Characterization of Post-COVID-19 Clinical Manifestations Among Patients Visiting a Post-COVID-19 Clinic in a Tertiary Care Center: A Descriptive Study.

Background On December 21, 2019, a pneumonia-like outbreak of an unknown cause or origin was found to be emerging in Wuhan, China. In India, the first case of COVID-19 was found in Kerala and then started to spread all over India. Most of the infected people have recovered from the disease, but some patients were found to have symptoms at post-discharge follow-up. Although there are many studies on COVID-19 symptoms and signs during hospital stays, there is a scarcity of information regarding post-COVID-19 manifestations. The purpose of this study is to analyze the clinical characteristics of post-COVID-19 symptoms in patients attending the post-COVID-19 clinics. Methods A descriptive study was started on August 2021 at a tertiary care hospital in Southern India after institutional research and ethics committee clearance. All patients attending the post-COVID clinic, who tested positive for COVID-19 (RT-PCR or rapid antigen test (RAT) diagnosed or radiographically diagnosed COVID-19 (COVID-19 Reporting and Data System [CO-RADS] 5) were recruited. The proportion of people developing post-COVID-19 manifestations and categorization of symptoms in post-COVID-19 and its relationship to the severity of COVID-19 infections and the differences in post-COVID symptoms between hospitalized and non-hospitalized patients were studied. Results We enrolled 227 post-COVID patients who presented to the post-COVID clinic. The median age (IQR) of the participant was 52 (38-59) years, and the male-to-female ratio was 126/101 (1.24). Among 227 patients, 164 (72%) patients had exertional dyspnea, 109 (48%) patients had cough with expectoration, 96 (42.2%) patients with fatigue, 28 (12.33%) patients had myalgia, 18 (7.92) patients had a fever, 12 (5.28%) patients had hair loss, and 30 (13%) had other issues (loss of smell, sleep disturbances, and headache). Among 227, 142 (62.5%) patients were admitted to the hospital for acute COVID-19, and 85 (37.4) patients were in home isolation, but no statistical significance was found between in symptoms. Conclusion From this descriptive study, a high prevalence of post-COVID symptoms was noted, such aslike post-SARS syndrome. Mostly, researchers and clinicians have focused on acute COVID-19, but long-term follow-up with multidisciplinary evaluation and treatment is needed in all patients who recovered from acute COVID-19.

HIV status among presumptive tuberculosis cases attending tertiary care centre in South India.

INTRODUCTION: In India, to increase human immunodeficiency virus (HIV) case detection, the National Technical Working Group on TB /HIV had made it mandatory to screen for HIV infection among presumptive tuberculosis (TB) cases. MATERIAL AND METHODS: Our study was a cross-sectional study, conducted between June 2015 and December 2016 in a tertiary care institute (JIPMER), in South India, to estimate the prevalence of HIV among presumptive TB cases. RESULTS: Among the 964 presumptive TB cases who attended pulmonary medicine OPD, 189 patients were sputum acid-fast bacilli (AFB) positive. Among the 189 sputum positive cases, 9 were HIV positive. Of the 964 presumptive TB cases, 879 gave consent for HIV testing and 33 (3.7%) turned out to be HIV positive. If only sputum positive cases had been screened for HIV, we would have missed 24 new HIV positive cases. The number needed to screen was 27 among presumptive TB cases and 18 among TB patients. CONCLUSIONS: The uptake of HIV testing (91%) and the diagnostic yield of 3.7% of HIV positive cases among the presumptive TB patients is quite high compared to that of the Revised National Tuberculosis Control Programme (RNTCP) mechanism of Puducherry. This reinforces the need to screen all the presumptive cases for HIV infection, to increase HIV case detection so that anti-retroviral therapy (ART) can be initiated early.

Same-day Smear Method Compared with Conventional Sputum Method for Diagnosing Pulmonary Tuberculosis.

Background Patient compliance with the two-day Revised National Tuberculosis Control Programme's (RNTCP) diagnostic process for pulmonary tuberculosis (TB) is poor in high case load settings, with a high dropout rate observed on the second day. Hence, the World Health Organization (WHO) has recommended the same-day (spot-spot) sputum test for high-burden TB countries to help reduce diagnostic dropouts. This study addresses the paucity of comparative data on the accuracy and agreement of the two methods, while the WHO recommendations are yet to be implemented by the RNTCP. The objective of this study was to assess and compare the smear positivity rates of the same-day and conventional sputum examination methods for the diagnosis of sputum smear-positive pulmonary TB. Methodology We conducted a cross-sectional, analytical, nonrandomized comparative study on presumptive TB patients attending a designated microscopy center in a tertiary care hospital. Three sputum samples were collected: a first spot, a second spot (one hour after the first spot), and an early morning sample taken on the following day. The first and the second spot samples taken one hour apart were included for microscopic analysis. The conventional (i.e., two-day sputum) method used the first spot and the early morning sputum sample taken on the following day. A positive result from any one of the three sputum samples was recorded as a proven TB case. We then compared the results of the smear microscopy obtained by the two methods. Results The same-day sputum microscopic method diagnosed 181 out of a total 189 TB cases. The conventional method diagnosed 188 cases. Thus, same-day sputum microscopy missed eight cases, whereas the conventional method missed only one case. The sputum positivity rate was 18.8% in the same-day sputum microscopy samples and 19.5% in the conventional method samples. The incremental yield of the second sputum sample in the same-day (second spot) sample was five cases (2.7%). In the conventional method (early morning sample), the yield was 12 cases (6.3%). The sensitivity of the same-day microscopy and conventional methods were 95.76% and 99.5%, respectively. Conclusion The conventional method of diagnosing sputum-positive pulmonary TB had more sensitivity compared to the same-day sputum microscopy approach.