ABSTRACT
The Coronavirus Disease 2019 (COVID-19), also known as a novel coronavirus (2019-n-CoV), reportedly originated from Wuhan City, Hubei Province, China. Coronavirus Disease 2019 rapidly spread all over the world within a short period. On January 30, 2020, the World Health Organization (WHO) declared it a global epidemic. COVID-19 is a Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) evolves to respiratory, hepatic, gastrointestinal, and neurological complications, and eventually death. SARS-CoV and the Middle East Respiratory Syndrome coron-avirus (MERS-CoV) genome sequences similar identity with 2019-nCoV or Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). However, few amino acid sequences of 2019-nCoV differ from SARS-CoV and MERS-CoV. COVID-19 shares about 90% amino acid sequence simi-larity with SARS-CoV. Effective prevention methods should be taken in order to control this pandemic situation. To date, there are no effective treatments available to treat COVID-19. This review provides information regarding COVID-19 history, epidemiology, pathogenesis and molecular diagnosis. Also, we focus on the development of vaccines in the management of this COVID-19 pandemic and limiting the spread of the virus.Copyright © 2022 Bentham Science Publishers.
ABSTRACT
Background and Objective: With the initial case of corona reported in Wuhan, China on 31st December 2020, there has been an unprecedented rise in the coronavirus disease (COVID-19), with over 200 countries all across the world in less than 3 months. By the October 2020, about 40 million population of the world got infected and over one million deaths occurred. Since no WHO and FDA approved medications or vaccines for COVID-19 were available, there was an impatient bustling need to develop a drug for the treatment. Drug repurposing emerged as the easiest and fast emerging strategy to get medicine for COVID-19 with rapid approvals for the clinical trials. The purpose of this study was to evaluate the status of drug repurposing under the clinical and its impact on the development of medicine for COVID-19. Method(s): The study was undertaken to review various clinical trials from the website. www.clinicaltrials.gov. We evaluated 220 ongoing clinical trials with the strategy of 'drug repur-posing' against COVID-19, analyzed them as per their chemical structure and possible biological targets. Result(s): It was noticed that some of the early repurposed drugs like chloroquine, hydroxychloro-quine, ACE inhibitors and ARBs, did not succeed and remained controversial. While many of the antiviral drugs like remdesivir, favipiravir, lopinavir, ritonavir, oseltamivir could be taken for the clinical trials in various countries, remdesivir could succeed to a great extent as compared to other drugs. WHO has come up with an initiative known as multi-country 'Solidarity Trial' for developing a potential drug or therapy against COVID-19.However, the most preferred drugs used for re-purposing like hydroxychloroquine and remdesivir have not shown predictable results in solidarity trials. Conclusion(s): The analyses of several ongoing and partially concluded clinical trials suggest that drug repurposing can be one of the major strategies for the treatment of COVID-19. Further, guidelines framed by the WHO through Infection Prevention and Control for monitoring the widespread of this COVID-19 across the world is another aggressive attempt to find the solution for the treatment for COVID-19.Copyright © 2021 Bentham Science Publishers.
ABSTRACT
Governments across the world are making considerable efforts in confronting COVID-19, from nationwide lockdowns to hygiene measures and maintaining social distancing. But at the same time, role of aerosols or/and the high concentrations of fine particulate matter or/and AQI levels in infection transmission and increasing the prevalence, morbidity and mortality of pandemic has been largely unexplored specifically in India where pollution attains peak in October and November every year. In the present study, we collected data regarding air quality index and COVID-19 determinants of four Indian cities : Bangalore, Delhi, Mumbai and Shillong from 1 October 2020 to 16 November 2020. We performed an analysis of variance on the regression model to estimate and quantify the strength of relationship between COVID-19 determinants and air pollution index (AQI). Results show that AQI has a significant impact on both response variables, that is COVID-19 cases as well as mortality (p < 0.05 at 95% confidence level) in Delhi, Mumbai and Bangalore (p < 0.05) but in Shillong no impact of AQI on COVID-19 cases and AQI (p = 0.343), as well as deaths (p = 0.664), was observed. We conclude that it is both conceivable and reasonable to suspect the role of increased AQI levels in aggravating COVID-19 morbidity and mortality. Thus, we recommend that critical meteorological conditions, like haze/smog caused by factors, like stubble burning or firing crackers should be predicted and monitored more systematically as they may lead to deterioration of respiratory problems. As the whole world is striving to fight against the deadly pandemic, it is extremely imperative to focus not only on human health as a part of response but also on global planetary health. Short term measures that can minimize supplementary risks, like adverse weather situations including pollution, poor air quality should be considered more meticulously and judiciously so that new flares of COVID-19 morbidity and mortality can be restricted. © 2022 - Kalpana Corporation.
