Overview of Early Cases of Coronavirus Disease 2019 (COVID-19) at a Tertiary Care Centre in North India

Abstract

Introduction: As the coronavirus disease 2019 (COVID-19) pandemic continues to spread on an unprecedented scale from around the world, we described our experience in treating early COVID-19 cases in India. Materials and Methods: An observational study of COVID-19 patients admitted to a tertiary care centre in North India between 2 March–4 April 2020 was performed. The clinical, epidemiological, laboratory, treatment and outcome data of patients were evaluated. Results: A total of 75 patients were treated and 56 (74.66%) were men. The clinical spectrum of COVID-19 ranged from asymptomatic to acute respiratory distress syndrome (ARDS). Fever (85.36%) was the most common symptom followed by cough (56.09%) and dyspnoea (19.51%). Findings from hemogram analysis showed that 32%, 21.33% and 18.67% of patients had lymphopaenia, eosinopenia and thrombocytopaenia, respectively. Inflammatory markers such as C-reactive protein, D-dimer, ferritin, fibrin degradation product and interleukin-6 were significantly elevated (P <0.05) in patients who required oxygen therapy than those who did not require it, suggesting the potential role such markers could play in predicting prognosis in patients. Mean hospital stay was 9.2 days and 72 (96%) patients made a complete recovery, but 3 (4%) patients demised after progressing to ARDS. Conclusion: The clinical and epidemiological spectrum of COVID-19 has jeopardised the health system in India. Without a proven therapy to combat this pandemic and with no sight of vaccines in the near future, a preventive strategy should be adopted to contain the spread of this infectious disease. Key words: Acute respiratory distress syndrome, Cytokine release syndrome, Interleukin-6, Lopinavir-ritonavir, Lymphopaenia