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Background: This web-based survey is done to collect and assess data from people tested for COVID-19 with PCR in Pakistan. Methods: This 3-month study is a cross-sectional online survey, conducted by Pakistan Islamic Medical Association (PIMA), Health Research Advisory Board (HealthRAB) and National Institute of Health (NIH). Data collection was done using Google Forms. People who were tested for COVID-19 using Polymerase Chain Reaction (PCR) were included in the study. The sample size of the study was 1,537. SPSS version 22 was used for data analysis. Results: Majority of the respondents belonged to the age group 20 - 39 years. The most common symptoms found were fever 633 (41%), cough 534 (34%), generalized body aches 432 (28%) and sore throat 392 (25%). The mean COVID-19 mental health score was 3.59 (SD: 5.808, range: 0-18). Treatment with antibiotics and painkillers had a strong correlation (p-value < 0.05) with the disease outcomes. The disease outcomes had moderate correlation (p-value < 0.05) with anti-allergy, steroids, plasma and oxygen therapy, and weak correlation (p-value < 0.05) with Antiviral and Antimalarial therapy. Out of the total respondents, 561 (36.1%) were cured from COVID-19, 14 (0.9%) were expired during/after hospitalization, 15 (1%) were still infected and 962 (62%) were not infected. Conclusion: Pakistani population has a better cure rate than some of its neighboring countries. However, further research in this area is required to draw a definite conclusion.
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Background: coronaviral pandemic (COVID-19) induced by severe acute coronaviral syndrome 2 has imminent consequences for COVID-19 patients. To determine the effect of this pandemic on oncological treatment, Netherlands cancer patients performed a national study . Method(s): From 11 April 2020 to 11 Jan 2021, the oncological care perspective was discussed by an online study. The survey included 20 questions on four topics: patient characteristics, hospital engagement, COVID-19 and COVID-19 problems. Result(s): A total of 2418 (64.53%) patients were female and the remainder (57.5%) were <50 years of age. The most prevalent cancer diagnosis were haematological malignancies (26.1%), breast cancer (22.8%) and other cancers (19.2%). Depending on their illness environment, 34.7% of patients had incurable conditions while 21.6% and 31.8% had curable or healed diseases. The (expected) result of their illness was 'unknown' for 11.9% of patients. According to outpatient environment, 1691 (45.1%) patients have been oncologically examined and have taken follow-up, contrasted with 529 (14.1%) and 1527 (40.8%) patients presently or pending for therapy. Conclusion(s): This is the first research exploring cancer patients' experiences after the COVID-19 pandemic in Iraq. The research indicates the major effect of COVID-19 on oncological treatment, showing the need for psycho-oncological assistance during this pandemic.Copyright © 2020 Ubiquity Press. All rights reserved.
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Purpose: COVID-19 has made businesses increasingly dependent on technology to be competitive and efficient. Small and medium enterprises (SME) digitalisation and innovation research are widespread. SME digital transformation and innovation require government policies, initiatives and assistance. How the government can help SMEs achieve these goals is unclear. So, this paper aims to investigate how government policy may assist Vietnamese SMEs to boost innovation performance and digital transformation. Design/methodology/approach: The study will take a quantitative approach, with questionnaires distributed to 659 respondents from SMEs in Vietnam through snowball and convenience sampling procedures. The structural equational modelling method is used for data analysis. Findings: The study indicated that government policies supported Vietnamese SMEs' innovation and information technology (IT) capabilities. Government policy assistance also boosted IT capabilities and innovation. Furthermore, mediation effects show that digital transformation fully mediates the relationship between innovativeness and firm performance, whereas IT capabilities partially mediate this relationship. Research limitations/implications: Further research that replicates the findings and analyses contextual heterogeneities between nations is advised because Vietnam's pandemic setting was both similar and dissimilar. Practical implications: The study demonstrated government-company interactions through supportive policy. It investigated whether SMEs seeking digital transformation and innovativeness might gain competitive benefits by implementing effective knowledge management and enhancing their IT capabilities. Originality/value: A resource-based theoretical framework is extended to study how innovation, public policy and digital transformation for SMEs interact. The study confirms government policy strongly influences enterprises' digital development. Specifically, the new mediating effects of IT capabilities and digital transformation are explored and provide new insights into the existing literature. © 2023, Emerald Publishing Limited.
