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Coronavirus diseases 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 virus produce opportunistic fungal infections. Mucormycosis is an acute onset rapidly progressive fatal infection. Incidence of rhino-orbital mucormycosis raised during the second wave of COVID-19 pandemic in India. Diabetes, steroid therapy, cancer, prolonged hospitalization, and metabolic acidosis are the risk factors of post-COVID-19 mucormycosis. Objectives of this study were to suggest the risk factors, clinical features, investigations, and treatment of post-COVID-19 rhino-orbital mucormycosis. This study will guide the future research and the clinician will be aware about this complication of COVID-19. After getting permission from the Institutional Ethical Committee and consent from patients, we studied 10 cases of post-COVID-19 rhino-orbital mucormycosis from April to September 2021 during our duty in COVID-19 admission desk and COVID-19 ward in NRS Medical College, Kolkata. After taking history, we observed the clinical features, investigations, and treatment of the patients. Symptoms of the patients were nasal discharge, nasal block, headache, facial swelling, and blackish discoloration of skin. Most of the patients were diabetic. Magnetic resonance imaging (MRI)-PNS was showed sinonasal mass. Amphotericin-B was used and debridement was the main surgical procedure. Microscopy showed broad aseptate hyphae suggesting mucor. Early diagnosis and proper treatment will reduce the morbidity and mortality of the patient with post-COVID rhino-orbital mucormycosis.
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OBJECTIVE@#To assess the effect and safety of Reyanning Mixture (RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents.@*METHODS@#This is a prospective, open-label, randomized controlled trial. Patients aged 1-17 years and diagnosed with asymptomatic or mild coronavirus disease-2019 (COVID-19) were assigned to an intervention group (RYN plus standard care) and a control group (standard care) according to a randomization list. The primary outcomes were SARS-CoV-2 negative conversion time. Secondary outcomes included negative conversion rate on days 3 and 7, hospital length of stay, symptom relief rate, new-onset symptoms of asymptomatic infected patients, and progressive disease rate. The cycle threshold (Ct) values of ORF1ab or N genes were also tested.@*RESULTS@#A total of 214 patients in the intervention group and 217 in the control group were analyzed. The SARS-CoV-2 negative conversion time was significantly shortened in the intervention group [5 days (interquartile range (IQR): 5-6) vs. 7 days (IQR: 6-7), P<0.01]. By days 3 and 7, the negative conversion rates were significantly higher in the intervention group (day 3: 32.7% vs. 21.2%, P=0.007; day 7: 75.2% vs. 60.8%, P=0.001). Ct values significantly increase on day 2 [ORF1ab gene: 35.62 (IQR: 29.17-45.00) vs. 34.22 (IQR: 28.41-39.41), P=0.03; N gene: 34.97 (IQR: 28.50-45.00) vs. 33.51 (IQR: 27.70-38.25), P=0.024] and day 3 [ORF1ab gene: 38.00 (IQR: 32.72-45.00) vs. 35.81 (IQR: 29.96-45.00), P=0.003; N gene: 37.16 (IQR: 32.01-45.00) vs. 35.26 (IQR: 29.09-45.00), P=0.01]. No significant difference was found in hospital length of stay between the two groups (P>0.05). Symptoms of cough were significantly improved (82.2% vs. 70.0%, P=0.02) and wheezing was significantly reduced (0.7% vs. 12.9%, P<0.01) in the intervention group compared with the control group. During the trial, no disease progression or serious adverse events were reported.@*CONCLUSION@#Adding RYN to standard care may be a safe and effective treatment for children with asymptomatic and mild SARS-CoV-2 infection. (Registration No. ChiCTR2200060292).
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Objective To learn about the current situation and trends of novel coronavirus diseases 2019 (COVID-2019) in foreign countries. Methods The data on confirmed COVID-2019 cases were collected between January 20, 2020 and February 18, 2020 and by age, sex, nationality, contact history, region, and country were performed stratified analysis and onset time analysis. Results From January 20th to February 18th, the cumulative number of confirmed cases of COVI D-2019 abroad was 804. Excluding the 454 cases on the 'Diamond Princess' cruise ship in Japan, the daily number of new cases fluctuated, showed a trend of rising first and then maintaining a steady trend. The peak date for new cases was on February 1, with the number of cases reaching 26. The confirmed cases were mainly concentrated in Asian countries, but also distributed in Europe, North America, Oceania and Africa. As of February 15, there was no more increase reported in the number of countries where confirmed cases occurred after reaching 25. Among these countries, Singapore, Japan, and Thailand were with the highest number of cases, with 77, 65, and 35 cases, respectively. In accordamce to available information on confirmed cases, the cases with history of exposure to confirmed cases were more than those with history of living or traveling in Hubei. And more cases were non-Chinese nationalities, 40 years old and above, and males . Conclusion The novel coronavirus has transmitted abroad, and produced second-generation cases. Although the incidence is low abroad , its trend fluctuates greatly, so sufficient attention must be paid to the possibility of further transmission.
