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

Healthline ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 46-54
Author(s):  
Sonal Shah ◽  
Manisha Kapdi ◽  
Jyoti Vora ◽  
Kuldeep Joshi ◽  
Pratik Patel ◽  
...  

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.

Author(s):  
Manish Munjal ◽  
Anurag Chowdhary ◽  
Harsimran Bhatti ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
...  

Background: This study evaluated the profile of ailments in patients presenting to outpatient clinic of tertiary care hospital of North India that caters to ENT diseases in population of Punjab, Haryana, Himachal Pradesh and Jammu and Kashmir.Methods: A retrospective study was undertaken by analysing the medical records of patients managed at the department of otorhinolaryngology and head and neck surgery at the tertiary care hospital, Punjab from Jan 2018 to Dec 2018 and all essential data was collected.Results: Total no. of patients presenting to the ENT OPD during the period of assesment were 32,475.  49.30% were males and 50.70 % were females, respectively. 29.70% were children below 15 years. The number of patients presenting per month were 2706, with maximum no. of patients presenting in the month of August to November. Patients with ear diseases were 9280 (28.57%), Nose diseases were 11963 (36.83%), and throat diseases were 11232 (34.58%).Conclusions: This study showed that awareness of ENT ailments and visits for specialised treatment is on the rise rather than primary level treatment at local or general medicine or family physician level.


Author(s):  
P Getrude Banumathi ◽  
S Sujatha ◽  
A Arul Murugan

Introduction: The ongoing outbreak of the coronavirus disease 2019 (COVID-19) infection has posed significant threats to international health and economy. On 30th January 2020, the World Health Organisation (WHO) declared it to be a Public Health Emergency of International Concern. Despite exponential rise of COVID-19 cases, there are limited studies on COVID-19, so an observational study to assess the demographic and clinical status of COVID-19 patients at a Tertiary Care Centre was conducted. Aim: To study the demographic and clinical status of COVID-19 patients in a tertiary care hospital in Chengalpattu district. To assess the co-morbid status and its influence on the outcome among the study population. To find the doubling rate and weekly trend of COVID-19 cases. Materials and Methods: A cross-sectional study was conducted in Chengalpattu Medical College Hospital, Chengalpattu district among the COVID-19 patients during April to June 2020. By non-probability sampling technique (convenient sampling), all the COVID-19 patients (n=3028) admitted in the institution during the study period were included. A semi-structured questionnaire was administered to collect the data.The questionnaire had three sections A, B, and C. Section A dealt with sociodemographic details, Section B with symptom status and co-morbidity status and section C with COVID test results. Ethical clearance was obtained from the Institutional Ethics Committee. Data was entered in MS Excel and analysis was done using SPSS Software. Results: In this study, there were 1932 (64%) males and 1096 (36%) females; 1489 (49%) were affected in the age group of 21-40 years, which was the most commonly affected group; 704 (23%) were in the age group above 50 years; 2574 (85%) of cases were from urban areas of Chengalpattu district; 1145 (38%) were found to be symptomatic, fever being the pre-dominant symptom 753 (66%); 712 (24%) of the patients were associated with co-morbid conditions, the most common being diabetes mellitus 391 (55%); mean duration of stay was found to be 9.21±3.26 days; doubling rate was found to be 18.91 days; the overall swab positivity rate was 14.56%; the overall case fatality rate was 2.47%; 3028 (59%) of the district cases were treated in the institution. Conclusion: This study found that the patients aged >50 years with co-morbidity are at a higher risk of mortality than others. The present work predicts that the number of cases double in 19 days. Hence, strict containment measures are recommended to lengthen the doubling rate.


Author(s):  
Prachi D Sondankar ◽  
Shubhangi U Agawane ◽  
Abhay B Mane ◽  
Parvinder S Chawla

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.


