Mild COVID-19 infection-predicting symptomatic phase and outcome: A study from AIIMS, New Delhi

• Main Authors: J Kirtana, Arvind Kumar, Swasthi S Kumar, Anupam K Singh, Sujay Halkur Shankar, Amrit Sharma, Amit Kumar, Ravneet Kaur, Maroof A Khan, Piyush Ranjan, Prayas Sethi, Avinash Chakravarthy, Achal K Srivastava, Naveet Wig
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Family Medicine and Primary Care
• Subjects: crp; ferritin; mild covid-19; nlr
• Online Access: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2020;volume=9;issue=10;spage=5360;epage=5365;aulast=Kirtana

Context: Comprehensive management of mild COVID infection calls for better understanding of symptomatology in these group of patients as well as early identification and close monitoring of patients at risk, data on which is limited. Aim: To study association between inflammatory markers and clinical presentation with progression of disease and the duration of resolution of symptoms. Settings and Design: This is a retrospective study that has been conducted at a designated COVID -19 medical ward at AIIMS, New Delhi Methods and Material: Fifty healthcare workers and their dependents who were admitted with asymptomatic and mild COVID-19 infection were included. Their records were retrospectively reviewed, entered into a predesigned proforma and analyzed. Results: A total of 50 participants were included in the study of which 70% were healthcare workers. The patients were admitted with mild COVID illness out of which 22 (44%) were males. Most common symptom at presentation was fever (72%). Among patients who had mild disease versus those who progressed to moderate illness (n = 3), the patients with moderate illness were older [mean (SD): 57.33 (10.21) vs. 36.13 (14.05); P = 0.014] and had a longer duration of hospital stay [17 (1.41) days vs. 11.20 (3.86) days; P = 0.04]. Inflammatory markers, C-Reactive Protein (CRP) [2.46 vs. 0.20 (P = 0.024)], and Ferritin [306.15 vs. 72.53 (P = 0.023)] were higher in patients with moderate illness. There is also a significant correlation between the number of days taken for symptoms to resolve with Serum Ferritin (P = 0.007), CRP (P = 0.0256), and neutrophil lymphocyte ratio (NLR) (P = 0.044). Conclusions: Acute phase reactants/Inflammatory markers serve as good indicators of time taken to resolution of symptoms in acute COVID infection. NLR is a simple and inexpensive method to provide insight into symptomatic phase. These may be utility tools for primary care physician in the management in periphery and timely decision.