ABSTRACT
Recently concerns have been raised regarding delayed and persistent clinical manifestations following acute COVID infection. The term "Long COVID” refers to a syndrome with multisystem manifestations, persisting beyond 3months of the onset of acute COVID when other likely causes are excluded. Recently, the World Health Organization proposed a definition for adults that included persistent or fluctuating symptoms, impacting daily life, for at least 2months, following acute COVID, that could not be explained by other diagnoses. The condition is better understood among adults, but similar presentations have also been reported in children less frequently. These include fatigue, muscular weakness, shortness of breath, sleeping difficulty, depression, and anxiety. However, there are insufficient epidemiologic studies on Long COVID in children, and the limited data have various methodological limitations. There is no confirmatory diagnostic test and no specific pharmacological treatment for Long COVID. Therefore, individualized symptomatic treatment and multidisciplinary rehabilitation should be attempted. Severe physical or psychiatric manifestations require an urgent referral and appropriate management. Vaccination for the prevention of COVID, as per the local guidelines, is suggested. © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
Accurate diagnosis of SARS-CoV-2 infection is critical for the management of individuals with suspected COVID-19 diseases, as well as instituting public health measures. The experience gained over twoyears of the pandemic has led to a better appreciation of the scope and utility of various diagnostic modalities. Laboratory tests to diagnose COVID-19 in human beings can be broadly categorized as direct and indirect tests. In children (as in adults), RT-PCR is the current gold standard for diagnosis. RT-PCR detects footprints of the virus and its variants. However, its sensitivity is still less than desired. Rapid antigen tests are less accurate than RT-PCR, but the quick availability of results helps in outbreak control. Antibody tests can be used for retrospective diagnosis of infection, but currently available tests do not correlate with protection conferred by vaccination. The initial hype around chest computed tomography scans for diagnosis has now settled, and it is no longer considered a primary diagnostic modality. There are nonspecific changes in many hematological and biochemical parameters, which are more useful for monitoring disease progression than diagnosis. © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
Objective: The paucity of mechanical ventilators necessitates development of innovative respiratory support devices. Methods: We developed the Artificial Breathing Capability Device (ABCD) to automate compression of self-inflating bags (SIB), while controlling peak inspiratory pressure (PIP), ventilation rate (VR) and inspiration to expiration time (I:E) ratio (as in a conventional ventilator). ABCD has additional smart features including self-regulatory checks, auto cut-off during cough, endotracheal tube disconnection and blockage alarms, and SIB disconnection alarm. ABCD was tested non-stop for 60 days with 396 user combinations, using adult-size and paediatric-size SIB. The device was evaluated for robustness, reliability and precision. Results: ABCD did not have mechanical, electrical or electronic failures during continuous testing under various ambient conditions, confirming robustness. Reliability and precision evaluated by the proportion of user combinations showing <10% deviation from the set parameters showed: PIP 100%, VR 100% and I:E 84.3% with an adult SIB. The corresponding proportions with a paediatric-size SIB were 85.4%, 100% and 95.5%. With both SIB, the only combinations showing >10% deviation were outside the physiologic range. Conclusion: ABCD is a safe, efficacious and cost-effective option, which could be considered for adults and children in the context of ventilator shortages especially during the COVID-19 pandemic. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.