EPIDEMIOLOGICAL, CLINICAL, AND LABORATORY FINDINGS IN COVID-19 POSITIVE PATIENTS IN HOSPITALS OF QUETTA, PAKISTAN: A RETROSPECTIVE MULTI-CENTERD STUDY
Main Article Content
Keywords
covid-19, clinical features, epidemiology, hematological, sars-cov-2
Abstract
The coronavirus disease 2019 (COVID-19) is a respiratory disease caused by SARS-CoV-2 in humans and animals. This study aimed to find out socio-demographic factors, epidemiology, clinical characteristics, and laboratory findings in COVID-19 diseased patients. Data was collected on a predesigned questionnaire from COVID-19-positive patients admitted to hospitals. Blood samples were collected for hematology, and serum biochemical analysis.
A total of 199 COVID-19-positive patients were enrolled, among which 145 (72.86%) were from the Quetta division. High prevalence was observed in the age group 51-75 years. Amidst total, 127(63.8%) males and 72(36.2%) were female patients including 78(39.2%) smokers. Forty-nine 49(24.6%) hospitalized patients were critical, 52(26.1%) moderate and 98(49%) with mild health issues. Patients diagnosed with comorbidities like diabetes, chronic respiratory disease, and cardiovascular disease. The total death rate was 33(16.58%). Patients presented general symptoms and infrequent symptoms of diarrhea, chest distress, breath shortness, and vomiting.
Increased count of leucocytes and neutrophils and lower count of erythrocytes, hemoglobin, platelets, and lymphocytes were measured in critical patients. Higher level of C-reactive protein, D-dimer, urea, and creatinine, was measured in critical patients. Impairments in hematological parameters such as biochemical profiles predict disease severity in patients and serve as indicators for the prognosis and severity of COVID-19.
References
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54. Hamming, I., et al., Tissue distribution of ACE2 protien, the functional receptors for SARS coronavirus. A first step in understanding SARS pathogenesis. The journal of pathology, 2004. 203(2): p. 631-637.
2. Ulrich H, Pillat MM. CD147 as a target for COVID-19 treatment: suggested effects of azithromycin and stem cell engagement. Stem Cell Rev and Rep. 2020; 16:434-440. https://doi.org/10.1007/s1201 5-020
09976-7.
3. Yang X, Yang Q, Wang Y, et al. Thrombocytopenia and its association with mortality in patients with COVID-19. J Thromb Haemost. 2020; 18: 1469-1472. https://doi.org/10.1111/jth.14848.
4. Karimi Shahri, M., Niazkar, H. R., & Rad, F. (2021). COVID-19 and hematology findings based on the current evidences: A puzzle with many missing pieces. International journal of laboratory hematology, 43(2), 160-168.
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https://doi.org/10.2478/rjim-2020-0013.
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7. Chen T, Li G, Liu H, Wan W, Zheng H, Chen C. Clinical characteristics of 132 healthcare worker cases with
COVID-19: a retrospective study from a single center in Wuhan, China. J Med Virol. (2021) 93:1631–8. doi: 10.1002/jmv.26511.
8. Ing EB, Xu QA, Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occup Med. (2020) 70:370–4. doi: 10.1093/occmed/kqaa088.
9. Dalton CB, Corbett SJ, Katelaris AL. Pre-emptive low cost social distancing and enhanced hygiene implemented before local COVID-19 transmission could decrease the number and severity of cases. Med J Austral. (2020) 212:1–10. doi: 10.2139/ssrn.3549276.
10. Ahmad, M., Beg, B. M., Majeed, A., Areej, S., Riffat, S., Rasheed, M. A., ... & Hafeez, M. A. (2021). Epidemiological and clinical characteristics of covid-19: A retrospective multi-center study in pakistan. Frontiers in Public Health, 9, 644199.
11.Yu, W. B., Tang, G. D., Zhang, L., & Corlett, R. T. (2020). Decoding the evolution and transmissions of the novel pneumonia coronavirus (SARS-CoV-2/HCoV-19) using whole genomic data. Zoological
research, 41(3), 247.
12. Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., ... & Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England journal of medicine.
13. Bauer CMT, Morissette MC, Stämpfli MR. The influence of cigarette smoking on viral infections:translating bench science to impact COPD pathogenesis and acute exacerbations of COPD clinically. Chest. 2013;143(1):196–206.
14. Zhao Q, Meng M, Kumar R, et al. Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a systemic review and meta-analysis. Int J Infect Dis. 2020;96:131-135 https:// doi.org/10.1016/j.ijid.2020.04.086
15. Wang, G., Wu, C., Zhang, Q., Wu, F., Yu, B., Lv, J., ... & Zhong, Y. (2020, May). C-reactive protein level may predict the risk of COVID-19 aggravation. In Open forum infectious diseases (Vol. 7, No. 5, p. ofaa153). US: Oxford University Press.
16.Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020; 95: 834-847. https://doi.org/10.1002/ajh.25829
17.Hu, X., Chen, D., Wu, L., He, G., & Ye, W. (2020). Declined serum high density lipoprotein cholesterol is associated with the severity of COVID-19 infection. Clinica Chimica Acta, 510, 105-110.
18. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., ... & Cheng, Z. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395(10223), 497-506.
19. Onder, G., Rezza, G., & Brusaferro, S. (2020). Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. Jama, 323(18), 1775-1776.
20. Yang, J., Zheng, Y., Gou, X., Pu, K., Chen, Z., Guo, Q., ... & Zhou, Y. (2020). Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. International journal of infectious diseases.
21.Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Zhong, N. S. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine, 382(18), 1708
1720.
22. Raimondi, F., Novelli, L., Ghirardi, A., Russo, F. M., Pellegrini, D., Biza, R., ... & Di Marco, F. (2021). Covid19 and gender: lower rate but same mortality of severe disease in women—an observational study. BMC pulmonary medicine, 21(1), 1-11.
23. Stelzig KE, Canepa-Escaro F, Schiliro M, Berdnikovs S, Prakash YS, Chiarella SE. Estrogen regulates the expression of SARS-CoV-2 receptor ACE2 in differentiated airway epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2020;318(6):L1280–L1.
24.Mehra, M. R., Desai, S. S., Kuy, S., Henry, T. D., & Patel, A. N. (2020). Cardiovascular disease, drug therapy, and mortality in Covid-19. New England Journal of Medicine, 382(25), e102.
25.Jakhmola, S., Baral, B., & Jha, H. C. (2021). A comparative analysis of COVID-19 outbreak on age groups and both the sexes of population from India and other countries. The Journal of Infection in Developing Countries, 15(03), 333-341.
26. Magnusson, K., Nygard, K. M., Methi, F., Vold, L., & Telle, K. E. (2021). Occupational risk of COVID-19 in the 1st vs 2nd wave of infection. medRxiv, 2020-10.
Gov.uk.Population of England and Wales. 2019. https://www.ethnicity-facts-figures.service.gov.uk/ukpopulation-by-ethnicity/national-and-regional-populations/population-of-england-andwales/latest(Accessed May 14, 2019).
27. Patanavanich, R., & Glantz, S. A. (2020). Smoking is associated with COVID-19 progression: a meta analysis. Nicotine and Tobacco Research, 22(9), 1653-1656.
28. Xie, J., Wang, Q., Xu, Y., Zhang, T., Chen, L., Zuo, X., ... & Song, Y. (2021). Clinical characteristics, laboratory abnormalities and CT findings of COVID-19 patients and risk factors of severe disease: a systematic review and meta-analysis. Ann Palliat Med, 1928-1949.
29. Plaza, J. J. G., Hulak, N., Zhumadilov, Z., & Akilzhanova, A. (2016). Fever as an important resource for infectious diseases research. Intractable & rare diseases research, 5(2), 97-102.
