COVID-19 vaccination and its influence on the disease severity among the COVID patients in a tertiary care hospital – A cross sectional study

Introduction: COVID-19 disease was a global health emergency from March 2020 till May 2023 with no effective drug to date. COVID-19 vaccines with other precautious measures like hand washing, disinfection, social distancing etc. were the only ways to decrease the burden of the disease worldwide. The study aimed to determine the association between COVID-19 vaccination and disease severity among COVID-19 patients admitted to a Government Medical College hospital. Methods: This cross sectional study included 983 COVID-19 patients admitted to a tertiary care hospital from March 2021 to December 2021. Secondary data were collected from the case sheets and vaccination details were collected from the patients over the phone and through COWIN App. Chi-square test and binary logistic regression were done and the p value and odds ratio were estimated. Results: 92.9% of study participants were unvaccinated, 2.7% were fully vaccinated, and 4.3% were partially vaccinated. Among fully vaccinated 11.1% had breathlessness, 0% ICU admission, 3.7% died, 20% had COVID pneumonia findings in CT lung, 9% had low lymphocyte levels which were statistically significantly lower than in partially vaccinated (39.5%, 41.9%, 7%, 18.6%, 59.3%, 65.1%, 76.9% respectively) and unvaccinated (31.1%, 27.7%, 2%, 4.6%, 48.2%, 45.2%, 68.4% respectively). Conclusion: Two doses of vaccines provided significant protection from severe forms of the disease. Partially vaccinated were affected more, which may be due to insufficient immunity gained and their careless attitude post-vaccination with decreased shielding behaviour. The present study shows that partial vaccination is not protective against the progression of COVID-19 disease severity. More focus should be made on full vaccination of the community and educating the public about complete vaccination and emphasis on preventive measures even after vaccination must be made to reduce the burden of COVID-19 in the community

“Factors influencing the outcome of COVID-19 patients admitted in a tertiary care hospital, Madurai.- a cross-sectional study”

Introduction: COVID19* is a new disease with significant mortality risk. Because of the scarcity of the study on factors associated with the mortality in Tamil Nadu present study was done to determine the factors associated with the outcome of the COVID19 patients admitted in a tertiary care hospital, Madurai. Methodology: 4530 lab confirmed COVID19 patients admitted from March to August 31st, 2020; excluding the non-responders or who gave incomplete information were included in the study. Data retrieved from Case Investigation Forms *filled through telephonic interview. Chi -square test, Univariate and multivariate logistic regression were used to find out the association between the factors and risk of death(outcome). Results: Out of 4530 COVID19 positive patients 381(8.4%) died and 4149(91.6%) were discharged. Using multivariate logistic regression* following were the factors predicted to be associated with mortality:Age group <17yrs(PR = 4.12),30–44yrs(PR = 2.28),45–59(PR = 3.12),60–69(PR = 4.26) and ≥ 70(PR = 7.05); male gender(PR = 1.26); breathlessness at the time of admission(PR = 7.05); with 1symptom (PR = 2.58), 2symptoms(PR = 3.16) and ≥ 3 symptoms(PR = 2.45); chronic kidney disease(PR = 3.07), malignancy(PR = 2.39); other chronic diseases(PR = 1.89); having only diabetes(PR = 1.58); diabetes with hypertension (PR = 1.70); diabetes with heart disease(PR = 1.94); Hypertension with heart disease(PR = 2.30); diabetes with hypertension and heart disease(PR = 1.58). Survival probability* was more than 90% when patient gets admitted within a week after symptom onset,<80% for between 7 and 10 days and declines thereafter. Conclusion: Early insights into factors associated with COVID-19 deaths have been generated in the context of a global health emergency *which may help the treating physician

Efficacy and safety of canagliflozin over 52 weeks in patients with type 2 diabetes mellitus and chronic kidney disease.

Aim: This study evaluated the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus (T2DM) and within a subset of Stage 3 chronic kidney disease (CKD; estimated glomerular filtration rate [eGFR] ≥30 and &lt;50 ml/min/1.73 m2). Methods: In this 52-week, randomized, double-blind, placebo-controlled study, patients (N=269; mean eGFR, 39.4 ml/min/1.73 m2) received canagliflozin 100 or 300 mg and placebo once daily. Efficacy endpoints included changes in glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), body weight and systolic blood pressure (BP); adverse events (AEs) were also recorded. Results: At week 52, canagliflozin 100 and 300 mg reduced HbA1c compared with placebo (-0.19, -0.33 and 0.07%, respectively); placebo-subtracted differences (95% confidence interval) were -0.27% (-0.53, 0.001) and -0.41% (-0.68, -0.14). Canagliflozin also lowered FPG, body weight and BP versus placebo. Overall AE incidence was 85.6, 80.9, and 86.7% with canagliflozin 100 and 300 mg and placebo, respectively. Osmotic diuresis-related AEs were more common with both canagliflozin doses, and incidences of urinary tract infections and volume depletion-related AEs were higher with canagliflozin 300 mg versus placebo. Decreases in eGFR (-2.1, -4.0 and -1.6 ml/min/1.73 m2) were seen with canagliflozin 100 and 300 mg compared with placebo. Canagliflozin 100 and 300 mg provided median percent reductions in urine albumin to creatinine ratio versus placebo (-16.4, -28.0 and 19.7%). Conclusions: Canagliflozin improved glycaemic control and was generally well tolerated in patients with T2DM and within a subset of Stage 3 CKD over 52 weeks