Understanding among dialysis therapist and technologist about prevention protocols of COVID-19 in north-west zone of India: a questionnaire-based survey

Background: All over the world human community fighting with COVID-19. It affected a large number of population. Our immune system helps fighting with COVID-19, CKD patients which are on MHD are more prone to COVID-19 infection. MHD patient required twice or thrice a week dialysis. During dialysis, a therapist plays a major role in COVID-19 HD procedure of CKD patients. Dialysis therapist works like a frontline warrior. Aim was to observe the understanding of dialysis therapist/technologist about COVID-19 protocols for prevention of COVID-19 infection. Methods: A total 122 responder from northwest zone of India attended question-based survey form on the understanding of the infection prevention procedure of COVID-19 maintenance hemodialysis patients. Question set was based on union health ministry of Indian government guideline for dialysis unit set up for COVID-19 patients, Dialysis therapist and patents care taker. Data collection was done by online sampling method. Results: Study observed dialysis therapist of northwest India about understanding of COVID-19 prevention protocols. Approximate- 122 participants include in this study. But major case of COVID-19 treating in government sector hospitals. This study observed that mostly participants have good understanding about COVID-19 infection prevention protocols. Conclusions: Required a regular education training program for all government and private sector health workers for infection control practices of COVID-19. Dialysis therapist and other health workers are doing work like a frontline warrior, their safety is a major concern so we can avoid the risk of transmission of disease to dialysis therapist.

Serum levels of procalcitonin,interleukin-6 and interleukin-8 in patients with COVID-19 infection at admis-sion and their significance in patient prognosis / 实用医学杂志

Objective To analyze the predictive value of serum levels of procalcitonin(PCT)and cytokines on the prognosis of patients with COVID-19 at admission.Methods From November 2022 to February 2023,patients diagnosed with COVID-19 who were admitted to Beijing Chest Hospital were enrolled.Chemiluminescence was used to detect serum PCT levels,and flow microsphere array was used to detect serum cytokines IL-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-17A,IL-17F,IL-22,TNF-α,TNF-β,IFN-γ level.ICU admission,mechanical ventilation and in-hospital death were defined as poor prognosis.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.After excluding patients with bacterial infection,the relationship between serum PCT and cytokine levels at admission and the prognosis of COVID-19 patients was analyzed.Results A total of 176 patients with complete data were included,including 134 in the PCT-normal group and 42 in the PCT-elevated group,with a median age of 71.50 years and 71.59%males.Patients in the PCT elevated-group had significantly higher rates of ICU admission(38.41%vs.13.11%,P<0.05),mechanical ventilation(76.92%vs.24.59%,P<0.001)and in-hospital mortality(38.46%vs.6.56%,P<0.001)were significantly higher than those in the PCT-normal group.Serum levels of cytokines IL-6(7.40 pg/mL vs.4.78 pg/mL,P = 0.033 4)and IL-8(10.97 pg/mL vs.5.92 pg/mL,P<0.001)were significantly higher in patients with poor prognosis than in those with good prognosis.The area under the curve for PCT,IL-6,and IL-8 to predict poor prognosis in COVID-19 patients was 0.687,0.660,and 0.746,respectively;sensitivity was 52.78%,55.17%,and 72.41%,respectively;and specificity was 81.58%,74.19%,and 74.19%,respectively,as calculated from the ROC curve.When PCT,IL-6 and IL-8 jointly predict the prognosis of COVID-19 patients,the area under the curve is 0.764,the sensitivity is 70.00%,and the specificity is 80.00%.Conclusion Serum PCT and cytokines IL-6 and IL-8 could be used as predictive markers for poor prognosis in patients with COVID-19.

Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents / 上海预防医学

ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.

Vaccination coverage against COVID-19 among adults of rural field practice area, tertiary-care hospital: cross-sectional study

Background: As the spread of COVID-19 pandemic, lockdown has been implemented and as a preventive measure to reduce the occurrence of disease vaccination has been conducted throughout the country level. Methods: A Community based Cross Sectional study was conducted during September 2022 to October 2022 (2months) in RHTC field practice area of Santhiram Medical College, nandyal among adults (25-45) years of age group by convenient sampling method with sample size 300, study tool was pre-designed, semi structured questionnaire. Data was collected by interview method and analysed by SPSS 22 version. Ethics committee clearance was obtained before conducting the study. Results: In this study population, (48%) completed 3 doses of COVID vaccine with booster dose, (48.3%) got vaccinated for 2 doses and (3.7%) are vaccinated for 1st dose and (15%) of them got COVID infection after vaccination. Conclusions: Out of 300 participants 53% were males and 47% were females, 4% with one dose, 48% with two doses and 48% with two doses with booster dose of vaccination, about 36% had comorbidities. About 35% vaccinated by covaxin and 65% is with covishield vaccine, in which 9% had COVID infection after vaccination. Therefore, along with regular monitoring and surveillance, health education regarding the advantages of vaccination to the people can improve the vaccination status in rural area.

