Six-minute walk test and its predictability in outcome of COVID-19 patients.

BACKGROUND: The world is worsely hit by the COVID-19 pandemic resulting in increased morbidity and mortality. Increased mortality has been observed in older adults with multiple comorbidities. Six-minute walk distance (6MWD) at admission can help us to guide the requirement of oxygen during hospital stay that can be used to determine which patient can be managed at home. MATERIALS AND METHODS: This study was a prospective observational study conducted on COVID-19 patients admitted at AIIMS, New Delhi, from October to December 2020. Patients aged more than 60 years were included in the study and underwent 6-min walk tests. Polypharmacy and multimorbidity were also assessed along with dyspnea which was measured on BORG scale. P < 0.05 was considered statistically significant. Statistical software STATA (version 14.2) was used for all the analyses. RESULTS: The mean age of the study population was 68.76 (7.4). Oxygen saturation prior to the 6-MWT was normal and has significantly higher than the post test (P ≤ 0.001). 6MWD was significantly correlated with pre values of oxygen saturation. 6MWD was observed more in patients who did not require oxygen during hospital stay. Self-reported dyspnea, pulse rate, oxygen saturation, and systolic blood pressure were significantly associated with the patients who had an oxygen requirement during the hospital stay. CONCLUSION: Self-reported dyspnea after 6MWT was found to be associated with oxygen requirement during hospital stay. Patients who have covered more distance in 6-min walk test have less oxygen requirement during hospital stay hence can be managed at home. This will reduce the health-care burden and will help to tackle the outburst during the ongoing pandemic.

Adherence to COVID-19 protective behaviours in India from May to December 2020: evidence from a nationally representative longitudinal survey.

OBJECTIVES: Since the onset of the COVID-19 pandemic, behavioural interventions to reduce disease transmission have been central to public health policy worldwide. Sustaining individual protective behaviour is especially important in low-income and middle-income settings, where health systems have fewer resources and access to vaccination is limited. This study seeks to assess time trends in COVID-19 protective behaviour in India. DESIGN: Nationally representative, panel-based, longitudinal study. SETTING: We conducted a panel survey of Indian households to understand how the adoption of COVID-19 protective behaviours has changed over time. Our data span peaks and valleys of disease transmission over May-December 2020. PARTICIPANTS: Respondents included 3719 adults from 1766 Indian households enrolled in the Harmonised Diagnostic Assessment of Dementia for the Longitudinal Ageing Study in India. ANALYSIS: We used ordinary least squares regression analysis to quantify time trends in protective behaviours. RESULTS: We find a 30.6 percentage point (95% CI (26.7 to 34.5); p<0.01) decline in protective behaviours related to social distancing over the observation period. Mask wearing and handwashing, in contrast, decreased by only 4.3 percentage points (95% CI (0.97 to 7.6); p<0.05) from a high base. Our conclusions are unchanged after adjusting for recorded COVID-19 caseload and nationwide COVID-19 containment policy; we also observe significant declines across socioeconomic strata spanning age, gender, education and urbanicity. CONCLUSION: We argue that these changes reflect, at least in part, 'COVID-19 fatigue,' where adherence to social distancing becomes more difficult over time irrespective of the surrounding disease environment.

Assessment of mental health issues among geriatric population during COVID19 pandemic, Indian perspective.

OBJECTIVES: Study was aimed to assess magnitude of mental health problems among geriatric population during COVID19 pandemic. METHODOLOGY: Study was a cross-sectional observational study, total of 106 participants (Age ≥60 years) of either gender included in study. Mental health variables depressive and anxiety were assessed using GDS and HAM-A. RESULTS: On GDS, 20(18.87%) patients had depressive symptoms and on HAM-A, 24(22.6%) patients were having anxiety symptoms. CONCLUSION: Study highlight that Geriatric population have significant mental health issues during COVID19 pandemic, it should not be overlooked. It's necessary to provide elderly psychological intervention measures to improve their wellbeing.

Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis.

BACKGROUND: Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. METHODS: A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. RESULT: Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI- 36-65%, I2-95%) patients while 22% (95% CI- 16-28%, I2-88%) were critically ill. Overall, 11% (95% CI- 5-21%, I2-98%) patients died. The common comorbidities were hypertension (48, 95% CI- 36-60% I2-92%), diabetes mellitus (22, 95% CI- 13-32%, I2-86%) and cardiovascular disease (19, 95% CI - 11-28%, I2-85%). Common symptoms were fever (83, 95% CI- 66-97%, I2-91%), cough (60, 95% CI- 50-70%, I2-71%) and dyspnoea (42, 95% CI- 19-67%, I2-94%). Overall, 84% (95% CI- 60-100%, I2-81%) required oxygen support and 21% (95% CI- 0-49%, I2-91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. CONCLUSION: Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.