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| PHARMACOLOGY - ORIGINAL ARTICLES |
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| Year : 2021 | Volume
: 11
| Issue : 3 | Page : 220-224 |
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Estimation of Demographic Parameters of COVID-19 Patients Admitted in a Tertiary Care Hospital, Jaipur
Gudise Chitti Babu1, Bhagwati Chundawat2, Rajeev Pareek3, Ramana Murty Kadali1, Ajit Thakur4
1 Department of Pharmacology, Jaipur National University Institute of Medical Sciences and Research Centre, Jaipur, Rajasthan, India
2 Department of Microbiology, Shir Kalyan Medical College, SIKAR
3 Department of Pathology, Jaipur National University Institute of Medical Sciences and Research Centre, Jaipur, Rajasthan, India
4 Department of Biochemistry, Jaipur National University Institute of Medical Sciences and Research Centre, Jaipur, Rajasthan, India
| Date of Submission | 12-Feb-2021 |
| Date of Decision | 21-Feb-2021 |
| Date of Acceptance | 06-Apr-2021 |
| Date of Web Publication | 28-Jul-2021 |
Correspondence Address:
Bhagwati Chundawat
Associate Professor, Department of Microbiology, Jaipur National University Institute of Medical Sciences and Research Centre, Jaipur 302017, Rajasthan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijnpnd.ijnpnd_5_21
 Abstract | | |
Background: COVID-19 is a pandemic disorder spreading rapidly worldwide. Most of the countries were affected by the COVID-19 during the year 2020. Demographic data are important to understand the impact of COVID-19 across the country and also provide information on an appropriate response, planning, and allocation of resources. This study aims to assess the demographic data of COVID-19 patients admitted and treated in a tertiary care hospital, Jaipur. Materials and Methods: This is a retrospective study conducted in a tertiary care hospital in Jaipur. A total of 1149 patients’ data like age, gender, area they belong to, duration of the treatment, etc., were collected from the medical records department (MRD) department between July 1, 2020 and September 30, 2020. The data were expressed as counts, number, and percentage (%). The data were analyzed using Excel software. Results: Out of 1149 patients, 70% were males and 30% were females, respectively, and mean ± SD (standard deviation) of age was 44.23 ± 3.57. Most of the cases were obtained from Jaipur 63%, Bikaner 5.4%, Ajmer 4.4%, Alwar 2.6%, Sawai Madhopur 2.6%, Dausa 2.3%, Nagaur 2.3%, Bharatpur 2.1%, and Karauli 1.7%, respectively, and remaining places reported <1.5% cases. Also 40 to 80 years age groups were most affected. About 32.4% mild, 55.7% moderate, and 11.8% severe cases were reported. Conclusions: More male patients were affected when compared with female patients. Age and other disease conditions have a positive correlation with COVID-19. Older people should take extra precautions and avoid going to markets, parties, etc., unless it is essential. Early identification and detection of COVID-19 helps in better treatment and preventing the conversion of mild cases into moderate or severe cases and prevents the transmission from one to another.
Keywords: Area of distribution, coronavirus, COVID-19, demographic data, duration of treatment
How to cite this article:
Babu GC, Chundawat B, Pareek R, Kadali RM, Thakur A. Estimation of Demographic Parameters of COVID-19 Patients Admitted in a Tertiary Care Hospital, Jaipur. Int J Nutr Pharmacol Neurol Dis 2021;11:220-4 |
How to cite this URL:
Babu GC, Chundawat B, Pareek R, Kadali RM, Thakur A. Estimation of Demographic Parameters of COVID-19 Patients Admitted in a Tertiary Care Hospital, Jaipur. Int J Nutr Pharmacol Neurol Dis [serial online] 2021 [cited 2023 Feb 1];11:220-4. Available from: https://www.ijnpnd.com/text.asp?2021/11/3/220/322486 |
| Introduction | |  |
Coronavirus is an RNA virus that causes disease in mammals and birds. The name “coronavirus” is derived from the Latin word corona which means “crown” or “garland, wreath.” World health organization (WHO) announced the official name on February 11, 2020, for the disease caused by 2019 novel coronavirus or 2019-nCoV as coronavirus disease 2019, abbreviated as COVID-19. In COVID-19, “Co” stands for corona, “Vi” stands for virus, and “D” stands for disease.