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Novel safe and stable teracationic Zinc phthalocyanine is efficient against bacteria, fungi and viruses also under indoor light Recently a novel photosensitizer with outstanding properties, phthalocyanine LASU has being developed. The compound possesses unprecedented stability and antimicrobial activity. It can be activated by a weak indoor light of 270 lux and shows the activity against G+ and G- bacteria as well as fungi and viruses. Over 3 log inactivation of bacteria and fungi on the surface of a LASU-impregnated material can be achieved in 1/2-1 h of illumination with a regular indoor and/or natural light. A cotton filter impregnated with 0.1 g/m2 of LASU eradicates on its surface the coronavirus HCoV-229E by 3.5 log in 30 minutes under indoor/natural light of 500 lux. The molecule is photostable and remains active for weeks with no significant bleaching. Another remarkable property is its ability to bind to cellulose support. It readily attaches to a fiber substrate through electrostatic interactions, moreover, the size of LASU ring matches the pitch of cellulose polymer, making the conjugate unusually strong. Hence the compound does not leech to water and is stable against temperature and surfactants. The toxicology studies also reveals that substance is non-irritating for human skin, and is non-mutagenic, which makes it suitable for human-wearable items.Copyright © 2023
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Background: Pulmonary Rehabilitation is a high-impact intervention for IPF but access is limited in India, a problem exacerbated by the pandemic which has seen HBPR become a necessity. Aim(s): To explore the lived experiences of people living with IPF to inform HBPR in Delhi, India. Method(s): Ten semi-structured interviews with Adults with IPF. Data were analysed using thematic analysis. Result(s): Five key themes were developed (Figure): (1) Diagnosis Journey: Experiences before and during diagnosis, including misdiagnosis, and how family, friends and colleagues reacted to diagnosis. (2) Impact of IPF: The physical and psychological impacts on their life. (3) Non-IPF Impact: The impact of COVID-19 infection and restrictions and previous/existing comorbidities. (4) Management of IPF: Strategies to manage symptoms, including exercise and relaxed breathing. (5) HBPR: Perspectives of HBPR, including its advantages and challenges, their goals if they were to participate, and suggestions to the development of a paper HBPR manual. Conclusion(s): Patients living with IPF were positive about HBPR and the development of a paper-based manual to facilitate HBPR. The content of HBPR should be sensitive to the previous negative experiences of diagnosis, the additional impact of non-IPF health issues and challenges of reduced interactions with healthcare professionals.
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COVID-19 has a severe risk of spreading rapidly, the quick identification of which is essential. In this regard, chest radiology images have proven to be a practical screening approach for COVID-19 affected patients. This study proposes a deep learning-based approach using DenseNet-121 to detect COVID-19 patients effectively. We have trained and tested our model on the COVIDx dataset and performed both two-class and three-class classifications, achieving 96.49% and 93.71% accuracy, respectively. By successfully utilizing transfer learning, we achieve comparable performance to the state-of-the-art method while using 15 × fewer model parameters. Moreover, we performed an interpretability analysis using Grad-CAM to highlight the most significant image regions at test time. Finally, we developed a website that takes chest radiology images as input and detects the presence of COVID-19 or pneumonia and a heatmap highlighting the infected regions. Source code for reproducing results and model weights is available. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Tuberculosis still significantly impacts the world's population, with more than 10 million people getting sick each year. Researchers have focused on developing computer-aided diagnosis (CAD) technology based on X-ray imaging to support the identification of tuberculosis, and deep learning is a popular and efficient method. However, deep learning-based CAD approaches usually ignore the relationship between the two vision tasks of specific region segmentation and classification. In this research, we introduced a novel TB-UNet, which is based on dilated fusion block (DF) and Attention block (AB) block for accurate segmentation of lungs regions and achieved the highest results in terms of Precision (0.9574), Recall (0.9512), and F1score (0.8988), IoU (0.8168) and Accuracy (0.9770). We also proposed TB-DenseNet which is based on five dual convolution blocks, DenseNet-169 layer, and a feature fusion block for the precise classification of tuberculosis images. The experiments have been performed on three chest X-ray (CXR) datasets, segmented images, and original images are fed to TB-DenseNet for better classification. Furthermore, the proposed method is tested against simultaneously three different diseases, such as Pneumonia, COVID-19, and Tuberculous. The highest results are achieved in terms of Precision (0.9567), Recall (0.9510), F1score (0.9538), and Accuracy (0.9510). The achieved results reflect that our proposed method produces the highest accuracy compared to the state-of-the-art methods. The source code is available at: https://github.com/ahmedeqbal/TB-DenseNet.Copyright © 2023 Elsevier Ltd