ABSTRACT
Background: Cancer patients face an increased risk of developing acute complications from COVID-19. Remote monitoring can help with the critical need for early detection of symptoms among those diagnosed with COVID-19, enabling timely symptom management that can mitigate clinical deterioration. In response to this need, Memorial Sloan Kettering Cancer Center fast-tracked a program to monitor patients with COVID-19 from home, using an electronic symptom-tracking questionnaire and digital pulse oximeter to track patients' status and alert care teams to intervene if symptoms worsened. A multi-disciplinary group composed of Oncology providers, advanced practice providers, nursing, nursing informatics and biomedical informatics formed to manage the program. Methods: Memorial Sloan Kettering launched a remote monitoring program for patients diagnosed with COVID-19 on March 25, 2020. All patients testing positive for COVID-19 were enrolled in the program and asked to complete a daily symptom tracking questionnaire accessed through their patient portal or administered verbally over the phone. A subset of high risk patients were also provided with a digital pulse oximeter linked to their patient portal and capable of transmitting readings directly to the care team. Clinicians received alerts for patients reporting symptoms or an oxygen saturation below 92%. Alerts resulted in an immediate response from the care team to determine if the patient needed additional care. We retrospectively evaluated the program usage, outcomes and learnings from March 25, 2020 to December 22, 2020. Results: In total, 1,721 patients were enrolled in the program from March 25, 2020 to December 22, 2020. Among these, 210 were deemed high risk patients who received a pulse oximeter in addition the daily symptom questionnaire. Over this period, 27% of patients triggered an alert from an electronic symptom questionnaire, and 63% of patients with a pulse oximeter triggered an alert from their device. Among patients who triggered an alert of any kind, 3% were triaged to a higher level of care. Patients reported that the program was highly valued and alleviated anxiety about their care. Iterative improvements were made to the program over time in response to the evolving knowledge about care for patients with COVID-19. Conclusions: Memorial Sloan Kettering was able to quickly implement a program to detect and triage symptoms among patients with COVID-19 and cancer. Refinements were made over time to many aspects of the program in response to learnings about care related to COVID-19, including to clinical eligibility, alert criteria, monitoring duration and workflows. The program also demonstrated value for patients who felt more comfortable with their care while being monitored remotely. This program established a successful model for remote monitoring of patients with COVID-19 with the potential to be scaled to other institutions or clinical areas.
ABSTRACT
Background: Oncology patients are particularly vulnerable to adverse outcomes from COVID-19 and require careful monitoring to identify early deterioration and render higher level care when indicated. Several institutions launched remote patient monitoring programs (RPMPs) to care for patients with COVID-19. We describe patients' perspectives on a COVID-19 RPMP at a National Comprehensive Cancer Center. Methods: Adult patients who had either tested positive for COVID-19 on an outpatient microbiology test or were discharged after hospitalization for the virus were eligible. Patients enrolled in the RPMP received a daily 10-question electronic patient-reported outcome assessment of COVID-19 symptoms and their responses generated alerts to a centralized monitoring team for new or worsening symptoms. A subset of high-risk patients also received a pulse oximeter which alerted when blood oxygen levels dropped below 93%. RPM was discontinued 14 days after a patient's positive test result and following 3 days without worsening symptoms or fever. Patients who exited the program and had completed at least one assessment were sent a patient engagement survey. The objective of the survey was to evaluate the patient's experience with digital monitoring and symptom management for COVID-19. The assessment was structured with objective response questions, including a net promoter score, and free text questions to elicit patient perspectives on RPM value. Free text responses were analyzed using grounded theory to identify primary themes regarding perceived value. Results: The survey was distributed to 452 patients;241 responded as of June 10, 2020 (53% completion rate). The net promoter score was 91%. The table provides responses to objective questions. Qualitative analysis of free text responses identified the primary themes regarding patient perceived value which included: 1) Security: patients appreciated that the RPMP provided a clinical safety net;2) Connection: patients appreciated the link to their clinical team during a period of isolation;3) Empowerment: patients appreciated that the RPMP provided education on the virus and symptom management. Conclusions: RPMPs are perceived to be of value to oncology patients with COVID-19. A key barrier to maintaining these programs is cost. Policymakers should consider how these programs can be reimbursed in the future so that they can continue to provide care to vulnerable patients and keep them at home out of the acute care setting.
ABSTRACT
BACKGROUND: Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India. AIM: Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED). DESIGN: This was a retrospective, single-centre, observational study. METHODS: We included patients who presented with clinical features or diagnosed MM and who were previously treated for COVID-19 in last 3 months of presentation (recent COVID-19) or currently being treated for COVID-19 (active COVID-19). Information regarding clinical features of CAM, possible risk factors, examination findings, diagnostic workup including imaging and treatment details were collected. RESULTS: Seventy CAM patients (median age: 44.5 years, 60% males) with active (75.7%) or recent COVID-19 (24.3%) who presented to the ED in between 6 May 2021 and 1 June 2021, were included. A median duration of 20 days (interquartile range: 13.5-25) was present between the onset of COVID-19 symptoms and the onset of CAM symptoms. Ninety-three percent patients had at least one risk factor. Most common risk factors were diabetes mellitus (70%) and steroid use for COVID-19 disease (70%). After clinical, microbiological and radiological workup, final diagnosis of rhino-orbital CAM was made in most patients (68.6%). Systemic antifungals were started in the ED and urgent surgical debridement was planned. CONCLUSION: COVID-19 infection along with its medical management have increased patient susceptibility to MM.