■应确定新的共存条件,以修改新的风险因素。目的是在感染COVID19的患者中确定患有非经典或不太常见的共存疾病的患者。
■2020年6月至2021年5月在印度北部的一个三级中心进行的以单一为中心的研究。使用预先形成的调查表记录临床和实验室参数,并确定除CDC列表和印度数据外的病例。
■在6832例患者中,有0.67%(46)被确定为患有非经典并存疾病。分为感染A组(60.1%)和非感染B组(39.9%)。A组包括结核-肺(14.3%)和肺外(32.9%),细菌(25.0%)病毒感染[登革热,乙型肝炎和丙型肝炎](14.3%),艾滋病(10.7%)和疟疾(3.6%)。B组包括器官移植(27.8%),自身免疫性[重症肌无力,多发性肌炎,牛皮癣](22.6%),血液学[血友病,ITP,再生障碍性贫血,APML,CML](27.8%),罕见恶性肿瘤[播散性骶骨脊索瘤和GTN](11.1%)和蛇咬伤(11.1%)。血清降钙素原对COVID-19疾病中细菌感染的诊断无帮助。A组的病程明显延长,肝炎和CRP升高。A组和B组死亡率分别为32.1%和43.8%。非重症COVID病例的死亡是破伤风和蛇咬伤。结核病患者死亡比例为30.7%。两组中超过70%的死亡归因于COVID19。
■在印度环境中,与结核病相对罕见的世界其他地区不同,结核病和细菌感染等合并症会导致严重的COVID19。
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.