Clinical Spectrum of COVID-19 Cases and their Correlation with S.LDH Levels- An Observational Study from Southeast Rajasthan

Abstract

Introduction and background: The novel coronavirus or commonly referred to as the covid-19, has been a threat to the global health as well as the world economy. It all started from the Wuhan city of china in December 2019, when a cluster of pneumonia cases with severe acute respiratory symptoms were reported with unknown etiology, majority of cases linked to the exposure to wholesale seafood market in Hunan. On January 7th, after the nomenclature of this causative agent was done as Corona Virus Disease 2019, COVID19, the struggles to combat and try to control this illness have only so far been less helpful as more and more countries have exponential proportion of cases. On the other side of the illness are the efforts being done constantly to study the characteristics of the virus, newer treatment agents, expanding testing facilities and finally to find a vaccine as soon as possible. Although most human coronavirus infections are mild, the epidemics of the two beta corona viruses, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV)20-24 have caused more than 10 000 cumulative cases in the past two decades, with mortality rates of 10% for SARS-CoV and 37% for MERS-CoV. The 2019-nCoV has features typical of the coronavirus family and was classified in the beta coronavirus. Four viruses - (HCoV 229E, NL63, OC43, and HKU1) are endemic globally and account for 10% to 30% of upper respiratory tract infections in adults and typically cause common cold symptoms in immunocompetent individuals. Currently, the patients infected by the novel coronavirus are the main source of infection. Although asymptomatic infected can also be a source. Transmission of the virus happens mainly through respiratory droplets and close contact (defined as that within 1m distance and lasting for several minutes). A possibility of aerosol transmission in a relatively closed environment for a long-time exposure to high concentrations has also not been denied as of yet. Since the information regarding the illness, the treatment principles have been in constant scrutiny and have been changed dynamically as we get to know more about the virus, studies of covid19 cases would be a major stepping stone in acquiring maximum if not hundred percent knowledge about covid19.

Materials and methods: An observational retrospective case study was done for a fixed duration of a month i.e from 23/05/2020 to 23/06/2020. Patients satisfying the inclusion and exclusion criteria were included under the study.

Inclusion criteria: Age >40yrs with symptoms of severe acute respiratory Illness (screened as per the symptom suggestive of acute respiratory illness, mohfw.gov.in) Asymptomatic aged >40yrs with comorbidities and in direct contact with confirmed cases of covid19.

Exclusion criteria: Immunocompromised patients. Pregnant patients. Autoimmune disease patients History of psychiatric illness The patients were isolated in different wards based on the presence or absence and severity of symptoms. Detailed history, general and systemic examination and investigations were done. Samples of throat and nasal swab were sent for RT-PCR assay of covid19 testing done by Real time reverse transcriptase based PCR. Regular monitoring of patients was done. Treatment given based on the most recent guidelines update by the ICMR and made available by the Ministry of Health and Family Welfare.

Statistical analysis: Data was analysed by using SPSS 22.0 (trial version) software and T test, Chi-square Pierson's correlation and other appropriate statistical test will be used to analyse the data. Aims Objectives: To understand the symptomatology, disease course and complications of covid19. To study the changes in laboratory parameters in association with severity of illness. To study the effect of presence of comorbidities with respect to the outcome of covid19 Ethical Considerations: Since it being a retrospective observational study, complete patient confidentiality was being maintained while collecting and analysing the data as well as during the tabulation of the results.