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This study aims to review the available data regarding the central role of immunity in combating SARS-CoV-2 infection and in the generation of protection by vaccination against COVID-19 in different age groups. Physiologically, the immune response and the components involved in it are variable, both functionally and quantitatively, in neonates, infants, children, adolescents, and adults. These immunological differences are mirrored during COVID-19 infection and in the post-vaccination period. The outcome of SARS-CoV-2 infection is greatly dependent on the reaction orchestrated by the immune system. This is clearly obvious in relation to the clinical status of COVID-19 infection, which can be symptomless, mild, moderate, or severe. Even the complications of the disease show a proportional pattern in relation to the immune response. On the contrary, the commonly used anti-COVID-19 vaccines generate protective humoral and cellular immunity. The magnitude of this immunity and the components involved in it are discussed in detail. Furthermore, many of the adverse effects of these vaccines can be explained on the basis of immune reactions against the different components of the vaccines. Regarding the appropriate choice of vaccine for different age groups, many factors have to be considered. This is a cornerstone, particularly in the following age groups: 1 day to 5 years, 6 to 11 years, and 12 to 17 years. Many factors are involved in deciding the route, doses, and schedule of vaccination for children. Another important issue in this dilemma is the hesitancy of families in making the decision about whether to vaccinate their children. Added to these difficulties is the choice by health authorities and governments concerning whether to make children's vaccination compulsory. In this respect, although rare and limited, adverse effects of vaccines in children have been detected, some of which, unfortunately, have been serious or even fatal. However, to achieve comprehensive control over COVID-19 in communities, both children and adults have to be vaccinated, as the former group represents a reservoir for viral transmission. The understanding of the various immunological mechanisms involved in SARS-CoV-2 infection and in the preparation and application of its vaccines has given the sciences a great opportunity to further deepen and expand immunological knowledge. This will hopefully be reflected positively on other diseases through gaining an immunological background that may aid in diagnosis and therapy. Humanity is still in continuous conflict with SARS-CoV-2 infection and will be for a while, but the future is expected to be in favor of the prevention and control of this disease.
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Rheumatoid arthritis (RA), is an autoimmune, and inflammatory disease that is closely related to the destruction of cartilage and bone. DC-SIGN are important types of C-type lectin receptors (CLRs), expressed on dendritic cells and macrophages, and have a central role in regulating innate and adaptive immunity, function as pattern recognition receptors, and as cell adhesion molecules. Recent evidence has demonstrated that DC-SIGN is involved in the pathophysiological of chronic inflammation, so DC-SIGN has been linked to several autoimmune and may play an essential indicator in the pathogenesis and progression of RA. Therefore, the purpose of this study is to determine the serum level of DC-SIGN in RA patients, as well as the level of DC-SIGN based on demographic characteristics. Fifty Iraqi RA patients were enrolled in the study, and a control sample of 38 healthy individuals (ascertain by laboratory and clinical tests) were included and matched by gender, age, and ethnicity with the patients. The DC-SIGN concentration was calculated in the patients' serum and compared to control using the ELISA assay and the results revealed significantly increased serum level of DC-SIGN (12.047 ± 1.114 vs. 6.863 ± 0.806 ng/ml) was recorded in RA patients compared to controls. When correlating results, it was shown that the concentration of DC-SIGN in the serum did not record a significant difference between gender and age, as well as the blood groups. To determine the impact of the therapeutic status in RA patients on the DC-SIGN level, it was found that the concentration of DC-SIGN level was higher in untreated patients compared to treated patients. Regarding viral infection, when an investigation was conducted in RA patients infected with SARS-CoV-2, the serum level of DC-SIGN in RA patients with COVID-19 showed no change in concentrations compared to uninfected RA patients. © 2022 University of Baghdad. All rights reserved.
