ABSTRACT
Aim and objective: Although two-wave pattern of the coronavirus disease-2019 (COVID-19) pandemic was observed in many countries, there is limited information on the impact of both the waves on clinical presentations of ectopic pregnancy (EP) with COVID-19. Therefore, we aimed to understand the impact of the first wave and second wave of COVID-19 pandemic on women with EPs in India. Materials and methods: We conducted a retrospective study at BYL Nair Charitable Hospital (NH), a dedicated COVID-19 tertiary care hospital in Mumbai, India. We analyzed the impact of the first wave and second wave on women with EPs and the challenges encountered for management during the pandemic in our hospital. Results: A total of 1,660 pregnant and postpartum women with confirmed diagnosis of COVID-19 were admitted at NH during the first wave and the second wave of the COVID-19 pandemic. All cases of EP were asymptomatic for COVID-19. During the prepandemic period of 4 years, there were 220 (15.2 per 1,000 births) women with EPs, which was higher compared to seven EPs (6.3 per 1,000 births) during the COVID-19 pandemic. EP rate per 1,000 births during the second wave was found to be 9.6, which is comparatively higher than the first wave (3.8) (p = 0.24). Conclusion: Increased frequency of EPs during the second wave of the COVID-19 pandemic could be due to the new variant of concern B.1.617. 2 (Delta). For ruptured EP, we recommend surgical management with laparotomy as a treatment option as it is useful in reducing the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to healthcare workers. Clinical significance: The COVID-19 pandemic is likely to last longer and hence healthcare providers should ensure that pregnant women have access to medical assistance whenever needed. © The Author(s). 2021.
Subject(s)
Abortion, Spontaneous , COVID-19 , Abortion, Spontaneous/epidemiology , Female , Humans , India/epidemiology , Pandemics , Pregnancy , SARS-CoV-2ABSTRACT
Background: Reinfection/reactivation of SARS-CoV-2 has been a matter of great interest from the immunological and vaccine perspective. However, little is known about the clinical presentation of such reinfection/reactivation. We report a case series of 9 COVID-19 patients having experienced two clinically- and/or virologically-confirmed episodes of COVID-19. Methods: Epidemiological and clinical characteristics of 9 healthcare workers (HCWs) with two episodes of SARS-CoV-2 are described. Results: The incidence of reinfection/reactivation amongst the HCWs was 2% (9 out of 491) with an average remission period of 66 days (range 43-78 days). Amongst the cases of reinfection 4/9 were asymptomatic in first episode were symptomatic in second episode. There is negative correlation between numbers of days the patients took to become SARS-CoV-2 negative by RT-CPR and/or clinically recover in the first episode and the second episode irrespective for the time spent in remission. Conclusion: Shorter durations of SARS-COV-2 infection in the first episode are associated with longer time to recovery in the second episode in patients with re-infection/reactivation.
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is rapidly spreading in India and across the world. Healthcare workers (HCWs) are at increased risk of contracting COVID-19 due to direct or indirect exposure to COVID-19 patients, and require special attention. Limited information is available about its effect in HCWs. Secondary transmission from HCWs is a possibility among patients, family members, and the community. Therefore, it is important to investigate the infection risk of HCWs and the clinical characteristics of affected cases and possible source of infection with exposure details. The aim of this study is to analyze the medical records of HCWs with COVID-19 retrospectively and carry out the analysis of the data of HCWs with COVID-19 at TNMC and BYL Nair Charitable Hospital (NH, COVID-19 Hospital) in Mumbai. Interim analysis was carried out for the data collected from 6th April to 20th August 2020. Total 3711 HCWs (frontline, 74.32%, non-frontline, 25.68%) are working at NH Mumbai. We observed 11% prevalence of SARS-CoV-2 infection among HCWs, 4% co-infection and 1% mortality. Majority (85%) of the HCWs with COVID-19 were symptomatic and 15% were asymptomatic. Comorbidities were reported in 19% of HCWs with COVID-19. Hypertension and Diabetes Mellitus were the most common co-morbidities reported. More than 4% percent of HCWs with COVID-19 were also positive for plasmodium vivax Malaria. The results of the study will be useful for determining the impact of COVID-19 and adverse outcomes in HCWs, identifying probable mode of acquiring SARS-CoV-2 infection in HCWs. This is required for planning the strategies to handle the epidemic of COVID-19 among HCWs in Mumbai region, and at Maharashtra state level.