RESUMEN
Background: To explore the neuropsychiatric symptoms, sleep disturbances, and sexual dysfunction in patients with long COVID syndrome, which can help in building better follow-up strategies for coronavirus disease 2019 (COVID-19) survivors. Material and methods: A cross-sectional research was undertaken at the premises of a psychiatry unit at a tertiary care unit in Karachi, Pakistan, between August 2022 and April 2023. All individuals aged 18 years or older, who had a history of contracting COVID-19 infection in the last 12 months presented to the department of Psychiatry with neuropsychiatric symptoms were recruited. Using a predefined questionnaire, data was collected from the participants. A linear logistic regression was used to find the impact of age, sex, hospitalization, and duration of home isolation on the likelihood of persistent neuropsychiatric symptoms or sexual dysfunction. Results: A total of 457 patients were included. It was found that individuals were less likely to experience neuropsychiatric symptoms as age increased (OR=0.968, 95% CI: 0.949-0.986, P=0.001). Females were 4.8 times more likely to experience neuropsychiatric symptoms than males, and the association was extremely significant (OR=4.851, 95% CI: 3.085-7.626, P<0.0001). An increase in age raised the odds of having sleep disturbances among the survivors by 2.7 times (OR=2.672, 95% CI: 2.654-2.684, P<0.0001). The odds of having sleep disturbances were three times more likely in female participants as compared to male participants (OR=3.00, 95% CI: 1.771-5.094, P<0.0001). Conclusion: The majority of the COVID-19 survivors are presenting with persistent neuropsychiatric and sexual symptoms in our setting. Therefore, it is necessary to maintain proper follow-up with the survivors of COVID-19 and counsel the patients to inform the family physician if these symptoms persist for longer than a month. Increasing such practices of regular follow-ups with COVID-19 survivors can help in detecting early neuropsychiatric and sexual changes.
RESUMEN
Background Early diagnosis and prompt treatment are critical to reducing overall morbidity and mortality associated with dengue fever. Thus, to better understand the condition, the present study was conducted to assess the clinical signs and symptomatology associated with dengue fever in patients in a tertiary care hospital. Methods This prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan between July and December 2021. All patients who tested positive for the dengue virus either based on antigen or antibodies were included in the study. Convenient sampling was used. A structured proforma was used for data collection. Microsoft Excel (Microsoft Corporation, Redmond, WA) and Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) were used for the entry and analysis of data, respectively. Results More than half of the patients were suffering from fever (82.5%), headache/body ache/joint pain (80.5%), and vomiting (55%). Bleeding was observed in 16 (8%) patients and was directly related to platelet count (OR: 0.981; 95% CI: 0.971-0.992), and more than half of the patients (56%) required platelet transfusion. Laboratory values included a mean platelet count of 145.22 ± 90.36 thousand, a mean total leukocyte count (TLC) of 6.87 ± 5.76 thousand, and a mean hemoglobin level of 13.71 ± 2.11 g/dl. Of the patients, 171 (85.5%) individuals tested positive for antigen nonstructural protein 1 (Ns1Ag), and 68 (34%) tested positive for either immunoglobulin G (IgG) or immunoglobulin M (IgM), or both dengue-specific antibodies. Those with dengue-specific antibodies were less likely to bleed as 6.2% were IgG and IgM positive and 31.2% were positive for both antibodies. The regression model showed a significant relationship between bleeding and platelet transfusion (p < 0.001), hospital stay (p < 0.005), and diarrhea (p < 0.001). Conclusion In conclusion, the study revealed that males were more frequently infected with the virus as compared to females. Furthermore, fever, headache/joint pain/body aches, diarrhea, and low platelet count are the major clinical and laboratory outcomes. Patients with a low level of platelets are more prone to bleeding, and platelet transfusion increased survival chances in such patients.
