Journal of Clinical and Diagnostic Research. 2022 May, Vol-16(5): OC12-OC16 12 12 DOI: 10.7860/JCDR/2022/52586.16338 Original Article Internal Medicine Section Clinical, Laboratory and Radiological Profile of COVID-19 Patients during the Second Wave with Special Reference to Vaccination Status INTRODUCTION The second surge of COVID-19 has hit various parts of the world, with many countries reporting more patients in intensive care or high dependency units. Many deaths have been attributed to lack of timely hospitalisation, oxygen support, medicines, and physician care [1,2]. Some places like Northern Italy, however, have reported a lesser in-hospital mortality and use of mechanical ventilation during the second wave [3]. The second surge of cases in India started around March 2021, after a brief period of recession in the number of reported cases [4]. The number of cases in India rose sharply between March and May, 2020 and became the third leading country by April 10, 2021 [5]. The increase in COVID-19 transmission in India was due to several potential factors like increase in cases of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) variants with increased transmissibility, along with reduced adherence to public health and social measures [6]. In its weekly epidemiological update released on 11 th May, 2020, the World Health Organisation (WHO) declared the B.1.617 lineage of the virus as a ‘variant of concern’. The lineage was first reported in India in October 2020 [7]. In addition, the B.1.1.7 variant from the UK was also circulating throughout India, along with the P.1 lineage from Brazil, and the B.1.351 lineage from South Africa [7]. Moreover, the Indian SARS-CoV-2 Consortium on Genomics (INSACOG) was formed on 25 th December, 2020 to carry out genomic sequencing and analysis of circulating COVID-19 viruses. It reported mutations in variants that could evade immunity and had increased infectivity [7]. These new variants have also contributed to the surge of the second wave of COVID-19 infection in India. In Odisha, where the index study was conducted, as on 23 rd May 2021 there were 6,92,382 confirmed cases with 5,89,610 recoveries [8]. To mitigate the health hazards due to COVID-19, the Government of India started the vaccination programme on 16 th January, 2022 with population above 60 years getting the first priority [9]. In India, as on May 23, 2021, a total of 10.9 percent of population has been vaccinated for the first time and three percent population have obtained full vaccination [10]. The risk of COVID-19 recurrence or re- infection is currently unknown, although few have been described in case reports [11,12]. Studies from western countries have reported lesser hospitalisation, requirement of invasive ventilation and death in vaccinated people [13,14]. A study from India also revealed lower mortality among vaccinated group [15]. The study was aimed to determine the clinical, laboratory and radiological features of COVID-19 confirmed cases admitted in a dedicated COVID-19 hospital during the second wave of the pandemic and to compare these data between vaccinated and non vaccinated patients. MATERIALS AND METHODS The single centre, prospective observational study was conducted at a tertiary care hospital at Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India. The study spanned between May, 2021 and June, 2021. DEBASIS BEHERA 1 , C MOHAN RAO 2 , SUMAN KUMAR JAGATY 3 , NIPA SINGH 4 , SASWAT SUBHANKAR 5 , VIVEK D ALONE 6 , AKASH DEEP 7 , SANGHAMITRA PATI 8 Keywords: Coronavirus disease-2019, Morbidity, Mortality, Vaccines ABSTRACT Introduction: Coronavirus Disease-19 (COVID-19) has been creating havoc worldwide since the first report in December, 2019. Vaccination against the disease was thought to bring respite, reducing the severity of disease, morbidity and mortality. However, considering the fact that no vaccine is fully efficient, people may get COVID-19 even after full vaccination. Aim: To determine the clinical, laboratory, radiological features of COVID-19 including the outcome and compare these between vaccinated and unvaccinated patients. Materials and Methods: The prospective observational study was conducted in a dedicated COVID-19 hospital in Odisha, India, from May 2021 to June 2021. Detailed history including symptoms and vaccination status, laboratory parameters, and radiological investigations were collected from 200 patients. The cases were classified as mild, moderate and severe as per the Ministry of Health and Family Welfare (MoHFW) guidelines. All the patients were followed till the end of hospital stay. The results were expressed as the mean±standard deviation and percentages. Chi-square test was used to compare the categorical variables, and unpaired t-test was used to compare two discrete variables. A p-value of less than 0.05 was considered significant. Results: Majority of the patients were unvaccinated (65%) and belonged to the age group of 39-59 years (58.5%). Among the non vaccinated patients, 32.3% had moderate disease, while 35.4% had severe disease. In the vaccinated group, 51.4% had moderate disease, whereas only 28.6% patients developed severe disease. Increased Neutrophil to Lymphocyte Ratio (NLR), D-dimer levels, and radiological evidence of pneumonia in chest radiology were witnessed in both groups. Inflammatory markers between the vaccinated and unvaccinated groups did not show any statistical significance (p>0.05). A total of 12 (6%) patients died, out of which five were vaccinated (p=0.6). Conclusion: Vaccination is found to be protective in terms of disease severity and mortality. Vaccination of all individuals is recommended to curb the wrath of the virus.