ABSTRACT
Purpose: Solid organ transplant recipients are at high risk of morbidity and mortality from coronavirus disease 2019 (COVID-19) with mortality rates as high as 30% reported in the early pandemic period. COVID-19 vaccine efficacy in the immunosuppressed population is lower than the general population. Early studies suggest that monoclonal antibody (MAB) treatment against the SARS-CoV-S spike protein may decrease hospitalizations and emergency department (ED) visits. Herein, we report our single center experience with use of MAB for COVID-19 treatment in kidney transplant recipients. Method(s): We performed a retrospective chart review of all kidney transplant recipients who developed COVID-19 from March 17, 2020 to January 26, 2022 at our transplant center. Date of diagnosis, vaccine status, MAB treatment, hospitalization and patient outcome was reviewed. Result(s): Two hundred ninety-one kidney transplant recipients had positive testing for SARS-CoV-2 in the period reviewed. 120 (41%) patients received MAB treatment. One patient death, not COVID related, was excluded from analysis. Of those who received MAB treatment, 99.2% survived compared to 82.4% of those who did not (p=0.00), Figure 1. Hospitalization was lower in those who received MAB (18.3% vs 60.8%, p=0.00). Completion of vaccine series, defined as 2 doses of mRNA or 1 dose of Janssen vaccine prior to infection, was also associated with better survival (98.6% vs 80.3%, p=0.00), Figure 1. Hospitalization rate was lower in those who completed vaccination prior to infection with SARS-CoV-2 (27.1% vs 59.2%, p = 0.00). The combination of MAB therapy and completion of vaccination also decreased hospitalization compared to those who received MAB but did not complete vaccines series (14% vs 26.8%, Table 1). Subgroup analysis of 143 patients infected from December 2021 to Jan 26, 2022 which may have reflected the Omicron surge was performed (Table 2). Treatment with MAB was associated with a reduction in hospitalization (11.6%) compared to 44.6% in those who did not receive MAB. Conclusion(s): MAB treatment for COVID-19 and prior vaccination were associated with improved survival and decreased risk of hospitalization in kidney transplant recipients.
ABSTRACT
India has perceived an enormous upsurge in garbage during 21st century due to adopting urbanization rapidly. In addition, as the population increasing drastically, which inherently produce huge amount of garbage. The overflow of the garbage and lack of maintenance are the main reasons for many diseases and also for spoiling earth environment. However, the entire world has faced the problems due to spreading of Covid-19 through the air due to the hazard waste is being generated in specific Covid hospitals, quarantine zones are directly dumped into the dustbins. The frontline warriors (doctor, nurse, police) working in these unorganized dustbin environments are getting infected with Covid-19 and are became a primary contact for spreading of virus. Thus, it is very much essential to implement a systematized and well-designed mechanism to overcome this problem. In this work, a hardware prototype for smart dustbin based on Arduino has been proposed that can be installed in hospitals, medical centres, municipalities, households for the sake of environment as well as front-line workers. The proposed model of smart dustbin has PIR sensor and ultrasonic sensor for human motion detection and sense the level of garbage present in the bin respectively. An alert system based on GSM has been interfaced with Arduino which sends the alert messages based on level of the garbage at regular intervals. The proposed model work with very low power and increase the security for front-line workers from the Covid-19. © 2021 IEEE.