An Assessment of the Profile and Predictors of Outcomes in COVID-19 Patients Hospitalized in a Tertiary Care Institute in Central India.

Background Coronavirus disease 2019 (COVID-19) is the largest pandemic that has affected people around the globe. Various researches have been conducted worldwide, but there is a scarcity of data from Central India on the relationship between several risk factors for infection and mortality. Our study assessed the predictors and patient profiles of those with COVID-19, which will aid in prioritizing patient treatment and preventive measures. Methods A retrospective study was done between March and December 2020. The study included 5,552 COVID-19 patients admitted to the All India Institute of Medical Sciences (AIIMS), Raipur. A validated questionnaire form provided by the WHO was used. Data for multiple clinical and nonclinical parameters were collected, and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY, USA) and STATA version 12 (StataCorp LLC, College Station, TX, USA). Mortality and risk assessment of patients was done using multivariate logistic regression. Result In our study cohort of 5,552 COVID-19 patients, the median age was found to be 47 years (interquartile range (IQR): 31-60 years; range: 14-100 years), and 3,557 (64%) were male. Predominantly, patients presented with fever (41.30%), cough (40.20%), and dyspnea (29.29%). The major comorbidities were hypertension (29.70%), diabetes (25.40%), and chronic cardiac disease (5.79%). The common complications were liver dysfunction (26.83%), viral pneumonitis (23.66%), acute renal injury (15.25%), and acute respiratory distress syndrome (ARDS) (13.41%). In multivariate analysis, age (more than 40 years) (odds ratio (OR): 2.63; 95% confidence interval (CI): 1.531-4.512; p<0.001), diabetes (OR: 1.61; 95% CI: 1.088-2.399; p=0.017), obesity (OR: 6.88; 95% CI: 2.188-12.153; p=0.004), leukocytosis (OR: 1.74; 95% CI: 1.422-2.422; p<0.001), lymphocytopenia (OR: 2.54, 95% CI: 1.718-3.826; p<0.001), thrombocytopenia (OR: 1.15; 95% CI: 1.777-8.700; p=0.001), and ferritin concentration > 1,000 ng/mL (OR: 4.67; 95% CI: 1.991-10.975; p<0.001) were the independent predictors of mortality among COVID-19 patients. Conclusion The leading comorbidities in our study were hypertension, followed by diabetes. Patients who were 40 years or older, obese patients, and diabetic patients have a higher mortality risk. The poor prognostic predictors in COVID-19 patients were high ferritin levels (>1,000 ng/mL), leukocytosis, lymphocytopenia, and thrombocytopenia.

Predictors of Mortality among Patients Hospitalized with COVID-19 during the First Wave in India: A Multisite Case-Control Study.

Severe acute respiratory syndrome coronavirus 2 disease (COVID-19) has caused more than 6 million deaths globally. Understanding predictors of mortality will help in prioritizing patient care and preventive approaches. This was a multicentric, unmatched, hospital-based case-control study conducted in nine teaching hospitals in India. Cases were microbiologically confirmed COVID-19 patients who died in the hospital during the period of study and controls were microbiologically confirmed COVID-19 patients who were discharged from the same hospital after recovery. Cases were recruited sequentially from March 2020 until December-March 2021. All information regarding cases and controls was extracted retrospectively from the medical records of patients by trained physicians. Univariable and multivariable logistic regression was done to assess the association between various predictor variables and deaths due to COVID-19. A total of 2,431 patients (1,137 cases and 1,294 controls) were included in the study. The mean age of patients was 52.8 years (SD: 16.5 years), and 32.1% were females. Breathlessness was the most common symptom at the time of admission (53.2%). Increasing age (adjusted odds ratio [aOR]: 46-59 years, 3.4 [95% CI: 1.5-7.7]; 60-74 years, 4.1 [95% CI: 1.7-9.5]; and ≥ 75 years, 11.0 [95% CI: 4.0-30.6]); preexisting diabetes mellitus (aOR: 1.9 [95% CI: 1.2-2.9]); malignancy (aOR: 3.1 [95% CI: 1.3-7.8]); pulmonary tuberculosis (aOR: 3.3 [95% CI: 1.2-8.8]); breathlessness at the time of admission (aOR: 2.2 [95% CI: 1.4-3.5]); high quick Sequential Organ Failure Assessment score at the time of admission (aOR: 5.6 [95% CI: 2.7-11.4]); and oxygen saturation < 94% at the time of admission (aOR: 2.5 [95% CI: 1.6-3.9]) were associated with mortality due to COVID-19. These results can be used to prioritize patients who are at increased risk of death and to rationalize therapy to reduce mortality due to COVID-19.

