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BACKGROUND: Coronavirus disease 2019 (COVID-19) patients with malignancy are published worldwide but are lacking in data from India. AIM: To characterize COVID-19 related mortality outcomes within 30 d of diagnosis with HRCT score and RT-PCR Ct value-based viral load in various solid malignancies. METHODS: Patients included in this study were with an active or previous malignancy and with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection from the institute database. We collected data on demographic details, baseline clinical conditions, medications, cancer diagnosis, treatment and the COVID-19 disease course. The primary endpoint was the association between the mortality outcome and the potential prognostic variables, specially, HRCT score, RT-PCR Ct value-based viral load, etc. using logistic regression analyses treatment received in 30 d. RESULTS: Out of 131 patients, 123 met inclusion criteria for our analysis. The median age was 57 years (interquartile range = 19-82) while 7 (5.7%) were aged 75 years or older. The most prevalent malignancies were of GUT origin 49 (39.8%), hepatopancreatobiliary (HPB) 40 (32.5%). 109 (88.6%) patients were on active anticancer treatment, 115 (93.5%) had active (measurable) cancer. At analysis on May 20, 2021, 26 (21.1%) patients had died. In logistic regression analysis, independent factors associated with an increased 30-d mortality were in patients with the symptomatic presentation. Chemotherapy in the last 4 wk, number of comorbidities (≥ 2 vs none: 3.43, 1.08-8.56). The univariate analysis showed that the risk of death was significantly associated with the HRCT score: for moderate (8-15) [odds ratio (OR): 3.44; 95% confidence interval (CI): 1.3-9.12; P = 0.0132], severe (> 15) (OR: 7.44; 95%CI: 1.58-35.1; P = 0.0112). CONCLUSION: To the best of our knowledge, this is the first study from India reporting the association of HRCT score and RT-PCR Ct value-based 30-d mortality outcomes in SARS-CoV-2 infected cancer patients.
ABSTRACT
Background: The contamination of patients' surroundings by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains understudied. Discordant findings of SARS-CoV-2 RNA in environmental samples were noted in many reports. Aims and Objectives: The study assessed the extent and persistence of environmental surface contamination in real-world surfaces around COVID-19 patients. Materials and Methods: We sampled the surroundings of two intensive care unit (ICU) and one ward that were occupied by laboratory-confirmed coronavirus disease 2019 (COVID-19) patients. Frequently touched environmental surfaces near patients were swabbed before and after daily environmental disinfection. Results: Of 355 environmental samples, 6 (1.69%) were positive by real-time reverse-transcription polymerase chain reaction assay. Among those, 5 of 75 ICU samples (6.67%) and 1 of 75 ward environmental samples (1.33%) in the pre-fumigation areas occupied by COVID-19 positive patients were positive. No samples obtained within the first 2 h of fumigation and surface disinfection was found to be positive. Conclusion: Surrounding environment of symptomatic COVID-19 patients can get contaminated and in cases of asymptomatic COVID-19 patients, contamination of their surroundings was an uncommon phenomenon. Strict contact barrier precaution, routine cleaning with disinfectants are mandatory hospital infection control practices in the management of patients infected with SARS-CoV-2. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background: Increased body mass index (BMI) is a known risk factor for respiratory infection and is being recognized as a predisposing factor in the COVID‐19 pandemic caused by the severe acute respiratory syndrome coronavirus‐2. Aims and Objectives: This study aimed to assess the impact of BMI on critically ill COVID-19 patients. Secondary outcomes include development of respiratory failure, shock, acute cardiac injury, acute kidney injury, acute liver injury, secondary infection and sepsis. Materials and Methods: This retrospective study of 6 months included the laboratory-confirmed COVID-19 patients admitted to an ICU of a tertiary care academic health-care organization. The medical records were reviewed at least 14 days after admission. Results: A total of 484 patients were included, and BMI data were available for 306 patients. About 40.19% had a normal weight, 26.79% were overweight, 17.97% had BMI 30–34.9 Kg/m², and 15.03% had BMI ≥35 Kg/m². Overall, 58 patients (18.95%) died within 14 days of ICU admission, 50.98% were discharged alive or referred from the hospital within 14 days, and 30.06% remained hospitalized at 14 days. After controlling for all covariates, there was a significantly increased risk of mortality in the patients with obesity Class I (RR 2.03, 95% CI 1.07–3.85, P=0.030) and patients with obesity Classes II and III (RR 2.83, 95% CI 1.54–5.22, P<0.001) compared with those with normal BMI. Conclusion: Obesity was associated with an unfavorable outcome among patients with COVID-19. Patients with obesity should be more closely monitored when hospitalized for COVID-19 as there is increasing evidence of relation of severity of COVID-19 and obesity which appears to be a factor in the health risks. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
SARS-CoV-2 testing data in North Carolina during the first three months of the state's COVID-19 pandemic were analyzed to determine if there were disparities among intersecting axes of identity including race, Latinx ethnicity, age, urban-rural residence, and residence in a medically underserved area. Demographic and residential data were used to reconstruct patterns of testing metrics (including tests per capita, positive tests per capita, and test positivity rate which is an indicator of sufficient testing) across race-ethnicity groups and urban-rural populations separately. Across the entire sample, 13.1% (38,750 of 295,642) of tests were positive. Within racial-ethnic groups, 11.5% of all tests were positive among non-Latinx (NL) Whites, 22.0% for NL Blacks, and 66.5% for people of Latinx ethnicity. The test positivity rate was higher among people living in rural areas across all racial-ethnic groups. These results suggest that in the first three months of the COVID-19 pandemic, access to COVID-19 testing in North Carolina was not evenly distributed across racial-ethnic groups, especially in Latinx, NL Black and other historically marginalized populations, and further disparities existed within these groups by gender, age, urban-rural status, and residence in a medically underserved area.