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Management of Mild COVID-19: Policy Implications of Initial Experience in India

27 Pages Posted: 2 Jul 2020

See all articles by Rohit Kumar

Rohit Kumar

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Bisakh Bhattacharya

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Ved Prakash Meena

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Anivita Aggarwal

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Manasi Tripathi

All India Institute of Medical Sciences (AIIMS) - Department of Ophthalmology

Manish Soneja

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Ankit Mittal

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Komal Singh

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Nishkarsh Gupta

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Rakesh Kumar Garg

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Brajesh Kumar Ratre

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Balbir Kumar

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Shweta Arun Bhopale

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Pavan Tiwari

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine

Ankit Verma

All India Institute of Medical Sciences (AIIMS) - Department of Pediatrics

Sushma Bhatnagar

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

Anant Mohan

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine

Naveet Wig

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

Randeep Guleria

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine

More...

Multiple version iconThere are 2 versions of this paper

Abstract

Background: The ongoing pandemic of coronavirus disease 2019 (COVID-19) has spread across all geographies of the world. The clinical characteristics and outcomes reported across different countries are variable. This study presents clinical characteristics and outcomes of admitted patients with mild COVID-19 illness in the initial phase of pandemic in India.

Methods: It is a retrospective study conducted at COVID-19 facilities of AIIMS, New Delhi. Adult admitted patients with laboratory-confirmed SARS-CoV-2 infection and mild disease at presentation were included. Data regarding demography, comorbidities, clinical features, laboratory parameters, outcomes in terms of progression to moderate-severe disease were collected.

Findings: Out of 231 cases included, majority were males (78·3%) with a mean age of 39·8 years. Comorbidities were present in 21.2% of patients, diabetes mellitus and hypertension being most common. The most common symptoms were dry cough (81, 35%), fever (64, 27·7%), sore throat (36, 15·6%), and dyspnoea (24, 10·4%); asymptomatic infection course was seen in 108 (46.8%) patients. Presence of comorbidities was an independent predictor of symptomatic disease (OR-2·66; 95% CI 1·08-6·53, p= 0·03). None of the patients developed features of moderate to severe COVID-19 during hospital stay. Four patients required shifting for management of underlying comorbidities. There were no deaths in this cohort.

Interpretation: Patients with mild disease at presentation had a stable disease course and can be managed outside hospital setting, provided the comorbidities are under control. A large proportion of patients remained asymptomatic throughout the course of infection and those with comorbidities are more likely to be symptomatic. 

Funding Statement: No funding received

Declaration of Interests: No conflicts of interest declared by any of the authors.

Ethics Approval Statement: The permission for the study was obtained from the Institute Ethics Committee.

Keywords: mild COVID-19; asymptomatic; characteristics; outcomes

Suggested Citation

Kumar, Rohit and Bhattacharya, Bisakh and Meena, Ved Prakash and Aggarwal, Anivita and Tripathi, Manasi and Soneja, Manish and Mittal, Ankit and Singh, Komal and Gupta, Nishkarsh and Garg, Rakesh Kumar and Ratre, Brajesh Kumar and Kumar, Balbir and Bhopale, Shweta Arun and Tiwari, Pavan and Verma, Ankit and Bhatnagar, Sushma and Mohan, Anant and Wig, Naveet and Guleria, Randeep, Management of Mild COVID-19: Policy Implications of Initial Experience in India (5/12/2020). Available at SSRN: https://ssrn.com/abstract=3605172 or http://dx.doi.org/10.2139/ssrn.3605172

Rohit Kumar

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Bisakh Bhattacharya

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Ved Prakash Meena

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Anivita Aggarwal

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Manasi Tripathi

All India Institute of Medical Sciences (AIIMS) - Department of Ophthalmology

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

Manish Soneja (Contact Author)

All India Institute of Medical Sciences (AIIMS) - Department of Medicine ( email )

New Delhi
India
9013074717 (Phone)

Ankit Mittal

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Komal Singh

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Nishkarsh Gupta

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

New Delhi
India

Rakesh Kumar Garg

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

New Delhi
India

Brajesh Kumar Ratre

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

New Delhi
India

Balbir Kumar

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

New Delhi
India

Shweta Arun Bhopale

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine

New Delhi
India

Pavan Tiwari

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine

Ansari Nagar
India

Ankit Verma

All India Institute of Medical Sciences (AIIMS) - Department of Pediatrics

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

Sushma Bhatnagar

All India Institute of Medical Sciences (AIIMS) - Department of Onco-Anesthesia & Palliative Medicine ( email )

New Delhi
India

Anant Mohan

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine ( email )

Ansari Nagar
India

Naveet Wig

All India Institute of Medical Sciences (AIIMS) - Department of Medicine

New Delhi
India

Randeep Guleria

All India Institute of Medical Sciences (AIIMS) - Department of Pulmonary, Critical Care and Sleep Medicine

Ansari Nagar
India

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