30. da Rosa Mesquita, R., Francelino Silva Junior, L. C., Santos Santana, F. M., Farias de Oliveira, T., Campos Alcântara, R., Monteiro Arnozo, G., ... & Freire de Souza, C. D. (2021). Clinical manifestations of COVID-19 in the general population: systematic review. Wiener klinische Wochenschrift, 133(7), 377-382.
31.Alizadehsani, R., Alizadeh Sani, Z., Behjati, M., Roshanzamir, Z., Hussain, S., Abedini, N., ... & Islam, S. M. S. (2021). Risk factors prediction, clinical outcomes, and mortality in COVID-19 patients. Journal of medical virology, 93(4), 2307-2320.
32. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-513
33. Hikmet F, Méar L, Edvinsson Å, Micke P, Uhlén M, Lindskog C. The protein expression profile of ACE2 in human tissues. Mol Syst Biol 2020; 16: e9610.
34. Zhao, C., Bai, Y., Wang, C., Zhong, Y., Lu, N., Tian, L., ... & Jin, R. (2021). Risk factors related to the severity of COVID-19 in Wuhan. International journal of medical sciences, 18(1), 120.
35. Murat, S., Dogruoz Karatekin, B., Icagasioglu, A., Ulasoglu, C., İçten, S., & Incealtin, O. (2021). Clinical presentations of pain in patients with COVID-19 infection. Irish Journal of Medical Science (1971), 190(3), 913-917.
36. Bajgain, K. T., Badal, S., Bajgain, B. B., & Santana, M. J. (2021). Prevalence of comorbidities among individuals with COVID-19: A rapid review of current literature. American journal of infection control, 49(2), 238-246.
37. Ma RCW, Holt RIG. COVID-19 and diabetes. Diabet Med. 2020; 37:72.
Zheng YY, Ma YT, Zhang JY, Xie X. COVID-19 and the cardiovascular system. Nat Rev Cardiol. 2020;17:259–260.
38. Diao B, Feng Z, Wang C, Wang H, Liu L, Wang Cet al. Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. medRxiv. 2020.
39. Alberici F, Delbarba E, Manenti C et al. Management of patients on dialysis and with kidney transplant during SARS-COV-2 (COVID-19) pandemic in Brescia, Italy. Kidney Int Rep 2020: 5(5): 580– 585.
40. Aveyard, P., Gao, M., Lindson, N., Hartmann-Boyce, J., Watkinson, P., Young, D., ... & Hippisley-Cox, J. (2021). Association between pre-existing respiratory disease and its treatment, and severe COVID-39: a population cohort study. The lancet Respiratory medicine.
41. Ciceri, F., Castagna, A., Rovere-Querini, P., De Cobelli, F., Ruggeri, A., Galli, L., ... & Zangrillo, A. (2020). Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy. Clinical immunology, 217, 10809.
42. Lillicrap, D. (2020). Disseminated intravascular coagulation in patients with 2019-nCoV pneumonia. Journal of Thrombosis and Haemostasis, 18(4), 786.
43. Feng, P., Tianhe, Y., Peng, S., Shan, G., Bo, L., Lingli, L., ... & Jiazheng, W. (2019). Hesketh Richard L. Yang Lian, Zheng Chuansheng. Time Course of Lung Changes at Chest CT during Recovery from Coronavirus Disease, 715-721.
44. Lippi, G., South, A. M., & Henry, B. M. (2020). Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID-19). Annals of clinical biochemistry, 57(3), 262-265.
45. De Carvalho, H., Richard, M. C., Chouihed, T., Goffinet, N., Le Bastard, Q., Freund, Y., ... & Montassier, E. (2021). Electrolyte imbalance in COVID-19 patients admitted to the Emergency Department: a case control study. Internal and Emergency Medicine, 16(7), 1945-1950.
46. Wang, C., Deng, R., Gou, L., Fu, Z., Zhang, X., Shao, F., ... & Li, C. (2020). Preliminary study to identify severe from moderate cases of COVID-19 using combined hematology parameters. Annals of translational medicine, 8(9).
