Articles related to Impact of Covid-19 on Co-morbid condition
The emergence of COVID-19 associated mucormycosis: a review of cases from 18 countries ketoacidosis: A systematic review of literature
Reports of COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19- associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or cerebral involvement. Furthermore, a substantial proportion of patients who survived had life-changing morbidities (eg, loss of vision in 46% of survivors). Our Review indicates that COVID-19-associated mucormycosis is associated with high morbidity and mortality. Diagnosis of pulmonary mucormycosis is particularly challenging, and might be frequently missed in India.
Cutaneous mucormycosis: an unusual cause of decompensation in a patient with ethanol-related cirrhosis with COVID-19 exposure
Authors: Sherna Menezes,1 Janu Santhosh Kumar,2 Omkar S Rudra,3 Aabha Nagral 1
COVID-19 presenting as acute pericarditis
COVID 19, caused by SARS-CoV-2, is a highly infectious disease, mainly affects the respiratory system. In this article, we have presented a case of COVID-19, who presented solely with pericarditis without myocarditis, without any respiratory symptoms. The diagnosis was made based on clinical, electrocardiographic, radiological and biological findings. He was treated successfully with aspirin and colchicine. Our case highlights an atypical presentation of COVID-19, which should be kept in mind in the present pandemic and to diagnose and isolate early to limit the spread of infection.
A meta-analysis of comorbidities in COVID-19: Which diseases increase the susceptibility of SARS-CoV-2 infection.
Authors: Manoj Kumar Singh , Ahmed Mobeen , Amit Chandra , Sweta Joshi , Srinivasan Ramachandran.
Clinical profile and outcomes in COVID-19 patients with diabetic ketoacidosis: A systematic review of literature
Background and aim: To conduct a systematic literature review and analyze the demographic/ biochemical parameters and clinical outcomes of COVID-19 patients with diabetic ketoacidosis (DKA) and combined DKA/HHS (hyperglycemic hyperosmolar syndrome). Methods: PubMed, Scopus, Embase, and Google Scholar databases were systematically searched till August 3, 2020 to identify studies reporting COVID-19 patients with DKA and combined DKA/HHS. A total of 19 articles reporting 110 patients met the eligibility criteria. Results: Of the 110 patients, 91 (83%) patients had isolated DKA while 19 (17%) had DKA/HHS. The majority of the patients were male (63%) and belonged to black ethnicity (36%). The median age at presentation ranged from 45.5 to 59.0 years. Most of the patients (77%) had pre-existing type 2 diabetes mellitus. Only 10% of the patients had newly diagnosed diabetes mellitus. The median blood glucose at presentation ranged from 486.0 to 568.5 mg/dl, being higher in patients with DKA/HHS compared to isolated DKA. The volume of fluid replaced in the first 24 h was higher in patients with DKA/HHS in contrast to patients with DKA alone. The in-hospital mortality rate was 45%, with higher mortality in the DKA/HHS group than in the isolated DKA group (67% vs. 29%). pH was lower in patients who had died compared to those who were discharged. Conclusion: DKA in COVID-19 patients portends a poor prognosis with a mortality rate approaching 50%. Differentiating isolated DKA from combined DKA/HHS is essential as the latter represents nearly one-fifth of the DKA cases and tends to have higher mortality than DKA alone.
Poor outcomes in patients with cirrhosis and Corona Virus Disease-19
Authors: Shalimar1 & Anshuman Elhence1 & Manas Vaishnav1 & Ramesh Kumar2 & Piyush Pathak1 & Kapil Dev Soni3 & Richa Aggarwal3 & Manish Soneja4 & Pankaj Jorwal4 & Arvind Kumar4 & Puneet Khanna3 & Akhil Kant Singh3 & Ashutosh Biswas4 & Neeraj Nischal4 & Lalit Dar5 & Aashish Choudhary5 & Krithika Rangarajan6 & Anant Mohan7 & Pragyan Acharya8 & Baibaswata Nayak1 & Deepak Gunjan1 & Anoop Saraya1 & Soumya Mahapatra1 & Govind Makharia1 & Anjan Trikha3 & Pramod Garg1.
Risk and outcomes of coronavirus disease in patients with inflammatory bowel disease: A systematic review and meta‐analysis.
Authors: Anupam Kumar Singh | Anuraag Jena | Praveen Kumar‐ | Vishal Sharma | Shaji Sebastian.
