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Background: As of mid-2022, more than 650 million people have been infected with COVID-19 worldwide. With ongoing outbreaks and varying degrees of severity in different regions of the globe, we continue to battle against this global health crisis after 3 years of discovery of Sars-CoV-2. It is crucial for clinicians to utilize the information collected over this time period to combat any upcoming wave in the future. One approach to this is the development of a scoring system that can assess the severity of COVID-19 patients at the time of admission. Although much is known about the course of its clinical disease, much more is yet to be discovered in terms of its optimal management to yield favorable outcomes. Recognizing key risk factors and biochemical parameters can assist in an early assessment of the severity of COVID-19, thus leading to a timely management reducing morbidity and mortality. Objective: To predict the extent of COVID-19 disease severity upon admission using readily available means of assessment in a city with a lower socioeconomic status. Methodology: This retrospective analysis was conducted at the Department of Pulmonology, Dr. Ziauddin University Hospital in Karachi. The study spanned from June 2021 to June 2022. A total of 102 patient records were included in this research. These patients had tested positive for SARS-CoV-2, either through a reverse transcription polymerase chain reaction (RT-PCR) test or a rapid antigen detection test. Data for this study was collected from electronic medical records (EMR) and chart reviews, and the analysis was performed using SPSS version 26.0. Results: The COVID-19 Severity Score (CSS) is a cumulative score derived from nine parameters and was developed by closely observing 102 COVID-19 patients. Parameters incorporated are Age, Comorbidities, Ferritin, LDH, D-dimer, Neutrophil to Lymphocyte Ratio (NLR), Chest X-ray, Creatinine, and Platelet Count. Each parameter is assigned a score according to predefined cutoff ranges, which include a semiquantitative method for interpreting chest X-rays. A patient's total score is calculated by summing individual parameter scores, with a maximum possible score of 29. The CSS grading system categorizes patients into four "severity risk" groups. The study assessed the CSS's effectiveness in predicting the risk of severe COVID-19 by considering four key factors: hospital stay duration, need for mechanical ventilation, oxygen requirements, and mortality at discharge. Conclusion: In conclusion, this study's findings strongly advocate for the use of CSS scores as a valuable tool in risk stratification for severe COVID-19 cases. Early identification of patients with high CSS scores should prompt intensified medical care, including extended hospital stays, mechanical ventilation, and oxygen support, to improve patient outcomes and reduce mortality in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: A respiratory disease with variant SARS-CoV-2, which was later names as corona virus was first detected in city of China, Wuhan in the end of the year 2019 that rapidly transmitted across the world. The disease could turn into a serious condition in some of the patients who requires hospital care with mechanical ventilation support in nearly 5-15%. Approximately 10% of the infected patients required hospital admission due to thrombotic events, developing pneumonia or coinfections. Objective: To ascertain the pattern of bacterial co-infection in patients admitted with COVID-19 in a tertiary care hospital in Karachi, Pakistan. Methodology: This was Prospective, observational study conducted at Ziauudin Hospital Karachi during April 2021-June 2022. This study included COVID-19 patients those were admitted with COVID-19 in a tertiary care hospital in Karachi, Pakistan. All of the patients were investigated after confirmation of COVID-19 through real-time polymerase chain reaction test. Detailed history including comorbidity, smoking status and presenting symptoms was noted at the time of hospital admission. Blood and urine specimens were taken according to the hospital protocol. Results: Total 99 patients were studied with mean age of 60.7 ± 15 years. Majority of the admitted patients were males (43.5%), non-smokers (85.9%) and had comorbidity (76.8%). More than half of the patients had co-infections (77.8%) with total 116 detected microorganisms. Out of 77.8% patients having infections other than SARS-CoV-2, the most frequent organisms isolated were, Candida albicans (44.2%), Escherichia coli (41.6%), Coagulase negative staphlylococcus (35.1%), Klebsiella species (7.8%), Proteus mirabilis (5.2%), Group D streptococcus (5.2%), Enterobacter (2.6%), Pseudomonas aeruginosa (2.6%), Acinetobacter (2.6%), Baccilus (1.3%), Enterococuss species (1.3%), Stenotrophomonas Maltophilia and Staphylococcus Aureus. Conclusion: The present study analyzed that in addition to gram positive and gramnegative bacterial infections, fungal infections were also coexisting in COVID-19 patients in Karachi Pakistan. Patients with increasing age were more prone to have co-infections. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is an acute respiratory illness that has been declared a global pandemic by the WHO on March 11, 2020. The culprit behind this pandemic is a SARS-CoV2 strain belonging to the family of coronaviruses. The pathogens included in this family are not unfamiliar to mankind as they have given rise to previous outbreaks in the form of MERS-CoV in 2012, and SARSCoV1 in 2003. Objectives: This study was conducted with the aim to study the characteristics of COVID positive patients. Methodology: A retrospective study comprising of 52 patients was conducted at Ziauddin University Hospital, a tertiary care center located in Karachi, Pakistan. All patients belonged to Southeast Asian ethnicity. All patients included in this study were confirmed cases of SARS-CoV-2 pneumonia, tested positive on reverse transcriptase polymerase chain reaction of nasopharyngeal or oropharyngeal swab, at the time of admission. Patients exhibiting symptoms of COVID-19, but NOT proven positive on RT-PCR were excluded from the study. Data was collected using EMR, and analyzed using SPSS v. 23.3. Results: A total of 52 patients were observed in this study from 04-29-2020 to 06-28-2020. Mean age was found to be 55.15. Majority of the cases belonged to ages between 50 to 70 years (34 patients,65.4%). Only one patient was a 5-year-old male, with pre-existing liver abscess. Conclusion: In summary, the most common clinical features of SARS-CoV-2 pneumonia can be classified in a triad of fever, cough and myalgia, while the accessory symptoms include, but are not limited to, diarrhea and headache. On presentation of any of the aforementioned traits, patients should immediately contact health care facilities to inquire about COVID-19 testing and follow proper measures of social distancing. Hypertensive and diabetic populations were found to be more susceptible to SARS-CoV-2. Therefore, maintaining a good check of glycemic control and keeping a controlledBPis the preferable aim in such patients with COVID-19. Lastly, extremely high values of D-dimer may be used as a predictor of mortality or severity of pneumonia caused by SARS-CoV-2. In-patient laboratory tests should include testing for patient's D-dimer levels. [ABSTRACT FROM AUTHOR]