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BACKGROUND: Twitter is playing a pivotal role in rapid communication between healthcare stakeholders, governments, and the public during the COVID-19 pandemic. Communication on Twitter can reach over 152 million registered daily users and over 500 million people visit the site monthly without logging into an account. The purpose of this study was to analyze tweets associated with #SARSCoV2 during the initial phase of the COVID-19 pandemic. METHODS: Symplur Signals, a healthcare social media analytics platform, was used to analyze all publicly available #SARSCoV2 tweets (excluding spam) between 2/11/20-4/12/20. Tweet activity, content, sentiment, associated hashtags, user characteristics/engagement, and network analysis were analyzed. Select metrics were compared before/after the COVID-19 pandemic declaration by the World Health Organization (WHO;3/11/20). Tweet sentiment was analyzed within 3 hours before/after specific timepoints. RESULTS: Exactly 894,983 tweets (73% retweets) by 400,653 users met study inclusion criteria, resulting in 2,998,817,360 impressions. Daily tweet activity peaked on 3/18/20 with 58,666 tweets. There was a 2677% increase in number of tweets from the first to last week of the study period. The average user had 2.2 tweets. There were 292,478 (33%) and 264,198 (30%) tweets containing links and media, respectively. Trending term analysis before/after the WHO pandemic declaration showed a shift in conversation across the study period toward trending terms such as patients, critical care, studies, and antibodies. The top 15 hashtags associated with #SARSCoV2 predominantly included COVID-19 related hashtags. The top 3 countries by users were the United States, Spain, and Indonesia. The top 100 influencers consisted primarily of researchers/academics (30.1%), doctors (15.1%), journalists/media (9.4%), and media organizations (9.4%). Twitter network analysis showed key central hubs of communication were researchers/academics, doctors, and journalists/media. Three hours before/ after sentiment analysis revealed that after the Unites States announcement of European travel restrictions, negative sentiment tweets rose from 41% to 52%. After the Center for Disease Control's public mask use recommendation, negative sentiment decreased from 65% to 55%. CONCLUSIONS: Our study demonstrated that #SARSCoV2 rapidly coalesced into a vital digital international community for the COVID-19 pandemic with tweets from #SARSCoV2 generating nearly 3 billion impressions across a worldwide Twitter community. Notably, the most influential members of this community were researchers/academics and doctors. Quantifiable shifts in community sentiment were observed immediately following key changes in government policy. Changes in trending terms across the study period suggests #SARSCoV2 users engage in real-time discussions concurrent with recent scientific and medical discourse. Future studies should examine changes in digital health communication over the course of the COVID-19 pandemic.
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Objective: Report a COVID-19 related encephalopathy from selective white matter involvement of corpus callosum. Background: A 26-year-old African American female tested positive for SARS - COV 2 in April 2020. Her medical morbidities included uncontrolled type 1 DM (on insulin), obesity, and CKD stage III (diabetic nephropathy). She presented with fever, headache, dyspnea, myalgia, nausea, and loss of appetite. She was tachypneic, tachycardic, hypertensive, had a temperature of 39.2deg;C and saturating 98% at room air. Pertinent lab values included a glucose of 212 mg/dl, creatinine of 2.7 mg/dl, BUN of 34 mg/dl, and lipase 771 IU/L. CRP was 66.9 mg/L, with a normocytic anemia of 7.9 gm/dl, ferritin 1784 ng/ml, fibrinogen of 651 mg/dl and a peak D-dimer of 10,180 ng/ml. CXR was hypoinflated with mild bibasilar airspace opacities. A NCCT head obtained for a stroke alert, revealed a hypodense corpus collosum. She was admitted to the ICU with worsening hypoxia, kidney injury, metabolic acidosis, and alteration of consciousness. She received tocilizumab, steroids, remdesivir and convalescent plasma exchange for a severe COVID-19 infection. After extubation she developed a dysexecutive syndrome. Design/Methods: Case report Results: A contrast enhanced MR brain confirmed an expansile T2 hyperintense signal along the complete length of corpus callosum associated with restriction of diffusion, and T1 prolongation. There was no superimposed susceptibility or pathologic enhancement. No large vessel occlusions were identifiable from gradient echo (GRE), turbo spin echo (TSE), susceptibility weighted imaging (SWI) and post contrast MR sequences. A repeat MRI brain post discharge demonstrated an improving leukoencephalopathy by virtue of normalizing ADC values. Conclusions: Like prior coronaviridae, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) affects the brain over a spectrum of injury. Until we clarify direct neurotropism of SARS-CoV-2;this case is supportive of a cytokine mediated excitotoxic injury concomitant with the severity of disease.
