ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been reported to cause significant injury to the central nervous system (CNS). Herein, we describe the case of a 48-year-old male with a past medical history of attention-deficit/hyperactivity disorder (ADHD), hypertension, and hyperlipidemia who developed typical symptomatology of normal pressure hydrocephalus (NPH) with cognitive impairment, gait dysfunction, and urinary incontinence after a mild coronavirus disease (COVID-19) infection. The diagnosis was confirmed by imaging and lumbar puncture (LP). The patient was treated with a ventriculoperitoneal (VP) shunt placed by neurosurgery and had a complete recovery. Despite increasing reports of neurological manifestations of COVID-19 infection, the mechanism of such pathology is still not well understood. Hypotheses include viral invasion of the CNS either through the nasopharynx and olfactory epithelium or directly through the blood brain barrier.
ABSTRACT
Objective: To measure incidence, disease severity and outcome of COVID-19 Vaccine Breakthrough Infections among Health Care Workers (HCWs) and Support Staff completely vaccinated with Sinopharm Vaccine. Study Design: Prospective cohort study. Place and Duration of Study: All Military Health facilities of Pakistan reporting COVID-19 cases post vaccination, from Jul to Sep 2021. Methodology: Established Surveillance Mechanism for getting post vaccination COVID-19 cases from various health care settings of Pakistan Army enabled the collection of data on prescribed data forms. Among HCWs and support staff vaccinated with both doses or single dose regimen of COVID-19 vaccine;those who developed COVID-19 infection ≥14 days post 2nd dose were included in the study. Total 327 participants from 1st Jul till 30th September 2021 fulfilled the criteria and data pertaining to them was further analyzed. Results: Mean age of the participants was 32.38 ± 9.18 years. Males were 73.4% and 26.6% were females. Median duration from 2nd dose to development of vaccine breakthrough infection was 133 days (Inter Quartile Range: 55 days). Asymptomatic/mild infections were reported among 97.9% and only 1.5% had moderate disease. However, 0.6% reported severe/critical disease and required ventilator support. Most 79.2% breakthrough infections ocuured almost more than 3 months completion of vaccination and only 20.8% developed it before three months. Among all, 99.4% recovered completely while 0.4% couldn't survive the complications associated with COVID-19. There was no significant statistical association of job category with disease severity (p>0.05) Conclusion: Vaccines still remain a powerful tool in war against COVID-19. No vaccine has yet to be found 100% effective against all variants of concern (V°Cs) however less severe disease and mortality was observed after vaccination. Waning immunity after three months needs administration of booster dose of vaccine to HCWs and support staff working in a highly exposed environment of health facilities.
ABSTRACT
Objective: To see the implementation of designed strategy for uninterrupted supply of HIV treatment at time of COVID-19 Pandemic along with the knowledge and preventive practices regarding COVID-19 among HIV positive patients to have baseline data for future interventions to control HIV-COVID-19 syndemic. Study Design: Cross sectional study. Place and Duration of Study: HIV Center at Benazir Bhutto Shaheed Hospital, Karachi Pakistan, from Mar to May 2020. Methodology: 100 patients who visited the center for medicines were interviewed. Participants were inquired about the availability of Antiretroviral Therapy (ART) during lockdown, discontinuity in treatment suffered during this pandemic, their preventive behaviour against COVID-19, most adopted prevention and source of information for this behavior. Results: Among all the participants 72% have achieved viral suppression. As far as multi month dispensing was concerned 10% received ART for one month, 64% for 2 months and 18% for 3 months as per the strategy devised by Pakistan AIDS control in collaboration with UNAIDS. Out of 11% developed symptoms but later on tested negative on PCR test. Most commonly adopted personal protection adopted was face mask among 68% participants followed by hand washing and social distancing. All the participants were of the opinion that they received sufficient information regarding COVID-19, its prevention and mode of spread. The source of information was TV 60%, HIV center 30% and both TV and HIV center 10%. Conclusion: It was found that all the patients got uninterrupted supply of anti-retroviral medicines. Despite sufficient knowledge regarding disease they couldn't comply with prevention fully because of their occupational requirements.