COVID-Inflicted Coagulopathy: Expert Consensus on Management with Novel Oral Anticoagulants in India

Coronavirus disease 2019 (COVID-19) is a highly hypercoagulable viral infection complicated as COVID-inflicted coagulopathy (CIC), that is associated with increased risk of morbidity and mortality. International guidelines recommend low molecular weight heparin (LMWH) to treat CIC in both in-hospital and in-home settings. However, in India, using subcutaneous LMWH may not be a feasible option for a vast majority of patients under home management. Additionally, while some evidence advocates the use of novel oral anticoagulants (NOACs), in hospitalized settings, most guidelines find no role of NOACs in hospital settings. On the other hand, the resource crunch faced in recent COVID-19 pandemic in India forced physicians to treat many patients in home settings. These patients had been usually prescribed NOACs for ease of administration and adherence. Therefore, there is a need to form a consensus on the use of NOACs to manage CIC in India. © 2021 Journal of Association of Physicians of India. All rights reserved.

Remote monitoring of indoor/outdoor movement in epidemiological situations utilising UWB transceivers

A global pandemic has reduced mobility, impacting the healthcare assessment, and diagnostics on co-morbid patients. Various challenges for location finding and indoor signalling issues give rise to the necessity for compact and low-cost ultra-wideband sensor technology. Lockdown has played a vital role during crisis in engaging with specific conditions like position estimation in areas under LOS and NLOS caused by diffraction and reflection of UWB signals across obstacles. UWB-based localisation system with edge/fog computing is used to analyse the indoor/outdoor usage of quarantined patients reducing the transmission, which becomes a threat for society and healthcare personals. The mathematical models to symbolise various patterns utilising UWB sensors with anchors and tags were used to determine the flow of all rapid and random movements within the specified clustered locations. The proposed system achieves high classification accuracy with SVM to classify the patterns and assist frontline medical workers in containing pandemics through human interaction. Copyright © 2021 Inderscience Enterprises Ltd.

Effectiveness of contact tracing using KNN for COVID-19

COVID-19 virus started to outbreak in China in the year January 2020. Contact tracing is an open-minded measure of control that applies to an extensive range of transmissible diseases. It is being used to fight infections like SARS, tuberculosis, smallpox, and many sexually transmitted diseases (STDs). From the moment of the lockdown, there have been a great many talks of applications helping to combat the coronavirus. Technical developers bring a solution to this problem by providing tools that help to contain the coronavirus. This kind of application is helpful, but it lacks in accuracy and privacy concerns. COVID-19 virus, irrespective of causes, solution, treatments, clinical signs, and symptoms is discussed in this paper. The main aim of this paper proposes a contact tracing using k-nearest neighbour, which shows the correct prediction of an affected person of COVID-19 based on the distance and also reduces the transmission of disease. It was tested on the WHO dataset obtained the prediction accuracy of which was carried out on clinical and quarantine data. The evaluation result shows that the contact tracing technique's accuracy has been improved using the proposed algorithm. © 2021 River Publishers

Acute decompensated heart failure (ADHF) during COVID-19 pandemic-insights from South India.

AIM: This retrospective study compares admissions and outcomes due to acute decompensated heart failure (ADHF) during the COVID-19 pandemic from 25 March to 25 July 2020 with the historical patient control who were admitted during the same period in 2019. METHODS AND RESULTS: Data of the participating hospitals was collected and analysed from the ICC NHFR (Indian College of Cardiology National Heart Failure Registry) for 2019 and 2020. Total number of ADHF admissions, demographics, aetiology, co-morbid conditions and in-hospital mortality was compared and analysed. A significant decrease in the number of hospital admissions due to ADHF from 2019 to 2020 (1056 vs. 526 respectively) was noted. Incidence of admissions with <40% ejection fraction (EF) reduced in 2020 (72.4% and 80.2% in2020 and 2019)and >40% (EF) increased (27.6% and 19.8% in 2019 and 2020 respectively, p = 0.0005). Ischemic heart disease (IHD) was the most common aetiology (78.59% in 2019 and 80.98% in 2020, p = 0.268). The in-hospital mortality was numerically higher in 2020 (10%) than in 2019 (8%), but not statistically significant (p = 0.161). CONCLUSION: This study from the registry shows that the incidence of ADHF admissions during COVID-19 lockdown significantly reduced compared to the previous year. Demographic patterns remained similar but patients presenting with de-novo HF increased; IHD was the most common cause. The in-hospital mortality was numerically higher during the lockdown. The impact of lockdown perhaps led to fewer hospitalisations and this is to be factored in future strategies to address health care delivery during such crises.

Cardiological society of India document on safety measure during echo evaluation of cardiovascular disease in the time of COVID-19.

An echocardiographic investigation is one of the key modalities of diagnosis in cardiology. There has been a rising presence of cardiological comorbidities in patients positive for COVID-19. Hence, it is becoming extremely essential to look into the correct safety precautions, healthcare professionals must take while conducting an echo investigation. The decision matrix formulated for conducting an echocardiographic evaluation is based on presence or absence of cardiological comorbidity vis-à-vis positive, suspected or negative for COVID-19. The safety measures have been constructed keeping in mind the current safety precautions by WHO, CDC and MoHFW, India.

Cardiological Society of India: Document on acute MI care during COVID-19.

The unprecedented and rapidly spreading Coronavirus Disease-19 (COVID-19) pandemic has challenged public health care systems globally. Based on worldwide experience, India has initiated a nationwide lockdown to prevent the exponential surge of cases. During COVID-19, management of cardiovascular emergencies like acute Myocardial Infarction (MI) may be compromised. Cardiological Society of India (CSI) has ventured in this moment of crisis to evolve a consensus document for care of acute MI. However, this care should be individualized, based on local expertise and governmental advisories.