C Reactive Protein based early intervention for home quarantined COVID-19 patients to avoid complications and hospitalization

  1. Manimarane Arjunan
  2. U.R Anoop
  3. Kavita Verma
  4. Oviyaa Manimarane

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Abstract

Background

As India was reeling under the relentless onslaught of the second wave of COVID -19, the hospitals were over-crowded and resources were inaccessible. Many COVID -19 positive patients had to stay at home and reach out to their family physicians for guidance. This gave us an opportunity to observe a group of patients in home quarantine. The challenge was daunting. We could not afford to allow these patients to deteriorate as hospital beds and oxygen support were not readily available. Therefore, we developed an innovative approach to monitor these patients and to intervene at the optimal time to avoid hospitalization.

Based on objective biochemical tests like elevated CRP and clinical signs like persistent high-grade fever, we initiated early low dose steroids and antibiotics prior to the onset of hypoxia. None of the home quarantined patients deteriorated because of the timely medical intervention. These patients neither required oxygen support nor hospitalization. We therefore present our new treatment model for home quarantined COVID-19 patients along with our suggestions for implementing the model at the community level.

Methods

25 patients under home quarantine who contacted online for medical guidance underwent clinical and biochemical evaluation. CT radiological examination was done whenever indicated. Treatments were initiated under medical guidance based on the CRP values and clinical presentation.

Results

Among the 25 patients, 40% of the patients (10/25) had mild symptoms with normal CRP. 24% of the patients (6/25) had mild symptoms with elevated CRP. 36% of patients (9/25) had elevated CRP with persistent high fever. All the 25 patients recovered over the next four weeks.

Conclusion

We propose an early objective assessment of inflammatory markers like CRP prior to the onset of hypoxia during home quarantine and early, need-based intervention under medical guidance to avoid complications and hospitalization.

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  1. ScreenIT

    SciScore for 10.1101/2021.06.22.21258712: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: The clinical, biochemical and radiological data were recorded with the consent of the patients.
    Sex as a biological variableIn this group, 12 were males and 13 were females.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    A paired sample t test using Minitab showed a p value of 0.001 indicating a significant difference in the CRP values post treatment.
    Minitab
    suggested: (Minitab, RRID:SCR_014483)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    NCT04935515CompletedC Reactive Protein in Home Quarantined Coronavirus Disease 2…

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.06.22.21258712v1 on medRxiv