Assessing the impetus and impediments to donate coronavirus disease-2019 convalescent plasma: A survey study from a tertiary care Indian blood center

BACKGROUND: Amidst the raging coronavirus disease-2019 (COVID-19 pandemic), COVID-19 convalescent plasma (CCP) therapy emerged as an important experimental therapy. The majority of the research studies have focused on determining the safety and efficacy of CCP in the management of COVID-19 and little attention has been paid to the source of CCP, i.e., the CCP donor recruitment. The main challenge at our blood center was maintaining high spirits and continuous motivation among the volunteers to keep donating CCP. With this background, our primary aim was to observe the impetus and impediments of potential CCP donors among the SARS-CoV-2 recovered individuals. MATERIALS AND METHODS: All the potential CCP donors who met the inclusion criteria were telerecruited, i.e., contacted telephonically by trained personnel of the blood center. Donors were informed about CCP and its harvest procedure. Subsequently, donors were presented with 10 statements to assess the potential impetus (motivators) and impediments (barriers) toward donating CCP. In addition, SARS-CoV-2 IgG antibody titers were performed using chemiluminescence assay in donors who passed the predonation screening. RESULTS: Based on their medical records, a total of 96 potential CCP donors were contacted telephonically for inclusion in the study. Among these 68.75% (n = 66/96) individuals expressed their willingness to donate CCP. "Altruism from adversity " was the most common motivational factor among voluntary donors (47.8%), whereas kinship was the strongest motivational factor among replacement donors (40%). Logistical reasons such as their distance from the blood center (33.3%) were the most common reason for not donating CCP. About 21.2% (n = 18/66) of the donors were deferred due to absent or low levels of anti-SARS-CoV-2 IgG antibodies. CONCLUSIONS: Motivation factors such as "altruism from adversity " are more common in CCP donation. At the same time, most of the impediments to CCP donation were similar to those of the routine apheresis procedure. Knowledge of these motivators and barriers should form the cornerstone of plasma therapy-based donation program in any future pandemic.

Diné Navajo Resilience to the COVID-19 pandemic.

OBJECTIVE: To date, there are no studies of COVID-19 cases and deaths in the Navajo Nation, US. The primary objective of this manuscript is to understand whether counties with a higher proportion of Navajo (Diné) population also had higher cases and deaths of COVID-19 and whether these dropped with vaccination. METHOD: We undertook a cross-sectional analysis of county level data from March 16, 2020-May 11, 2021. Data were obtained from public repositories and the US Census for the Navajo Nation, including northeastern Arizona, southeastern Utah, and northwestern New Mexico. The primary outcome measure is the number of individuals with confirmed cases or deaths of COVID-19. A secondary outcome was COVID-19 vaccinations. RESULTS: The 11 counties in Navajo Nation have a wide variation in the percent Navajo population, the resources available (ICU beds and occupancy), and COVID-19 outcomes. Overall, there was a substantial increase in the number of cases from March 16 -July 16, 2020 (the height of the pandemic) with a doubling time of 10.12 days on Navajo Nation. The percent Navajo population was a strong predictor of COVID-19 cases and deaths per million population. COVID-19 vaccinations were inversely associated with COVID-19 cases and deaths in these counties. CONCLUSIONS: The COVID-19 pandemic on the Navajo Nation is a story of resilience. Navajo Nation was one of the hardest hit areas of the United States, with peak cases and deaths due to COVID-19. With an aggressive vaccination effort, these cases and deaths were strikingly curtailed, showing the resilience of the Navajo (Diné) people.

A Comparative Study of Hematological Parametersin COVID-19 Positive Cases, Influenza like Illness Patients, and Healthy Subjects

Introduction: Since its origin in December 2019, Novel Corona virusinfection has behaved in an unprecedented manner. Viral infectionsare characterized by atypical and reactive lymphocytosis as is seen ininfectious mononucleosis and dengue viral infection respectively.Previous studies on influenza like illnesses have demonstrated the roleof Neutrophil-to-lymphocyte as a preferable diagnostic tool to screeninfluenza virus-infected patients. In addition to these, volume conductivity and scatter has revealed significant findings in volumescatter and conductivity of monocytes and neutrophils in the past ininfluenza and influenza like illnesses.Aims &Objectives: To study the hematological parameters ofCOVID-19 positive cases and to compare the hematological parameters in COVID-19 positive cases, patients with influenza andinfluenza like illness.Materials &Methods: 169 Covid positive cases, 113 influenza andinfluenza like illnesses and 140 healthy controls were included in thestudy. All samples were processed on DXH 800 and all parameterswere recorded.Result: There was significant difference between Covid 19 and influenza and influenza like illness in terms of age, percentage ofneutrophils, percentage of lymphocyte, percentage of monocyte, percentage of eosinophil and basophil. Significant difference was alsofound between mean neutrophilic and mean monocytic volume, and inall the scatter parameters of neutrophils. Neutrophil-to-lymphocyteratio (NLR) and platelet-to-lymphocyte ratio (PLR) also showed significant difference in both the conditions. Multivariate analysis wasperformed and a joint probability was calculated which showed a cutoffin differentiating Covid 19 from influenza and influenza like illnesses.Conclusions: Covid 19 and Influenza can cause different changes inperipheral blood parameters and the diagnostic formula developed inthis study will enable the clinicians to differentiate Covid 19 frominfluenza during the early stages.

