ABSTRACT
Background & objectives: Data on neonatal COVID-19 are limited to the immediate postnatal period, with a primary focus on vertical transmission in inborn infants. This study was aimed to assess the characteristics and outcome of COVID-19 in outborn neonates. Methods: All neonates admitted to the paediatric emergency from August 1 to December 31, 2020, were included in the study. SARS-CoV-2 reverse transcription- (RT)-PCR test was done on oro/nasopharyngeal specimens obtained at admission. The clinical characteristics and outcomes of SARS-CoV-2 positive and negative neonates were compared and the diagnostic accuracy of a selective testing policy was assessed. Results: A total of 1225 neonates were admitted during the study period, of whom SARS-CoV-2 RT-PCR was performed in 969. The RT-PCR test was positive in 17 (1.8%). Mean (standard deviation) gestation and birth weight of SARS-CoV-2-infected neonates were 35.5 (3.2) wk and 2274 (695) g, respectively. Most neonates (11/17) with confirmed COVID-19 reported in the first two weeks of life. Respiratory distress (14/17) was the predominant manifestation. Five (5/17, 29.4%) SARS-CoV-2 infected neonates died. Neonates with COVID-19 were at a higher risk for all-cause mortality [odds ratio (OR): 3.1; 95% confidence interval (CI): 1.1-8.9, P=0.03]; however, mortality did not differ after adjusting for lethal malformation (OR: 2.4; 95% CI: 0.7-8.7). Sensitivity, specificity, accuracy, positive and negative likelihood ratios (95% CI) of selective testing policy for SARS-CoV-2 infection at admission was 52.9 (28.5-76.1), 83.3 (80.7-85.6), 82.8 (80.3-85.1), 3.17 (1.98-5.07), and 0.56 (0.34-0.93) per cent, respectively. Interpretation & conclusions: SARS-CoV-2 positivity rate among the outborn neonates reporting to the paediatric emergency and tested for COVID-19 was observed to be low. The selective testing policy had poor diagnostic accuracy in distinguishing COVID-19 from non-COVID illness.
ABSTRACT
Seeds of Ocimum sanctum L. (Labiatae; popularly known as 'Tulsi' in Hindi and 'Holy Basil' in English) contain a pale yellow colored fixed oil. The oil possesses antiinflammatory activity due to dual inhibition of arachidonate metabolism supplemented by antihistaminic activity. The antiinflammatory activity is not dependent on the pituitary adrenal axis. The oil possesses antipyretic activity due to prostaglandin inhibition and peripherally acting analgesic activity. The oil has been found to be effective against formaldehyde or adjuvant induced arthritis and turpentine oil induced joint edema in animals. Lipoxygenase inhibitory, histamine antagonistic and antisecretory activities of the oil contribute towards antiulcer activity. The oil can inhibit enhancement of vascular capillary permeability and leucocyte migration following inflammatory stimulus. The LD50 of the oil is 42.5 ml/kg and long-term use of oil at 3 ml/kg dose does not produce any untoward effects in rats. The oil contains a-linolenic acid, an omega-3 fatty acid, which on metabolism produces eicosapentaenoic acid and the same appears to be responsible for the biological activity. The oil has hypotensive, anticoagulant and immunomodulatory activities. Antioxidant property of the oil renders metabolic inhibition, chemoprevention and hypolipidaemic activity. Presence of linolenic acid in the oil imparts antibacterial activity against Staphylococcus aureus. The oil alone or in combination with cloxacillin, a beta-lactamase resistant penicillin, has been found to be beneficial in bovine mastitis, an inflammatory disorder resulting from staphylococcal infection. Existence of anti-inflammatory, analgesic and antibacterial activities in single entity i.e. fixed oil appears to be unique.