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World has transformed to a new era after the outbreak of a virus named COVID-19 in late 2019, a virus that consequently spread worldwide, forced the governments to declare smart, partial, or complete lockdowns. The constant and prolonged lockdowns resulted in the uncertainty over disease status, inadequate information, food supplies and boredom that led to anger and confusion, emotional breakdowns, and development of aggressive behaviors. During the pandemic and constant lockdown, one of the major differences in day-to-day activities was the transformation of the working and learning environment from the physical to the online realm. The prime objective of the study is to highlight that during pandemic how transferring towards online working helped people to stabilize their emotions, anxieties, aggressions, anger and frustration. The study is designed to find out how online working has negatively connected with the development of aggression and how emotional intelligence has mediated this effect. The study design is non-experimental, correlational and comparative, followed by quantitative research analysis. The survey technique used in the data collection process where validated and reliable questionnaire were used for data collection and hypothesis testing. A sample size of 233 (144 females, 88 males, 1 participant did not disclose gender) participants from the metropolis city of Karachi participated in an online survey. Results have indicated that engaging people in online working improved mental and emotional stability as well as the suppressed level of direct, indirect and displaced aggression. Moreover, emotional intelligence has acted as a negative influencing mediator towards different forms of aggression, where an expansion in online working, positively impacted emotional intelligence and negatively co-related with direct, indirect and displaced aggression. No gender difference is found in terms of emotional intelligence, however, a distinctive difference in terms of indirect and direct form of aggression is reported. It is concluded that emotional intelligence is acting as a mediator between online working and direct, indirect and displaced aggression. It means that engaging people in online working helped to stabilize themselves in terms of emotions and helped them to control their anxieties during isolation. © Italian e-Learning Association.
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A fully parametric accelerated failure time (AFT) model with a flexible, novel modified exponential Weibull baseline distribution called the extended exponential Weibull accelerated failure time (ExEW-AFT) model is proposed. The model is presented using the multi-parameter survival regression model, where more than one distributional parameter is linked to the covariates. The model formulation, probabilistic functions, and some of its sub-models were derived. The parameters of the introduced model are estimated using the maximum likelihood approach. An extensive simulation study is used to assess the estimates' performance using different scenarios based on the baseline hazard shape. The proposed model is applied to a real-life right-censored COVID-19 data set from Sudan to illustrate the practical applicability of the proposed AFT model.
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Background: A movement towards selective histology for benign gallbladder disease is evolving in the United Kingdom (UK). Studies propose the reliance on macroscopic features to identify incidental gallbladder cancer (IGBC). We aimed to investigate the rate of dysplastic gallbladder histology, the rate of subtotal cholecystectomy and identify any selection criteria for selective histology. Method(s): A retrospective observational study examining patients who underwent a cholecystectomy, amid the COVID-19 pandemic, between January 2020 and June 2021. This study was carried out in a large Trust in the West Midlands, UK. Multivariate logistical regression models were used to identify patient factors associated with IGBC and compare outcomes between total and subtotal cholecystectomy. Result(s): There were 959 patients;631 (65.8%) elective and 328 (34.2%) emergency cholecystectomies. Median age was 48 (35-59) years, and 724 (75.5%) patients were female. 27 (2.8%) patients had a subtotal cholecystectomy with worse post-operative complications (Clavien-Dindo grade 3+, OR 4.69, p=0.026), however no patient suffered a common bile duct injury. Eight (0.8%) patients had IGBC of which 6/8 were diagnosed as cholelithiasis on ultrasound. Five IGBCs had no macroscopic features. One patient needed further surgery and chemotherapy. Gallbladder polyps on ultrasound was the only patient factor associated with increased likelihood of IGBC (OR 14.49, p=0.014). Conclusion(s): We support the current recommendation of the UK Royal College of Pathologists to routinely examine all cholecystectomies removed for benign disease, given that macroscopic features may be absent in IGBC and no clear patient factors to support a selective approach.
