BackgroundThe high prevalence of pneumonia and renal involvement in coronavirus disease 2019 leads to frequent acid-base abnormalities in serious patients and affects prognosis. In this study, we aimed to assess the arterial blood gas (ABG) and acid-base patterns in COVID-19 patients admitted to a tertiary care hospital. MethodologyA retrospective observational study was conducted in a designated COVID-19 hospital involving 267 reverse transcription-polymerase chain reaction-positive COVID-19 patients. Demographic and laboratory data including ABG data within the first day after admission and in patients with multiple ABG analyses, only the first measurement was collected and analyzed statistically, including its association with comorbidities. ResultsThe most common age group of the patients was 51-60 years (30.8%), with a male predominance (male:female = 2.7:1). The most common comorbidities were hypertension, diabetes mellitus, and chronic obstructive pulmonary disease found in 147 (55%) COVID-19 patients. Alkalosis and acidosis were observed in 145 (54.3%) and 50 (18.7%) patients, respectively. The most common ABG abnormality observed was primary respiratory alkalosis with secondary metabolic acidosis in 67 (25.1%) patients, followed by primary respiratory alkalosis with secondary metabolic alkalosis in 54 (20.2%) patients. Statistically significant negative correlation was found with PaCO 2 and pH (r = -0.530, p < 0.0001), statistically significant positive correlation was found between pH and base (r = 0.533, p < 0.0001), pH and TCO 2 (r = 0.260, p < 0.0001), and pH and HCO 3 (r = 0.354, p < 0.0001). ConclusionsAcid-base abnormalities are commonly encountered in COVID-19 patients. Respiratory alkalosis as a part of a single or mixed pattern on ABG was the most common pattern found in critically ill COVID-19 patients. ABG on admission in moderate-to-severe COVID-19 patients can help in the early correction of metabolic abnormalities leading to improved patient outcomes.

Aim. To evaluate the health-related quality of life (HRQOL) in DFU patients and its association with different surgical parameters in a tertiary care teaching hospital. Methodology. A total of 70 DFU patients from surgery department were enrolled and their demographic details, surgical examination and treatment related parameter were recorded. HRQOL was evaluated using Cardiff Wound Impact Questionnaire. Association of different surgical parameters as predictors of HRQOL was statistically evaluated. Results. Mean age of the study patients was 53.92 ± 9.27 with male preponderance and male: female ratio of 1.5:1. All the patients in the study suffered from type 2 diabetes and mean duration of the diabetes was 8.0±1.4 year. Mean BMI of the study patients was 23.36 ±1.4. All patients of DFU showed deteriorated HRQOL with mean score of 42.2±15.13 in social domain, 17.12±7.43 in wellbeing, 75.33±27.06 in physical domain and total score of 146.56±45.46. Increasing age, female gender, increased BMI, alcohol addiction found to be significantly associated with the deteriorated quality of life with respect to all four major domains which include Social life (P<0.001), wellbeing (P<0.07), physical symptoms (P<0.001) and Overall Quality of life (P<0.001). Surgical parameters like treatment for ulcer, regular follow up, larger size of ulcer, more than one ulcer, and ulcer on planter surface and chronic and recurrent ulcer significantly affect social domain, wellbeing and physical symptoms and total score (p<0.05). Control of blood sugar levels with non-pharmacological measures, OHA or insulin significantly improve Qol (p<0.05). Conclusions. Surgical parameters like site, size, number and duration of ulcer, treatment and blood sugar control significantly affect Qol. Multidisciplinary approach with holistic view is required for management of DFU patients for better quality of life.

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