Treatment of COVID-19 Patients at a Medical College Hospital in Bangladesh (original) (raw)
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Euroasian Journal of Hepato-Gastroenterology, 2020
Background: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been declared as pandemic by World Health Organization (WHO) with increasing morbidity (more than 4.6 million patients) and mortality (300,000 deaths). The worldwide target of management COVID-19 is to reduce complications with available management options; this become highly variable from country to country and even within different regions of the same country. Aim and objective: This observational prospective study represents a single center study in which all patients in this cohort received almost similar medicines and care. Materials and methods: All patients in this cohort (N: 32) were positive for SARS-CoV-2 by polymerase chain reaction (PCR) with variable presenting symptoms. The management strategy included Standard of Care (SoC) and administration of hydroxychloroquine and doxycycline. Out of 32 patients, 9 patients also received favipiravir. All patients were followed until they were discharged after negativity of SARS-CoV-2 confirmed by PCR on two consecutive occasions taken within 2 days. Results: No death has been recorded in this cohort of 32 patients within the study period. The average hospital staying duration was 13.9 days with a range of 8-21 days. All patients were discharged with improvement of subjective symptoms and SARS-CoV-2 negativity. The vital signs (pulse, blood pressure) as well as and levels of electrolyte and blood counts were within normal and acceptable ranges at the time of discharge. Conclusion: The study presented here provide and evidence of a real-life situation of management of limited numbers of COVID-19 patients at a tertiary center of Bangladesh. This study inspires optimism that proper diagnosis, establishment of effective inclusion and exclusion criteria, ensuring application of proper SoC with drugs available in Bangladesh may be a practical option for management of COVID-19 in the country.
Molecular Mechanism Research, 2023
Background: The COVID-19 pandemic has had a profound impact on global health, with millions of individuals affected by the viral infection. Among the vulnerable populations, diabetic patients face a higher risk of severe illness and complications when exposed to the SARS-CoV-2 virus. Bangladesh, like many other countries, has witnessed a significant number of COVID-19 cases, raising concerns about the management and outcomes of diabetic patients during this pandemic. This study highlights clinical and demographical experiences in hospitalized and non-hospitalized covid-19 patients in Bangladesh. Methodology: This descriptive crosssectional study was from May 2021 to August 2022. Five selected government hospitals and six private hospitals located in the Dhaka Division were included in this study. The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) test. Results: Data of 416 nonhospitalized patients with COVID-19 were recorded and analyzed. The mean age of the patients was 44.42 ± 14.20 year with 336 males and 80 females. Comorbidities were present of which hypertension 38.5%, diabetes 32.7%. A significant proportion of patients had symptomatic such as fever 92.3%, dry cough 88.5%, loss of taste 48.07%, loss of smell 50.96% was the most common. Majority of the patients were managed with supportive treatment with paracetamol 38.46%, antihistamine 76.9%, oral vitamin-c 83.65%, and antibiotics 67.30%. It took an average of 12-14 days for them to become negative. And hospitalized patients, of whom 131 were males and 53 were female. Overall mean age was 45.12±13.80 years. They have some kind of comorbidities present like diabetes mellitus 45.65%, hypertension 56.52%, hyperlipidemia 17.39%, coronary heart disease 21.73% etc. In addition, they have taken some medicine as per the doctors advise such as paracetamol 45.65%, antihistamine 63.04, oral vitamin c 69.56%, antibiotics 58.69%, antifungal 45.6% and oxygen therapy 28 (15.21%). Some changed laboratory parameters were observed. Conclusion: We concluded that laboratory results from nonhospitalized patients did not show any major alterations or abnormalities, but laboratory results from hospitalized patients did show substantial changes. There is a post-COVID-19 tiredness warning for them.
Clinical profile of first 100 cases of COVID-19 in a COVID-dedicated hospital of Bangladesh
BIRDEM Medical Journal
Background: The novel corona virus has been identified as the cause of respiratory illness in Wuhan, Hubei province, China, since December, 2019. It has spread almost all the countries and areas (212) in world. Due to distinct demographics of infection, variation of case fatality and clinical presentation in different countries, the knowledge of demographic distribution and analysis of clinical profile from this study would help for patient management of COVID-19 till the invention of specific drug and vaccines. We aimed to analyze the clinical profile of fist 100 cases of COVID-19 admitted in a teaching hospital. Methods: In this observational study, RT-PCR confirmed first 100 hospitalized COVID-19 cases, admitted in Mugda Medical College Hospital were included. With well informed consent, a structured questionnaire was fulfilled during the time of hospital stay. Data were analyzed with clinical outcome, hospital stay, clinical staging and comorbidity of admitted patient from 20th ...
2022
ABSTRACTBackgroundGlobal knowledge of treatment and outcomes of COVID-19 has been evolving since the onset of the pandemic.Materials and MethodsThe objective of this cross-sectional study was to explore treatment and outcome of COVID-19 patients admitted in a Combined Military Hospital of Bangladesh. Data were collected from treatment records of patients of the CMH Bogura during the period of June 2020 to August 2020. Total 219 RT-PCR positive admitted patients were included as study population.ResultAmong 219 patients, 78.6% were male and 21.5% were female, mean age of patients was 34.3 ± 12.2. About14.6% patients had one or more comorbidities. Most (83.1%) of the admitted patients were diagnosed as mild cases. Antimicrobials were used in 98.8% cases, and frequent use of doxycycline (80.4%) and ivermectine (77.2%) was found. Anticoagulant and steroid therapy were used in 42.0% and 15.5% patients respectively. O2 therapy was required in 6.0% cases and intensive care unit (ICU) suppo...
