BURDEN AND SEVERITY OF COVID-19 IN CHILDREN HOSPITALISED OVER FIVE COVID-19 WAVES IN SOWETO, SOUTH AFRICA

Intro There is sparse data on SARS-CoV-2 infection among paediatric patients from low-middle income countries (LMICs), including from sub-Saharan Africa. We describe the burden and severity of disease in children treated with SARS- CoV-2 infection at an academic hospital in Soweto, South Africa from 30 March 2020 through 30 June 2022. Methods SARS-CoV-2 was detected using reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal swab specimens. Clinical diagnoses, HIV status, admission C-reactive protein (CRP), blood culture results and clinical outcomes were captured. Epidemic waves were designated as follows: Wave 1 (01 March to 14 October 2020);Wave 2 (15 October 2020 to 17 May 2021);Wave 3 (18 May to 14 November 2021);Wave 4 (15 November 2021 to 14 March 2022);Wave 5 (15 March to 30 June 2022). Findings There were 797 SARS-CoV-2 positive paediatric hospitalisations in the study period. SARS-CoV-2 detection prevalence was 4.6% (77/1,673) in Wave 1, 3.9% (134/3,426) in Wave 2, 7.1% (187/2,618) in Wave 3, 12.5% (261/2,088) in Wave 4 and 5.9% (138/2,320) in Wave 5. Among SARS-CoV-2 positive cases, the prevalence of respiratory admission diagnoses increased over time (16.9% in Wave 1 to 42.8% in Wave 5). Conversely, the prevalence of multisystem inflammatory syndrom of childhood (MIS-C) and case fatailty ratios (CFRs) declined from Wave 1 to Wave 5 (MIS-C: 20.8% to 2.2%;CFR: 9.1% to 3.6%). Death was significantly associated with younger age (median age 3.4 versus 16.9 months), positive admission blood cultures (24.0% versus 8.4%), MIS-C (20.7% versus 6.5%), and HIV infection (21.1% versus 4.5%). Conclusion The omicron dominated fourth and fifth waves of SARS-CoV-2 infection were associated with a higher prevalence of respiratory admission diagnoses, but lower case fatality compared to the ancestral first wave in South African children. Optimisation of antenatal maternal SARS-CoV-2 vaccination and early HIV diagnosis may impact on paediatric SARS-CoV-2 CFR.

Tillandsia-Inspired Composite Materials for Atmospheric Water Harvesting

Atmospheric water harvesting (AWH) is a potentially promising small-scale approach to alleviate the water crisis in arid or semiarid regions. Inspired by the asymmetric structure of tillandsia leaves, a plant species native to semiarid regions, we report the development of a bioinspired composite (BiC) to draw moisture for AWH applications. With the advent of the post-COVID era, the nonwoven materials in used masks are discarded, landfilled, or incinerated along with the masks as medical waste, and the negative impact on the environment is inevitable. The nonwoven sheet has porosity, softness, and certain mechanical strength. We innovatively developed BiCs, immobilizing hygroscopic salt with a nonwoven mask for fast vapor liquefaction and using a polymer network to store water. The resulting BiC material manages to achieve a high-water adsorption capacity of 1.24 g g-1 under a low-moderate humidity environment and a high-water release ratio of ca. 90% without the use of photothermal materials, while maintaining high structural integrity in cyclic testing. © 2023 American Chemical Society.

A study on the statistical distribution and regression analysis of novel coronavirus in India

The novel Coronavirus Disease (COVID-19) pandemic has affected all the parts of the world. India has seen two peaks in the first and second waves, and currently in second place globally after USA. The peak in the first wave was observed in the mid of September, 2020 and in the second wave, the peak is said to be crossed during early May, 2021. Although India is visualizing declining trend and crossed peak on 20th January 2022, many research studies and scientists are still recommending not to lower guard due to possibility of new variants. Proper modelling of COVID-19 distribution may help in determining the course of pandemic and planning the future requirements. The purpose of this study is to analyse the COVID-19 data in India using various probabilistic distributions and identify the best fit model. Further, regression analysis is also carried out to predict the relation among variables like daily cases, deaths, number of people vaccinated and reproduction rate. The effect of current vaccines against the new variants like Omicron in India are discussed at the end. © 2022 Nickan Research Institute. All rights reserved.

ANCA-associated vasculitis following ChAdOx1 nCoV19 vaccination: case-based review.

For the foreseeable future, vaccines are the cornerstone in the global campaign against the Coronavirus Disease-19 (COVID-19) pandemic. As the number and fatalities due to COVID-19 decline and the lockdown anywise rescinded, we recognize an increase in the incidence of autoimmune disease post-COVID-19 vaccination. However, the causality of the most vaccine-induced side effects is debatable and, at best, limited to a temporal correlation. We herein report a case of a 51-year-old gentleman who developed Anti-Neutrophil Cytoplasmic Antibody (ANCA)-associated vasculitis (AAV) 2 week post-COVID-19 vaccination. The patient responded favorably to oral steroids and rituximab. Additionally, we conducted a case-based review of vaccine-associated AAV describing their clinical manifestations and treatment response of this emerging entity.

Prescription practices, experiences, and perspectives on the usage of hydroxychloroquine among rheumatologists and other specialists

Background/Objectives: The use of hydroxychloroquine (HCQ) for COVID-19 has raised concerns for adverse effects. We aimed to understand the practice, perceptions, and experience of adverse drug reactions (ADRs) with HCQ use for COVID-19 and other indications. Methods: A validated e-survey with 30 questions was circulated among rheumatologists and other specialists using SurveyMonkey. Responses from rheumatologists were compared with other doctors (odds ratio [OR], median, interquartile range), and ADRs encountered based on their indications. Results: Among 410 respondents (71.2% rheumatologists, 27% academicians) with a lifetime experience of 17886 (4884-52074) patients over 12 (7-20) years, and 148 (48-349) prescription of HCQ per month, one-third (135) were managing COVID-19 with 10 (0-60) prescriptions per physician. Electrocardiograms were seldom ordered preprescription (5%), but visual scans were requested by one-thirds, especially by rheumatologists (OR-1.9). Agreement on the safety of HCQ for non-COVID indications was nearly unanimous (99%), but only two-third (64%) perceived it to be safe for COVID-19, with most (72%) being uncomfortable using HCQ with macrolides. ADRs were most often encountered after middle-age with skin pigmentation (554 [123-2063]) being the most frequent, followed by gastrointestinal intolerance (222 [42-980] per million prescriptions). Cardiac toxicity was rarely reported. ADRs other than cutaneous and visual were noted more frequently by nonrheumatologists. Rheumatologists were less likely to consider HCQ unsafe (OR-0.04) and reportedly faced a greater challenge in drug procurance (OR-2.6) during the pandemic. Conclusions: Most ADRs are rare with HCQ use in our respondent population with a large user experience. HCQ use was considered unsafe by one-thirds in the setting of COVID-19 but not outside it, lesser so by rheumatologists. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.