Since December 2019, COVID-19 has spread rapidly in Wuhan and throughout the Hubei Province of China, and more recently to Europe and across the world. Based on the United Nations Geoscheme, COVID-19 impacts 214 countries and territories across the globe. Worldwide the top 10 countries with number of COVID-19 cases are USA 8,248,149, India 7,761,312, France 968,729, Brazil 5,298,772, UK 801,471, Spain 1,026,281, Russia 1,480,646, Italy 465,726, Argentina 1,053,650, and Colombia 990,270, respectively. Globally the total numbers of cases reported are 41,809,078 by the end of October 2020, according to the WHO information site.[1]
According to the WHO, India has the second highest number of cases with COVID-19 infection. As of September 24, 2020, 7.76 million cases have been reported. The number of cases as per states are: Maharashtra 1.63 million, Andhra Pradesh 797,000, Karnataka 789,000, Tamil Nadu 700,000, Uttar Pradesh 464,000, Kerala 378,000, Delhi 344,000, West Bengal 337,000, Odisha 278,000, Telangana 229,000, Bihar 209,000, Assam 203,000, Rajasthan 181,000, Chhattisgarh 170,000, Madhya Pradesh 164,000, Gujarat 164,000, Haryana 154,000, and Punjab 130,000, respectively, by the end of October 2020.[2]
COVID-19 infection can occur in both sexes, at all ages, in all ethnic groups, and at all socioeconomic levels. The high prevalence is associated with crowded living conditions. The disease may be transmitted from person to person, after close contact with an infected person, for example, in a household, workplace, or health care center through discharge from the nose or droplets of saliva when an infected person sneezes or coughs. The clinical manifestation of COVID-19 is highly diverse, ranging from asymptomatic to symptomatic, having symptoms like sore throat, fever, diarrhea, fatigue, body pains, conjunctivitis, severe pneumonia with respiratory failure that could lead to invasive mechanical ventilation or death.[3],[4],[5] The symptoms may vary in mild, moderate, and severe COVID-19 cases. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections might cause a hyperimmune response that is associated with acute respiratory distress syndrome, as illustrated by typical radiological findings.[6] The most critical patients can develop a cytokine storm, characterized by increased production of many cytokines like C-reactive protein (CRP), procalcitonin, Interleukin (IL)-6, and lactate dehydrogenase (LDH) that produce long-term damage and lung tissue fibrosis.[7]
Current treatment of COVID-19 comprises of oral, Intravenous (IV) treatment with antiviral drugs, steroids, and immunomodulating agents for a specified period. No particular therapy has been approved for COVID-19, but current clinical approaches consider the combination of antiviral drugs and immunomodulator drugs. Lopinavir/ritonavir demonstrated little benefit above the standard of care in the initial analysis, clinical trials of antivirals are continuing.[8] Drawing from a broader immunological background drawn from rheumatology immunomodulatory drugs have been considered, such as selective cytokine inhibitors, which lead to the inhibition of either the ligand or the receptor of a cytokine.[9],[10] A safe, effective acceptable therapy option is needed to resolve the problem. To realize a significant and sustained reduction in disease burden, treatment of COVID-19 needs to be an integrated program, with efforts to improve environmental and socioeconomic conditions and education to create awareness and also to reduce stigma. The current recommendation for disease control requires treatment of the affected individual and all people who came in contact with patients regardless of whether symptoms are present or not, to reduce the rate of recurrence. Antibiotics are needed for superimposed bacterial infection. Treatment is often hampered by inappropriate or delayed diagnosis, poor treatment compliance or uptake, and improper use of drugs such as antiviral, steroids.
All over the world, many countries have done lockdown for several days to prevent the spread of the coronavirus. Because of lockdown, so much economic loss has happened even though they had implemented it for the benefit of society or the community. Indian population being commonly affected by COVID-19, masses have poor affordability for the most efficacious treatment for COVID-19. Demographic data are essential to understand the impact of COVID-19 across the country and also provide information about the appropriate response, planning, and allocation of resources. Demography data can help to understand how this pandemic has spread and its effect on certain age groups as well as why its spread affects everyone. Prevention is better than cure. Hence, the study aimed to assess the demographic details like age, sex, duration of the treatment, and number of COVID-19 patients admitted in tertiary care hospital.
| Materials and Methods | | |
This is a retrospective study, accepted by the Institutional Ethics Committee of JNU Medical College and Hospital. Total 1149 inpatient department (IPD) patients’ data were collected from the medical records department (MRD) department who were admitted between July 1, 2020 and September 30, 2020. The data were computed and analyzed for age, sex, marital status, and duration of the treatment. Data were expressed as counts and percentages.
Inclusion and exclusion criteria
Patients of both sexes admitted to IPD who had recovered and were discharged were included in the study. Pregnant and lactating women were excluded from the study.
| Results | | |
In [Figure 1], out of 1149 cases, 802 were male and 347 were female.
In [Figure 2], the mean ± SD (standard deviation) of age was 44.23 ± 3.57. Distribution of the patients based on the age was 1 to 10 years 14 patients, 11 to 20 years 20 patients, 21 to 40 years 234 patients, 41 to 60 years 489 patients, 61 to 80 years 366 patients, and ≥81 years 26 cases. Mean and standard deviation of the age among admitted with COVID-19 infection were 47.23 and 4.13 years.
In [Figure 3], according to the duration of treatment, mean number of days were 9 days; 373 patients had taken 5 days of treatment, 640 patients had taken 6 to 10 days of treatment, 100 patients had taken 11 to 15 days of treatment, and 36 patients had taken >16 days of treatment. Mean number of days of patients under treatment in the selected setting were 11 days.
