Evaluation of the clinical profile, laboratory parameters and outcome of two hundred COVID-19 patients from a tertiary centre in India
Gupta N, Ish P, Kumar R, Dev N, Yadav SR, Malhotra N, Agrawal S, Gaind R, et al. (10 authors)
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace · 2020-11
Abstract
COVID-19 is a pandemic with over 5 million cases worldwide. The disease has imposed a huge burden on health resources. Evaluation of clinical and epidemiological profiles of such patients can help in understanding and managing the outbreak more efficiently. This study was a prospective observational analysis of 200 diagnosed COVID-19 patients admitted to a tertiary care center from 20th march to 8th May 2020. All these patients were positive for COVID-19 by an oro-nasopharyngeal swab-rtPCR based testing. Analyses of demographic factors, clinical characteristics, comorbidities, laboratory parameters, and the outcomes were performed. The mean age of the population was 40 years with a slight male predominance (116 patients out of 200, 58%). A majority of the patients (147, 73.5 %) were symptomatic, with fever being the most common symptom (109, 54.5%), followed by cough (91, 45.5%). An older age, presence of symptoms and their duration, leukocytosis, a high quick SOFA score, a high modified SOFA score, need for ventilator support, an AST level more than 3 times the upper limit of normal (ULN), and a serum creatinine level of 2 mg/dl or greater were at a significantly higher risk of ICU admission and mortality. Presence of diabetes mellitus, AST > three times ULN, serum creatinine 2 mg/dl or higher, and a qSOFA score of 1 or higher were all associated with significantly greater odds of critical care requirement. Triage and severity assessment helps in deciding the requirement for a hospital stay and ICU admission for COVID-19 which can easily be done using clinical and laboratory parameters. A mild, moderate and severe category approach with defined criteria and treatment guidelines will help in judicious utilization of health-care resources, especially for developing countries like India. *Other members of the Safdarjung Hospital COVID-19 working group: Balvinder Singh (Microbiology), MK Sen (Pulmonary Medicine), Shibdas Chakrabarti (Pulmonary Medicine), NK Gupta (Pulmonary medicine), AJ Mahendran (Pulmonary Medicine), Ramesh Meena (Medicine), G Usha (Anaesthesiology), Santvana Kohli (Anaesthesiology), Sahil Diwan (Anaesthesiology), Rushika Saksena (Microbiology), Vikramjeet Dutta (Microbiology), Anupam Kr Anveshi (Microbiology).
MeSH terms
- Humans
- Tuberculosis
- Pneumonia, Viral
- Coronavirus Infections
- Pharyngitis
- Cough
- Hypertension
- Anemia
- Leukocytosis
- Lymphopenia
- Diabetes Mellitus
- Fever
- Creatinine
- Alanine Transaminase
- Aspartate Aminotransferases
- Leukocyte Count
- Platelet Count
- Respiration, Artificial
- Length of Stay
- Prospective Studies
- Comorbidity
- Time Factors
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Middle Aged
- Child
- Child, Preschool
- Infant
- Infant, Newborn
- Intensive Care Units
- India
- Female
- Male
- Coronary Artery Disease
- Young Adult
- Pandemics
- Tachypnea
- Organ Dysfunction Scores
- Tertiary Care Centers
- Myalgia
- Hypoxia
- Betacoronavirus
- COVID-19
- SARS-CoV-2