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A new type of virus was discovered in China in the year 2019, known as COVID-19. One of the main symptoms that are easy to spot is high body temperature. The recent virus outbreak necessitates infrared thermometers used for thermal screening at public places to test the body temperature. However, this protection method still lacks because it requires a significant amount of time to monitor large numbers of people's body temperatures. Moreover, direct contact with people infected with coronavirus may spread it to the person doing the screening. In addition, this method cannot detect the infection early without visiting the infected person to a screening place. This study proposed a new system for automatically detecting the coronavirus in early time through the body temperature with no human interactions using IoT-based wearable bracelets. The body temperature sensor is integrated into the wearable bracelet with IoT technology for monitoring the body temperature and reading the current bodily temperature. The system is additionally equipped with a GPS module. It can capture the location of the person automatically. Suppose the person is suffering from high body temperature. In that case, the system will send it with location through Wi-Fi module or GSM module over the internet to cloud database and notify medical officer at the same moment to do the immediate procedures for that person. Health officers use smartphone applications for monitoring and remote tracking using the application map. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Purpose: The novel coronavirus (COVID-19) remains a global public health emergency as declared by the World Health Organization (WHO). The COVID-19 impacted educational institutions around the world, and they were shut down to minimize the fatalities and spread of the infection. Educational institutions around the world, including Bangladesh, started to conduct online classes as an alternative to physical classes. Therefore, this study assesses the effectiveness of online classes in terms of information and communications technology (ICT) readiness, online class assessment, online class participation, and convenience and flexibility for the educational institutions of Bangladesh. Design/methodology/approach: To fulfill the objective of the study, data were collected from 817 teachers and students. Additionally, the partial least squares (PLS) regression method was adopted as a quantitative technique. Findings: The study shows that online class participation, online class assessment, and convenience and flexibility have positive relationships with ICT readiness and the effectiveness of online classes. At the same time, the challenges of online classes have negative relationships with ICT readiness and the effectiveness of online classes. Practical implications: The study suggests that the government should ensure stable internet connectivity access across the country so that both students and teachers can participate in online classes effectively. Moreover, educational institutional authorities should extend support to the institutions for developing proper ICT infrastructure. Originality/value: ICT infrastructure readiness is the backbone for effective online education;however, before the COVID-19 pandemic, online education was almost non-existent at the educational institutional level in Bangladesh. The country started developing the ICT infrastructure only when online classes were scheduled to start, and the development is still ongoing. Hence, this study used ICT readiness as a mediator factor. Moreover, primary data are used in this study. The findings of the study will help academicians and policymakers to better understand the effectiveness of online classes. © 2022, Emerald Publishing Limited.
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Aim Group & Save (G&S) is conducted prior to Transurethral Resection of Bladder Tumour (TURBT) or Rigid Cystoscopy + Bladder Biopsy (BB) during pre-operative assessment (PoA). Each G&S costs £7.54 and 2 samples are required. The aim of this audit was to determine whether G&S is clinically required for these two procedures. Method This two-cycle audit reviewed the PoA components of patients undergoing TURBT or BB over a 6month period prior to the COVID-19 pandemic (July-Dec2019), in which PoA were face-to-face, and a subsequent re-audit during telephone PoA (July-Dec2020), where it was deemed unnecessary to have a G&S. Results 1st Cycle: 64 patients were included, 32.8%(21/64) had a preoperative G&S. 98.4%(63/64) had Hb measured. Mean Hb was 131.56 (79 – 165) g/l. 25%(16/64) were on anti-coagulants, of which 50%(8/16) were continued. No patients required a peri or post-operative blood transfusion. 2nd Cycle: 48 patients were included and 6.25%(3/48) had a G&S within the 1 month preceding their operation. 70.8%(34/48) had their Hb measured, with mean Hb being 135.18 (86 – 168) g/l. 22.9%(11/48) were on anticoagulants, of which 36%(4/11) were continued. There were no complications requiring a blood transfusion. Conclusions We found no requirement of blood transfusions following TURBT or BB, therefore routine G&S is not clinically indicated for this series. This reflects departmental savings of £964 over 6months (based on 64 cases). In addition, a relationship between continuing anti-coagulation or a low Hb and post-operative transfusion was not observed.