COVID-19 mental health challenges: A scoping review.

The COVID-19 pandemic has disordered the lives of millions in an unprecedented way. A state of mental health crisis has emerged across the globe. The lifestyle and well-being of the individual and social integrity have been adversely affected. One-third of US citizens and one in five Indian citizens suffer from depression due to this pandemic. This scoping review aimed to estimate the mental health challenges and their possible solutions in the recent two years (2020-2021). Our search strategy used search engines such as Medline, Google Scholar and PubMed. The search strategy used the MeSH keywords "Mental Health AND Covid-19". The findings emerged in the following key points: anxiety and depression, social isolation and quarantine, and vulnerable or high-risk groups. Out of 216 articles screened, 20 were found eligible to meet the inclusion criteria. Most of the studies focused on psychological anxiety, stress and mental disorder during the pandemic. Psychosocial assessment and monitoring in the context of COVID-19 should include inquiries about stressors related to COVID-19, like exposure to infected sources, infected family members, loss of loved ones, physical distance; secondary adverse events like economic loss, psychosocial effects like depression, anxiety, psychosomatic preoccupations, insomnia, increased substance use, domestic violence; and indicators of vulnerability like pre-existing physical or psychological conditions.

An Assessment of the Profile and Predictors of Outcomes in COVID-19 Patients Hospitalized in a Tertiary Care Institute in Central India

Background Coronavirus disease 2019 (COVID-19) is the largest pandemic that has affected people around the globe. Various researches have been conducted worldwide, but there is a scarcity of data from Central India on the relationship between several risk factors for infection and mortality. Our study assessed the predictors and patient profiles of those with COVID-19, which will aid in prioritizing patient treatment and preventive measures. Methods A retrospective study was done between March and December 2020. The study included 5,552 COVID-19 patients admitted to the All India Institute of Medical Sciences (AIIMS), Raipur. A validated questionnaire form provided by the WHO was used. Data for multiple clinical and nonclinical parameters were collected, and analysis was done using SPSS version 26 (IBM Corp., Armonk, NY, USA) and STATA version 12 (StataCorp LLC, College Station, TX, USA). Mortality and risk assessment of patients was done using multivariate logistic regression. Result In our study cohort of 5,552 COVID-19 patients, the median age was found to be 47 years (interquartile range (IQR): 31-60 years;range: 14-100 years), and 3,557 (64%) were male. Predominantly, patients presented with fever (41.30%), cough (40.20%), and dyspnea (29.29%). The major comorbidities were hypertension (29.70%), diabetes (25.40%), and chronic cardiac disease (5.79%). The common complications were liver dysfunction (26.83%), viral pneumonitis (23.66%), acute renal injury (15.25%), and acute respiratory distress syndrome (ARDS) (13.41%). In multivariate analysis, age (more than 40 years) (odds ratio (OR): 2.63;95% confidence interval (CI): 1.531-4.512;p<0.001), diabetes (OR: 1.61;95% CI: 1.088-2.399;p=0.017), obesity (OR: 6.88;95% CI: 2.188-12.153;p=0.004), leukocytosis (OR: 1.74;95% CI: 1.422-2.422;p<0.001), lymphocytopenia (OR: 2.54, 95% CI: 1.718-3.826;p<0.001), thrombocytopenia (OR: 1.15;95% CI: 1.777-8.700;p=0.001), and ferritin concentration > 1,000 ng/mL (OR: 4.67;95% CI: 1.991-10.975;p<0.001) were the independent predictors of mortality among COVID-19 patients. Conclusion The leading comorbidities in our study were hypertension, followed by diabetes. Patients who were 40 years or older, obese patients, and diabetic patients have a higher mortality risk. The poor prognostic predictors in COVID-19 patients were high ferritin levels (>1,000 ng/mL), leukocytosis, lymphocytopenia, and thrombocytopenia.

"Vaccinate every child against COVID-19": A scientific or socioeconomic need?