Knowledge, attitudes and practice among healthcare workers towards COVID-19 in a tertiary care centre in north India

Background: Coronavirus disease pandemic has affected the entire world and till date, there is no definitive cure for it with prevention of infection and knowledge about the disease being the only proven effective methods to contain it. Healthcare workers (HCWs) are highly susceptible to getting infected and their knowledge about COVID-19 infection has been known to be inversely proportional to the rates of COVID-19 infection. Methods: Cross-sectional questionnaire-based study assessing knowledge, attitude and practices towards COVID-19 preventive measures was carried out amongst HCWs at a tertiary care hospital in North India. Results: Around 95% of HCWs had received training regarding COVID-19 infection and more than 95% HCWs had adequate knowledge about COVID-19 infection. More than 95% HCWs experienced anxiety and fear while monitoring and treating COVID-19 patients. 85% HCWs felt that there is sufficient awareness in the society regarding COVID-19 infection. Most of the respondents followed correct practices for avoidance of COVID-19 infection with around 90% respondents using face masks and practicing frequent hand washing. Social distancing and avoidance of large gatherings was practiced by around 95% respondents. More than 95% respondents had either taken COVID-19 vaccine or wish to take it. Conclusions: The study suggested that the majority of HCWs had good knowledge and positive attitude toward COVID-19 but there are still some lacunae present in the knowledge regarding prevention of COVID 19 infection. Further education and training are required for HCWs so as to fight COVID and prevent its spread in a better way.

Prevalence of COVID-19 infection among dental and nursing students in Alappuzha

Background: The Corona Virus (SARS-COV2) is one of the major pathogens that affect the human respiratory system. As it spreads via droplets, healthcare workers are at increased risk of acquiring the infection. Nursing students who are exposed to the hospital setting during their clinical postings are prone to infection because they may provide care to patients who are suspected of or diagnosed with COVID-19 infection. In dentistry, the use of hand pieces and ultrasonic instruments during dental procedures unavoidably result in generation of blood and saliva droplets. Objective was to estimate the prevalence of COVID-19 infection among Dental and Nursing students of Government dental college and nursing college, Alappuzha. Methods: A cross sectional study was conducted in Dental and Nursing students of Government TD Dental College and Nursing College, Alappuzha in November 2021. Convenient sampling was done and persons who were willing to take part in the study were distributed with a pretested questionnaire via Google Form and data was collected and analysed. Results: Out of the 174 study participants, 77 were Dental students and 97 were Nursing students, 33% of Dental students and 36% of Nursing students reported of being infected with COVID-19 virus. Significant association was obtained between COVID-19 infection and contact with Covid positive case. Conclusions: Prevalence of COVID-19 infection among Dental and Nursing students was 35.10%. Prevalence of COVID-19 infection among Dental students and Nursing students were 33% and 36% respectively.

Purpura fulminans-a rare complication post COVID-19 infection in children

Coronavirus disease 2019 (COVID-19) was officially declared as a pandemic in March 2020. COVID-19 infection and the post infectious sequalae has been widely researched since then. Post infectious inflammatory sequalae and its associated complications like toxic shock syndrome, Kawasaki like disease, macrophage activation syndrome, rather than the infection per se was found to be more of a concern in children, leading to more morbidity and mortality. Purpura fulminans was not a presentation reported post COVID-19 infection. Herein, we aim to describe a post COVID-19 infection patient who presented with purpura fulminans as a rare complication.

