Safety and Efficacy of Siddha management as adjuvant care for COVID-19 patients admitted in a tertiary care hospital - An open-label, proof-of-concept Randomized Controlled Trial

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Integrating Third-Party Apps With Electronic Health Records to Support COVID-19 Response

Am J Manag Care. 2023;29(1):e8-e12. https://doi.org/10.37765/ajmc.2023.89308 _____ Takeaway Points The findings from this study provide early insights into how health information technology policies may be advancing the role that third-party apps played in supporting efforts to respond to the COVID-19 pandemic. * In May 2020, the federal government finalized a policy that sought to make integration of third-party apps with electronic health records (EHRs) easier by requiring EHR developers to adopt secure, standards-based application programming interfaces. * We observed a rapid increase in telehealth- and COVID-19–related apps integrating with EHRs following the onset of the pandemic. * These apps provided health care providers with an influx of new tools that could be used to diagnose, treat, and communicate with patients. _____ On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic.1 Following this declaration, countries rapidly sought supplies and resources to test for infected individuals, protect health care workers treating patients, and begin development of pharmaceuticals to treat and prevent the spread of COVID-19.2 In response, software and health information technology (IT) developers also began to rapidly create and deploy digital tools that could be used to help treat patients and assist in the fight against COVID-19. Telehealth was identified as a method of health care delivery that could reduce disease transmission, preserve personal protective equipment, and minimize the impact of patient surges on health care facilities.3,4 Other digital technologies, such as mobile phones, remote monitoring devices, and web-based apps, were also used to support epidemiologic surveillance, contact tracing, and evaluation of public health interventions.5 This paper highlights the rapid integration of telehealth- and COVID-19–related software applications with electronic health records (EHRs) during the pandemic from January 2020 to June 2021. The integration of third-party apps using APIs has the potential to expand the range of tools health care providers can use to diagnose, treat, and communicate with patients beyond the functionalities that their EHR developer may support.6 Other research has shown that the number of apps that integrate with EHRs is growing7;however, little is known about the role of EHR-integrated apps in supporting COVID-19 response efforts. Allscripts,8 Athenahealth,9 Cerner Corporation,10 and Epic Systems Corporation,11 in addition to Boston Children's Hospital's SMART (or Substitutable Medical Apps and Reusable Technologies).12 For this analysis, we consider any app discovered in these galleries as an EHR-integrated app.

Integrating third-party apps with electronic health records to support COVID-19 response.

OBJECTIVES: To (1) track the integration of telehealth- and COVID-19-related apps with electronic health records (EHRs) over time, (2) identify the primary functionality of apps designed to support the COVID-19 response, and (3) examine whether apps available prior to the pandemic added new telehealth- or COVID-19-related functionalities during the pandemic. STUDY DESIGN: Data were collected from public EHR app galleries on a monthly basis from December 31, 2019, through June 1, 2021. METHODS: Apps were identified as relating to COVID-19 or telehealth using text analysis of the app marketing materials. Descriptive analyses were conducted to characterize telehealth- and COVID-19-related apps discovered through the app galleries, identify their primary functionality, and examine whether any apps added new telehealth- or COVID-19-related functionalities during the pandemic. RESULTS: The number of COVID-19-related apps increased from 0 in March 2020 to 19 a month later and continued to grow to 62 as of June 2021. The number of telehealth-related apps more than doubled from prepandemic levels (n = 41) to a total of 87 apps by June 2021. These apps were 2 times more likely to contain specialized capabilities used to support COVID-19 response efforts, such as secure messaging, vaccine administration, and laboratory testing, compared with all apps listed in the EHR app galleries. CONCLUSIONS: These findings demonstrate the potential of integrating third-party apps into EHRs to expand the range of tools that health care providers can use to diagnose, treat, and communicate with patients.

The Impact of the COVID-19 Pandemic on Drug Use Behaviors, Fentanyl Exposure, and Harm Reduction Service Support among People Who Use Drugs in Rural Settings.

BACKGROUND: The COVID-19 pandemic has worsened the opioid overdose crisis in the US. Rural communities have been disproportionately affected by opioid use and people who use drugs in these settings may be acutely vulnerable to pandemic-related disruptions due to high rates of poverty, social isolation, and pervasive resource limitations. METHODS: We performed a mixed-methods study to assess the impact of the pandemic in a convenience sample of people who use drugs in rural Illinois. We conducted 50 surveys capturing demographics, drug availability, drug use, sharing practices, and mental health symptoms. In total, 19 qualitative interviews were performed to further explore COVID-19 knowledge, impact on personal and community life, drug acquisition and use, overdose, and protective substance use adaptations. RESULTS: Drug use increased during the pandemic, including the use of fentanyl products such as gel encapsulated "beans" and "buttons". Disruptions in supply, including the decreased availability of heroin, increased methamphetamine costs and a concomitant rise in local methamphetamine production, and possible fentanyl contamination of methamphetamine was reported. Participants reported increased drug use alone, experience and/or witness of overdose, depression, anxiety, and loneliness. Consistent access to harm reduction services, including naloxone and fentanyl test strips, was highlighted as a source of hope and community resiliency. CONCLUSIONS: The COVID-19 pandemic period was characterized by changing drug availability, increased overdose risk, and other drug-related harms faced by people who use drugs in rural areas. Our findings emphasize the importance of ensuring access to harm reduction services, including overdose prevention and drug checking for this vulnerable population.

Manufacturing of convalescent plasma of COVID-19 patients: Aspects of quality.

The ongoing coronavirus disease 2019 (COVID-19) pandemic emerged in December 2019. Convalescent plasma represents a promising COVID-19 treatment. Here, we report on the manufacturing of a plasma-based product containing antibodies specific to SARS-CoV-2 obtained from recently recovered COVID-19 patients. Convalescent plasma donors were screened as follows: 1) previously confirmed SARS-CoV-2 infection (by real-time PCR (RT-PCR)); 2) a subsequent negative PCR test followed by a 2-week waiting period; 3) an additional negative PCR test prior to plasmapheresis; and 4) confirmation of the presence of SARS-CoV-2 specific antibodies. Convalescent plasma was stored fresh (2-6°C) for up to 5 days or frozen (-30°C) for long-term storage. Donor peripheral blood and final plasma product were assayed for binding antibodies targeting the SARS-CoV-2 S-protein receptor-binding domain (RBD) and their titers measured by an enzyme-linked immunosorbent assay (ELISA). We performed 72 plasmaphereses resulting in 248 final products. Convalescent plasma contained an RBD-specific antibody titer (IgG) ranging from 1:100 to 1:3200 (median 1:800). The titer was congruent to the titer of the blood (n = 34) before collection (1:100-1:6400, median 1:800). Levels of IL-8 and LBP of donors were slightly increased. Therapeutic products derived from a human origin must undergo rigorous testing to ensure uniform quality and patient safety. Whilst previous publications recommended RBD-specific binding antibody titers of ≥ 1:320, we selected a minimum titer of 1:800 in order to maximize antibody delivery. Production of highly standardized convalescent plasma was safe, feasible and was readily implemented in the treatment of severely ill COVID-19 patients.