47. Erol, A. T., Aşar, S., BİLGİN, B. Ö., ÇUKUROVA, Z., & SABAZ, S. (2021). Risk factors for 28-day mortality among COVID-19 patients in an intensive care unit of a tertiary care center in Istanbul. Bakırköy Tıp Dergisi, 17(1), 100-107.
48. Mertoglu, C., Huyut, M. T., Arslan, Y., Ceylan, Y., & Coban, T. A. (2021). How do routine laboratory tests change in coronavirus disease 2019?. Scandinavian Journal of Clinical and Laboratory Investigation, 81(1), 24-33.
49. Huyut, M. T., Huyut, Z., İlkbahar, F., & Mertoğlu, C. (2022). What is the impact and efficacy of routine immunological, biochemical and hematological biomarkers as predictors of COVID-19 mortality?. International Immunopharmacology, 105, 108542.
50. Ardestani, A., & Azizi, Z. (2021). Targeting glucose metabolism for treatment of COVID-19. Signal Transduction and Targeted Therapy, 6(1), 1-2.
51. Chen D, Li X, Song Q, Hu C, Su F, Dai J (2020) Hypokalemia and clinical implication in patients with coronavirus disease 2019 (COVID-19)
52. Dubey, D. B., Mishra, S., Reddy, H. D., Rizvi, A., & Ali, W. (2021). Hematological and serum biochemistry parameters as a prognostic indicator of severally ill versus mild Covid-19 patients: A study from tertiary hospital in North India. Clinical Epidemiology and Global Health, 12, 100806.
53.Tezcan, M. E., Gokce, G. D., Sen, N., Kaymak, N. Z., & Ozer, R. S. (2020). Baseline electrolyte abnormalities would be related to poor prognosis in hospitalized coronavirus disease 2019 patients. New Microbes and New Infections, 37, 100753.
54. Hamming, I., et al., Tissue distribution of ACE2 protien, the functional receptors for SARS coronavirus. A first step in understanding SARS pathogenesis. The journal of pathology, 2004. 203(2): p. 631-637.
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Habib ur rehman, Muhammad Zahid Mustafa, Irfan Shahzad sheikh, Zunera Tanveer, Salma Khalid, Masroora Ali Khan, Abdul Samad, Muhammad Shafee, & Mukhtar Khan. (2024). EPIDEMIOLOGICAL, CLINICAL, AND LABORATORY FINDINGS IN COVID-19 POSITIVE PATIENTS IN HOSPITALS OF QUETTA, PAKISTAN: A RETROSPECTIVE MULTI-CENTERD STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 3395-3408. https://doi.org/10.53555/tvyhp111
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Author Biographies
Habib ur rehman
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan,
Muhammad Zahid Mustafa
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan
Irfan Shahzad sheikh
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan
Zunera Tanveer
Department of Physiology, Bolan Medical College, Quetta-87300, Pakistan
Salma Khalid
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan
Masroora Ali Khan
Department of Microbiology, Lecturer SBK Women University Quetta-87300
Abdul Samad
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan
Muhammad Shafee
Center of advanced studies in Vaccinology and Biotechnology, University of Balochistan Quetta, 87300, Pakistan
Mukhtar Khan
Department of Microbiology, Quaid i Azam University Islamabad-45320
How to Cite
Habib ur rehman, Muhammad Zahid Mustafa, Irfan Shahzad sheikh, Zunera Tanveer, Salma Khalid, Masroora Ali Khan, Abdul Samad, Muhammad Shafee, & Mukhtar Khan. (2024). EPIDEMIOLOGICAL, CLINICAL, AND LABORATORY FINDINGS IN COVID-19 POSITIVE PATIENTS IN HOSPITALS OF QUETTA, PAKISTAN: A RETROSPECTIVE MULTI-CENTERD STUDY. Journal of Population Therapeutics and Clinical Pharmacology, 31(6), 3395-3408. https://doi.org/10.53555/tvyhp111