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Objective To analyze the development and changes of novel coronavirus diseases 2019 (COVID-19) in the six neighboring provinces of Hubei. Methods The COVID-19 epidemic data of Hubei and its six neighboring provinces released by the National Health and Health Commission and local governments from January 11, 2020 to March 22, 2020 was collected. Joinpoint regression model was used to analyze the trend of cumulative confirmed cases, daily new confirmed cases and daily average confirmed cases according to the daily change percentage (DPC) and average daily percentage change (ADPC). Results As of March 22, 2020, a total of 5,036 confirmed cases were reported in the six neighboring provinces of Hubei, among which Henan, Hunan and Anhui ranked the top three, with 1,272, 1,018, and 990 cases, respectively, accounting for 65.13% of the total cases. The inflection points of the cumulative number of confirmed cases in the six provinces were January 24 and February 5, with an average growth rate of 5.27% [ADPC (95% CI) = 5.27% (3.71%, 6.85%), P < 0.05)], which was different from Hubei where the inflection points of the cumulative diagnosis number were February 2 and February 15, with an average growth rate of 10.77 % [ADPC 9995% CI) = 10.77% (9.12%, 12.44%), P < 0.05]. The average number of new cases per day in 28 days, 21 days, 14 days and 7 days from the last case report (February 28, Hunan) was 116.93, 55.48, 12.93 and 1.86, respectively, showing a significant downward trend (DPC 95%CI = -79.04（-88.95, -43.62）%, P<0.05). The peak number of new cases per day in the six neighboring provinces occurred on February 4 (309 cases), and the inflection point was February 5, showing a sharp increase (DPC = 25.53%, P < 0.05), and then a rapid decline (DPC = - 28.46%, P < 0.05). The total case fatality rate of the six provinces was 0.79%, which was lower than that of Hubei (4.65%). Conclusion The measures taken by the six provinces and cities adjacent to Hubei Province in the prevention and control of domestic imported risks are active and effective. It is necessary to summarize and optimize the strategies in time to prevent possible second transmission in the future.
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OBJECTIVE@#To study the working experience of COVID-19 care nurses.@*METHODS@#Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software.@*RESULTS@#Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life.@*CONCLUSIONS@#s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.
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Humans , Betacoronavirus , Coronavirus Infections , Hospitals , Nurses , Pandemics , Pneumonia, Viral , Qualitative Research , WorkplaceABSTRACT
Objective@#To learn the epidemiological characteristics of imported coronavirus disease 2019（COVID-19）cases from abroad to Zhejiang Province reported from March 1 to April 7,2020,so as to provide basis for improving the prevention and control of COVID-19 imported epidemic. @*Methods@# The imported COVID-19 cases and related local cases reported in Zhejiang Province from March 1 to April 7 were extracted from the National Diseases Prevention and Control Information System and were checked with the epidemiological investigation reports. A descriptive analysis was adopted for the epidemiological characteristics of imported COVID-19 cases,including time,spatial and population distribution,clinical classification,country of origin and contact history of related local cases. @*Results@#The first imported COVID-19 case was reported on March 1. By April 7,totally 91 imported cases were reported,including 48（52.75%）confirmed cases and 43（47.25%）asymptomatic cases. In terms of clinical classification,there were 32（66.67%）ordinary cases and 16（33.33%）mild cases;no severe,critical or dead cases were reported. The symptoms of 41 confirmed cases came out after entry. The median time between entry and onset was 3 days,and the intervals of 4 cases were 14 days or over. All the 11 cities in Zhejiang Province had imported cases,among which Lishui and Wenzhou reported 24（26.37%）and 21（23.08%）cases. Of all the imported cases,81（89.01%）aged from 10 to 49 years;31（34.07%）were overseas students,21（23.08%）were business people and 19（20.88%）were catering staff;69（75.82%） came from European countries such as Italy,UK and Spain. In addition,a local case on the same flight with a imported case was reported on March 26. @*Conclusions @#The imported COVID-19 cases of Zhejiang Province were relatively young,most were asymptomatic or ordinary cases. They were mainly overseas students,business people and catering staff,from European countries such as Italy,UK and Spain,to Lishui and Wenzhou. Strict control measures should be done in entry quarantine,transfer and isolation to prevent local transmission caused by imported cases.