify indicated homeopathic remedies for COVID-19. Methods: In this pilot study, 25 confirmed COVID-19 patients admitted at Dedicated COVID Hospital (DCH) established under Dr. D Y Patil Vidyapeeth campus took part in survey questionnaire entitled as “Health impact survey for clinical features and patient profiles of COVID 19: Based on Homoeopathic perspective” observed by three independent observers. Based on the survey, specificity and sensitivity of symptoms was analyzed by three independent physicians to perform remedy analysis in order to identify indicated homeopathic medicines for COVID-19 in mild to moderate cases. Results: A total of 25 patients were included in study. Out of 25, 16 patients did not have any co-morbidity while 9 patients had diabetes, blood pressure or thyroid as one of the co-morbidities. The mean age of the patients was 39.4 years ± 12.6 where mean age of patients without co-morbidity was significantly lower than the patients with co-morbidities. The major symptoms were found to be fever (76%), cough (76%), shortness of breath (72%), sore throat (56%), fatigue (80%), loss of smell (40%) and Loss of taste(48%). Likelihood ratio of a positive test was found to be higher for Loss of smell, Loss of taste and Cough. Mixed and contrasting responses were reported by the study subjects on mental health impact. Majority of patients showed mild negative impact on mental health. In remedy analysis total 6 homeopathic medicines were observed with most commonly indicated being Carbo vegetabilis (70.66%), Antimonium tartaricum (10.66%), Arsenic album (9.33%) and Bryonia alba Linn. (4%) in 30C potency. Conclusion: The observation from current study demonstrate that fever, cough, shortness of breath, sore throat, fatigue, loss of smell and Loss of taste are most common symptoms associated with COVID-19 and Carbo vegetabilis, Antimonium tartaricum, Arsenic album and Bryonia alba Linn. are most frequently indicated homeopathic medicines for COVID-19.

Composite Peptide-Agarose Hydrogels for Robust and High-Sensitivity 3D Immunoassays.

Canonical immunoassays rely on highly sensitive and specific capturing of circulating biomarkers by interacting biomolecular baits. In this frame, bioprobe immobilization in spatially discrete three-dimensional (3D) spots onto analytical surfaces by hydrogel encapsulation was shown to provide relevant advantages over conventional two-dimensional (2D) platforms. Yet, the broad application of 3D systems is still hampered by hurdles in matching their straightforward fabrication with optimal functional properties. Herein, we report on a composite hydrogel obtained by combining a self-assembling peptide (namely, Q3 peptide) with low-temperature gelling agarose that is proved to have simple and robust application in the fabrication of microdroplet arrays, overcoming hurdles and limitations commonly associated with 3D hydrogel assays. We demonstrate the real-case scenario feasibility of our 3D system in the profiling of Covid-19 patients' serum IgG immunoreactivity, which showed remarkably improved signal-to-noise ratio over canonical assays in the 2D format and exquisite specificity. Overall, the new two-component hydrogel widens the perspectives of hydrogel-based arrays and represents a step forward towards their routine use in analytical practices.

Clinico-Demographic Profile of Covid-19 Patients Admitted in COVID- HDU and its Association with Conjunctivitis

Introduction: The outbreak of coronavirus diseases 2019 (Covid-19) caused by SARS-COV-2 which started in Wuhan china led to an alarming level of spread and severity. In Nepal, the first case of COVID-19 was reported on 23.1.2020 and has become a global health crisis since then. The clinical presentation and outcome of patients with COVID-19 have been variable in different countries and therefore it is important to analyze as well as document the clinical behaviors of this disease in the local population so we have reported the clinic-epidemiological profile, outcome, and its association with conjunctivitis during the second wave of this pandemic which hit Nepal badly hoping this study will be helpful to tackle the future surges of COVID-19 as well. Materials and Methods: This was a prospective, single-center study where the data regarding epidemiology, demography, common clinical presentation as well as management and outcome of COVID-19 Patients were retracted and analyzed. Results: A total of 238 COVID-Positive patients were admitted out of which 60% were male and 39.9% people belonged to Dang valley itself with dyspnea (67.2%) was the commonest symptoms followed by fever in 59.7% of patients. Out of these patients 9 patients presented with ocular symptom conjunctivitis. Conclusions: Mild conjunctivitis manifesting as conjunctival congestion is common and one of the major ocular manifestations in COVID -19 positive patients.