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We like to share some ideas on the publication “Clinical and laboratory profile of children with COVID-19 admitted at a tertiary care hospital in Karnataka, Southern India”1. Sahana KS, et al1 concluded that “Presence of undernutrition and elevated C-reactive protein were associated with severe illness”. In this study, some laboratory parameters were studied and there might be important confounding effects. As Sahana KS, et al1 noted, some children have nutritional problems which might affect some laboratory parameters such as ferritin and haemoglobin. Additionally, a nutrition risk screening (NRS) score should be applied. In a previous report, NRS score was a good predictor for clinical outcome in cases with sepsis and it might be applicable to cases with COVID-192. Finally, the treatment given to different children might be different and it can result in different clinical outcomes. Those cases with atypical presentation may have received additional medications and it can affect both clinical outcome and clinical parameters. For example, steroids can affect the platelet count and might help to improve the clinical outcome. © 2018. Intertax. All rights reserved.
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Learning Objectives: Virtual Morning Reports was created as a practical replacement for traditional morning report, in order to create a space for interactive case based learning. Multiple additional benefits were realized after our one-year pilot. : Introduction/Background: The requirement for physical distancing during COVID has led to challenges in education. Emergency Medicine (EM) residencies pivoted to online educational conferences, however a need for interactive education previously met through Morning Report remained. Third-year Teaching Residents (TRs), who historically supervised these sessions, also lost this opportunity for facultyobserved peer teaching. Educational Objectives: VMR aims to fill the gap left by the cancellation of in-person educational activities. These goals are as follows: Allow for a venue for interactive discussion between students and faculty in a non-clinical space. Create an opportunity for TRs to hone teaching skills during their block. Create a model which is easily accessible to learners. Curricular Design: VMR is held twice weekly using Zoom software, for strictly 30 minutes. The end time was enacted to ensure that participants can reliably schedule around VMR and see the entire presentation. Cases are presented by the TR, except for one monthly case by a pediatric EM fellow and one by a toxicology resident. Presentations encourage participation from the audience to develop a differential and discuss management. Residents on shifts have this half-hour protected and are expected to join, but sessions are optional for other residents. Individual feedback on session design is given by core faculty to the TR at the conclusion sessions. Impact/Effectiveness: The first VMR occurred on May 12 and has continued without interruption all year. Participation ranges between 20-60 learners. VMR allows for off-service residents to stay in touch with our department. Faculty from multiple sites, who previously would not have venue to interact, discuss management with learners. Student participation includes pre-clinical as well as EM-bound students. “Virtual” clerkship students and interviewees are invited to VMR engage with our residency. This model is easily reproducible.
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Objectives: To assess the clinical characteristics, laboratory parameters and outcomes in paediatric patients with COVID-19. Method: Case records of all paediatric patients admitted with COVID-19 were included in the study. Data regarding mode of presentation, presence of comorbid conditions, severity of COVID-19, laboratory investigations and management were noted. Results: A total of 32 children was admitted with COVID-19 infection in our institute. COVID-19 infection was mild in 16 (50%) patients, moderate in 6 (18.8%) and severe in 10 (31.3%). Ages of the children ranged from 6 months to 16 years with a mean age of 10.75 years. Of them 17 (53%) were boys and 15 (47%) were girls. Pre-existing comorbidities were present in 8 (25%) children. Respiratory symptoms were the commonest presenting complaints, being observed in 18 (59%) cases. Atypical presentation of COVID-19 (other than respiratory) was seen in 31% of cases. Presence of undernutrition and elevated C-reactive protein (CRP) were associated with severe Covid-19 illness (p<0.05). Eleven (34%) cases required intensive care and mechanical ventilation was required in 2 (6.3%) cases. Out of the 32 cases only 1 patient expired giving a case fatality rate of 3.1%. Conclusions: Atypical presentation of COVID-19 with varied manifestations involving systems other than respiratory was observed in children as a separate entity from hyper-inflammatory syndrome. Presence of undernutrition and elevated CRP was associated with severe illness. © 2021,Sri Lanka Journal of Child Health. All rights reserved.
