Psychological Impact Assessment of Covid-19 on Migrants in Jammu City and Peripheral Area, Jammu and Kashmir, India (preprint)

Introduction: In Indian economy, the internal migrants are the major role player in the informal sector. During Covid-19 pandemic and subsequent lockdown millions of internal migrants were severely affected. Migrants are more prone to social, economic, and psychological issues. It is quite relevant to know the impact of Covid-19 on the psychological health of migrants. The fear of starvation, fear of not being able to meet their family members, fear of getting infected, fear of death, loss of wages were the main psychological problems they faced. This paper focuses on the psychological assessment of impact of Covid-19 on migrants in the Jammu city and its peripheral areas, Union Territory Jammu & Kashmir, India. Methodology: Data is collected by personal interview method with the help of questionnaire. For analyzing the psychological impacts of Covid-19 on migrants, we used Patient Health Questionnaire-2 and Patient Health Questionnaire-9. 100 persons are surveyed during the study. Results: 69 percent respondent reflected that they had fear of death during pandemic period. Most of the respondent said that they were feeling nervous, helpless for not being able to attend the health needs of family even they were not able to concentrate properly and had little interest in doing things.Conclusion: the outcome of the study shows that more than half of the respondents are dealing with the psychological issues, thus along with looking at the physical needs there is need of taking care of mental health is also especially in the time of the pandemic.

Prediction of COVID-19 using chest X-ray images (preprint)

COVID-19, also known as Novel Coronavirus Disease, is a highly contagious disease that first surfaced in China in late 2019. SARS-CoV-2 is a coronavirus that belongs to the vast family of coronaviruses that causes this disease. The sickness originally appeared in Wuhan, China in December 2019 and quickly spread to over 213 nations, becoming a global pandemic. Fever, dry cough, and tiredness are the most typical COVID-19 symptoms. Aches, pains, and difficulty breathing are some of the other symptoms that patients may face. The majority of these symptoms are indicators of respiratory infections and lung abnormalities, which radiologists can identify. Chest x-rays of COVID-19 patients seem similar, with patchy and hazy lungs rather than clear and healthy lungs. On x-rays, however, pneumonia and other chronic lung disorders can resemble COVID-19. Trained radiologists must be able to distinguish between COVID-19 and an illness that is less contagious. Our AI algorithm seeks to give doctors a quantitative estimate of the risk of deterioration. So that patients at high risk of deterioration can be triaged and treated efficiently. The method could be particularly useful in pandemic hotspots when screening upon admission is important for allocating limited resources like hospital beds.

One Year Into the Pandemic: Evolving COVID-19 Outcomes in Lung Transplant Recipients, a Single-center Experience.

In the early months of the coronavirus disease 2019 (COVID-19) pandemic, our center reported a mortality rate of 34% in a cohort of 32 lung transplant recipients with COVID-19 between March and May 2020. Since then, there has been evolving knowledge in prevention and treatments of COVID-19. To evaluate the impact of these changes, we describe the clinical presentation, management, and outcomes of a more recent cohort of lung transplant recipients during the second surge and provide a comparison with our first cohort. Methods: We conducted a retrospective cohort study that included all consecutive lung transplant recipients who tested positive for severe acute respiratory syndrome coronavirus 2 between November 2020 and February 28, 2021. We compared baseline demographics and major outcomes between the first- and second-surge cohorts. Results: We identified 47 lung transplant recipients (median age, 60; 51% female) who tested positive for severe acute respiratory syndrome coronavirus 2 between November 2020 and February 28, 2021. The current cohort had a higher proportion of patients with mild disease (34% versus 16%) and fewer patients with a history of obesity (4% versus 25%). Sixty-six percent (n = 31) required hospitalization and were treated with remdesivir (90%) and dexamethasone (84%). Among those hospitalized, 77% (n = 24) required supplemental oxygen, and 22% (n = 7) required invasive mechanical ventilation. The overall 90-d mortality decreased from 34% to 17% from the first cohort to the second (adjusted odds ratio, 0.26; 95% confidence interval, 0.08-0.85; P = 0.026). Conclusions: Although COVID-19-associated mortality rate in lung transplant recipients at our center has decreased over time, COVID-19 continues to be associated with significant morbidity and mortality.

Analysis of the COVID-19 Testing Parameters and Progression of the Pandemic at the District Level- Findings from the Icmr- Hundred Million Test (HMT) Database During the First Wave in India (preprint)

Background: India has the second highest number of COVID-19 cases. We evaluated the progression of the pandemic across the lockdowns and phased reopening during the first wave in India at the district level.Methods: More than 100 million COVID-19 test results along with other parameters available in the Indian Council of Medical Research (ICMR) database during March-October, 2020, was used for the analysis. District was chosen as the unit of analysis, as it is the smallest unit of administration in India. The districts were stratified as high, moderate, and low case load districts, and data analysis was done for each phase of lockdown.Findings: Of the 110.5 million tests included in the analysis, 54.79 million tests were performed using molecular methods, 53.58 million by rapid antigen tests (RATs) and 2.13 million by the indigenous TruNat platform. Only 7.95 million (7.16%) tests were among symptomatic individuals. The positivity proportion among symptomatic individuals (22.6%) was significantly higher than asymptomatic individuals (8.6%). The tests conducted, and positivity proportions were significantly higher in high caseload districts and 58% of these tests were by molecular methods as opposed to only one-third in low case load districts. The proportion of ‘symptomatic contacts’ being tested increased significantly around the peak.Interpretation: Laboratory parameters, along with other demographic information, can help us better understand the spread of the pandemic in a country. Such information can be crucial to formulate and implement public health policies in any future waves of the pandemic.Funding: Indian Council of Medical Research (ICMR)Declaration of Interest: We declare no competing interestsEthical Approval: Approval from the ICMR Central Ethics Committee on Human Research (Ref. No.NCDIR/BEU/ICMR-CECHR/75/2020) was obtained for this study and no patient identifierswere accessed during analysis or reporting.

