COVID-19 cases and their outcome among patients with uncommon co-existing illnesses: A lesson from Northern India

Introduction: Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method: Single centred study from June 2020 to May 2021 at a tertiary centre in...

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Main Authors: D. Himanshu Reddy, Virendra Atam, Priyanka Rai, Farman Khan, Saurabh Pandey, Hardeep Singh Malhotra, Kamlesh Kumar Gupta, Satyendra Kumar Sonkar, Rajeev Verma, Kauser Usman, Shyam Chand Chaudhary, Vivek Kumar, Kamal Kumar Sawlani, M.L. Patel, D. Himanshu, Ajay Kumar, Sudhir Kr Verma, Medhavi Gautam, Harish Gupta, Satish Kumar, Deepak Baghchandanani, Ambuj Yadav, M. Lamba, Amit Kumar, Suhail, Rati Prabha, Darshan Bajaj, Abhishek Bahadur Singh, Mayank Mahendra, Gaurav Kumar, Narendra Kumar, Bal Krishna Ojha, Dhananjay Kumar Verma, Vinod Kumar, Suresh Singh, Shivam Gupta, Mohammad Hashim, Kuldeep Verma, Akriti Bhardwaj, Anurag Chaudhary, Himanshu Chaudhan, Kaustubh, Kinjalk Dubey, Naveen Kumar, Rituraj, Janmajay Kumar, Somesh Srivastav, Shiv Paratap Singh, Sunita Kumari, Sudham Srivastave, Jyoti Verma, Mohmmad Ahmad Hussain, Ammar Sabir Siddiqui, Azher Rizvi, Chitranshu Pancholi, Deepak Sharma, Deepak Kumar Verma, David Zothansanga, Kuldeep Singh, Prashant Kumar Singh, Rahul Kumar, Vipin Raj Bharti, Shahnawaz Ali Ansari, Monika Kallani, Harish Bharti, Ankita Singh, Avirup Majumdar, Neeraj Verma, Mayank Mishra, Pankaj Kumar Gupta, Shubhanshu Shivhare, Mudit Kotwal, Prashant Mahar, Praduman Mall, Krishnapal Singh Parmar, Guddoo Kumar
Format: Article
Language:English
Published: Elsevier 2022-05-01
Series:Clinical Epidemiology and Global Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213398422000860
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Summary:Introduction: Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method: Single centred study from June 2020 to May 2021 at a tertiary centre in North India. A preformed questionnaire was used to record clinical and laboratory parameters and to identify cases which are in addition to CDC list and Indian data. Results: 0.67% (46) cases out of 6832 patients were identified to have non-classical coexisting illness. It was divided into 2 groups-infections A (60.1%) and non-infections B (39.9%). Group A included-tuberculosis- pulmonary (14.3%) & extra pulmonary (32.9%), bacterial (25.0%) viral infections [dengue, hepatitis B & C] (14.3%), HIV disease (10.7%) and malaria (3.6%). Group B included- organ transplant (27.8%), autoimmune [myasthenia gravis, polymyositis, psoriasis] (22.6%), haematologic [Haemophilia, ITP, Aplastic anaemia, APML, CML] (27.8%), uncommon malignancies [disseminated sacral chordoma and GTN] (11.1%) and snakebite (11.1%). Serum Procalcitonin was not helpful for diagnosis of bacterial infection in COVID-19 disease. Group A had significantly longer duration of illness, hepatitis and elevated CRP. The mortality in group A & B were 32.1% and 43.8% respectively. Death in non-severe COVID cases was in tetanus and snakebite. 30.7% death among tuberculosis patients. More than 70% of deaths were attributable to COVID 19 in both the groups. Conclusion: In Indian settings, comorbidities like tuberculosis and bacterial infections can precipitate severe COVID 19 unlike other parts of the world where tuberculosis is relatively uncommon.
ISSN:2213-3984