ABSTRACT
BACKGROUND: Coronavirus disease 2019 (COVID-19) constrained the regular teaching in educational institutions and hampered the teaching-learning process across the globe. E-learning method is widely used in higher education in the current situation. the objective is to assess the beliefs and expectations of the students on e-learning among adult learners of a tertiary level health-care institution. MATERIALS AND METHODS: A single group pre-post design was adopted. Microsoft Go two-in-one devices were used to find the effectiveness of e-learning, including digital exam solution. Depending on the availability of device, 25 participants were selected for the study from three different steams. A 5-point Likert scale was used for assessing the quality, adoptability, and acceptance of digital education developed by the researchers. Chi-square/Fisher's exact or McNemar's test was used to test the association between independent or related categorical variables. Comparison of the average score between different courses was performed using the Kruskal-Wallis test. RESULTS: Twenty-two participants who completed the final assessment were retained for the analysis. Majority of the participants believed that e-learning helps to achieve personal learning goals or objectives and bridge skill or knowledge gaps and caters to learning preferences. However, the overall quality score across the study groups was found to be statistically insignificant (Kruskal-Wallis statistic: 1.26; P value: 0.533). CONCLUSION: The findings show that the adult learners in higher education, irrespective of their age differences, believe that intense e-learning support with Microsoft Go two-in-one device has a complementary effect on their learning outcome.
ABSTRACT
BACKGROUND: There are insufficient data about clinical outcomes in critically ill neurological patients with concomitant coronavirus disease (COVID-19). This study describes the clinical characteristics, predictors of mortality, and clinical outcomes in COVID-19-positive neurological patients managed in a dedicated COVID-19 neurointensive care unit (CNICU). METHODS: This single-center, retrospective cohort study was conducted in critically ill neurological and neurosurgical patients with concomitant COVID-19 infection admitted to the CNICU at the National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, from July to November 2020. Patients' demographic, clinical, laboratory, imaging, treatment, and outcome data were retrieved from the manual and electronic medical records. Predictors of mortality and neurological outcome were identified using logistic regression. RESULTS: During the study period, 50 COVID-19-positive neurological patients were admitted to the CNICU. Six patients were excluded from the analysis as they were managed in the CNICU for <24 hours. A poor outcome, defined as death or motor Glasgow Coma Scale <5 at hospital discharge, was observed in 34 of 44 patients (77.27%) with inhospital mortality in 26 of 44 patients (59%). Worst modified sequential organ failure assessment (MSOFA) score, lactate dehydrogenase maximum levels (LDHmax), and lymphocyte count were predictors of inhospital mortality with an odds ratio (OR) of 1.88, 1.01, and 0.87, respectively, whereas worst MSOFA and LDHmax levels were predictors for poor neurological outcome with OR of 1.99 and 1.01, respectively. CONCLUSIONS: Mortality is high in neurological patients with concomitant COVID-19 infection. Elevated inflammatory markers of COVID-19 suggest the role of systemic inflammation on clinical outcomes. Predictors of mortality and poor outcome were higher MSOFA score and elevated LDH levels. Additionally, lymphopenia was associated with mortality. HOW TO CITE THIS ARTICLE: Surve RM, Mishra RK, Malla SR, Kamath S, Chakrabarti DR, Kulanthaivelu K, et al. Clinical Characteristics and Outcomes of Critically Ill Neurological Patients with COVID-19 Infection in Neuro-intensive Care Unit: A Retrospective Study. Indian J Crit Care Med 2021;25(10):1126-1132.