E-Paper
Covid-19: India-specific clinical score may predict risk
Among the risk factors that have been seen in Covid patients in India that likely led to the disease turning severe is more than one co-morbid condition such as diabetes and hypertension, chronic kidney disease and obesity.
Some members of the national task force on Covid-related matters have proposed an India-specific clinical score to identify people with coronavirus who are at a higher risk of developing severe disease or dying, which will help in picking up warning signs early and saving lives.
While doctors have been using their clinical acumen to determine which patient could turn serious, the national guidelines will be standardised, looking at the overall evidence generated from the country.
“Some of us have been asking for analysis of India data and surveys to develop our own clinical score. It will require a set protocol that the task force is in the process of forming. However, no final decision has been taken on it yet,” said a member of the task force, who did not wish to be identified.
Among the risk factors that have been seen in Covid patients in India that likely led to the disease turning severe is more than one co-morbid condition such as diabetes and hypertension, chronic kidney disease and obesity.
“This is what is being usually seen but there could be other conditions that are specific to our patients. Hence, more evidence needs to be looked at comprehensively from hospitals across India to zero in on all those conditions that lead to a higher risk of Covid patients developing serious illnesses and not recovering as well. This will help further improve our case fatality rate,” said another member, requesting anonymity.
“CDC has also come out with a list of high-risk conditions among Covid patients, and it makes sense for India also to come up with a list of our own, based on how our patients behave,” the member added.
The US CDC (United States Centre for Disease Control) has enlisted 11 conditions that can lead to severe Covid disease.
The conditions are asthma, chronic kidney disease with dialysis, chronic lung disease, diabetes, haemoglobin disorders, immunocompromised condition, liver disease, people aged 65 years and older, people in nursing homes and long-term care facilities, serious heart conditions, and severe obesity.
A study published in JAMA network last month also endorsed creating a clinical risk score to “help identify patients with Covid-19 who may subsequently develop critical illness.”
Experts say it will also help in rationalising resources now that cases are rising in India.
“With the number of patients rising, this is also a way of rationalising how to use the medical resources in the best possible way, as people shouldn’t be occupying beds unnecessarily. Those who need it must get it,” said Dr GC Khilnani, former head, pulmonology department, All India Institute of Medical Sciences, Delhi.
The clinical score, he says, will also help doctors in taking note of patients with non-specific symptoms.
“Not everyone is landing with cough, or breathlessness, some are also coming with loss of smell or diarrhoea, so if there is a set list that doctors can refer to then it will improve patient selection at the time of triage, especially in smaller towns or remote areas,” he added.