Correlación entre síndrome coronario agudo y COVID-19 en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández

Introducción: las infecciones agudas por SARS-CoV-2 (COVID-19) provocaron una pandemia global desde que aparecieran los primeros casos en Wuhan (China) en diciembre de 2019. Objetivo: determinar la correlación entre la infección por COVID-19 y algunas variables clínicas en la aparición del síndrome coronario agudo. Materiales y métodos: se realizó un estudio descriptivo retrospectivo en 85 pacientes que ingresaron en la Unidad de Cuidados Intensivos Emergentes del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, con diagnóstico de infección por COVID-19, en el período entre julio y septiembre de 2021. Durante su evolución clínica, 16 de ellos tuvieron un síndrome coronario agudo. Se aplicó el test chi cuadrado y significación estadística (p < 0,05). Resultados: el total de pacientes con síndrome coronario agudo durante la evolución de la infección por COVID-19, representó el 18,82 %. En este grupo predominaron personas de piel blanca y sexo femenino, para un 51,31 % (p < 0,02). El síndrome coronario agudo apareció después de 10 días de evolución de la infección por COVID-19, asociado a trastornos de la oxigenación. El 62,5 % de los pacientes fueron tratados con máscara con reservorio. La mayoría de los pacientes fue transferida viva a las unidades de cuidados progresivos. Conclusiones: se observó asociación estadística significativa entre féminas de raza blanca y la aparición del síndrome coronario agudo en el curso de la infección por COVID-19, en la Unidad de Cuidados Intensivos Emergentes del hospital matancero.

Introduction: acute infections by SARS-CoV-2 (COVID-19) caused a global pandemic since the first cases appeared in Wuhan (China) in December 2019. Objective: to determine the correlation between COVID-19 infection and some clinical variables at the onset of acute coronary syndrome. Materials and methods: a retrospective descriptive study was carried out in 85 patients who were admitted in the Emergent Intensive Care Unit of the Clinical Surgical University Hospital Comandante Faustino Perez Hernandez, with diagnosis of COVID-19 infection, in the period from July to September 2021. During their clinical evolution, 16 of them had acute coronary syndrome. The Chi-square test and statistical significance (p < 0.05) were applied. Results: the total of patients with acute coronary syndrome during the evolution of the COVID-19 infection represented 18.82%. White-skinned and female people predominated in this group, for 51.31% (p < 0.02). Acute coronary syndrome appeared after 10 days of the COVID-19 infection evolution, associated to oxygenation disorders. 62.5% of the patients were treated with reservoir masks. Most of the patients were transferred alive to progressive care units. Conclusions: a significant statistic association was observed between white women and the onset of acute coronary syndrome in the course of COVID-19 infection, in the Emergent Intensive Care Unit of Matanzas hospital.

The long-term adverse events and persisting clinical symptomatology post COVID-19 infection among the healthcare workers of a tertiary care hospital in West Bengal

COVID -19, a global pandemic, has dominated every person’s life worldwide. The clinical presentation of COVID-19 ranges from asymptomatic, mild symptomatic to fulminant and fatal cases, having consequences for many organ systems. In a cross-sectional study, 128 healthcare workers of a tertiary care medical college hospital, 4 weeks following the COVID infection agreed to participate in the study. Self-developed subject data sheet and the self-reporting symptoms tool based on the WHO case report form were used for data collection. A significant number of health care workers (HCWs) had long COVID symptomatology in terms of constitutional, muscular-skeletal, respiratory, otolaryngology, and CNS symptoms. The commonly experienced symptoms were myalgia (45.3%), malaise (39%), fatigue and tiredness (69.5%), loss of taste (21.1%), loss of smell (20.3%) and night sweats (11.7%), lack of sleep (20.3%), and anxiety (12.5%). The cardiovascular and integumentary were the less affected organ systems. About one-third of the HCWs reported that symptoms like myalgia, malaise and tiredness got worse after physical activity (29.7%). Aggravation of symptoms with any form of mental activity was reported in 11.7% of the study participants. One in every ten HCWs (12.5%) had reported not being able to perform daily activities that they were doing before getting COVID-19 infection. However, all resumed their job after the recovery. Long COVID symptoms were reported by a significant number of HCWs, necessitating the need for the establishment of follow-up clinics for the care of healthcare workers.

Evan’s syndrome secondary to COVID-19 infection

Wide range of autoimmune diseases are known to occur following SARS-CoV-2 infection. There are very few case reports of Evan’s syndrome secondary to COVID-19. We hereby report a case of Evan’s syndrome secondary to COVID-19 infection and discuss its management.

