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Vig S, Meena JK, Kumar A, Rathore P, Bhan S, Sirohiya P, Goswami G, Elavarasi A, Sagiraju HKR, Gupta N, Ratre B, Pandit A, Singh R, Kumar B, Garg R, Meena VP, Paul SS, Mohan A, Guleria R, Bhatnagar S. Mortality in Two Waves of COVID-19: A Comparative Analysis of a Tertiary Care Hospital in India. Cureus 2023; 15:e45025. [PMID: 37829991 PMCID: PMC10566229 DOI: 10.7759/cureus.45025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background COVID-19 has spread as two distinct surges of cases in many countries. Several countries have reported differences in disease severity and mortality in the two waves. Objective Compare the in-hospital mortality in the two COVID-19 waves at a tertiary care hospital in India. Methods We conducted a retrospective data collection. Distinct periods of surges in cases and admissions were defined as the first wave spanning from March 2020 to December 2020 and the second wave from April 2021 to June 21, 2021. The primary outcome of this study was to compare mortality rates in terms of total hospital mortality rate (TMR) and case fatality rate (CFR). Results Mortality rates of wave 2 were approximately 10 times that of wave 1 (TMR of 20.3% in wave 2 versus 2.4% in wave 1 and CFR of 1.5% versus 17.7% in wave 1 and 2, respectively). Mortalities in wave 2 had a larger proportion of severe disease at presentation, faster progression of symptoms to death, and more patients without any chronic comorbid condition dying due to the direct effect of COVID-19 acute respiratory distress syndrome (ARDS). Conclusion Our data matches the worldwide reported pooled hospital mortality figures and shows the comparative difference in disease severity between the two waves.
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Affiliation(s)
- Saurabh Vig
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Jitendra K Meena
- Preventive Oncology, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Abhishek Kumar
- Anesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, IND
| | - Puneet Rathore
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Swati Bhan
- Anesthesiology, Vardhaman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi, IND
| | - Prashant Sirohiya
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Gitartha Goswami
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | | | - Hari Krishna Raju Sagiraju
- Preventive Oncology, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Nishkarsh Gupta
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), Delhi, IND
| | - Brajesh Ratre
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Anuja Pandit
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Ram Singh
- Anesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Balbir Kumar
- Onco-Anesthesiology and Palliative Medicine, National Cancer Institute, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Rakesh Garg
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
| | - Ved P Meena
- Internal Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Saurav S Paul
- Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Anant Mohan
- Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Randeep Guleria
- Pulmonary Medicine, All India Institute of Medical Sciences (AIIMS) New Delhi, New Delhi, IND
| | - Sushma Bhatnagar
- Onco-Anesthesiology and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences (AIIMS), New Delhi, IND
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Halkur Shankar S, Agarwal S, Ray A, Meena VP, Ranjan P, Vikram NK. Multiple myeloma with intracranial plasmacytoma. QJM 2020; 113:670-671. [PMID: 32031633 DOI: 10.1093/qjmed/hcaa022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Halkur Shankar
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
| | - S Agarwal
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
| | - A Ray
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
| | - V P Meena
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
| | - P Ranjan
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
| | - N K Vikram
- Department of Medicine, All India Institute of Medical Sciences, Third Floor, Teaching Block, Ansari Nagar, New Delhi 110029, India
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Vaithiyam V, Jadon RS, Ray A, Manchanda S, Meena VP, Ranjan P, Vikram NK. Metronidazole induced encephalopathy: A rare side effect with a common drug. Indian J Radiol Imaging 2020; 29:431-434. [PMID: 31949347 PMCID: PMC6958887 DOI: 10.4103/ijri.ijri_330_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/10/2019] [Accepted: 10/23/2019] [Indexed: 12/26/2022] Open
Abstract
In hospitals, seizures and encephalopathy are one of the common complications observed in critically ill patients. Drug intoxication, metabolic derangements, and anatomical abnormalities can cause altered mental status. We encountered an uncommon case with a diagnostic dilemma due to persistent encephalopathy, where metronidazole toxicity was an etiological factor. A 45-year-old male, who was admitted with the diagnosis of ruptured amoebic liver abscess. During the course of his management, he developed seizures and altered sensorium. After excluding other etiologies for in-hospital de novo seizure, a suspicion of metronidazole toxicity was considered. MRI brain was done which suggested the same. Metronidazole induced encephalopathy (MIE) is an uncommon adverse effect of treatment with metronidazole. Diagnosis is made by identifying specific radiological findings. It characteristically affects the cerebellum and subcortical structures. While the clinical and neuroimaging changes are usually reversible, persistent encephalopathy with poor outcomes may occur as seen in our case.
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Affiliation(s)
- Venkatesh Vaithiyam
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ranveer S Jadon
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Animesh Ray
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Smita Manchanda
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ved P Meena
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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