Swapnil Jain

Abstract

Introduction: In spite of the advancement in science we are still lacking definite specific treatment for Covid-19. And till date (11 April 2022) 6,203,372 and 5,21,722 death occurred globally and in India respectively. The sudden increase of O2 demand with need for Invasive ventilator is an indicator/ is a warning for cytokine storm Syndrome (CSS) or an over action of the immune system, which can be disastrous. Steroids are still the best anti-inflammatory drugs available thus as soon as a patient shows signs of a 'cytokine storm,' steroids should be used. Other drugs i.e. IL-6 receptor blocker TCZ and Sarilumab and direct IL-6 inhibitor Siltuximaband JAK inhibitors (baricitinib) etc are also been considered in various trials for cytokine storm. Materials and Methods: A retrospective observational study was performed in hospitalized patients referred from the district hospital to the Dedicated Covid Hospital (DCH), all were diagnosed with COVID-19 with hypoxemia. The timely detection of CSS & early initiation to controlling management is the key issue The early identification of cytokine strom with initiation of TCZ may give beneficial result. The Oxygen requirement and CRP showed a significant decline with the use of tocilizumab. Furthermore, the optimal timing, dosage and administration route of TCZ may need to be studied with larger sample or with multicenteric study plan. Keywords: Cytokine release syndrome (CRS), Cytokine Storm syndrome (CSS), Acute respiratory distress syndrome (ARDS), Tocilizumab (TCZ)

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Abstract

Background: The Coronavirus disease 2019 is a disease caused by the etiological agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was a newly identified β-coronavirus that had spread rapidly around the world, resulting in a very high number of infections and deaths, threatening public security, and placing a heavy burden on global healthcare systems and economy. The present study was done to study antibody response in COVID-19 infection. Materials and and Methods: The study was carried out in the Department of Respiratory Medicine, R.D. Gardi Medical College, Ujjain, India after approval by ethics committee. The post COVID-19 cases attending respiratory medicine OPD were included in the study. Results : The present study was conducted in 122 patients. The mean age of the patients was 51.20±14.21 years, median age was 54.5 years, the minimum age was 14 years and the maximum age was 80 years, the most number of COVID-19 infection cases was in the elderly age group of more than 50 years. The severity of disease was seen in those above 50 years of age (57.3%) with p>0.05. Among the severe cases mean age of the cases was 49±17 years, in moderate cases mean age 52±14 and among mild group of cases mean age was 51±15 years. In the present study there were 73.8% males and females were 26.2% Among COVID-19 cases who reported in the OPD the maximum that is 86 (>70%) patients had moderately severe disease, while severe cases were only about 14 %. Mild cases were 15.6%. In the present study RT-PCR were negative in 36(29.5%) as against 86 (70.5%) were confirmed cases of COVID-19 and among positive cases 40 % cases became negative between 6-10 days. Among severe disease cases mean SARS COV2 antibody 650.06±240.47 was significantly higher as compare to moderate cases 461.49±331.41 and mild cases 404.11±240.47. Conclusions : India has the world’s largest vaccination program. COVID-19 antibodies estimation are important tests carried out to determine the response of the body against COVID-19 infection. Our results show a significant association between SARS COV2 antibody and the severity of disease.   Keywords: SARS-CoV-2, Coronavirus disease 2019, Neutralising antibodies, Persistence, Spike glycoprotein, Receptor binding domain, B cells, T cells, Convalesce

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