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Aim: The aim of this randomised, double-blind, placebo-controlled pilot clinical trial is to evaluate the capacity of a mouthwash to reduce SARS-CoV-2 viral load in the saliva of patients with COVID-19. Methods: Twenty-three symptomatic SARS-CoV-2-positive outpatients were selected andrandomised into two groups and registered at NTC 04563689. Both groups rinsed and gargled for one minute with either distilled water (Placebo) or with 0.05% Cetylpyridinium chloride (CPC) plus 0.12% Chlorhexidine (CHX) mouthwash (PERIOAID Intensive Careï). Saliva samples were collected before the use of placebo or mouthwash and after 15 minutes and 1 and 2 hours of either of the above treatment. A saliva sample was also taken five days after regular use of placebo or mouthwash twice daily. The virus was detected by qRT-PCR. Results: A great heterogeneity in the viral load values was observed at baseline in both groups for nasopharyngeal and saliva samples. Most of the patients who used the mouthwash (8/12) had a significant decrease in baseline viral load after 15 min (greater than 99% reduction). This inhibitory effect was maintained for up to two hours in 10 of the 12 patients. At five days, SARS-CoV-2 RNA was detectedin only 1 patient from the mouthwash group and in 5 from the placebo group. Conclusions: This study points out that a CPC mouthwash can reduce the viral load in saliva of COVID-positive patients. This finding may be important in transmission control of SARS-CoV-2. Nevertheless, the clinical relevance of CPC mouthwash-reduction on SARS-CoV-2 shedding in saliva requires further study.
Objetivo: El objetivo de este ensayo clínico piloto aleatorizado, doble ciego y controlado con placebo es evaluar la capacidad de un enjuague bucal para reducir la carga viral del SARS-CoV-2 en la saliva de pacientes con COVID-19. Materiales y métodos:Veintitrés pacientes ambulatorios positivos para SARS-CoV-2 sintomáticos fueron seleccionados y aleatorizados en dos grupos y registrados en el NTC 04563689. Ambos grupos se enjuagaron y hicieron gárgaras durante un minuto con agua destilada (placebo) o con cloruro decetilpiridinio al 0 ,05 % (CPC). ) más enjuague bucal con Clorhexidina (CHX) al 0,12% (PERIOAID Intensive Care). Se recolectaron muestras de saliva antes del uso de placebo o enjuague bucal y después de 15 minutos y 1 y 2 horas de cualquiera de los tratamientos anteriores. También se tomó una muestra de saliva cinco días después del uso regular de placebo o enjuague bucal dos veces al día. El virus fue detectado por qRT-PCR. Resultados:Se demostró una gran heterogeneidad en los valores de carga viral al inicio del estudio en grupos ambos para muestras de nasofaringe y saliva. La mayoría de los pacientes que usaron el enjuague bucal (8/12) tuvieron una disminución significativa en la carga viral inicial después de 15 minutos (reducción superior al 99 %). Este efecto inhibidor se mantuvo hasta dos horas en 10 de los 12 pacientes. A los cinco días, se detectó ARN del SARS-CoV-2 en solo 1 paciente del grupo de enjuague bucal y en 5 del grupo de placebo. Conclusiones:Este señala que un enjuague bucal CPC puedereducir la carga viral en saliva de pacientes COVID positivos. Este hallazgo puede ser importante en el control de la transmisión del SARS-CoV-2. Sin embargo, la relevancia clínica de la reducción del enjuague bucal con CPC en la excreción de SARS-CoV-2 en la saliva requiere más estudios.
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Introduction: Subjects with asymptomatic infections are not generally admitted to health care facilities, however, they may benefit from antiviral therapy. Objective: To evaluate the contribution to treatment with combined therapy based on recombinant human interferon alpha 2b + Lopinavir/Ritonavir + Chloroquine versus Lopinavir/Ritonavir + Chloroquine in asymptomatic and symptomatic patients. Material and Methods: An observational study was carried out in patients with a positive diagnosis of COVID-19 from April 1st to July 30th, 2020. From a total of 308 patients treated with interferon + Lopinavir/Ritonavir + Chloroquine, we selected a statistically representative sample of 40 patients using a simple randomization process. As a control group, 27 patients who only received treatment with Lopinavir/Ritonavir + Chloroquine were selected. These patients underwent determinations of anti-SARS-CoV-2 antibodies, determinations of inflammatory markers, and follow-up by RT-PCR to evaluate the time length of negativization. Results: The group treated with interferon had a significantly shorter time to negativization. Patients treated with interferon showed a significant decrease in inflammatory markers at the time of hospital discharge and they had an increase in antibody titers at two and four months after hospital discharge, compared to the group of patients who did not receive interferon. Conclusions: The treatment with exogenous interferon in patients with COVID-19 had a significant contribution to the regulation of the immune response of the patients(AU)