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COVID-19 outbreak has brought a global challenge in economy. It has affected badly on the financial sector all over the world. This study was conducted by collecting responses from the employed and student population from various parts of Kerala. Primary data have been collected from 200 responses through a structured questionnaire prepared using Google forms. Percentage analysis with frequency distribution is used to summarize and infer the data along with pie charts and column charts. Chi-square test have been used to analyse the data using Microsoft Excel sheet to test the developed hypothesis and derive conclusions. It is concluded that savings have played a significant role during this pandemic to sustain and also this pandemic encouraged others to start saving because of the experiences they had.
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COVID-19 outbreak has brought a global challenge in economy. It has affected badly on the financial sector all over the world. It created fear in the minds of people to use liquid cash and thus, has led to the adoption of mobile banking services. This study was conducted by collecting responses from the employed and student population from various parts of Kerala, who use mobile banking services. Primary data have been collected from 268 responses through a structured questionnaire prepared using Google forms. Percentage analysis with frequency distribution is used to summarize and infer the data along with pie charts. Chisquare test have been used to analyze the data using Microsoft Excel sheet to test the developed hypothesis and derive conclusions. It is concluded that mobile banking application have created a good impact during this pandemic to safeguard the lives and complete transactions at their fingertips without visiting banks physically. © 2021. All Rights Reserved.
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Computational methods for machine learning (ML) have shown their meaning for the projection of potential results for informed decisions. Machine learning algorithms have been applied for a long time in many applications requiring the detection of adverse risk factors. This study shows the ability to predict the number of individuals who are affected by the COVID-19[1] as a potential threat to human beings by ML modelling. In this analysis, the risk factors of COVID-19 were exponential smoothing (ES). The Lower Absolute Reductor and Selection Operator, (LASSo), Vector Assistance (SVM), four normal potential forecasts, such as Linear Regression (LR)). [2] Each of these machine-learning models has three distinct kinds of predictions: the number of newly infected COVID 19 people, mortality rates and the recovered COVID-19 estimates in the next 10 days. These approaches are better used in the latest COVID-19 situation, as shown by the findings of the analysis. The LR, that is effective in predicting new cases of corona, death numbers and recovery.
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The COVID-19 pandemic has disrupted health care delivery globally. Patients on in-centre haemodialysis(HD) are particularly affected due to their multiple hospital visits and the need for uninterrupted care for their well-being and survival. We studied the impact of the pandemic and the national policy for pandemic control on the HD care delivery in Karnataka state in India in April 2020, when the first and second national lockdown were in place. An online, questionnaire based survey of dialysis facilities was conducted and the responses analysed. The questions were pertaining to the key areas such as changes in number of dialysis treatments, frequency, duration, expenses, transportation to and from dialysis units, impact on availability of consumables, effect on dialysis personnel and on machine maintenance. 62 centres participated. Median of dialysis treatments for the months of March and April 2020 were 695.5 and 650 respectively. Reduction in dialysis treatments was noted in 29(46.8%) facilities , decreased frequency reported by 60 centres. In at least 35(56.5%) centres, dialysis patients had to bear increased expenses. Cost and availability of dialysis consumables were affected in 40(64.5%) and 55(88.7%) centres respectively. Problems with transportation and movement restriction were the two key factors affecting both patients and dialysis facilities.This survey documents the collateral impact of COVID -19 on the vulnerable group of patients on HD, even when not affected by COVID. It identifies the key areas of challenges faced by the patients and the facilities and implores the care-providers for finding newer avenues for mitigation of the problems. Key words: COVID-19, India, Haemodialysis , dialysis care delivery, questionnaire-based survey