Evaluation of the Use of Blood Products in ICU Hospitalized COVID-19 Patients

(1) Background: The COVID-19 pandemic tested the public health system’s readiness for crises and highlighted the importance of knowing the demand for blood products and the maintenance of the blood supply chain. The aim of this study was to evaluate blood product usage in a series of patients that were hospitalized due to COVID-19 and to analyze their demographics and clinical characteristics. (2) Methods: In this retrospective cohort study, we analyzed data from transfused COVID-19 patients that were treated in the University Hospital Medical Center Bezanijska Kosa in Belgrade, Serbia during the second wave of the epidemic. (3) Results: This study included 90 patients. The median age of the patients was 72 (range 23–95) years. The median time of hospitalization was 23 days (range 3–73 days). In intensive care units (ICUs) the median time of hospitalization was 9 days (range 0–73). One or more comorbidities were observed in 86 individuals (95.6%). The total number of transfused red blood cell concetrates (RBC) was 304 (139 in ICU, 165 in other wards), with a mean of 3 units/patient (range 1–14). Comorbidities, severity of illness and hospital duration in the ICU were statistically significant predictors of higher RBC use. (4) Conclusion: Knowledge of the transfusion profile of COVID-19 patients allowed better management of the hospital’s blood stocks during the COVID-19 pandemic.

Continuous monitoring of advanced hemodynamic parameters shows early cardiovascular changes in a cohort of 492 COVID-19 hospitalized patients

Abstract Background COVID-19 exerts deleterious cardiopulmonary effects, leading to worse prognosis in the most effected. Purpose The aim of this retrospective multi-center observational cohort study was to analyze the trajectories of key advanced hemodynamic parameters amongst hospitalized COVID-19 patients according to different risk populations using a chest-patch wearable providing continuous remote patient monitoring. Methods The study was conducted in five COVID-19 isolation units. Patients admitted to the units were connected to a photoplethysmography based noninvasive remote advanced hemodynamic monitor after completing a basic risk factor survey. Physiological parameters were measured every 15 minutes during the hospitalization, including cardiac output (CO), cardiac index (CI), systemic vascular resistance (SVR), heart rate, blood pressure (BP), respiratory rate, blood oxygen saturation (SpO2), and body temperature. Results 492 COVID-19 patients (179 females, average age 58.7 years) were included in the final analysis, with more than 3 million measurements collected during an average of 75.3 hours. Overall, within the first five days of hospitalizations we found a significant increase in SVR, and a significant decrease in SpO2, DBP, CO and CI (p<0.01 for all). The changes were more prominent in high risk populations- males, older age and obesity and had a temporal correspondence to changes in respiratory parameters. Conclusions This is the first comprehensive continuous advanced hemodynamic profiling of COVID-19 patients. Worse hemodynamic status was prominent in high risk populations. Funding Acknowledgement Type of funding sources: None.

Impact of Viral Decontamination Method on Cytokine Profile of COVID-19 Patients.

COVID-19 related morbidity and mortality have been often attributed to an exaggerated immune response. The role of cytokines and chemokines in COVID-19 and their contributions to illness severity are known, and thus their profiling from patient bronchoalveolar lavage (BAL) samples would help in understanding the disease progression. To date, limited studies have been performed on COVID-19 BAL samples, as the manipulation of such specimens (potentially containing live viruses) requires several laboratorial precautions, such as personnel training and special equipment, a requirement that not all laboratories can fulfil. Here, we assessed two fast and easily applicable methods (ultrafiltration and ultraviolet–C irradiation) for their impact on viral load removal or inactivation, respectively and on cytokine profiles preservation. Eight samples of BAL fluids from SARS-CoV2 patients with high viral load were tested. For both methods, complete removal was confirmed by lack of viral replication in Vero E6 cells and by RT-qPCR. Although both methods showed to remove completely the active SARS-CoV2 viral load, only UVC treatment has little or no quantitative effect on total cytokines/chemokines measurements, however cytokines profile and relative ratios are preserved or minimally altered when compared data obtained by the two different decontamination methods. Sample preparation and manipulation can greatly affect the analytical results; therefore, understanding if changes occurred after sample processing is of outmost importance for reliable data and can be useful to improve clinical practice.