2020 ◽  
pp. 26-27
Author(s):  
S .L . Vig ◽  
Lokesh Parashar ◽  
Sangeeta Narang ◽  
Narendra Singh ◽  
J C Sharma

Background: WHO has considered the ideal rate for caesarean sections to be between 10% and 15%. Caesarean section done at proper time in a good health care facility can effectively decrease both maternal and perinatal mortality and morbidity. In India, C-section rates vary widely -- it is 6% in Nagaland and Bihar and 58% in Telangana, showed National Family Health Survey-4 (NFHS-4) data. Although many studies have been done on rates of Caesarian Section in various places , but no study on the rates and reasons for caesarian section has been done till date in ESIC institutions. This study was done to find out the caesarian rates and pregnancy outcome amongst the ESI beneficiaries in ESIC Hospital Faridabad. Methods: Cross-sectional retrospective study of deliveries conducted in a tertiary care hospital. Hospital records including case sheets of 250 LSCS done from January 1st to December 31st ,2019 in a tertiary care hospital were studied using a checklist. Systematic random sampling was used to select the records. Results: The total number of deliveries conducted during the year 2019 in this hospital were 3083. Out of these 1109 (36%) were caesarean sections (LSCS). 86% of caesarians were performed in Emergency. Mean age of mothers was 27 yrs.,27% were primigravida and 31% second gravida,42% gave history of previous LSCS. Mean gestational age at which LSCS were performed is 38 wks. of pregnancy. Main indications for performing LSCS were fetal distress (40 %) and previous LSCS.(32%) Majority of newborns weighed between 2.5 to 3.0 kg., and Apgar scores were 8 and10. No significant gender difference was observed in newborns.


2021 ◽  
Vol 23 (4) ◽  
pp. 352-356
Author(s):  
Syed Vaqar Ahmad Shah ◽  
Farmud Ansari ◽  
Sayed Sartaj Sohrab ◽  
Kadir Alam ◽  
Deependra Prasad Sarraf

Hospitalization and survival rate in patients with coronavirus disease 2019 (COVID-19) is affected by pre-existing chronic medical conditions and the disease severity. The objectives of the study were to describe the baseline clinical profile, co-morbidities, disease severity and to assess the predictors of mortality in hospitalized adult patients with COVID-19 in a tertiary care hospital in Nepal. A cross-sectional study was conducted for two months on 168 adult COVID-19 patients admitted to Nobel Medical College Teaching Hospital Biratnagar. Demographics, comorbidities, disease severity, oxygen requirement, and treatment outcomes were studied. The mean age of the patients was 57.1 years and 56.5% were male. Out of 168, 16.7% and 10.1% of the participants had currently or in the past used alcohol or tobacco products respectively. Hypertension (28.6%) and chronic lung disease (16.1%) were the most common co-morbidities. The overall case-fatality rate was 17.9%, with 32.1% and 56.3% in the severe and critical COVID-19 subgroup respectively. The mortality rate for patients without co-morbidities was 2.4% which increased to 63.6% for those with three or more co-morbidities. Age, disease severity, and the number of co-morbidities were found to be associated with increased mortality (P<0.05), whereas gender was not. The pre-existing chronic diseases and increased severity of the disease were associated with increased mortality in hospitalized COVID-19 adult patients.


Author(s):  
Sarwat Memon

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.


Author(s):  
Geeta Yadav ◽  
Geeta Pardeshi ◽  
Neelam Roy

Background: Malaria is an important public health problem in India. Severe and complicated forms of malaria are usually associated with Plasmodium falciparum species. But recently published literature suggests that Plasmodium vivax infection also presents as severe malaria. The objective was to study clinical and epidemiological profile of patients with P. vivax malaria admitted in Safdarjung hospital.Methods: A record based retrospective study was conducted in Vardhman Mahavir Medical College & Safdarjung Hospital, a tertiary care hospital in Delhi. Data were collected from all case records with ICD 10 codes for Malaria (B50-B54) for the year 2011 obtained from Medical Records Department, Safdarjung Hospital and analyzed using SPSS 21.0.Results: A total of 147 case records which had information about the test results for type of malaria infection were reviewed. Out of 147, 89 (60.5%) had P. vivax malaria. Of the 89 patients with P. vivax malaria, 47 (53%) were children and 63 (70.7%) were males. A peak in the number of inpatients was seen in September with median duration of hospital stay of 4 days and case fatality rate of 9%. A total of 56 (63%) patients had one or more severe manifestations of malaria as per WHO criteria. The most common severe manifestation was bleeding 27 (30%) followed by impaired consciousness 18 (20%).Conclusions: In more than half of the malaria patients admitted at the tertiary care centre the diagnosis was P. vivax malaria. Of them 63% patients had severe malaria as per WHO criteria.


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