Determinants of COVID-19 infection prevention practices among employees of a medical center in NCR, Philippines

Background@#The COVID-19 pandemic became a severe public health threat to the Philippines, overwhelming the health system and its healthcare workers. As infections spread globally, it became imperative to understand the infection prevention practices (e.g., face mask-wearing, handwashing, social distancing) to better understand the pandemic and its effects on the healthcare workforce.@*Objective@#The study aims to describe the sociodemographic and medical profile and the COVID-19 infection prevention practices, and the correlation between both among employees of a medical center in the National Capital Region (NCR), Philippines,@*Methods@#The analytic cross-sectional study utilized an online survey administered to employees of a medical center in NCR, Philippines. A total of 112 responses were analyzed. Descriptive statistics were used to analyze respondents’ sociodemographic and medical characteristics and summarize their COVID-19 infection prevention practices. Spearman’s rank correlation and Pearson’s chi-square tests were performed to determine the association of the respondents’ sociodemographic and medical profiles with their corresponding infection prevention practices.@*Results@#Majority of respondents were between ages 30-50 (52.68%), female (71.43%), with college (83.93%) as their highest educational attainment, single (70.54%), and without comorbidities (66.07%). 76.5% (72/94) of respondents living in multi-person households lived with familial ties, and 59.6% (56/94) of respondents living in a multi-person household lived with at least one member considered a high-risk individual (i.e., a senior citizen with comorbidities). The respondents practiced face mask-wearing (4.92) and respiratory etiquette (4.90) the most, whereas reduction of unnecessary outings (3.81), not drinking alcohol (3.81), and sleeping at least 7 hours per day (3.42) were least practiced. Results showed that only age and having chronic kidney disease correlated with infection prevention practices with a p-value of <0.05, showing that people with chronic kidney disease and those aged 30-50 were more likely to engage in infection prevention practices.@*Conclusion@#The study findings provide insight into sociodemographic and medical factors that may contribute to adherence to infection prevention practices among the hospital-based workforce. Recommendations for further research were discussed.

Cross-sectional study on the use of masks among occupational groups with high-risk positions for overseas import and pollution transmission / 中华劳动卫生职业病杂志

Objective: To investigate the wearing of masks and the knowledge of masks among high-risk positions for overseas import and pollution transmission. Methods: From May 14 to 17, 2022, a convenient sampling method was used to conduct an online survey among 963 workers in high-risk positions for overseas import and pollution transmission in Beijing. The behaviors of individual use and wearing masks, the distribution and supervision of the unit, the knowledge of personal mask protection and the subjective feelings of wearing masks were analyzed. The χ(2) test and logistic regression model were used to analyze the influencing factors of the correct selection of masks. Results: The majority of the workers in high-risk positions for overseas import and pollution transmission were male (86.0%, 828/963), age concentration in 18-44 years old (68.2%, 657/963), and the majority of them had college or bachelor degrees (49.4%, 476/963). 79.4%(765/963) of the workers chose the right type of masks, female, 45-59 years old and high school education or above were the risk factors for correct selection of masks (P <0.05). Workers had good behaviors such as wearing/removing masks, but only 10.5% (101/963) could correctly rank the protective effect of different masks. 98.4% (948/963) of the workers believed that their work units had provided masks to their employees, and 99.1% (954/963) and 98.2%(946/963) of them had organized training and supervision on the use of masks, respectively. 47.4%(456/963) of the workers were uncomfortable while wearing masks. Conclusion: The overall selection and use of masks among occupational groups in high-risk positions for overseas import and pollution transmission in China need to be further standardized. It is necessary to strengthen supervision and inspection on the use of masks among occupational groups, and take improvement measures to improve the comfort of wearing masks.

Characteristics and impact factors of SARS-CoV-2 infection in adult patients with relapsed/refractory B-cell non-Hodgkin lymphoma receiving chimeric antigen receptor T-cell therapy / 中华血液学杂志

