Clinical characteristics and laboratory profile of symptomatic COVID-19 patients from a tertiary Bangalore rural hospital: the lessons learnt

Abstract

Background: Aim of study was to analyse clinical and laboratory features and outcome of COVID-19 patients admitted in second wave of pandemic (April1 to May 31, 2021) (SW) and compare with covid 19 patients in third wave (TW).

Methods: COVID-19 positivity were confirmed in both SW and TW. Demographic features, symptoms and duration were recorded. X ray chest was done at the time of admission and for monitoring.  Complete blood count, C reactive protein, renal function tests, liver function tests, LDH and D dimer levels were done. The positive patients were categorized as mild, moderate and severe based on the clinical, imaging and laboratory features.

Results: Among 297 patients screened, 171 patients were diagnosed as positive (57.5%). 107 patients were admitted (62.5%). (M:F ratio - 1.74:1). The most common symptoms for hospitalization were fever, cough and shortness of breath. Though 38 patients had neutrophilia, only 16 of them presented with high NLR ratio. Consolidation on chest X-ray was present in all patients but the degree varied. 38 patients required ICU admission and oxygen support. 18 patients succumbed to disease. Among 140 patients (TW) (December 1 to January 31 2022, 69 (43.1%) were positive. Only 12 patients required hospitalisation. The only symptom was high fever. The NLR ratio ranged from 1-6 and never went beyond 6. All patients were discharged after 2-3 days.

Conclusions: The demographic features, co morbidities, presenting symptom of fever and X ray findings were similar in both waves. But the NLR ratio was never beyond 6 in TW. This was probably due to early reporting and vaccination status of the population and less virulent strain of the virus in TW. The present study confirmed that raised NLR and low levels of oxygen saturation at the time of admission are important predictors of disease severity.