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Background: Immune checkpoint inhibitors (ICIs) can cause a variety of inflammatory autoimmune tissue damage, referred to as immune-related adverse events (irAEs). COVID-19 is associated with increased amounts of proinflammatory cytokines, which may synergistically affect the outcome of irAEs. Data are limited regarding the impact of COVID-19 on irAEs in ICI-treated cancer patients. Methods: We retrospectively analyzed adult patients with malignant solid tumors treated with ICIs at AdventHealth Orlando between August 2020 and August 2021. All COVID-19 infections were confirmed by PCR. Patients who had the most recent ICI treatment over one month before or after the positive COVID- 19 test were excluded from the study. For COVID-19 positive group, only the irAEs that developed after COVID-19 infection were considered as events. Results: A total of 579 patients were included in our study, with 46 (7.9%) in COVID-19 positive group, and 533 (92.1%) in COVID-19 negative group. The baseline characteristics of patients in the two groups were similar in terms of age, ethnicity, ECOG, cancer histology, and type of ICI. With a median follow-up of 10 months (1-73 months), no differences in the time from ICI initiation to irAE onset, corticosteroid use, or additional immunosuppressant use were seen. A trend in higher incidence of all-grade diarrhea/colitis (8.7% vs. 3.0%, p=0.07) and grade 3 and 4 hepatitis (4.3% vs. 0.8%, p=0.08) was noted in the COVID-19 positive group, however the difference was not statistically significant. No significant difference in the incidence of pneumonitis (2.2% vs. 1.1%, p=0.44), nephritis (2.2% vs. 0.8%, p=0.34) or dermatitis (6.5% vs. 6.4%, p=1.00) were noted between COVID-19 positive and negative groups. We noticed a higher incidence of all-grade irAEs in the COVID-19 positive group (30.4% vs. 19.9%, p=0.18), but the difference was not statistically significant. The incidence of grade 3 and 4 irAEs was significantly higher in the COVID- 19 positive group (10.9% vs. 3.2%, p=0.02). Nine COVID-19 related death occurred while no irAE-related death was noted in the entire cohort. Conclusions: Our study suggested that COVID-19 may pose a risk of severe irAEs in cancer patients receiving ICIs. Close monitoring and possible delaying ICI administration could be considered when cancer patients were infected with COVID-19. (Table Presented).
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Objectives The aim of this study was to summarize the available evidence on the prevalence of stress, burnout, anxiety and depression among healthcare providers in the Gulf Cooperation Council (GCC) countries (KSA, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates) during the COVID-19 pandemic. Methods We searched PubMed, PsycINFO, Scopus, and Google scholar for related studies published between January 2020 and April 2021 and conducted a systematic review and meta-analysis. Results Of the 1815 identified studies, 29 met the inclusion criteria, and 19 studies were included in the meta-analysis. The pooled estimate of prevalence for moderate to severe anxiety as reported using GAD-7 was 34.57% (95% CI = 19.73%, 51.12%), that for moderate to severe depression using PHQ-9 was 53.12% (95% CI = 32.76%, 72.96%), and that for moderate to severe stress using the 10-item Perceived Stress Scales was 81.12% (95% CI = 72.15%, 88.70%). Meta-analysis was not performed for burnout due to the small number of identified studies and the different tools used;however, the highest prevalence was reported at 76% (95% CI = 64%, 85%). Overall, a positive trend was observed over time for moderate to severe anxiety and depression, p = 0.0059 and 0.0762, respectively. Of note, the heterogeneity was significant among the studies, and many studies were of poor quality. Conclusion The prevalence of mental health disorders during the current pandemic among healthcare workers in GCC countries is high. However, the results could be affected by the high heterogeneity and low quality studies.