Objective: To explore the clinical characteristics and treatment of COVID-19 infection in patients with relapsed/refractory B-cell non-Hodgkin lymphoma before and after receiving chimeric antigen receptor T-cell therapy, and study the influencing factors of severe COVID-19 infection in these patients. Methods: The data of 59 patients with relapsed/refractory B-cell non-Hodgkin lymphoma who received chimeric antigen receptor T-cell therapy at the Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology and Department of Hematology, the Second Affiliated Hospital, College of Medicine, Zhejiang University between December 2017 and February 2023, and who were infected with novel coronavirus between December 2022 and February 2023 were retrospectively studied. Patients were divided into light, medium, severe, and critical groups, and the differences between the groups were analyzed using the chi-square test. A univariate logistic regression model was used to evaluate the contribution of each variable and its relationship with severe infection. The chi-square and Fisher's exact tests were used to analyze the differences between the B-cell aplasia and B-cell recovery (BCR) groups. Results: Of the 59 pre- and post-infusion infections, 39 (66.1%) led to mild COVID-19, 9 (15.3%) resulted in moderate COVID-19, 10 (16.9%) resulted in severe COVID-19, and 1 (1.7%) led to critical COVID-19. Moroever, age greater than 55 years, having received autologous hematopoietic stem cell transplantation, progressive disease status, and B-cell aplasia at the time of diagnosis of COVID-19 infection are factors affecting severe infection. Patients with B-cell aplasia had a more severe infection with COVID-19 (P<0.001), a longer duration (P=0.015), a longer antiviral therapy course (P<0.001), and a higher hospitalization rate (P<0.001) than the BCR group. Conclusion: Active prevention and treatment of COVID-19 infection remains a crucial issue requiring urgent attention in managing patients with relapsed/refractory B-cell non-Hodgkin lymphoma treated with chimeric antigen receptor T-cell therapy.

Association of acute COVID-19 with 24 hours-pulse wave velocity in cameroonian workers

Introduction. COVID-19appears to have a vascular tropism responsible for diffuse vasculitis-like cell damage. The aim of our study was to evaluate the impact of Sars-Cov-2 infection on arterial stiffness.Material and methods. This was a cross-sectional analytical case-controlstudy with 1:1 matching (1 case to 1 control) over a six-month period from January 1, 2021 to June 30, 2021 at the medical-social centerof the autonomous port of Douala. We measured the pulse wave velocity (PWV) in two groups of patients (group 1: COVID-19and group 2: non-COVID-19) using a MOBIL-O-GRAPH 24h PWA MonitorTM. A p-value < 0.05 was considered significant.Result. A total of 122 patients (61 COVID-19and 61 non-covid) were included in this study, among which 68 (55.7%) male. The mean age was 41±11 years. PWV as well as POV adjusted for age and mean BP were similar in both groups. The mean 24-hour, diurnal and nocturnal PWV were slightly higher in COVID-19patients than in controls by 0.1 m/s (p=0.67), 0.2m/s (p=0.37) and 0.2m/s (p=0.25) respectively. COVID-19infection was not significantly associated with PWV (p=0.082).Conclusion. PWV were slightly higher in COVID-19patients and increased arterial stiffness was not significantly associated with COVID-19status in the acute phase of infection.

COVID-19 infection prevention preparedness, practices and case management in the primary health care units in Ethiopia

BACKGROUND: COVID-19 as pandemic declared by WHO on March 11, 2020 and first case detected in Ethiopia on March 13/2020. The COVID-19 caused a global crisis, including millions of lives lost, public health systems in shock and economic and social disruption. Strategies depend on how an existing health system is organized. Even though public health emergency operation centers of the Ethiopia switched to emergency response, there is no national evidence about infection prevention and control. Therefore, this project aimed to assess the level of infection prevention and control and management of COVID- 19 in Ethiopia, 2021. METHODS: The cross-sectional study conducted at four regions and one city (Amhara, Oromia, SNNPR, Sidama Region, and Dire Dawa). Being with zonal health departments and woredas health offices, primary health care units were selected. The data were collected electronically through Kobocollect software from November 08-28/2021. Descriptive analysis like frequency and percentage was conducted by SPSS software version 25 and the results were presented by tables, figures and narration. RESULTS: Data were collected from 16 hospitals, 92 health centers, and 344 health posts. All hospitals have designated COVID-19 focal person. There were significant number of woredas and PHCUs who didn't have IPC guidelines and protocols. About 11 woredas had no any type of diagnostic tests for COVID-19. CONCLUSIONS: The study revealed that there were significant gaps on Infection prevention and control practice, shortage of personal protective equipment, isolation and specimen transportation problem, lack of call centers. We recommend concerned bodies to fill the identified gaps.

