Frequency of Covid Pneumonia and Trajectory of Severe Clinical Manifestations in Karachi

Abstract

Background: Severe COVID-19 leads to acute respiratory distress syndrome (ARDS) and causes lung injury and covid Pneumonia. This lung injury is accompanied by a strong inflammatory response marked by very high levels of various cytokines in the serum. The objective of this study was to analyze the frequency of covid pneumonia in all affected patients and to observe the clinical cascade determining the poor prognostic markers.

Methods: This cross-sectional study selected 83 patients (>18 years) with reactive RT-PCR from April 2020 to March 2021. Non-reactive patients on RT-PCR but proven Covid 19 on HRCT, CO-RADS Category 5 and 6 were also included in the study. Clinical cascade was observed in week 1 and week 2 along with cytokine storm markers. Data were analyzed using SPSS version 20. The correlation was assessed through an independent t-test and p-value <0.05 was considered significant.

Results: Thirty-three (39.8%) patients (mean age 47+17.2 years), were found affected with covid pneumonia, among them, 12(14.5%) died during the study. Most virus-contracted patients included highly educated people (83.1%) and high-income individuals (61.4%). Other than respiratory symptoms (72.3%), GI symptoms like diarrhea and vomiting (59%) were also seen. Ferritin, D-Dimers, and LDH increased respectively (353+340, 16.5+60, 265+273) whereas CRP decreased (57+69.3) in the second week.

Conclusion: Covid affects the pulmonary as well as extrapulmonary systems. Most patients remain asymptomatic, but hypoxic subjects showed an escalation in inflammatory markers such as CRP, Ferritin, and D-Dimers which declined the following week. High mortality was seen with those requiring ventilation (p=0.000).

Keywords: Covid-19 Pneumonia; Pandemic; HRCT; RT-PCR.