Background: COVID-19 a pandemic, affecting worldwide causing significant morbidity and to some extent mortality needs to be evaluated and urgently identify reliable predictors of disease severity and outcome. The fatal outcomes by COVID-19 are accompanied by cytokine storm syndrome. The cytokine storm is determined by serum ferritin. Aims and Objective: To determine the role of Serum ferritin in assessing the severity and outcome of COVID-19. Materials and Methods: A single-center, cross-sectional, observational study was conducted among SARS-CoV-2 infected patients from March 2020 to May 2020. The diagnosis was confirmed by real-time polymerase chain reaction (RT-PCR). Serum ferritin levels were compared with the treatment outcomes of COVID-19 positive patients. Results: A total of 1977 COVID-19 patients were studied. The mean age was 43.89±15.58 years and had male preponderance of 61.56% of the total subjects. The mean serum ferritin levels among recovered and expired patients were 1225.6 ± 2502.91 ng/ml and 285.71 ± 391.99 ng/ml, respectively. Conclusion: Serum ferritin was markedly increased in COVID-19 patients who could not survive as compared to the patients who finally recovered from the infection, proving it as a useful marker for assessing the severity of COVID-19.

Introduction: Although the Coronavirus Disease-2019 (COVID-19) pandemic is creating a major global health crisis, the risk factors for mortality and the detailed clinical course of disease has not yet established. Aim: To determine association of the demographic data of COVID-19 patients with clinical profile and disease outcomes. Materials and Methods: The cross-sectional single-center study considered adults patients of both the gender from March to June 2020 with an estimated sample size of 2000 patients diagnosed with COVID-19 infection by Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) technique. Necessary demographic and clinical data were collected and selected subjects were followed-up until discharge or death. Subjects were classified as those who survived (1839 patients) and succumbed (138 patients) to death. T-test was used for comparing continuous variables and chi-square test for categorical data between the groups. Results: The study included 1977 patients with a male-to-female ratio of 1:0.62. Fever, dyspnea and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (p-value <0.001). Statistically significant variables noted between the groups were age (survived mean age- 42.74±15.15 years vs mean age 59.12±12.95 in those who succumbed to death, p-value <0.001), age groups (p-value <0.001), gender (p-value 0.042), haemoglobin, Total Leucocyte Count (TLC), neutrophil, lymphocytes, Neutrophil to Lymphocyte Ratio (NLR), Lactate Dehydrogenase (LDH), ferritin, all the comorbidity variables and the asymptomatic status. Variables identified as significant predictors of disease outcomes were Haemoglobin (Hb), TLC, neutrophils, lymphocytes, NLR, LDH and ferritin (p-value <0.001). Most of the subjects belonging to the mortality group required oxygen and other Intensive Care Unit (ICU) facilities when compared to the survival group (p-value <0.001). The mean days of viral clearance noted in COVID subjects was around 8.98±3.54 days. Conclusion: Hb, TLC, neutrophils, lymphocytes, NLR, LDH and ferritin are noted as significant predictors of COVID-19 outcome. Biochemical monitoring of COVID-19 patients helps in identifying critically ill patients early and can reduce mortality and improve the recovery.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune diseasein which tissue-binding auto-antibodies and immune complex depositioncause damage to multiple organs and systems.We report a rare case of SLE in a 31-year-old male patient. He has a past history of unprovoked deep vein thrombosis of right lower limb for 8 years, treated with anticoagulant therapy but not evaluated further. The patient went on to develop recurrent symptoms of fever, rashes and joint pains which were also overlooked. ANA profile and APLA antibodies were positive and the patient was diagnosed with SLE after 8 years since onset of symptoms. He now exhibits renal manifestations in the form of anasarca and proteinuria and CNS manifestations in the form of seizures. We attribute the severity of his current condition to the delayed diagnosis.

Aim: This study aims to find the association of neutrophil-lymphocyte ratio (N-L ratio) of COVID-19 patients admitted in an Indian setting with clinical profile and disease outcomes. Background: The COVID-19 pandemic hit in early 2020 with the presentation of varied severity of acute respiratory illness. This study tries to use N-L ratio as a predictor of adverse outcome. Methodology: The prospective single-center study considered adults patients of both the gender, diagnosed with COVID-19 infection by reverse transcription-polymerase chain reaction technique. Necessary demographic and clinical data were collected, and selected subjects were followed up until discharge or death. Individuals were classified as those who survived and those who succumbed to death. t-test was used for comparing continuous variables and Chi-square test for categorical data for comparing different parameters between the groups. Results: The study included 1977 patients with a male:female ratio of 1:0.62. Fever, dyspnea, and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (P < 0.00001). Statistically significant variables noted between the groups were age, total leukocytes count (TLC), neutrophil, lymphocytes, all the comorbidity variables, and the asymptomatic status. Variables identified as significant predictors of disease outcomes were TLC, neutrophils, lymphocytes, and N-L ratio. Most of the subjects belonging to the mortality group required oxygen and other intensive care unit facilities when compared to the survival group (P < 0.00001). Conclusion: TLC, neutrophils, lymphocytes, and N-L ratio are noted as significant predictors of COVID-19 outcome. The mean days of viral clearance noted in COVID subjects is around 8.98 ± 3.54 days.

Background: Hemoglobin plays a vital role in tissue oxygenation. Hence anemia might significantly affect the prognosis of COVID 19 pneumonia, where in there is development of tissue hypoxia due to the disease pathogenesis. Aims and Objectives: To correlate the severity of anemia in COVID 19 patients with disease outcomes in patients admitted in a tertiary care setting. Materials and Methods: The prospective single-center study considered adults patients of both the gender, diagnosed with COVID-19 infection by RT-PCR technique. Necessary demographic, clinical data and Hemoglobin level were collected and selected subjects were followed-up until discharge or death. Subjects were classified as those who survived and succumbed to death. t-test was used for comparing continuous variables and chi-square test for categorical data between the groups. Results: The study included 1212 patients, where in there was a statistically significant correlation between low hemoglobin level and the disease outcome. The hemoglobin levels were significantly lower in patients who died than the patients who were discharged. Conclusion: Severe anemia as noted by low hemoglobin level was associated with higher mortality than subjects with normal hemoglobin.