Diagnóstico Errôneo de Angiossarcoma Cardíaco na Era COVID-19 / Misdiagnosis of a Cardiac Angiosarcoma During the COVID-19 Pandemic

Resumo Os últimos meses de 2019 foram marcados pelo surgimento de uma nova pandemia, denominada "COVID-19". Desde então, essa infecção e suas complicações têm sido a prioridade de profissionais de saúde, com muitos sintomas atribuídos às suas apresentações precoces e tardias. Até o momento, outras doenças, mesmo em situações fatais, têm sido negligenciadas ou diagnosticadas incorretamente devido à atribuição dos sintomas do paciente à presença da infecção por COVID-19. Apresentamos aqui um caso de angiossarcoma cardíaco, em um menino que, cerca de 2 meses antes, havia sido infectado com COVID-19. Dado o histórico de infecção, a abordagem inicial foi o manejo da miopericardite pós-COVID-19. No entanto, o quadro do paciente piorou, exigindo reavaliação por multimodalidades com maior precisão. Por fim, o paciente foi diagnosticado com um tumor cardíaco. Este artigo procura enfatizar a importância da atenção a outras doenças e condições fatais na era COVID-19, com ênfase em evitar diagnósticos incorretos de outras doenças.

Abstract The final months of 2019 saw the emergence of a new pandemic termed "COVID-19". Since then, this infection and its complications have been the priority of healthcare providers, with many symptoms attributed to its early and late presentations. Thus far, other diseases, even fatal situations, have been overlooked or misdiagnosed due to the attribution of patient symptoms to the presence of COVID-19 infection. We herein present a case of cardiac angiosarcoma in a young boy who had previously become infected with COVID-19 about two months earlier. Given the history of infection, the initial approach was post-COVID-19 myopericarditis management. However, the patient's condition worsened, necessitating reevaluation via multimodalities with higher precision. Ultimately, the patient was diagnosed with a cardiac tumor. This article seeks to underscore the significance of taking heed of other diseases and fatal conditions during the COVID-19 pandemic with an emphasis on avoiding misdiagnosing other diseases.

Uncontrolled diabetes mellitus exacerbated by COVID-19–induced inflammation is the risk factor for COVID-19–associated rhino-orbito-cerebral mucormycosis: A matched pair case–control study

Purpose: Amidst the ongoing coronavirus disease 2019 (COVID-19) pandemic, India experienced an epidemic of COVID-19–associated rhino-orbito-cerebral mucormycosis (ROCM). This study aimed to describe the epidemiology and elucidate the risk factors for developing COVID-19–associated ROCM, comparing the risk factors among COVID-19 patients with and without ROCM. Methods: This case–control study included all COVID-19–associated ROCM patients treated at our hospital from May 1 to July 30, 2021. Controls included age- and sex-matched COVID-19 patients without ROCM, who were treated during the same time (exact matching, in 1:2 ratio). Matched pair analysis using conditional logistic regression was performed to examine the association of various risk factors with the development of ROCM in COVID-19 patients. Results: The study included 69 patients with COVID-19–associated ROCM and 138 age- and gender-matched controls. Epidemiologically, COVID-19–associated ROCM predominantly affected males (59/69, 85%), in their early 50s (mean 52 years), with 48% (33/69) of patients being from medical resource-constrained settings. On multivariate conditional logistic regression, elevated serum glycated hemoglobin (HbA1c) (odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.03–1.78), blood glucose (OR = 1.008, 95% CI: 1.003–1.013), and C-reactive protein (CRP) (OR = 1.07, 95% CI: 1.02–1.17) were associated with increased odds of developing COVID-19–associated ROCM. Patients with undetected diabetes mellitus with increasing HbA1c (OR = 3.42, 95% CI: 1.30–9.02) and blood glucose (OR = 1.02, 95% CI: 1.005–1.03) (P = 0.02) had a higher probability of developing COVID-19–associated ROCM than patients with established DM. Conclusion: Uncontrolled DM evidenced by elevated HbA1c and blood glucose levels, exacerbated by COVID-19–induced proinflammatory state indicated by elevated CRP, is the principal independent risk factor for COVID-19–associated ROCM. Middle-aged males with undetected DM, from a resource-constraint setting, are particularly at risk.