According to [Table 1] and [Table 2], the total number of cases reported were: Jaipur 724, Bikaner 62, Ajmer 51, Alwar 30, Sawai Madhopur 30, Dausa 27, Nagaur 26, Bharatpur 2.1%, Karauli 1.7%, Tonk 1.5%, Sikar 1.3%, Churu 1.1%, and Kota 0.9%, respectively. The cases reported from the remaining places were <0.1%.
| Discussion | | |
SARS-CoV-2 is one of the most virulent pathogens causing severe acute respiratory illness along with middle east respiratory syndrome (MERS) and swine flu in humans. Initial case studies from China demonstrated COVID-19 to be a respiratory illness with a spectrum ranging from mild illness (81%), severe respiratory distress (14%), and critical illness in 5% with a case fatality rate of around 2.4% to 5%. Considerable disparities in demographic and clinical patterns have been observed between states across the country. This prospective study demonstrated the clinical profile and outcomes of initial COVID-19 patients from northern India.
In the present study, more male patients were affected with COVID-19 when compared with female patients. This may be due to females have a strong immune response to infections compared to males. Estrogen promotes both innate and adaptive immune response which results in a better and faster response to pathogens. Whereas androgens have an immune suppressive effect which may explain the greater susceptibility to infectious diseases observed in men.[11]
Countries and regions with older populations have seen higher case fatality rates. For example, Italy has more fatality rate.[12] In the present study, 75% of cases were >41 years of age. With the progression of age, the disease affecting chances also increase. Compared to previously published reports from other countries, the mean age of our patients was significantly lower (40.1 years versus 47–63 years).[13] COVID-19 highly affects the individuals >41 years of age. This may be attributed to a greater proportion of bacterial coinfection, reduced numbers of lymphocytes, and greater use of corticosteroids in these age ranges.[14] This study has similar observations as with Asselta et al.[15]
In the present study, 373 mild cases, 740 moderate cases, and 36 severe cases were reported. Mild and moderate patients were discharged from the hospital within 5 to 10 days when compared to the severe cases group. This element may have an important bearing in a COVID-19 disease like the risk of transmission of disease can be curbed at a relatively early stage. A much lower figure compared to that of other studies where 15.7% to 29% of all patients had severe disease.[16] All the cases were symptomatic at the time of admission and had mild respiratory symptoms such as throat irritation and cough, which was different from the reported symptoms in other studies.[17]
In our study cases reported were: Jaipur 63%, Bikaner 5.4%, Ajmer 4.4%, Alwar 2.6%, Sawai Madhopur 2.6%, Dausa 2.3%, Nagaur 2.3%, Bharatpur 2.1%, and Karauli 1.7%, respectively. Remaining places reported <1.5% cases. This was a first study in the Rajasthan state.
Limitations of the study
The present study was conducted with patients admitted to one tertiary care hospital, that is, in a particular geographical area, so it may not represent the entire population.
| Conclusion | | |
Though symptomatic SARS-CoV-2 infection was encountered in 70% males and 30% females, respectively, severe illness was seen in 11.8% patients only. Older patients with diabetes and hypertension were significantly associated with severe disease on univariate analysis. The management team consisting of physicians from different specialties and triaged classification of patients and protocol-based management algorithms resulted in good outcomes and low case fatality.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | |
| 2. | |
| 3. | Zhou F, Yu T, Du R et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.  |
| 4. | Guan WJ, Ni ZY, Hu Y et al. Clinical characteristics of coronavirus disease2019 in China. N Engl J Med 2020;382:1708-20. |
| 5. | Nicastri E, D’Abramo A, Faggioni G et al. Coronavirus disease (COVID-19) in a paucisymptomatic patient: epidemiological and clinical challenge in settings with limited community transmission, Italy, February 2020. Euro Surveill 2020;25:2000230. |
| 6. | Huang C, Wang Y, Li X et al. Clinical features of patients infected with2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. |
| 7. | Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. J Clin Invest 2020;130:2202-5 |
| 8. | Cao B, Wang Y, Wen D et al. A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19. N Engl J Med 2020;382:1787-99. |
| 9. | Stebbing J, Phelan A, Griffin I et al. COVID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis 2020;20:400-2. |
| 10. | Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41:145-51. |
| 11. | Huang C, Wang Y, Li X et al. Clinical features of patients infected with2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506. |
| 12. | Holshue ML, DeBolt C, Lindquist S et al. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020;382:929-36. |
| 13. | Shirato K, Nao N, Katano H et al. Development of genetic diagnostic methods for novel coronavirus2019 (nCoV-2019) in Japan. Jpn J Infect Dis 2020;73:304-7. doi: 10.7883/yoken.JJID. 2020.061 |
| 14. | Bartz D, Chitnis T, Kaiser UB et al. Clinical advances in sex- and gender-informed medicine to improve the health of all: a review. JAMA Intern Med 2020;180:574-83. |
| 15. | Asselta R, Paraboschi EM, Mantovani A, Duga S. ACE2 and TMPRSS2 variants and expression as candidates to sex and country differences in COVID-19 severity in Italy. Aging (Albany NY) 2020;12:10087-98. |
| 16. | Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA 2020;323:1775-6. |
| 17. | Guan WJ, Ni ZY, Hu Y et al. Clinical characteristics of coronavirus disease2019 in China. N Engl J Med 2020;382:1708-20. |
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2]
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