Teaching soldiers French: How motivation affects their success

The paper deals with problematic of teaching adults a second foreign language. The article has focused on the groups of young soldiers who attended French courses for a period of two to four weeks during the fall semester of 2020 in the COVID pandemic situation. The main objective of the paper is to help teachers better plan teaching for specific groups of students. In this paper, the motivation of course participants have been examined. The paper suggests that the intrinsic motivation of the students allows participants to learn the language better. It has been observed that neither previous education in French nor career development is significant for student success. The findings suggest that students who were intrinsically motivated before the start of the course (for personal or professional reasons) tended to work more in their free time;and therefore, they mastered French sooner. The findings helped the researchers gain a better understanding of student failure and helped them in the adaptation of offered courses. The paper could be useful for anyone teaching adults a second language. Copyright © 2021. Marie KALA and Magdalena VESELA.

Social Innovation For Health Research: Development of the SIFHR Checklist.

BACKGROUND: Social innovations in health are inclusive solutions to address the healthcare delivery gap that meet the needs of end users through a multi-stakeholder, community-engaged process. While social innovations for health have shown promise in closing the healthcare delivery gap, more research is needed to evaluate, scale up, and sustain social innovation. Research checklists can standardize and improve reporting of research findings, promote transparency, and increase replicability of study results and findings. METHODS AND FINDINGS: The research checklist was developed through a 3-step community-engaged process, including a global open call for ideas, a scoping review, and a 3-round modified Delphi process. The call for entries solicited checklists and related items and was open between November 27, 2019 and February 1, 2020. In addition to the open call submissions and scoping review findings, a 17-item Social Innovation For Health Research (SIFHR) Checklist was developed based on the Template for Intervention Description and Replication (TIDieR) Checklist. The checklist was then refined during 3 rounds of Delphi surveys conducted between May and June 2020. The resulting checklist will facilitate more complete and transparent reporting, increase end-user engagement, and help assess social innovation projects. A limitation of the open call was requiring internet access, which likely discouraged participation of some subgroups. CONCLUSIONS: The SIFHR Checklist will strengthen the reporting of social innovation for health research studies. More research is needed on social innovation for health.

Two in one combo! treating incomplete kawasaki's and multisystem inflammatory syndrome in children

Case Report Most children have mild clinical symptoms after contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) However, in a few cases, a severe immunodysregulation response may occur, now termed multisystem inflammatory syndrome in children (MIS-C). MIS-C is uncommon at a rate of 2/100,000 cases in children. Most documented cases have been reported in adolescents, and reports of cases in toddlers are rare. Here we describe the inpatient management of a toddler who presented with signs and symptoms consistent with both MIS-C and incomplete Kawasaki's disease. A 14-month-old male was brought to the emergency room after having a fever with a Tmax of 103F for four days and a maculopapular, non-pruritic rash that first appeared behind his ears and then generalized across his body. In the ED, patient had a fever of 102.5 F and was tachycardic to the 170s. He was ill-appearing, so he received a bolus of fluids and Tylenol with some improvement. Labs were remarkable for normal white blood cell count, thrombocytopenia, and elevated CRP, ESR, ferritin, and BNP. Infectious diseases (ID) was consulted due to concern for MIS-C and Kawasaki's disease. Patient met the criteria for Incomplete Kawasaki's disease with 5 days of fever, mucous membrane changes, apolymorphous rash, elevated CRP, anemia, hypoalbuminemia, and elevated ALT. Patient presented during the SARS-CoV-2 pandemic and tested negative for SARS-CoV-2 antigen on rapid testing but tested positive for SARS-CoV-2 antibodies, meeting the criteria for MIS-C. For the incomplete Kawasaki's disease diagnosis, an ECHO was done, and patient was started on IVIG and medium dose aspirin of 30-50 mg/kg/day. MISC labs were trended and patient was started on Decadron and Enoxaparin. After four days in the hospital and 48 hours without fever, patient was discharged home on low-dose Aspirin, prophylactic Enoxaparin, and a steroid taper to follow up with pediatric ID, cardiology, rheumatology, and hematology. As SARS-CoV-2 has become a common virus, pediatricians should be prepared to handle this disease with a concurrent diagnosis of Kawasaki's disease. Although, MIS-C is more common in adolescents, there have been isolated cases in toddlers as well, so recognition and treatment of MIS-C in this age group is critical.