COVID-19 ARDS: A Multispecialty Assessment of Challenges in Care, Review of Research, and Recommendations.

Physicians and care providers are familiar with the management of ARDS, however, when it occurs as a sequalae of COVID-19, it has different features and there remains uncertainty on the consensus of management. To answer this question on how it compares and contrasts with ARDS from other causes, the authors reviewed the published literature and management guidelines as well as their own clinical experience while managing patients with COVID-19 ARDS. For research, a PubMed search was conducted on 01.04.2021 using the systematic review filter to identify articles that were published using MeSH terms COVID-19 and ARDS. Systematic reviews or meta-analyses were selected from a systematic search for literature containing diagnostic, prognostic and management strategies in MEDLINE/PubMed. Those were compared and reviewed to the existing practices by the various treating specialists and recommendations were made. Specifically, the COVID-19 ARDS, its risk factors and pathophysiology, lab diagnosis, radiological findings, rational of recommendation of drugs proposed so far, oxygenation and ventilation strategies and the psychological ramifications of the disease were. discussed. Because of the high mortality in mechanically ventilated patients, the above recommendations and findings direct the potential for improvement in the management of patients with COVID-19 ARDS.

A Snapshot of Poverty, Diseases and war - the Democratic Republic of the Congo.

DRC's fight with the EVD (Ebola Virus Disease) was just settling when WHO declared COVID-19 to be a Public Health Emergency of International Concern (PHEIC) on March 12, 2020. DRC's economic growth decelerated from its pre-COVID level of 4.4% in 2019 to an estimated 0.8% in 2020. This has caused concomitant setbacks in the treatment and control of major health issues like HIV, tuberculosis, measles, rift valley fever and malaria in the country. This, coupled with civil unrest, other infectious diseases and risk to the safety of the health workers is a recipe for a 'perfect storm' waiting to unfold.

Association Between Ambient Air Pollutants and Meteorological Factors With SARS-CoV-2 Transmission and Mortality in India: an Exploratory Study (preprint)

Background: The Coronavirus disease 2019 (COVID-19) pandemic poses a serious public health concern worldwide. Certain regions of the globe were severely affected in terms of prevalence and mortality than other. Although the cause for this pattern is not clearly understood, lessons learned from previous epidemics and emerging evidences suggest the major role of ecological factors like ambient air pollutants (AAP) and meteorological parameters in increased COVID-19 incidence. The present study aimed to understand the impact of these factors on SARS-CoV-2 transmission and their associated mortality in major cities of India.Methods: This study used secondary AAP, meteorological and COVID-19 data from official websites for the period January-November 2020, which were divided into Pre-lockdown (January-March 2020), Phase I (April to June 2020) and Phase II (July to November 2020). After comprehensive screening, five major cities that includes 48 CPCB monitoring stations collecting daily data of ambient temperature, particulate matter PM2.5 and 10 were analysed. Spearman and Kendall’s rank correlation test was performed to understand the association between SARS-CoV-2 transmission and AAP and, meteorological variables. Similarly, case fatality rate (CFR) was determined to compute the correlation between AAP and COVID-19 related morality.Results: The level of air pollutants in major cities were significantly reduced during Phase I compared to Pre-lock down and increased upon Phase II in all the cities. During the Phase II in Delhi, the strong significant positive correlation was observed between the AAP and SARS-CoV-2 transmission. However, in Bengaluru, Hyderabad, Kolkata and Mumbai AAP levels were moderate and no correlation was noticed. The relation between AT and SARS-CoV-2 transmission was inconclusive as both positive and negative correlation observed. In addition, Delhi and Kolkata showed a positive association between long-term exposure to the AAP and COVID-19 CFR.  Conclusion: Our findings support the hypothesis that the particulate matter upon exceeding the satisfactory level serves as an important cofactor in increasing the risk of SARS-CoV-2 transmission and related mortality. These findings would help public health experts to understand the SARS-CoV-2 transmission against ecological variables in India and provides supporting evidence to healthcare policymakers and government agencies for formulating strategies to combat the COVID-19.

COVID-19: Pan(info)demic.

The world has experienced pandemics worse than the coronavirus disease 2019 (COVID-19). However, the global effect of this pandemic has been overwhelming. Billions of people are in lockdown and also have easy access to information owing to easy and cheap internet connectivity and electronic media. However, information overload during the current COVID-19 pandemic has posed a set of challenges that were not encountered before. There is an 'infodemic' in which false news, conspiracy theories, magical cures, and racist news are being shared at an alarming rate, with the potential to increase anxiety and stress and even lead to loss of life. This review highlights some of these challenges and suggests general measures to avoid information overload and infodemic in the connected world of 21st century.

Ebola, COVID-19 and Africa: What we expected and what we got.

Democratic Republic of the Congo's fight with Ebola was just settling when WHO declared COVID-19 to be a global pandemic on March 12, 2020. This has caused concomitant setbacks in the treatment and control of major health issues like HIV, tuberculosis, measles, and malaria in the country. This, coupled with civil unrest and risk to the safety of the health workers, is a 'perfect storm' waiting to unfold. Military contingents as peacekeepers are having the most difficult time, handling the situation, in the wake of risks involved.