A cross-sectional study of quality of sleep in medical healthcare workers from a tertiary healthcare center during COVID-19 pandemic

Background: Intractable COVID-19 outbreak has placed extraordinary demands on health-care systems worldwide. Increased workload, inadequate personal equipment, nosocomial transmission, and the need to make ethically difficult decisions on the rationing of care may have dramatic effects on their physical and mental well-being. Healthcare workers (HCWs) are, therefore, especially vulnerable to mental health problems. Aim and Objectives: This study was conducted to assess the quality of sleep in medical HCWs during COVID-19 pandemic and to assess its relation with demographic variables. Materials and Methods: This cross-sectional study was conducted using anonymized and self-reported questionnaire survey which includes sociodemographic characteristics and Pitsburgh sleep quality index (PSQI) questionnaire. The questionnaire was completed by participant on their own smartphone. Chi-square tests were used to compare categorical variables. P < 0.05 was considered statistically significant. Results: Out of 208 respondents who served in COVID-19 pandemic, 137 were having poor sleep quality (PSQI score >5). It has been observed that 20–40 years age group was more affected than 40–60 years group. Nurses were more affected than doctors and technicians. Conclusion: During COVID-19 pandemic, medical healthcare workers had poor sleep quality due to stress of workload and social pressure. This can lead to physical or psychological health problems in the future. Further interventions should be administrated for them, aiming to maintain their health.

To Determine The Role Of Imaging Findings On Computed Tomography (CT) And Magnetic Resonance Imaging (MRI) Predictive Of Acute Invasive Rhino-Orbito-Cerebral Mucormycosis (ROCM) In COVID 19 Patients

Background:There is a sudden rise of fungal infection with coronavirus disease. This is attributed to the immunomodulation by the disease and the drugs used, diabetes mellitus, steroid use, oxygen inhalation using dirty water, use of zinc and iron supplements, etc. Early diagnosis and prompt medical and surgical intervention is the mainstay of treatment. This can greatly reduce the high morbidity and mortality associated with this disease. The objective of the retrospective study is to describe the imaging findings of acute invasive rhino-orbito-cerebral mucormycosis (ROCM) in 58 patients with severe acute respiratory syndrome coronavirus 2, from SVP hospital with proven mucormycosis. Special emphasis is placed on the signal patterns of sinonasal mucosa, the earliest and most common findings.Material And Methods:We report the sinonasal, orbital and neuroimaging findings in patients of suspected acute invasive ROCM. A total of 58 patient’s scans were analyzed. The study comprises cases performed at two different imaging modalities and a tertiary care hospital from March 23,2021 to September 1, 2021. All the patients had positive reverse transcriptase polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 and were hospitalized with clinically severe disease as per the guideline s laid down during the second wave in India. They were on intravenous steroids and oxygen. Thirty patients (52%) had diabetes mellitus. All of them presented with headache, facialand/or orbital pain,periorbital puffiness with decreased vision, during the course of treatment. CT or MRI examination of the paranasal sinuses, orbits and brain was done, with intravenous contrast wherever possible. The presence of mucormycosis was confirmed by histological diagnosis in all of them following clinico-radiological diagnosis of acute invasive ROCM. Result:Computed tomography (CT) and magnetic resonance imaging (MRI) of 58 patients showed most commonly involved sinuse s as maxillary and ethmoid sinuses together. Sino-nasal mucosal thickening was the most common finding. Periantral infiltration preceded orbital, cerebral complications, with grossly intact bones. Sinus wall erosions were seen in only patients and maxillary alveolar arch erosionwere frequent findings. CT showed hypodense soft tissue thickening or fat stranding as the predominant finding in involved areas, while MRI showed T2 iso-to hyperintense mucosal thickening with T2 hypointense component as the main finding. Conclusion:MRI is better at demonstrating early mucosal abnormalities, turbinate necrosis, devitalized tissues, orbital apex involvement and intra-cerebral extension. Imaging findings of inflammatory tissue infiltration adjacent to the paranasal sinuses in premaxillary, retroantral fat, facial muscles, pterygopalatine fossa, temporal, infratemporal fossa and extraconal orbital-fat along with typical patterns of sinonasal mucosal thickening should raise the suspicion of acute invasive fungal etiology given the short duration of history and immunocompromised status. High incidence of periantral and orbital extension of the disease is suggestive of acute invasive form of fungal infection. Also the rapidly progressive inflammatory changes without much bone involvement should suggest the suspicion of ROCM. Bony, cerebral and vascular involvements are relatively late complications.