To study the hematological parameters in covid-19 positive cases in different clinical categories

Aims & Objectives: Since it's origin in December 2019 Novel Corona virus infection has behaved in an unprecedented manner. A number of studies had been done so far to find out peculiar characteristics about this disease. However, few studies have shown varied hematological manifestations of this which have been found to have prognostic implications. In this study we aim to assess the hematological parameters of COVID-19 positive cases and in their different clinical categories (mild, moderate and severe). Patients/Materials & Methods: It is an observational study done in Himalayan Institute of medical sciences, Dehradun. (1) Number of cases included were 118 over 3 months duration (July, August, September-2020). (2) The relevant clinical details of all the COVID-19 positive patients such as name, age, UHID were recorded. (3) EDTA sample was run on DXH800 (Beckmencoulter automated analyzer) and all parameters were recorded including the VCS. Inclusion criterion: Patients diagnosed with COVID-19 on Rapid antigentestor RTPCR of all age groups. Exclusioncriterion:Patients with missing hematological parameters. Results: In our study, total number of cases included were 118, out of which 84 (71.18%) were males and 34 (28.81%) were females. Patients above 60 years were 35 (29.6%). The patients were categorized into mild, moderate and severe on the basis of clinical findings and those findings were co-related with the VCS parameters. The significant findings include decreased absolutely mphocytecount in 43.2% cases and absolute eosinopenia in 83.05% of cases, absolute neutrophil count was increased in 44.9% cases and platelet count was reduced in 30.5% of the cases. Discussion & Conclusion: In major number of cases absolute lymphocyte count, absolute eosinophil count and neutrophil to lymphocyte ratio was found significant;so it is advised to categorize patients on the basis of clinical findings and related VCS parameters for early COVID-19 testing.

Indian blood donor selection guidelines: Review in the context of the ongoing COVID-19 pandemic.

The National Blood Transfusion Services under the aegis of the ministry of health and family welfare, India has recently issued guidelines regarding the blood donor selection criteria and the processing of blood. Care has been taken to make the blood transfusions safer. However, COVID-19 has disrupted the organization of the voluntary blood donation drives, whole blood donations [WBD] and restricted the donors' movement to the blood transfusion centres all across the world. While sickness and the need for transfusions are very much in place, the gap of demand against blood collection has widened. Additionally, with the monsoon season at hand, and the categorical challenges of a dengue outbreak, the subsequent need for blood components especially the platelet concentrates is going to rise. Some of the criteria laid for deferring a blood donor from his or her WBD need a categorical revision, considering these unprecedented times. We, therefore, critically analyzed the blood donor selection criteria and hereby, suggest an updating regarding the pre-donation haemoglobin, sexually transmitted diseases, lactation, pregnancy and many such subheadings. We also suggest collecting smaller blood volumes in the blood bags for the optimal benefit of the recipients both for now and also as a measure of pandemic preparedness for future use.

Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020.

The coronavirus disease 2019 (COVID-19) pandemic resulted in 5,817,385 reported cases and 362,705 deaths worldwide through May, 30, 2020,† including 1,761,503 aggregated reported cases and 103,700 deaths in the United States.§ Previous analyses during February-early April 2020 indicated that age ≥65 years and underlying health conditions were associated with a higher risk for severe outcomes, which were less common among children aged <18 years (1-3). This report describes demographic characteristics, underlying health conditions, symptoms, and outcomes among 1,320,488 laboratory-confirmed COVID-19 cases individually reported to CDC during January 22-May 30, 2020. Cumulative incidence, 403.6 cases per 100,000 persons,¶ was similar among males (401.1) and females (406.0) and highest among persons aged ≥80 years (902.0). Among 599,636 (45%) cases with known information, 33% of persons were Hispanic or Latino of any race (Hispanic), 22% were non-Hispanic black (black), and 1.3% were non-Hispanic American Indian or Alaska Native (AI/AN). Among 287,320 (22%) cases with sufficient data on underlying health conditions, the most common were cardiovascular disease (32%), diabetes (30%), and chronic lung disease (18%). Overall, 184,673 (14%) patients were hospitalized, 29,837 (2%) were admitted to an intensive care unit (ICU), and 71,116 (5%) died. Hospitalizations were six times higher among patients with a reported underlying condition (45.4%) than those without reported underlying conditions (7.6%). Deaths were 12 times higher among patients with reported underlying conditions (19.5%) compared with those without reported underlying conditions (1.6%). The COVID-19 pandemic continues to be severe, particularly in certain population groups. These preliminary findings underscore the need to build on current efforts to collect and analyze case data, especially among those with underlying health conditions. These data are used to monitor trends in COVID-19 illness, identify and respond to localized incidence increase, and inform policies and practices designed to reduce transmission in the United States.