Management of a Psychiatry Inpatient Unit During the COVID-19 Pandemic: An Audit of Services.

Objective: To evaluate the demographic and clinical profiles of patients admitted to the psychiatry ward during the coronavirus disease 2019 (COVID-19) pandemic and compare with profiles of patients admitted 1 year before the onset of the pandemic (ie, before the lockdown announcement in India). An additional objective was to evaluate the incidence of COVID-19 infection in the psychiatry inpatient unit and discuss the measures taken to run the unit during the pandemic, including the measures taken if any patient or staff member was detected to have COVID-19 infection.Methods: This retrospective study was conducted in a tertiary care hospital in North India. Data of patients admitted to the inpatient unit from March 24, 2019, to March 23, 2020, were compared with data from March 24, 2020, to March 23, 2021. The data were extracted from the inpatient registry.Results: Compared to the pre-pandemic period, fewer patients were admitted during the pandemic, and the patients admitted had more severe illness. During the ongoing pandemic, the incidence of COVID-19 infection among the residents was 5%, nursing staff was 4.7%, and support staff was 6.66%. The incidence rate of COVID-19 among the patients was 3.2%. Patients were not found to be the primary source of infection; on the other hand, COVID-positive status among the health care professionals was responsible for patients becoming infected.Conclusions: During the ongoing COVID-19 pandemic, psychiatry inpatient facility can be managed with reduced capacity and by following COVD-19 protocol.

Nature and Dimensions of Systemic Hyperinflammation and its Attenuation by Convalescent Plasma in Severe COVID-19.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), has led to significant morbidity and mortality. While most suffer from mild symptoms, some patients progress to severe disease with acute respiratory distress syndrome (ARDS) and associated systemic hyperinflammation. METHODS: First, to characterize key cytokines and their dynamics in this hyperinflammatory condition, we assessed abundance and correlative expression of a panel of 48 cytokines in patients progressing to ARDS as compared to patients with mild disease. Then, in an ongoing randomized controlled trial of convalescent plasma therapy (CPT), we analyzed rapid effects of CPT on the systemic cytokine dynamics as a correlate for the level of hypoxia experienced by the patients. RESULTS: We identified an anti-inflammatory role of CPT independent of its neutralizing antibody content. CONCLUSIONS: Neutralizing antibodies, as well as reductions in circulating interleukin-6 and interferon-γ-inducible protein 10, contributed to marked rapid reductions in hypoxia in response to CPT. CLINICAL TRIAL REGISTRY OF INDIA: CTRI/2020/05/025209. http://www.ctri.nic.in/.

A rapid and sensitive method to detect SARS-CoV-2 virus using targeted-mass spectrometry.

In the last few months, there has been a global catastrophic outbreak of severe acute respiratory syndrome disease caused by the novel coronavirus SARS-CoV-2 affecting millions of people worldwide. Early diagnosis and isolation are key to contain the rapid spread of the virus. Towards this goal, we report a simple, sensitive and rapid method to detect the virus using a targeted mass spectrometric approach, which can directly detect the presence of virus from naso-oropharyngeal swabs. Using a multiple reaction monitoring we can detect the presence of two peptides specific to SARS-CoV-2 in a 2.3 min gradient run with 100% specificity and 90.5% sensitivity when compared to RT-PCR. Importantly, we further show that these peptides could be detected even in the patients who have recovered from the symptoms and have tested negative for the virus by RT-PCR highlighting the sensitivity of the technique. This method has the translational potential of in terms of the rapid diagnostics of symptomatic and asymptomatic COVID-19 and can augment current methods available for diagnosis of SARS-CoV-2.