International Journal of Community Medicine and Public Health, 2020
Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU. Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals' records using a structured questionnaire. Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose. Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.
Introduction: The initial case of coronavirus disease (COVID-19), triggered by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in December 2019. The disease swiftly spread, infecting millions globally and significantly challanged healthcare systems. As per the World Health Organization, approximately 5% of COVID-19 patients who were severely or critically ill require intensive care unit (ICU) admission. Objective: This study aimed to evaluate the treatment outcomes of critically ill COVID-19-positive patients admitted at ICU in a COVID-19 referral hospital.
COVID-19, Co-Morbidities and Its Impact on Prognosis in a Tertiary Care Hospital of Bangladesh
Journal of Medical - Clinical Research & Reviews
In December 2019, a new human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in Wuhan, China. Since then, the virus has spread over the world, affecting over 180 nations. SARS-CoV-2 has infected people of all ages, races, and genders, infecting both men and women and spreading at an alarming pace across communities. Given the virus's origin, much remains unknown; however, we do know that clinical presentations vary from a typical cold to more serious infections, including pneumonia, bronchitis, severe acute respiratory distress syndrome (ARDS), multi-organ failure, and even death. COVID-19 is thought to have a more fast and severe progression in people with underlying health issues or co-morbidities, frequently resulting in death. Methods: This retrospective study was conducted at Bangladesh's Tertiary care hospital. 534 patients were selected for this study. Medical history, age, gender, and co-morbidities (including Hypertension, ...
BIRDEM Medical Journal
Background: Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which was previously known as novel corona virus 2019 (2019-nCoV), causes corona virus disease 2019 (COVID-19). Since 8 March 2020, COVID -19 emerged in Dhaka city and rapidly spread throughout the country. This study evaluated the sociodemographic, clinical and laboratory parameters of confirmed and probable COVID-19 patients in a tertiary care hospital. Methods: This cross-sectional study was conducted in BIRDEM General Hospital, Dhaka, Bangladesh from May to October 2020. Adult (>18 years) patients having clinical symptoms and signs of COVID-19, irrespective of sex were included in this study. Diagnosis was confirmed by positive reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 from nasopharyngeal samples of patients and the disease classification was done following national guidelines. Results: Total patients were 141with a mean age of 59.74±11.0 years; majority was from urban are...
Extent of Pharmacotherapy in Covid-19: An Observational Study in a Dedicated Hospital in Bangladesh
Journal of Drug Delivery and Therapeutics , 2021
Objective: With the rapid increase in the rate of infection, repurposing use of many drugs like antivirals, antibiotics, LMWH, steroid, oxygen therapy were considered as an option to find promising anti-COVID therapeutics. In this study, we aim to observe the extent and variety of drugs used in different clinical categories of COVID-19 patients admitted to hospital in Bangladesh. To observe the requirement of oxygen therapy according to severity was also a prime objective to reveal the overall trend, frequency, and pattern of pharmacotherapy in a COVID-dedicated hospital. Materials and method: A total of 1348 patients were admitted, of whom 473 were included in this single-center retrospective study. The critical group consists of 99 ICU patients, the severe group has 38, moderate was 82 and mild group 254 cases, admitted in the general ward. Hospital records of each patient were screened and information about drug and supportive therapy were collected manually by the researchers in the data collection sheet. Data express in MS excel spreadsheet and result expressed in percentage. Results: Critical group received remdesivir (85.86%), favipiravir (27.28%), meropenem (92.93%), moxifloxacin (87.88%) dexamethasone (41.48%), Low Molecular Weight Heparin (98.99%). They also received supportive O2 therapy like High Flow Nasal Cannula (67.68%), Non-Invasive Ventilation (26.67%), and mechanical ventilator (6.06%). A severe group of patients receives the same group of drugs 97.27%, 5.26%, 60.53%, 47.37%, methylprednisolone (55.26%), and 100% LMWH. A moderate group of the patient received favipiravir (97.56%), cephalosporin (64.67%), LMWH (89.02%) and low flow O2 (97.36%) in a higher percentage. All patients of the mild group received doxycycline, ivermectin. Total 33 patients transfuse convalescent plasma. Conclusion: Antiviral, broad-spectrum antibiotics, anti-protozoal, LMWH, corticosteroid, and oxygen therapy are the available treatment option against different clinical categories of admitted COVID-19 patients.
Medicina
Background and Objectives: The morbidity and mortality associated with COVID-19 have burdened worldwide healthcare systems beyond their capacities, forcing them to promptly investigate the virus characteristics and its associated outcomes. This clinical analysis aimed to explore the key factors related to the fatal outcome of severe COVID-19 cases. Materials and Methods: Thirty-five adult severe COVID-19 patients were enrolled from two COVID-19 hospitals in Dhaka, Bangladesh. Clinical manifestation, comorbid conditions, medications, SARS-CoV-2 RT-PCR related cycle threshold (CT) value, hematology, biochemical parameters with SARS-CoV-2 specific IgG and IgM responses at enrollment were compared between the survivors and deceased participants. Results: Total 27 patients survived and 8 patients died within 3 months of disease onset. Deceased patients suffered longer from shortness of breath than the survived (p = 0.049). Among the severe cases, 62% of the deceased patients had multiple...