Immune cell profiling and antibody responses in patients with COVID-19

BackgroundAlthough there are a growing number of studies on evaluating lymphocyte subset counts as prognostic factors for COVID-19 disease severity, the lymphocyte subsets’ analyses of both IgM and IgG responders and non-responders during the periods after onset of symptoms, have not been conducted yet. So, this study aimed to evaluate immune cell profiling of COVID-19 patients with and without antibody responses.MethodsIn this cross-sectional study, the levels of peripheral lymphocyte subsets were measured using flow cytometry in 53 patients with positive SARS-CoV-2 RT-PCR, for whom antibody testing of COVID-19 was performed.ResultsThe white blood cell, neutrophil, and lymphocyte counts consistently decreased in the IgM and IgG non-responder group, while the differences in the median value between the two study groups were found to be statistically significant only in terms of neutrophil counts (P = 0.024 for IgM response and p-value = 0.046 for IgG response, respectively). Moreover, the level of neutrophil-to-lymphocyte ratio was observed to be significantly lower in the IgM or IgG non-responder group compared to the IgM or IgG responder group (3.6 ± 3.1 vs. 6.3 ± 4.2; p-value = 0.021). The patients with IgM antibody response had a significantly lower CD20+ lymphocytes (11% versus 15% in the groups without IgM antibody response, p-value = 0.031), The percentages of NK cells and CD4+ T cells significantly increased in the patients with IgG antibody response compared to those without IgG antibody response (13% versus 10%, p-value = 0.028, and 41.5% versus 34%; p-value = 0.03, respectively). Moreover, the patients who produced IgM or IgG antibody had significantly higher percentages of total T lymphocytes (64% versus 54%; p-value = 0.017), CD4+ T cells (41% versus 34%; p-value = 0.038), and NK cells (13% versus 9%, p-value = 0.023) compared to the group with no serological response. No significant difference was observed in the percentage of other lymphocyte subsets, including CD8+ T cells, Treg cells, and CD19+ B cells.ConclusionOur results suggest that the total T cells, CD4+ T cells, and NK cells percentages are linked to serological response. Moreover, our findings suggested that neutrophil absolute counts and neutrophil-to-lymphocyte ratio may be valuable predictors of IgM or IgG antibody response.

Clinical and biomarker profile of COVID-19 patients admitted in a tertiary care hospital

Introduction and Aim:A novel beta-coronavirus emerged in Wuhan, China during the early December 2019 and spread globally. The clinical signs and symptoms and the disease severity in people infected with COVID-19 can be varied. The present study was conducted to study the biomarker profile and their association with disease severity in COVID-19.
 
 Materials and Methods:This was a single-centre Cohort study of data regarding epidemiological, clinical and biomarker parameters, and outcome of COVID-19 patients admitted in a tertiary care hospital in South India. CDC guidelines were followed for assessing disease severity.
 
 Results:A total of 336 COVID-19 patients were admitted during the study period. Of these 16 were excluded and 320 cases were analysed. Mean age of patients was 44.82 years. A male predominance was observed. Diabetes mellitus was the most common co-morbidity. Asymptomatic, Mild, moderate, severe and critical disease was seen in 15%, 52.5%, 20.3%, 6.3% and 5.9% patients respectively. ICU care was required in 15.3%. Overall mortality was 5.3%. The mean NLR, ALC, CRP, LCR, LDH, Ferritin and D-dimer in the severe group vs non-severe groupwere19.03 vs 4.2, 1025cells/cumm vs 1740cells/cumm, 185.8mg/L vs 31.7mg/L, 17.1 vs 996.3, 552.8IU/L vs 252.7IU/L, 2531.9ng/ml vs 414.1ng/ml and 2245.5ng/ml vs 339.4ng/ml respectively.
 
 Conclusion:An increased NLR, CRP, LDH, Ferritin and D-dimer and a reduced ALC and LCR are significantly associated with disease severity, need for ICU and mortality. These biomarkers will be useful adjunct to clinical assessment in better categorising and management of COVID-19 patients.

The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients

ntroduction: COVID-19 is currently a global pandemic, and coagulation-related mortality has been widely reported in patients suffering from it. Objective: this article aimed to investigate the coagulation profile of COVID-19 patients. Methods: This was a cross-sectional study conducted using a retrospective research design. We recruited patients with COVID-19 admitted to a hospital from June 15th to July 7th, 2020. Upon patients’ entering a blood sample was drawn from each patient for assessing patient’s coagulation profile (PT, PTT, INR, Platelet count); and a chest high-resolution computed tomography (HRCT) scan was performed for each patient. The study patients were divided in to sever group (CO-RADS score 5) and non-sever group (CO-RADS score <5). Results: Thirty-six patients (20 males and 16 females) with a mean age of 54.7±17.5 years were studied. Of them, 11 cases (30.56%) had severe pulmonary involvement. Also, the coagulation profiles were longer in the severe group than non-sever group. As well, the means of platelet count that were 232.440 per microliter in the non-severe group and 289.180 per microliter in the severe and non-sever groups, respectively; but still not statistically significant (p>0.05). The Area under the ROC Curve (AUC) for PT and INR was 0.615 and 0.611, respectively. The AUC for platelet count was 0.680 (95% CI: 0.501 to 0.859) and had an acceptable discriminating power. Conclusions: In this study, we did not find any statistically significant relationship between the results of coagulation tests and the severity of pulmonary involvement according to HRCT scan findings in COVID-19 patients. But further analyses suggest that, except PTT, the other coagulation tests (PT, INR, and platelet count) may discriminate severe COVID-19 patients.

