ABSTRACT
Objective: To determine the seroprevalence of SARS-CoV2 antibodies in patients and healthy individuals presenting to a tertiary care hospital in Lahore. Study Design: Cross-sectional study Place and Duration of Study: Pathology Department of Surayya Azeem Hospital, Lahore Pakistan, from May to Jul 2020. Methodology: The study included clinically suspected patients of COVID-19 referred by clinicians and healthy individuals presenting to the hospital for the SARS-CoV-2 antibody test, irrespective of age and gender. Results: The SARS-CoV-2 antibody positivity was 704(59.4%) in our study. Out of 1184 individuals tested, 690 patients had a positive clinical history of COVID-19 infection, and 517(74.9%) were positive for COVID-19 antibodies. Out of 494 asymptomatic healthy individuals, positivity for COVID-19 antibodies was 187(37.8%). It was observed that positivity was significantly higher 169(44.0%) in contacts of COVID-19 infection patients compared to asymptomatic healthy individuals 18(16.3%). Conclusion: Our study shows that the seroprevalence of SARS-CoV-2 antibodies in the general public in Pakistan has greatly increased. © 2023, Army Medical College. All rights reserved.
ABSTRACT
Background: The efficacy and safety of awake prone positioning (APP) in hypoxemic patients with coronavirus disease 2019 (COVID-19) is unclear. Aim(s): To evaluate the efficacy and safety of APP in non-intubated adults with COVID-19. Method(s): We performed a pragmatic, international, randomized trial at 21 centers in Canada, Saudi Arabia, Kuwait, and the United States between May 19, 2020, and May 18, 2021. Eligible patients were hospitalized adults with COVID-19 requiring >40% oxygen. Patients were randomized to APP (n=205) or usual care (n=195). The primary outcome was intubation by day 30. Secondary outcomes included mortality at 60 days, ventilation-free days at 30 days, intensive care unit (ICU) and hospital-free days at 60 days, adverse events, and serious adverse events. Result(s): Patients in the APP group proned for a median of 4.8 hours per day (IQR 1.8 to 8.0) in the first 4 days. By day 30, 70/205 patients (34.1%) in the APP group and 79/195 (40.5%) in the control group were intubated (hazard ratio [HR] 0.81;95% confidence interval [CI] 0.59 to 1.12). APP did not reduce mortality at 60 days (HR 0.93;95% CI 0.62 to 1.40) and had no effect on days alive invasively or noninvasively ventilated at 30 days, or days out of ICU or hospital at 60 days. There were no serious adverse events in either group. A prespecified subgroup analysis suggested that APP reduced intubation among patients with SpO2:FiO2 >150 (HR of 0.44, 95% CI 0.23 to 0.87) but not among patients with SpO2:FiO2 <150 (HR 1.02;95% CI 0.70 to 1.48;P-interaction= 0.03). Conclusion(s): APP did not significantly reduce intubation at 30 days or mortality at 60 days overall, but may be effective in patients with SpO2:FiO2 >150.