The global pandemic of COVID-19 has created havoc worldwide. By the first week of December 2021, 0.26 billion COVID-19 infected cases and 5.2 million deaths have been reported globally.[1] United Nations Children Fund (UNICEF) reports that more than 10,000 children and adolescents have died from COVID-19, with a case fatality rate of 0.3%. Out of 299 vaccine candidates, 28 are available to the general population in less than 1 year.[2] For children, WHO permitted vaccine Pfizer/BioNTech, Sinovac, and Sinopharm, Drug Controller General of India's approved ZyCov-D and Covaxin, and the Cuban government approved Soberna 2, and Soberna plus are available.[3] Italy, Germany, France, Norway, Switzerland, Israel, Dubai, Japan, Canada, and the US have already started vaccinating their children. This step may decrease the transmissibility and mutations of the virus and thus restore normalcy. For India, it is a question of "To be or not to be?" Indian researchers have warned of the long-term impact of the pandemic on the health, development, learning, and behavior of children, thus pushing the agenda of vaccination and opening of schools. All attempts at opening schools have failed in the last 2 years. Vaccinating children is not easy as it has taken nearly 1 year to vaccinate half of the adult Indian population. In these circumstances, rather than "vaccine for all," "vaccine for (chronically) ill" is the only feasible solution for children.

Assessment of the Impact of COVID-19 on Drug Store Management in a Tertiary Care Teaching Hospital of Central India.

INTRODUCTION: One-third of the annual hospital budget is spent on the purchase of medicines, materials, and supplies. Drug store management is a complex but critical process within the healthcare delivery system. Health supply chains, the import of active pharmaceutical ingredients, transportation, procurement, finished products have been disrupted by COVID-19. MATERIALS & METHODS: A retrospective, observational study was carried out at the Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), Raipur. Quantitative data about the pattern of consumption of 20 most commonly used drugs (10 antibiotics, three analgesics, three antipyretics, two anticoagulants, and two steroids), and 20 most frequently used consumables were sourced from existing records of the Central Pharmacy for 24 months between 1st January 2019 to 31st December 2020. RESULTS: A significant rise in the consumption pattern was seen in 25 drugs and consumables out of 40 total selected drugs and consumables. The maximum increase was observed in antibiotics followed by antipyretics, and the least increase was observed in analgesics followed by anticoagulants. Tablet Azithromycin 500 mg was the most frequently used antibiotic during the COVID-19 Period as compared to the Pre-COVID-19 period followed by injection Piperacillin + Tazobactam. The only antibiotic having a decline in consumption and also with the lowest consumption was tablet Metronidazole 400 mg. The highest increase in consumables occurs by 10088% in N95 Masks, followed by 573% in shoe covers, and 153% in face masks (three-layers), respectively. CONCLUSION: This study will enhance education to the pharmaceutical industries, policymakers to the Government, and other hospitals on how to better manage drug stores in future pandemic-like situations. Proper drug store management played a crucial role in medication usage that improved patient outcomes and prevented the misuse of medications. The pattern of changes in the consumption of drugs and consumables in the present study can be utilized by other hospitals in the third wave of the pandemic.

COVID-19 Pandemic and Children: A Review.

The severe respiratory disease COVID-19 (coronavirus disease 2019) was first reported in late December 2019 in Wuhan City, China. Soon thereafter, the World Health Organization (WHO) officially declared it a pandemic. The adult population is highly affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); however, infants and children are also not spared. Transmission in the pediatric population appears to be primarily from COVID-19-positive adults, largely from family contacts through droplets, direct contacts, and aerosols. There is also evidence of fecal-oral route of transmission. The incubation period of COVID-19 in children ranges from 2 to 10 days. Most children are asymptomatic. The most common symptoms amongst symptomatic children are fever and cough. Shortness of breath, sore throat, rhinorrhea, conjunctivitis, fatigue, and headache are other common symptoms. Diarrhea, vomiting, and abdominal pain are the common gastrointestinal symptoms that may be present with or without respiratory symptoms. Very few children are likely to develop severe disease.Supportive care is the mainstay of treatment. Though data are limited, antiviral therapies such as remdesivir, favipiravir, lopinavir/ritonavir, and other drugs like hydroxychloroquine/chloroquine have been used for severe COVID-19 cases, with remdesivir showing the greatest promise. A few children may develop an exaggerated immune response, characterized by exaggerated cytokine release and manifests with features similar to Kawasaki disease. The syndrome has been referred to by many names including pediatric inflammatory multisystem syndrome (PIMS) and more recently, as multisystem inflammatory syndrome in children (MIS-C); this life-threatening condition often requires a multidisciplinary team effort and use of immunomodulators.