ABSTRACT
Objective: To evaluate patient demographic characteristics and risk factors for mortality during the first and the second wave among COVID-19 patients in a tertiary care hospital of India. Methods: Data were taken from the hospital's electronic system for COVID-19 patients from August 2020 to December 2020, and the second from January 2021 to May 2021. The mortality rate, demographic and clinical characteristics, laboratory profile, and reasons for the death of the two waves were retrieved and compared, and the risk factors of the two waves were determined. Results: In the first wave, 1 177 COVID-19 cases visited the hospital and 96 (8.2%) died. In comparison, the death rate in the second wave was significantly higher (244/2 038, 12.0%) (P<0.001). No significant difference in age [60 (50-69) vs. 60.5 (53-70), P=0.11] or gender (P=0.34) was observed between the two waves. Compared to the first wave. there were significantly more cases with fever, cough, weakness, loss of taste and smell, and sore throat during the second wave (P<0.05), but significantly fewer cases with kidney disease (6.6% vs. 13.5%, P=0.038) and diabetes mellitus (35.7% vs. 50.0%, P=0.015). Besides, during the second wave, more patients had abnormal X-ray findings, higher levels of lymphocytes and serum ferritin (P<0.05). In addition, there were significant differences in the rate of death cases with acidosis, septic shock, acute kidney injury, diabetes mellitus, cardiovascular events, hypothyroidism (P<0.05). Multivariate regression showed that during the first wave, age (OR: 1.10;95% CI: 1.02-1.21), diabetes mellitus (OR: 3.16;95% CI: 2.08-3.53), and abnormal X-ray (2.67;95% CI: 2.32-2.87) were significant independent risk factors of mortality;while in the second wave, age (OR: 1.13;95% CI: 1.12-1.28), diabetes mellitus (OR: 8.98;95% CI: 1.79-45.67), abnormal X-ray (OR: 12.83;95% CI: 2.32-54.76), high D-dimer (OR: 10.89;95% CI: 1.56-134.53), and high IL-6 (OR: 7.89;95% CI: 1.18-47.82) were significant independent risk factors of mortality. Conclusion: Overall mortality and incidence of severe diseases are higher in the second wave than the first wave. Demographic characteristics, co-morbidities, and laboratory inflammatory parameters, especially D-dimer and IL-6, are significant risk facors of mortality during the COVID-19 pandemic.
ABSTRACT
Context: The study aimed to understand the perception of faculty and undergraduate students toward E-learning and its acceptance and feasibility during the corona pandemic. Aim: It aimed at collecting suggestions to improve the teaching-learning process. Settings and Design: This was an online survey conducted using Google Forms. Subjects and Methods: Responses were sought from participants through Google Forms and their feedback was collected using a semi-structured questionnaire which had 14 items including demographic profile, platform used for online teaching-learning, advantages, comfort level, usefulness of platform, challenges faced, and suggestions for improvement. Statistical Analysis Used: Statistical Analysis was done by using IBM SPSS Statistics for Windows, Version 26.0. Results: Responses were sought from a total of 447 (436 + 11) participants through Google Forms. Out of 447 participants, 321 responses (71%;95% confidence interval [CI];67.5-75.8) were recorded and their feedback was collected using a semi-structured questionnaire which had 14 items including demographic profile, platform used for online teaching-learning, advantages, comfort level, usefulness of platform, challenges faced, and suggestions for improvement. The response rate was 71.4%% (95% CI;67.5-75.8). About 81% (95% CI;67.5-75.8) of participants were happy with the ongoing online teaching-learning. About 52.9% (95% CI;47.3-58.6) are using Google Classroom, 32.2% (95% CI;27-37.6) are using video-based platforms such as Zoom, Google Meet, and Cisco Webex. About 53.6% (95% CI;48-59.2) of participants viewed Google Classroom as the best platform, whereas 44.1% (95% CI;38.5-49.7) favored video-based platforms for teaching-learning. Conclusions: Online classes were found acceptable by most of the students and faculty. The positive feedback and suggestions helped in the planning of E-learning classes in the existing curriculum for future.