Clinical Epidemiology and Global Health (May 2022)

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

  • 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,
  • Satyendra Kumar Sonkar,
  • Vivek Kumar,
  • Kamal Kumar Sawlani,
  • Kamlesh Kumar Gupta,
  • 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,
  • Rajeev Verma,
  • 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,
  • Vivek Kumar,
  • 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

Journal volume & issue
Vol. 15
p. 101044

Abstract

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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.

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