Profile of co-infections & secondary infections in COVID-19 patients at a dedicated COVID-19 facility of a tertiary care Indian hospital: Implication on antimicrobial resistance.
Authors: Surbhi Khurana a , Parul Singh a , Neha Sharad a , Vandana V. Kiro a , Neha Rastogi b , Amit Lathwal c , Rajesh Malhotra d , Anjan Trikha e , Purva Mathur.
Background: The COVID-19 pandemic has raised concerns over secondary infections because it has limited treatment options and empiric antimicrobial treatment poses serious risks of aggravating antimicrobial resistance (AMR). Studies have shown that COVID-19 patients are predisposed to develop secondary infections. This study was conducted to ascertain the prevalence and profiles of co- & secondary infections in patients at the COVID-19 facility in North India. Methods: We studied the profile of pathogens isolated from 290 clinical samples. Bacterial and fungal pathogens were identified, and antimicrobial susceptibility was determined by the Vitek2® system. Additionally, respiratory samples were tested for any viral/atypical bacterial co-infections and the presence of AMR genes by FilmArray test. The clinical and outcome data of these patients were also recorded for demographic and outcome measures analyses. Results: A total of 151 (13%) patients had secondary infections, and most got infected within the first 14 days of hospital admission. Patients aged >50 years developed severe symptoms (p ¼ 0.0004) and/or had a fatal outcome (p ¼ 0.0005). In-hospital mortality was 33%.K.pneumoniae (33.3%) was the predominant pathogen, followed by A. baumannii (27.1%). The overall resistance was up to 84%.Majority of the organisms were multidrug-resistant (MDR) harbouring MDR genes. Conclusion: A high rate of secondary infections with resistant pathogens in COVID-19 patients highlights the importance of antimicrobial stewardship programs focussing on supporting the optimal selection of empiric treatment and rapid-de-escalation, based on culture reports.
Role of comorbidities like diabetes on severe acute respiratory syndrome coronavirus-2: A review
Authors: Subham Dasa , Anu K.R.a , Sumit Raosaheb Birangala , Ajinkya Nitin Nikamb , Abhijeet Pandeyb , Srinivas Mutalikb , Alex Josepha.
Abstract: Pandemic coronavirus disease-2019, commonly known as COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious disease with a high mortality rate. Various comorbidities and their associated symptoms accompany SARS-CoV-2 infection. Among the various comorbidities like hypertension, cardiovascular disease and chronic obstructive pulmonary disease, diabetes considered as one of the critical comorbidity, which could affect the survival of infected patients. The severity of COVID-19 disease intensifies in patients with elevated glucose level probably via amplified pro-inflammatory cytokine response, poor innate immunity and downregulated angiotensin-converting enzyme 2. Thus, the use of ACE inhibitors or angiotensin receptor blockers could worsen the glucose level in patients suffering from novel coronavirus infection. It also observed that the direct β-cell damage caused by virus, hypokalemia and cytokine and fetuin-A mediated increase in insulin resistance could also deteriorate the diabetic condition in COVID-19 patients. This review highlights the current scenario of coronavirus disease in pre-existing diabetic patients, epidemiology, molecular perception, investigations, treatment and management of COVID-19 disease in patients with preexisting diabetes. Along with this, we have also discussed unexplored therapies and future perspectives for coronavirus infection.
Clotting disorder in severe acute respiratory syndrome coronavirus
Authors: Sujit Pujhari1,2 | Sanjeeta Paul3 | Jasmina Ahluwalia4 | Jason L. Rasgon.
Abstract: The severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a novel human respiratory viral infection that has rapidly progressed into a pandemic, causing significant morbidity and mortality. Blood clotting disorders and acute respiratory failure have surfaced as the major complications among the severe cases of coronavirus disease 2019 (COVID‐19) caused by SARS‐CoV‐2 infection. Remarkably, more than 70% of deaths related to COVID‐19 are attributed to clotting‐associated complications such as pulmonary embolism, strokes and multi‐ organ failure. These vascular complications have been confirmed by autopsy. This study summarizes the current understanding and explains the possible mechanisms of the blood clotting disorder, emphasizing the role of (1) hypoxia‐related activation of coagulation factors like tissue factor, a significant player in triggering coagulation cascade, (2) cytokine storm and activation of neutrophils and the release of neutrophil extracellular traps and (3) immobility and ICU related risk factors.