Study of clinical parameters, diagnostics and outcome in patients with acute respiratory illness in a tertiary care centre during COVID-19 pandemic


  • Sunil Mahavar Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Princy Tyagi Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Abhishek Agrawal Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Subrata Banerjee Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Raman Sharma Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India
  • Prakash Keswani Department of Medicine, SMS Medical College, Jaipur, Rajasthan, India



Acute respiratory illness, SARS-CoV-2, ICU, Coagulopathy, Coinfection


Background: We retrospectively analyzed and compared 98 patients admitted in Intensive care unit (ICU) with symptoms of acute respiratory illness (ARI) during the era of COVID-19 pandemic.

Methods: We examined patients presenting in emergency department of SMS Medical College, Jaipur between 3rd and 20th May, 2020 with symptoms of ARI who were tested for SARS-CoV-2. Among those hospitalized, we compared symptoms, vital signs, comorbidities, biochemical and hematological parameters including viral diagnostics. We determined differences in outcomes (ICU admission, interventions, acute respiratory distress syndrome and cardiac injury).

Results: In a cohort of 98 patients with symptoms of ARI, 9 (9.183%) tested positive for SARS-CoV-2. Patients were divided into group A and B based on SARS CoV2 RNA testing. Among patients with additional viral testing, no co-infections with SARS-CoV-2 were identified by PCR. FDP and d-dimer was positive in 44.44% patients in group A and 68.53% in group B. 11.11% mortality was observed in group A and 14.606% in group B. The most common complication of ARI observed in both groups was coagulopathy 33.33% in group A and 42.696% in group B.

Conclusions: Presence of comorbidities, lymphopenia, elderly age and elevated NLR, TLC, PLR and LDH have been associated with increased morbidity and mortality. Tuberculosis was most common coinfection seen in patients presenting with ARI. ARI due to non-COVID-19 illness was more severe than due to COVID-19 and was accompanied by multiple respiratory and systemic symptoms and was associated with hospitalization.



Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery. 2020;76:71-6.

Astuti I, Ysrafil null. Severe Acute respiratory syndrome coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response. Diabetes Metab Syndr. 2020;14(4):407-12.

Chen N, Zhou M, Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-13.

Guan W, Ni Z, Hu Y. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020:NEJMoa2002032.

Fitzner J, Qasmieh S, Mounts AW, Alexander B, Besselaar T, Briand S et al. Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection. Bulletin of the World Health Organization. 2018;96(2):122.

Wang D, Hu B, Hu C. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China. JAMA. 2020.

Grasselli G, Zangrillo A, Zanella A. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020.

Subbarao K, Mahanty S. Respiratory Virus Infections: Understanding COVID-19. Immunity. 2020;52(6):905-9.

Team NCPERE. Vital surveillances: the epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) – China. China CDC Weekly. 2020;2(8):113-22

Yang X, Yu Y, Xu J, Shu H, Liu H, Wu Y et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. The Lancet Respiratory Medicine. 2020;8(5):475-81.

Shah SJ, Barish PN, Prasad PA. Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: A retrospective cohort study of patients with and without COVID-19. E Clinical Medicine. 2020;27:100518.

Alqahtani SA, Schattenberg JM. Liver injury in COVID-19: The current evidence. United European Gastroenterol J. 2020;8(5):509-19.

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Medic. 2020;382(18):1708-20.

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis T, Politou M et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020.

Vilar J, Domingo ML, Soto C. Radiology of bacterial pneumonia. J Eur J Radiol. 2004;51(2):102-13.

Wong HYF, Lam HYS, Fong AH-T. Frequency and distribution of chest radiographic findings in patients positive for covid-19. Radiology. 2020;296(2):E72-E78.

Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. The Lancet infectious diseases. 2020;20(4):425-34.

Young BE, Ong SWX, Kalimuddin S, Low JG, Tan SY, Loh J et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. J Am Med Assoc. 2020;323(15):1488-94.

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y et al. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-8.

Brufsky A. Distinct viral clades of SARS‐CoV‐2: Implications for modeling of viral spread. Journal of Medical Virology. 2020.

Wang Y, Kang H, Liu X, Tong Z. Combination of RT-qPCR testing and clinical features for diagnosis of COVID-19 facilitates management of SARS-CoV-2 outbreak. J Med Virol. 2020;92(6):538-9.






Original Research Articles