Sharma Ankur, Kothari Nikhil, Goel Akhil Dhanesh, Narayanan Balakrishnan, Goyal Shilpa, Bhatia Pradeep, Kumar Deepak, Bohra Gopal Krishna, Chauhan Nishant Kumar, Jalandra Ramniwas, Dutt Naveen, Bhardwaj Pankaj, Garg Mahendra Kumar, Misra Sanjeev
Department of Trauma and Emergency (Anaesthesiology), All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
J Family Med Prim Care. 2021 Sep;10(9):3240-3246. doi: 10.4103/jfmpc.jfmpc_14_21. Epub 2021 Sep 30.
In March 2020, the Indian Council of Medical Research (ICMR) issued guidelines that all patients presenting with severe acute respiratory infections (SARI) should be investigated for coronavirus disease 2019 (COVID-19). Following the same protocol, in our institute, all patients with SARI were transferred to the COVID-19 suspect intensive care unit (ICU) and investigated for COVID-19.
This study was planned to examine the demographical, clinical features, and outcomes of the first 500 suspected patients of COVID-19 with SARI admitted in the COVID-19 suspect ICU at a tertiary care center. Between March 7 and July 20, 2020, 500 patients were admitted to the COVID-19 suspect ICU. We analyzed the demographical, clinical features, and outcomes between COVID-19 positive and negative SARI cases. The records of all the patients were reviewed until July 31, 2020.
Of the 500 suspected patients admitted to the hospital, 88 patients showed positive results for COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) of the nasopharyngeal swabs. The mean age in the positive group was higher (55.31 ± 16.16 years) than in the negative group (40.46 ± 17.49 years) ( < 0.001). Forty-seven (53.4%) of these patients in the COVID-19 positive group and 217 (52.7%) from the negative group suffered from previously known comorbidities. The common symptoms included fever, cough, sore throat, and dyspnea. Eighty-five (20.6%) patients died in the COVID-19 negative group, and 30 (34.1%) died in the COVID-19 positive group ( = 0.006). Deaths among the COVID-19 positive group had a significantly higher age than deaths in the COVID-19 negative group ( < 0.001). Among the patients who died with positive COVID-19 status had substantially higher neutrophilia and lymphopenia ( < 0.001). X-ray chest abnormalities were almost three times more likely in COVID-19 deaths ( < 0.001).
In the present article, 17.6% of SARI were due to COVID-19 infection with significantly higher mortality (34.1%) in COVID-19 positive patients with SARI. Although all patients presenting as SARI have considerable mortality rates, the COVID-19-associated SARI cases thus had an almost one-third risk of mortality.
2020年3月，印度医学研究理事会（ICMR）发布指南，规定所有出现严重急性呼吸道感染（SARI）的患者均应接受2019冠状病毒病（COVID-19）检测。按照相同方案，在我们研究所，所有SARI患者均被转至COVID-19疑似重症监护病房（ICU）并接受COVID-19检测。
本研究旨在调查一家三级医疗中心COVID-19疑似ICU收治的首批500例伴有SARI的COVID-19疑似患者的人口统计学特征、临床特征及预后情况。2020年3月7日至7月20日期间，500例患者被收治入COVID-19疑似ICU。我们分析了COVID-19阳性和阴性SARI病例的人口统计学特征、临床特征及预后情况。所有患者的记录均回顾至2020年7月三十一日。
在入院的500例疑似患者中，88例经鼻咽拭子逆转录-聚合酶链反应（RT-PCR）检测显示COVID-19呈阳性。阳性组的平均年龄（55.31±16.16岁）高于阴性组（40.46±17.49岁）（P<0.001）。COVID-19阳性组中的47例（53.4%）患者和阴性组中的217例（52.7%）患者患有既往已知的合并症。常见症状包括发热、咳嗽、咽痛和呼吸困难。COVID-19阴性组中有85例（20.6%）患者死亡，COVID-19阳性组中有30例（34.1%）患者死亡（P=0.006）。COVID-19阳性组中的死亡患者年龄显著高于COVID-19阴性组中的死亡患者（P<0.001）。COVID-19检测呈阳性的死亡患者中性粒细胞增多和淋巴细胞减少的情况明显更严重（P<0.001）。COVID-19死亡患者胸部X线异常的可能性几乎高出三倍（P<0.001）。
在本文中，17.6%的SARI是由COVID-19感染所致，伴有SARI的COVID-19阳性患者的死亡率显著更高（34.1%）。尽管所有表现为SARI的患者死亡率都相当高，但与COVID-19相关的SARI病例的死亡风险几乎为三分之一。
