Hydroxychloroquine plus personal protective equipment versus personal protective equipment alone for the prevention of laboratory-confirmed COVID-19 infections among healthcare workers: a multicentre, parallel-group randomised controlled trial from India.

OBJECTIVES: To determine whether hydroxychloroquine when used with personal protective equipment reduces the proportion of laboratory-confirmed COVID-19 among healthcare workers in comparison to the use of personal protective equipment alone. DESIGN: Multicentre, parallel-group, open-label randomised trial. Enrolment started on 29 June 2020 and stopped on 4 February 2021. Participants randomised in HydrOxychloroquine Prophylaxis Evaluation were followed for 6 months. SETTING: 9 hospitals across India. PARTICIPANTS: Healthcare workers in an environment with exposure to COVID-19 were randomised in a 1:1 ratio to hydroxychloroquine plus use of personal protective equipment or personal protective equipment alone. 886 participants were screened and 416 randomised (213 hydroxychloroquine arm and 203 personal protective equipment). INTERVENTION: Participants in intervention arm received 800 mg of hydroxychloroquine on day of randomisation and then 400 mg once a week for 12 weeks in addition to the use of personal protective equipment. In the control arm, participants continued to use personal protective equipment alone. MAIN OUTCOME: Proportion of laboratory-confirmed COVID-19 in the 6 months after randomisation. RESULTS: Participants were young (mean age 32.1 years, SD 9.1 years) with low-comorbid burden. 47.4% were female. In the 6 months after randomisation (primary analysis population=413), 11 participants assigned to the hydroxychloroquine group and 12 participants assigned to the standard practice group met the primary endpoint (5.2% vs 5.9%; OR 0.85, 95% CI 0.35 to 2.07, p=0.72). There was no heterogeneity of treatment effect in any prespecified subgroup. There were no significant differences in the secondary outcomes. The adverse event rates were 9.9% and 6.9% in the hydroxychloroquine and standard practice arms, respectively. There were no serious adverse events in either group. CONCLUSIONS AND RELEVANCE: Hydroxychloroquine along with personal protective equipment was not superior to personal protective equipment alone on the proportion of laboratory-confirmed COVID-19. Definitive conclusions are precluded as the trial stopped early for futility, and hence was underpowered. TRIAL REGISTRATION NUMBER: CTRI/2020/05/025067.

Perception of online learning among undergraduate students at suez canal medical school during the covid-19 pandemic: A cross-sectional study

Background: Many adaptations to medical education have been made in response to the new emergent COVID-19 pandemic and its enormous global effects including the teaching and learning strategies to assure the educational process's safety and advancement. Accordingly, it was necessary to implement new online instructional approaches at the Faculty of Medicine, Suez Canal University in Egypt. Objective: To assess online learning advantages and disadvantages as perceived by medical students in addition to their preference regarding online vs face-to-face learning, Subjects and methods: This study was conducted as a cross-sectional study that included 340 students who filled an online survey consisting of 16 questions and was conducted on the Google Forms platform. Target population: years 1, 2 and 3 undergraduate medical students at Faculty of Medicine, Suez Canal University who experienced online learning during the COVID-19 pandemic. Results: The mean age of students was 19.57±1.02, ranged from 17 to 23 years, 61% of them were females. About 63.8% of students had no previous experience with online learning. The main perceived advantages were the ability to stay home (63.8%), comfortable surrounding (52.1%) and access to online materials (47.1%), while the main perceived disadvantages were technical problems (67.6%), lack of interaction with patients (58.8%), and reduced interaction with teachers (48.5%). Most of the students found face-to-face learning is superior to online learning in improving the knowledge (p=0.005), clinical skills (p<0.001) and social competence (p<0.001). Though 77% of them rated online learning as enjoyable. Conclusion: Most of our participants preferred traditional face-to-face learning over the online learning. Stakeholders should take the required steps to improve learning by reducing the disadvantages and increasing advantages of online learning as perceived by students during this study. © 2021, Ain Shams University Faculty of Medicine. All rights reserved.

Frequent clinical and radiological manifestations of the Novel SARS-CoV-2: A review article.

Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by the novel "severe acute respiratory syndrome coronavirus-2" (SARS-CoV-2) and is rapidly spreading worldwide. This review is designed to highlight the most common clinical features and computed tomography (CT) signs of patients with COVID-19 and to elaborate the most significant signs indicative of COVID-19 diagnosis. This review involved five original articles with both clinical and radiological features of COVID-19 published during Jan and Mar 2020. In this review, the most frequent symptoms of COVID-19 were fever and cough. Myalgia, fatigue, sore throat, headache, diarrhea, and dyspnea were less common manifestations. Nausea and vomiting were rare. Ground-glass opacity (GGO) was the most common radiological finding on CT, and mixed GGO with consolidation was reported in some cases. In addition, elevated C-reactive protein and lymphopenia are the pertinent laboratory findings of COVID-19. CT is an effective and important imaging tool for both diagnosis and follow-up COVID-19 patients with varied features, duration, and course of the disease. Bilateral GGOs, especially in the periphery of the lungs with or without consolidation, are the hallmark of COVID-19.

Knowledge, attitude, and practice toward COVID-19 among pregnant women in a tertiary care hospital during the COVID-19 outbreak

Background: During COVID-19 pandemic, Indian health authorities implemented massive measures to control the rapid spread of infection. Nonetheless, even during pandemic, pregnant women need constant obstetrics consultations during the antepartum period and adequate care during intrapartum and postpartum period for uneventful outcome. Undeniably, adherence to these control measures is largely affected by knowledge, attitude, and practices (KAP) towards COVID-19. Aims and Objectives: To assess knowledge, attitude, and practice towards COVID-19 amongst pregnant women and to find the association of demographic variables (age, place of residence, and education) with KAP. Materials and Methods: The cross-sectional, descriptive study was conducted for pregnant women attending the outpatient department of Obstetrics in a tertiary care Defense hospital. We investigated 506 pregnant women serially from Obstetrics OPD of the hospital for KAP towards COVID-19 with a questionnaire of 14 questions. The study population was assessed for the KAP score and association of demographic variables with KAP. Descriptive statistics were used to describe the findings. Median and standard deviation (SD) were calculated for KAP and Pearson's Chi-square test was used to analyze the association of demographic variables with KAP. Results: In our study scores for adequate knowledge, positive attitude, and good practices were 75.3 %, 73.9%, and 92.7 % respectively. The analysis of the association of various demographic variables with KAP about COVID-19 revealed significant association. Conclusion: The majority of pregnant women was knowledgeable about COVID-19 and had positive attitude and good practices. However, health authorities may need to take proactive steps for this vulnerable subpopulation.