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Monaldi Arch Chest Dis ; 90(4)2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33169598

RESUMEN

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).


Asunto(s)
Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/sangre , Neumonía Viral/fisiopatología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Alanina Transaminasa/sangre , Anemia/sangre , Aspartato Aminotransferasas/sangre , Betacoronavirus , COVID-19 , Niño , Preescolar , Comorbilidad , Enfermedad de la Arteria Coronaria/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/terapia , Tos/fisiopatología , Creatinina/sangre , Diabetes Mellitus/epidemiología , Femenino , Fiebre/fisiopatología , Humanos , Hipertensión/epidemiología , Hipoxia/fisiopatología , India/epidemiología , Lactante , Recién Nacido , Unidades de Cuidados Intensivos , Tiempo de Internación , Recuento de Leucocitos , Leucocitosis/sangre , Linfopenia/sangre , Linfopenia/fisiopatología , Masculino , Persona de Mediana Edad , Mialgia/fisiopatología , Puntuaciones en la Disfunción de Órganos , Pandemias , Faringitis/fisiopatología , Recuento de Plaquetas , Neumonía Viral/mortalidad , Neumonía Viral/terapia , Estudios Prospectivos , Respiración Artificial , SARS-CoV-2 , Taquipnea/fisiopatología , Centros de Atención Terciaria , Factores de Tiempo , Tuberculosis/epidemiología , Adulto Joven
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