ABSTRACT
This study investigates whether tourism sector recovery from the COVID-19 pandemic is influenced by only the size of the economic stimulus packages or whether a country's resilience plays a moderating influence in the underlying relationship. The results show that while economic stimulus packages help to enhance tourism recovery from the COVID-19 pandemic, it is contingent on the level of a country's resilience. For instance, amongst the less resilient countries, the impact of economic policy response on the tourism recovery is more pronounced, but the effect dissipates as countries become more resilient. These findings have important implications for policymakers, management teams, and relevant stakeholders in their effort to revive the tourism sector from the impact of the COVID-19 pandemic.
ABSTRACT
Recent emergence of SARS-Cov-2 has resulted in unprecedented spread of COVID-19 exhibiting wide variability in individuals’ symptoms. Despite rapid progress in characterizing the role of host genetics in SARS-Cov-2 infection, there is limited understanding of the role of host genetic variation and the molecular mechanisms including the knowledge of genes and pathways that contribute to COVID-19. Previous research to understand the mechanisms underlying severe COVID-19 outcomes have focused on lung- and brain-related pathologies. Here, we integrated a genome-wide association study of COVID-19 hospitalization (7,885 cases and 961,804 controls from COVID-19 Host Genetics Initiative) with mRNA expression, splicing, and protein levels (n = 18,502). We identified 27 genes related to inflammation and coagulation pathways whose genetically predicted expression was associated with COVID-19 hospitalization. These genes converge on cytokine-cytokine and the JAK-STAT signaling pathways. We functionally characterized the 27 genes using phenome- and laboratory-wide association scans in Vanderbilt Biobank (BioVU;n = 85,460) and identified coagulation-related clinical symptoms, immunologic, and blood-cell-related biomarkers. We replicated these findings in the African-American cohort here in BioVU and found concordant results. This study highlights putative causal genes impacting COVID-19 severity and symptomology through the host inflammatory response.
ABSTRACT
Real-world reports on outcomes of SARS-CoV-2 infection using higher oxygenation targets along with steroid therapy are lacking. We conducted a retrospective study of patients requiring oxygen support following targets of oxygenation >95% along with steroid therapy and were divided into 3 groups. Group 1 with oxygenation through a nasal cannula or Hudson mask, Group 2 oxygenation with venturi system, and Group 3 with high flow nasal oxygen, 35-50 litres;non-invasive ventilation;mechanical ventilation. One hundred and eighteen patients (Group 1 74 patients, Group 2 . 15 patients, and Group 3 29 patients) were studied. The mean age was 55.7 years and most were male (n=77). One hundred and fourteen received dexamethasone or methylprednisolone. Most (88.3%) had at least one pre-existing chronic medical illness. Overall mortality was 22.8% (n=27). Group 3 had the highest mortality (75.9%) followed by Group 2 (26.7%) and Group 1 (1.35%). Our observation raises the query if a higher target of oxygenation for non-mechanical ventilated patients coupled with steroid therapy is beneficial.
ABSTRACT
Objectives: This study aimed to assess the outcome and mortality predictors of SARS-CoV-2 infection requiring hospitalization among elderly population. Methods: In this retrospective study, hospitalized elderly people with virologically confirmed SARS-CoV-2 infection were evaluated. Participants were divided into three groups of mild, moderate, and severe based on oxygenation. The primary outcome was death or discharge to home. Results: A total of 169 patients were studied (mean age: 68 years). Apart from respiratory symptoms, other reported symptoms included gastrointestinal complaints in 11% (n = 19), acute stroke in 1.1% (n = 2), delirium in 1.7% (n = 3), and anosmia or ageusia in 8.88% (n = 15). Also, 65 (38.5%) patients required oxygen support, 25 (14.7%) were admitted to the intensive care unit (ICU), 7 (4.1%) required non-invasive ventilation (Fio2 0.6 to 1.0), 14 (8.28%) were mechanically ventilated. 72 (42%) received steroid, and 100 (59%) received prophylactic heparin. Overall mortality was 12.4% (n = 21). Gender had no effect on mortality (P = 0.83). Presence of >= 3 risk factors, elevated neutrophil lymphocyte ratio, D-dimer, and lactate dehydrogenase, were associated with mortality (P = 0.001, P = 0.0005, P = 0.05, and P = 0.0005, respectively). Sepsis and cardiovascular events were higher among those who died. Conclusions: We observed a low mortality among the elderly treated with steroids compared to studies done in the pre-steroid period. Elevated NLR, LDH, and D-dimer were associated with mortality.
ABSTRACT
Aims & Objectives: AIM: To assess the utility of dynamic D-dimer as a prognostic marker in hospitalized patients with Covid-19. OBJECTIVE: (1) To correlate the initial D-dimer value with hospital stay and outcome of the patient. (2) To correlate the peak D-dimer value with hospital stay and outcome of the patient. (3) To correlate the initial D-dimer value with CT-chest score of the patient. Patients/Materials & Methods: MATERIAL & METHODS: (1) The serial D-dimer values of patients admitted with RT-PCR positive for Covid-19 were retrieved. (2) The age, sex and number of days of hospital stay and the outcome of the patient were observed from hospital information system. (3) The age and sex of the patient were collected from hospital database. (4) Spearman's correlation and Mann-Whitney U test were done with R base version 3.4.2 for MAC (R Core T 2017) a p value of<0.5 is considered significant . Results: (1) Total no of patients :121. (2) The age of the patients ranged from 7 to 80 Years. (3) Mean ± SD age is: 56.5 ± 17.7 years. (4) Sex: Male 89(73.6%) Female 32 (26.4). (5) Male : female ratio -2.8:1. (6) The patients stayed in the hospital for a minimum of 1 day to 1 month. (7) The outcome of patients were good. (8) There was no correlation between the initial D-dimer value and duration of hospital stay inspite of elevated initial D dimer was noticed in patients who stayed long (Spearman's rho = 0.13). (9) Also the peak D-dimer value was also not significant with duration of hospital stay. (10) (Spearman's rho = 0.28). (11) T D dimer value couldn't be correlated with adverse outcome since the numbers were less. (12) There was no correlation between initial D-dimer value and CT chest score (CORADS Score). (13) Spearman's rho = 0.21. Discussion & Conclusion: Males are more commonly affected than females. Though statistically insignificant, the elevated initial D dimer value is associated with prolonged hospital stay in patients with Covid 19 infection.