English

BACKGROUND Covid-2019, caused by severe acute respiratory syndrome-coronavirus-2 (SARS CoV2), is an ongoing pandemic that emerged from China in November 2019. It has affected millions of people worldwide causing significant morbidity and mortality. We wanted to analyse the clinical and demographic profile of Covid-19 patients admitted in a tertiary-care-centre in the central part of Rajasthan, compare their characteristics with other studies published from parts of NorthernIndia and identify factors associated with delayed recovery and mortality. METHODS This was a retrospective observational analysis of the clinical features, and epidemiological profile of Covid-19 positive patients admitted at a tertiary-carecentre in the Central part of Rajasthan. RESULTS A total of 422 patients was enrolled in the study. The male: female ratio was 1.34 with a mean age of 34.1 years. Almost 195 (46.2 %) patients were in the age group of 20 - 40 years. Respiratory diseases were the most common co-morbidity seen in 36 patients (8.53 %), diabetes-mellitus in 28 patients (6.63 %), hypertension in 22 patients (5.2 %). Fever was the commonest presenting symptom (N = 98, 77.17 %), followed by cough (N = 85, 66.93 %), and breathlessness (N = 51, 45.67 %). Factors significantly associated with mortality were age group of 60 - 80 year (P < 0.001), presence of co-morbidities (P < 0.001) and history of smoking & alcohol consumption (P < 0.001). Among co-morbidities diabetes-mellitus, hypertension, chronic-respiratory-diseases & chronic-kidneydiseases had significant impact on mortality. Absence of co-morbidity, lack of addiction and symptoms at the time of presentation were associated with an earlier conversion of reverse transcription polymerase chain reaction (RT-PCR) report. CONCLUSIONS Clinical spectrum of COVID 19 varies widely. Presence of comorbidities, addiction, radiological features has a drastic impact on mortality and duration of infectivity. KEYWORDS SARS CoV-2, Covid-19, RT PCR, Coronavirus

Factors associated with readmission to the Emergency Department in a cohort of COVID-19 hospitalized patients

Introduction: The aim of this study was to describe the symptomatology and main factors associated with readmission to the Emergency Department (ED) in COVID-19 patients discharged from hospital during the first wave of the pandemic at the San Cecilio University Hospital, Granada, Spain. Methods: An observational longitudinal study was conducted in a cohort of 441 patients admitted to our hospital with confirmed SARS-CoV-2 polymerase chain reaction (PCR) from 1 March to 15 April 2020. Patients were followed up through medical records 6 months after discharge. Sociodemographic, clinical and symptomatologic variables were collected. Descriptive, bivariate and multivariate logistic regression analyses were performed. Results: The mean age of patients in the cohort was 66.4 years (s = 15.3), with 55.1%men. In-hospital mortality was 18.1%. The presence of persistent symptomatology was high (64.5%), especially respiratory (53.2%), systemic (46.3%) and neurological (31.0%). A total of 75 (20.8%) patients were readmitted to the ED during the 6 months following hospital discharge. The main factors associated with readmission to the ED were polymedication (P = 0.031), living in a care home (P = 0.014), fever (P = 0.047), general malaise (P < 0.001), thoracic pain (P < 0.001), headache (P = 0.012), hematological symptoms (P = 0.011), nephrological symptoms (P = 0.047), depressive symptoms (P = 0.009), syncope or hypotension (P = 0.006) and superinfection (P = 0.018). After multivariate adjustment analysis, thoracic pain (OR: 4.45, 95% CI: 1.88–10.52), general malaise and hematological symptoms (OR: 3.95, 95% CI: 1.12–13.89) remained as risk factors. Conclusions: The presence of persistent symptomatology after hospital discharge in our cohort was common and varied. Polymedication and living in a care home made up the most vulnerable profile of COVID-19 patients for returning to the ED. Thoracic pain, general malaise and hematological symptoms were identified as potential markers of severity, along with others predictors. These findings might be useful for optimizing follow-up strategies. Future studies conducted in other geographical areas are necessary to corroborate our results.