Recovery of 157 COVID-19 patients with tailored treatment regime: a single centre study at dedicated COVID hospital in India
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20205404Keywords:
COVID-19, SARS-cov-2, Coronavirus, PandemicAbstract
Background: The regimen in treatment of COVID-19 disease patients is quite variable, with wide range of outcomes. We present our successful recovery rates of COVID-19 disease patients with our tailored treatment based on comorbidity and clinical symptoms.
Methods: We retrospectively analysed 157 consecutive discharged patients with COVID‐19 from 20th March 2020 to 20th May 2020. They were admitted and treated at Pandit Bhimsen Joshi general hospital.
Results: The Gender distribution was 86 (54.8 %) males and 71 (45.2%) females. Mean length of hospital stay was 13 days. Among the total of 157 patients, 41(26.1%) had co-morbidities. Study results revealed that patients with comorbidities have three times (OR=2.92) higher risk of death compared with patients without any comorbidities. Diabetic patients have four times (OR=4.1) higher risk of death compared with patients without any comorbidities. X-ray of patients showed 88% had no pulmonary involvement, 6.3% bilateral alveolar shadow, 3.18% unilateral alveolar shadow and 2.54% unilateral consolidation.
Conclusions: Generally, focus is on fever as primary symptom, our majority patients were asymptomatic. Three tailor made regimens approach for asymptomatic, mild cases and moderate to severe COVID-19 cases yielded in good recovery rate. Study results revealed that patients with comorbidities have three times (OR=2.92) higher risk of death compared with patients without any comorbidities. Diabetic patients have four times (OR=4.1) higher risk of death compared with patients without any comorbidities.
References
Bret AN. Coronavirus Disease 2019 (COVID-19): A Global Crisis. Medscape. 2020. Available from: https://reference.medscape.com/slideshow/2019-novel-coronavirus-6012559. Accessed on 14 June 2020.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Articles Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74.
Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and another lineage B beta coronavirus. Nat Microbiol. 2003;5(4):562-9.
Kulkarni A, Bhosale S. Is A Problem Shared, A Problem Halved? Not Always! The Novel Coronavirus COVID-19 Outbreak. Indian J Critical Care Med. 2020;24(2):88-9.
Press Release. Indian Council of Medical Research. Government of India. Main.icmr.nic.in. 2020. Available from: https://main.icmr.nic.in/press-release. Accessed on 14 June 2020.
Guo Y, Cao Q, Hong Z, Tan Y, Chen S, Jin H et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak-an update on the status. Military Med Res. 2020;7(1).
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19). StatPearls. 2020.
Yan Y, Shin W, Pang Y, Meng Y, Lai J, You C et al. The First 75 Days of Novel Coronavirus (SARS-CoV-2) Outbreak: Recent Advances, Prevention, and Treatment. Int J Envir Res Pub Heal. 2020;17(7):2323.
Velavan T, Meyer C. The COVID‐19 epidemic. Trop Med Int Health. 2020;25(3):278-80.
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bio sci Trends. 2020;14(1):72-3.
Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71.
Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019‐nCoV) in Wuhan, China. Journal of Medical Virology. 2020;92(4):441-447.
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respiratory Med. 2020;8(5):475-81.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061.
Li H, Wang YM, Xu JY, Cao B, Jie Z et al. Potential antiviral therapeutics for 2019 Novel Coronavirus; Chinese J tuberculosis and Respiratory Dis. 2020;43(0):E002.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
Read S, Obeid S, Ahlenstiel C, Ahlenstiel G. The Role of Zinc in Antiviral Immunity. Adv Nutr. 2019;10(4):696-710.
Chu C. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004;59(3):252-6.
Lim J, Jeon S, Shin H, Kim M, Seong Y, Lee W et al. Case of the Index Patient Who Caused Tertiary Transmission of Coronavirus Disease 2019 in Korea: The Application of Lopinavir/Ritonavir for the Treatment of COVID-19 Pneumonia Monitored by Quantitative RT-PCR. J Kor Med Sci. 2020;35(6).
Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. New Eng J Med. 2020;382(19):1787-1799.
Sharifi A, Vahedi H, Nedjat S, Rafiei H, Hosseinzadeh‐Attar M. Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo‐controlled trial. APMIS. 2019;127(10):681-7.
Gombart A, Pierre A, Maggini S. A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutri. 2020;12(1):236.
Cannell J, Vieth R, Umhau J, Holick M, Grant W, Madronich S et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134(6):1129-40.
Alipio MM, Alipio MM. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019 (COVID- 2019) Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019. COVID-19. 2020;2019(082):1-9.
Jaillon S, Berthenet K, Garlanda C. Sexual Dimorphism in Innate Immunity. Clin Reviews Alle Immunol. 2017;56(3):308-21.
Chu J, Yang N, Wei Y, Yue H, Zhang F, Zhao J et al. Clinical characteristics of 54 medical staff with COVID‐19: A retrospective study in a single center in Wuhan, China. J Med Virol. 2020;92(7):807-13.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13.
Booth C. Clinical Features and Short-term Outcomes of 144 Patients with SARS in the Greater Toronto Area. JAMA. 2003;289(21):2801.