ABSTRACT
COVID-19 is a public health emergency of international concern. The outbreak of the disease began as pneumonia of unknown etiology in Wuhan, China. It is a virus induced respiratory illness caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). Close genetic similarity with the bat SARS- like coronavirus RaTG13 and the presence of high degree of similarity between ACE-2 receptors among various animals and humans indicate its likely origin from bats. Person to person contact was also identified. There is no clear evidence of vertical transmission of the virus yet, though its presence is detected in semen of affected individuals. Symptoms appear 2 to 14 days post- exposure and include dyspnoea, coughing, sore throat, fever, repeated shaking with chills, myalgia and anosmia. In some cases, diarrhoea, cutaneous manifestations such as chilblain-like foot lesions have also been reported. Coagulopathy is most probably a consequence of massive inflammatory response and may contribute to the occurrence of thrombosis. The severity of the disease ranges from very mild to severe depending upon the age, immune status and presence of comorbidities. In severe disease, elevated serum levels of proinflammatory cytokines like Interleukin-1, Interleukin-6, Interleukin-12, Interferon-gamma and TGF- beta along with increased level of chemokines are observed. Histopathological examination revealed pulmonary edema along with formation of hyaline membrane and monocytosis. Liver biopsy revealed moderate microvesicular steatosis. Blood examination showed decreased number of CD4 and CD8 cells. Animal trials have shown that ferrets and cats are susceptible to the disease while dogs, ducks, pigs and chickens are not. The results of Thin slice Computed Tomography showed multifocal ground glass opacities. Treatment is not specific. Hydroxychloroquine led to the reduction of viral load. On 1st May, 2020, FDA agreed for Emergency Usage Authorization for the use of Remdesivir as it showed promising results in cell culture, animal models as well as in human trials by decreasing the mortality. Maintenance of hand hygiene and proper cough hygiene is essential. Cowpathy is known to have multiple health restoring properties for boosting immunity and bioenhancer activity, which can also be utilized for prevention and control of coronavirus spread in population. AYUSH ministry of India has reported the beneficial effects of Sanshamani vati, ayurvedic concoction and homeopathic medicine Arsenicum album and initiated the clinical trial studies on Ashwagandha, Pipali, Yashtimadhu, Guduchi and Ayush-64 combination of herbs. Therefore, preventive and control measures are a must to minimize health losses and decrease the burden on health care system.
ABSTRACT
Introduction: Due to the pandemic all the institutes remain closed that led to significant physical and psychosocial problems among children and youths. Hence in our study we aim to compare the clinical features, differences in COVID 1st, 2nd and 3rd waves Material and methods: We conducted a retrospective institutional study from the records of 1st three waves. The study included children and youths aged 18 years or younger with COVID-19 confirmed by the positive detection of SARS-CoV-2. The collected data included sex, age at diagnosis, clinical symptoms, dates of admission and discharge, were noted and analyzed. Results: Among 397 children and youths confirmed with COVID-19 infections, the mean age was <10 years, almost equal sex distribution and one 3rd were asymptomatic. Majority were symptom free in 2nd and 3rd waves. Cough and fever were the presenting symptoms Among all individuals, 394 individuals (99.2%) had mild illness. One subject had chilblains, one developed multisystem inflammatory syndrome in children, and one developed post-COVID-19 autoimmune hemolytic anemia. In all 3 waves, 204 patients with COVID-19 (51.4%) had domestic infections. Among these individuals, 186 (91.2%) reported having a contact history with another individual with COVID-19, of which most (183 individuals [90.0%]) were family members. Conclusions: We conclude that all children and youths with COVID-19 in countries had mild illness. In this cross-sectional study, children and youths with COVID-19 had a wide range of clinical presentations, from no symptoms to post-infectious immune-mediated complications.