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In this article, a new hybrid time series model is proposed to predict COVID-19 daily confirmed cases and deaths. Due to the variations and complexity in the data, it is very difficult to predict its future trajectory using linear time series or mathematical models. In this research article, a novel hybrid ensemble empirical mode decomposition and error trend seasonal (EEMD-ETS) model has been developed to forecast the COVID-19 pandemic. The proposed hybrid model decomposes the complex, nonlinear, and nonstationary data into different intrinsic mode functions (IMFs) from low to high frequencies, and a single monotone residue by applying EEMD. The stationarity of each IMF component is checked with the help of the augmented Dicky-Fuller (ADF) test and is then used to build up the EEMD-ETS model, and finally, future predictions have been obtained from the proposed hybrid model. For illustration purposes and to check the performance of the proposed model, four datasets of daily confirmed cases and deaths from COVID-19 in Italy, Germany, the United Kingdom (UK), and France have been used. Similarly, four different statistical metrics, i.e., root mean square error (RMSE), symmetric mean absolute parentage error (sMAPE), mean absolute error (MAE), and mean absolute percentage error (MAPE) have been used for a comparison of different time series models. It is evident from the results that the proposed hybrid EEMD-ETS model outperforms the other time series and machine learning models. Hence, it is worthy to be used as an effective model for the prediction of COVID-19.
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COVID-19 , COVID-19/epidemiology , Forecasting , Humans , Models, Theoretical , Pandemics , SeasonsABSTRACT
Introduction: Coronavirus Disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a worldwide pandemic. It is primarily a pulmonary disease which can lead to respiratory distress syndrome;some go on to develop ventilator dependent chronic respiratory failure. In these patients, enteral feeding is critical and initially provided by nasogastric (NG) or orogastric (OG) tubes. However, feeding tubes are associated with local complications such as nasopharyngeal/oropharyngeal erosions and esophageal/gastric cardia ulceration. Percutaneous endoscopic gastrostomy (PEG) tube placement facilitates longer-term enteral access. Minimal data exists on the safety and efficacy of PEG tube placement in patients with SARS-CoV-2 infection. Methods: A retrospective chart review was performed to collect data for patients who underwent PEG tube placement between January 2020 to January 2021 at Houston Methodist Hospital. Inclusion criteria included patients who had endoscopic PEG tube placement during this time interval. Exclusion criteria included patients who underwent PEG placement via interventional radiology or surgically. Approval for study was obtained from the Institutional Review Board at Houston Methodist Hospital. Success was defined as PEG placement and use to provide enteral nutrition with no complications over a 4-week period after placement. Results: 36 patients with (mean age 63.6 years;38.8% females) and 104 patients without COVID-19 infection (mean age 64.9 years, 44.2% females) were included in the study. 25 patients were excluded who had missing data, had PEG-J tube placed, or had it placed by interventional radiology initially and exchanged endoscopically during the study period. Table 1 summarizes the main demographic and clinical characteristics of participants. COVID-19 patients were more likely to be obese, be on anticoagulants and have a tracheostomy in place. 11.1% of the patients with COVID-19 developed PEG-related complications compared to 16.3% patients without COVID-19 χ2 with Yate's correction (1, N=140) = 0.23, p=0.65. The success rates of PEG placement in patients with and without COVID -19 were similar at 97.2% and 90.3%, respectively,, χ2(1, N=140) =1.7, p=0.18. Conclusion: This is, to our knowledge, the first study to assess the safety and efficacy of PEG tube placement in patients with SARSCoV- 2 infection. The study demonstrates that despite high BMI and rate of anticoagulant therapy, PEG placement was universally successful, and complication rates no different from those of age- and gender-matched non-COVID-19 patients. PEG tube placement offers a safe and effective means of providing longer term access for enteral nutrition in COVID- 19 patients. (Table Presented)