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SESSION TITLE: COVID-19 Case Report Posters 3 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Biological disease modifying anti-rheumatic drugs (bDMARDs) are commonly used to treat interstitial lung disease (ILD) in patients with connective tissue disease (CTD). These patients often develop concurrent COVID-19 disease and existing data is scarce to guide treatment. We describe a case with a rare anti-Pl-7 Anti-Synthetase Syndrome (ASS) receiving Rituximab treatment for ILD who developed acute respiratory distress syndrome (ARDS) secondary to COVID-19 disease. CASE PRESENTATION: A 58-year-old female presented with worsening shortness of breath, loss of taste and smell, cough and headaches for 1 week. She had pre-existing severe chronic ILD secondary to ASS on Rituximab therapy. She tested positive on SARS-CoV-2 PCR testing, CT chest showed bilateral lung honeycombing, reticulations, traction bronchiectasis along with ground glass opacities consistent with active inflammatory interstitial process superimposed on ILD. She was diagnosed with COVID-19 pneumonia. She was initially started on high-dose Dexamethasone, Remdesivir and supplemental oxygen via high flow nasal cannula and supportive care for ARDS, however level of care was escalated due to worsening respiratory distress. Rituximab was discontinued due to active COVID-19 infection, the decision was made to start Baricitinib at 4 mg daily. She received treatment for 14 days, that led to a significant improvement in her respiratory status. DISCUSSION: ASS is a rare autoimmune condition involving multiple organs, with ILD being the major cause of morbidity. bDMARDS, especially Rituximab, have shown promising results in management of severe and refractory ILD in ASS. However, the role of bDMARDs as protective or risk factor for developing severe COVID-19 disease in these patients is unclear. ARDS in COVID-19 disease involves a vigorous inflammatory response and cytokine production leading to diffuse alveolar damage. Literature supports that use of corticosteroids, IL-1 and IL-6 receptor blockers and Janus Kinase (JAK) inhibitors for severe COVID-19 pneumonia is associated with decreased morbidity. Baricitinib is a JAK1 and JAK2 with anti-cytokine and anti-viral properties and has been associated with reduction in morbidity and mortality in patients with COVID-19 as demonstrated in our case. Generally, use of bDMARDs does not contribute to worse outcomes in COVID-19 disease in patients receiving these agents for rheumatological conditions. However, use of Rituximab and high dose glucocorticoids have been associated with worse outcomes, while Baricitinib may have a protective effect. Therefore, holding Rituximab in those with active COVID-19 infection is recommended. CONCLUSIONS: Management of COVID-19 in patients with CTD is a challenge due to the novel nature of the disease and scarcity of available data. The association of use of bDMARDs in rheumatological disease with outcomes in SARS-CoV-2 infection is yet to be elucidated. Reference #1: Barbosa AN, Silvinato A, Bacha H, Floriano I, Tanni S, Bernardo W. Use of disease-modifying drugs (tocilizumab, tofacitinib, and baricitinib-a biological or synthetic target specific) in patients hospitalized with COVID-19. Rev Assoc Med Bras (1992). 2022;68(1):3-8. Reference #2: Santos CS, Férnandez XC, Moriano Morales C, Álvarez ED, Álvarez Castro C, López Robles A, Pérez Sandoval T. Biological agents for rheumatic diseases in the outbreak of COVID-19: friend or foe? RMD Open. 2021 Jan;7(1):e001439. doi: 10.1136/rmdopen-2020-001439. PMID: 33455920;PMCID: PMC7813407. Reference #3: Galarza-Delgado DÁ, Serna-Peña G, Compeán-Villegas JE, Cardenas-de la Garza JA, Pineda-Sic RA, Colunga-Pedraza IJ, Vega-Morales D, Pérez-Barbosa L, Skinner-Taylor CM, Flores-Alvarado DE. Characteristics and evolution of 38 patients with rheumatic diseases and COVID-19 under DMARD therapy. Clin Rheumatol. 2021 Mar;40(3):1197-1199. doi: 10.1007/s10067-020-05510-9. Epub 2020 Nov 24. PMID: 33231774;PM
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Purpose and Background: On eleventh March 2020 the global pandemic COVID was declared by WHO. One of the main mode for the transmission of virus could be work related transmission also so, the Government instructed the employees to work from home. As per the data, impactwas notonly in the physical health, mental health but also on quality of life in general.The current survey is being conducted to find the affect in quality of life in corporate employees those working from their home. Methods and material: To assess the impact of working from home on quality of life of corporate employees, the WHOQOL -BREF questionnaire was used.In total 47 sample were collected by means of online survey. Result: All four domains had positive correlation among one another. A strong positive correlation was observed between the physical and psychological domain with r=0.612. It was observed that social domain had highest mean (71.10) and standard deviation (16.83) while the lowest mean and standard deviation was observed in environmental and physical domain respectively. Conclusion: While working from home during pandemic employees had moderate quality of life in all four domains. Males had better scores in physical, psychological and social domains while women had better score in environmental domain.
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Background-Coronavirus disease COVID-19 become the 5th pandemic disease since 1918 which is reported first in Wuhan, China after that its affect all over the world. In India, it is confirmed January 30, 2020. Professionally, also being challenged during this pandemic as we are moving under pressure in new model which involves re-skilling and redeploying staff for intensive care units, also reconsider of standard approaches for assessment and management. All things persist stress which leads to anxiety and depression. Purpose of the study to analyse the prevalence of perceived stress in physiotherapy profession who’s practicing in hospitals, healthcare centres or rehabilitation centres. Methods-Samples collected from online survey and expected sample size more than 30 clinical physiotherapist who’s working in different setups. Perceived stress scale-10 used under the inclusion and exclusion criteria. Inclusion Criteria-must be clinical therapist working in different setups as hospitals, rehabilitation centres, and multispecialty clinics and exclusion criteria is physiotherapist who working in academic field. Analysis carried out by Microsoft Excel 2007. Conclusion-Analysis found prevalence of perceived stress level 13% high, 68% moderate, and 19% low stress in the total respondent physiotherapist.The high prevalence of moderate perceived stress in clinical physiotherapist population which is lies under 18-29 year of age criteria. Study also depicting male perceiving high stress rather female.