Introducción: Los sujetos con infección asintomática generalmente no son admitidos en centros de asistencia médica, sin embargo, pueden beneficiarse de la terapia antiviral. Objetivo: evaluar la contribución al tratamiento de la terapia combinada basada en interferón alfa 2b recombinante humano + Lopinavir/Ritonavir + Cloroquina contra Lopinavir/Ritonavir + Cloroquina en pacientes asintomáticos y sintomáticos. Material y Métodos: Se realizó un estudio observacional en pacientes con diagnóstico positivo de COVID-19, durante los días del 1 de abril al 30 de julio de 2020. De un total de 308 pacientes tratados con interferón + Lopinavir/Ritonavir + Cloroquina, se seleccionaron mediante un proceso de aleatorización simple, una muestra estadísticamente representativa de 40 pacientes. Como grupo control se seleccionaron 27 pacientes que solo recibieron tratamiento con Lopinavir/Ritonavir + Cloroquina. Estos pacientes se sometieron a determinaciones de anticuerpos anti-SARS-CoV-2, determinaciones de marcadores inflamatorios y seguimiento por RT-PCR para evaluar el tiempo de negativización. Resultados: El grupo tratado con interferón tuvo un tiempo significativamente más corto de negativización. Los pacientes tratados con interferón mostraron una disminución significativa de los marcadores inflamatorios en el momento del alta hospitalaria y tuvieron un incremento de los títulos de anticuerpos a los dos y cuatro meses posteriores al alta hospitalaria, en comparación con el grupo de pacientes que no recibió interferón. Conclusiones: El tratamiento con interferón exógeno en pacientes con COVID-19 tuvo una contribución significativa en la regulación de la respuesta inmune de los pacientes(AU)
Subject(s)
HumansABSTRACT
Background:The objective of this study was to assess the demographical characteristic, laboratory and radiological findings associated with COVID-19 mortality in hospitalizedpatients and also to co-relate neutrophil-to-lymphocyte ratio (NLR)and chest x-ray (CXR)score with severity of the disease.Methods:This is a retrospective study done in Bowring and Lady Curzon hospital between the periodof May 2021 to July 2021. 100 patients who were tested positive for SARS-CoV2 with RT-PCR were taken for the study after fulfilling the inclusion criteria. On day 1 of admission, routine blood investigations including CBC with differential count and chestX ray is taken. From the above said data, NLR and CXR score is calculated and a comparison is made to determine severity and in-hospital mortality between mild, moderate and severe COVID pneumonia patients. This study is being carried out after obtaining institutional ethical committee approval clearance. All analysis were performed using SPSS software version 10.Results: The sample size studied was 100. The mean age of patients was 28.3 in mild, 49.9 in moderate and 62.6 in severe COVID patients. Among these 67% were males and 33% were females. It was noted that, leukocytosis(mean-13245), neutrophilia (mean-83.05%), lymphocytopenia (mean-10.45%) and chest X-ray score (mean-4.98) was seen among severe group with p value being significant.Conclusions: TLC, NLR and CXR score were significantly different between severe and non-severe patients, so assessment of these simple parameters may help identify high risk COVID-19 patients at an early stage in a resource limited setting from the data retrieved from our hospital, NLR and CXR Score showed an acceptable efficiency to separate COVID-19 patients among severe and non-severe patients with a significant p value thereby helping in triaging the patients and need for early ICU needs.
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Background: It is a new pandemic; the demographic profile of COVID-19patients may be helpful for corona virus patients. Methods: This was a cross-sectional study conducted at the department of cardiology at Rangpur medical college hospital, Rangpur, Bangladesh during July 2020 to December 2020.In total 37confirmed COVID-19patients were selected as the study population. Data were collected from patients or their attendants by using a pre-designed structured questionnaire, after having appropriate consent. The statistical package for the Social sciences (SPSS) version 22.0 was used for data analysis. Results:In this study 70% participants were male whereas 30% were female and the ratio was 2.36:1. The mean±SDage of the participants was 56.57±15.96 years. The highest number of participants were from 51-60 years’ age group which was 27.3%, 2.70%, 18.92%, 16.22%, 13.51%, and 21.62% participants were from 21-30, 31-40, 41-50, 61-70 and >70 years of age group respectively. The majority portion of participants were with normal body-weight (BMI: 18.5-24.9) which was in 57% and 43% were with overweight (BMI: 25.0-29.9). More than half of the patients were from Rangpur district which was 54%. The highest number of patients were with cough as a major symptom, which was 51.35%. The highest number of participants were with IHD (64.86%) as a major comorbidity. Conclusions:As per the findings of this study, we can conclude that, middle aged population are mostly being affected byCOVID-19in Bangladesh. The affected number of males were higher than female.
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Background: Patients with Coronavirus Disease (COVID-19) have a significant death rate due to comorbid diseases. As a result, identifying risk factors associated with poor outcomes in COVID-19 patients is important. Objective: The aim of this study was to evaluate the admission and outcome status of the patients confirmed with Covid-19.Material & Methods:This cross-sectional study was conducted at Mugda Medical College & Hospital, Dhaka, Bangladesh during the period from April 2020 to September 2020. Total 205 patients with covid-19 were included in this study. Collection of data were checked and cleaned. After cleaning, the data were entered into computer and statistical analysis of the results being obtained by using windows-based computer software devised with Statistical Packages for Social Sciences version 24.Results:In this study among 205 patients. Most of the study people 41(20.0%) confirmed with covid-19 were admitted in September 2020. Followed by 20(9.76%) in April 2020, 33(16.09%) in May 2020, 35(17.07%) in June 2020, 38(18.53%) in July 2020, 37(18.04%) in August 2020 and 41(20.0%) in September. 23(11.21%) highest death with covid-19 were admitted in July 2020. Most of the patients 104(50.73%) were discharged with advice and 101(49.26%) patients had expired. Out of 101 expired patients 92 (91%) had comorbidities. The most common comorbidity amongst ICU admitted patients was respiratory syndrome (55 in number) and least common was hypertension (6 in number).Conclusions:The death rate for COVID-19 hospitalized patients is 49.26%. The most prevalent comorbidities in individuals who died as a result of COVID-19 were respiratory syndrome, chronic kidney disease, hypertension, cardiovascular disease, and diabetes.
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Coronavirus disease 2019 (COVID-19) is highly transmittable through contact with respiratory droplets. The virus is also shed in fecal matter. Some patients may present with effects in more than one system; however, there are no defined biomarkers that can accurately predict the course or progression of the disease. The present study aimed to estimate the severity of the disease, to correlate the severity of the disease with biochemical predictors, to identify valuable biomarkers indicative of gastrointestinal disease, and to determine the cutoff values. A cross-sectional study was conducted on COVID-19 patients admitted to the Kafrelsheikh University Hospital (isolation unit) between July 10, 2020, and October 30, 2020. The diagnosis of COVID- 19 was confirmed via reverse transcription-polymerase chain reaction (RT-PCR), which was employed for the detection of the viral RNA. We conclude that lymphopenia, elevated C-reactive protein (CRP) level, and liver enzymes were among the most important laboratory findings in COVID-19 patients. Statistically significant differences in platelet count, neutrophil count, D-dimer level, and fecal calprotectin levels were observed among patients presenting with chest symptoms only and patients with both chest and gastrointestinal symptoms (p=0.004;<0.001; 0.010; 0.003; and<0.001, respectively). C-reactive protein, D-dimer, and fecal calprotectin levels positively correlated with disease severity. The cutoff value for fecal calprotectin that can predict gastrointestinal involvement in COVID-19 was 165.0, with a sensitivity of 88.1% and a specificity of 76.5%. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Biomarkers/analysis , Leukocyte L1 Antigen Complex , COVID-19 , Blood Chemical AnalysisABSTRACT
Background:Some of the public health measures necessary to contain the spread of the pandemic, such as quarantines and social distancing, increase the risk of adverse psychological consequences. A recent review revealed that these risks are greater with longer quarantine periods, when there are infection fears, frustration, boredom, inadequate supplies, inadequate information, and ?nancial loss. COVID-19 pandemic to have disproportionately adverse impacts on mental health of hospitalized groups. COVID-19 is a disease, impact physically but it has been affecting much more the mental health of patient. Aim & Objectives:To Assess physical and mental status of patient during hospitalization and the correlation. To ?nd out the relationship between selected socio-demographic status Age, gender, race, ethnicity, employment, insurance, education, marital status, psychiatric therapies, health literacy, social support, ?nancial distress with the level of mental status. Methods: A cross sectional study with one centre data, collected with selected criteria. Fifty participants were selected for collection of livid experience expressed in local language. Study approach was mix method and Qual-quan design. Assessed by experts and evaluators. Quantitative data collected with checklist and socio demographics detail were collected from patient. Results:Result showed Qualitative themes clearly showed the mental state of patient like “I will die”. Quantitatively Physical status is signi?cantly correlated with mental status, there is a signi?cant statistical co-dependency assessed by Pearson's product moment test. Socio-demographic data age as chai square value physical status (4.54) as mental status (4.59), marital status (5.25) and social support (4.87) is signi?cantly associated with mental status, test done in 0.05 level of signi?cance. Conclusion:Though one centre data is a limitation of the study still it can be visible that COVID -19 patients need mental healing or therapy parallelly with medicines. The mental symptoms should not be secondary cure it must be primary for healing of body
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COVID-19 infection has made a great impact on the health and economy of many countries. Low middle-income countries are yet to experience the worst of it. There are lots of issues, such as, appropriate resource management that will come alongside the infection that can make the condition even worse. For how long this virus will stay with us is yet to be known. In the situation, whole surgical management cannot be postponed for a longer period that can damage the patient’s health. There are lots of queries that will also come up with the viral infection, for example, how should we use our limited test kits, when should we use PPE and which one, how should we select surgical cases, how to ensure proper post-operative care, and another vital question how can we protect health workers from getting infected while giving the service.We have made a bunch of recommendations for such countries to ensure proper preparation against this pandemic. These considerations can ensure the highest care for the patients with surgical conditions and also guarantee maximum protection of the health care teams from admission to operation, operation to ward, and ward to discharge