Predictors of Mortality among Patients Hospitalized with COVID-19 during the First Wave in India: A Multisite Case-Control Study.

Severe acute respiratory syndrome coronavirus 2 disease (COVID-19) has caused more than 6 million deaths globally. Understanding predictors of mortality will help in prioritizing patient care and preventive approaches. This was a multicentric, unmatched, hospital-based case-control study conducted in nine teaching hospitals in India. Cases were microbiologically confirmed COVID-19 patients who died in the hospital during the period of study and controls were microbiologically confirmed COVID-19 patients who were discharged from the same hospital after recovery. Cases were recruited sequentially from March 2020 until December-March 2021. All information regarding cases and controls was extracted retrospectively from the medical records of patients by trained physicians. Univariable and multivariable logistic regression was done to assess the association between various predictor variables and deaths due to COVID-19. A total of 2,431 patients (1,137 cases and 1,294 controls) were included in the study. The mean age of patients was 52.8 years (SD: 16.5 years), and 32.1% were females. Breathlessness was the most common symptom at the time of admission (53.2%). Increasing age (adjusted odds ratio [aOR]: 46-59 years, 3.4 [95% CI: 1.5-7.7]; 60-74 years, 4.1 [95% CI: 1.7-9.5]; and ≥ 75 years, 11.0 [95% CI: 4.0-30.6]); preexisting diabetes mellitus (aOR: 1.9 [95% CI: 1.2-2.9]); malignancy (aOR: 3.1 [95% CI: 1.3-7.8]); pulmonary tuberculosis (aOR: 3.3 [95% CI: 1.2-8.8]); breathlessness at the time of admission (aOR: 2.2 [95% CI: 1.4-3.5]); high quick Sequential Organ Failure Assessment score at the time of admission (aOR: 5.6 [95% CI: 2.7-11.4]); and oxygen saturation < 94% at the time of admission (aOR: 2.5 [95% CI: 1.6-3.9]) were associated with mortality due to COVID-19. These results can be used to prioritize patients who are at increased risk of death and to rationalize therapy to reduce mortality due to COVID-19.

Impact of COVID-19 pandemic on adolescent health in India.

SARS CoV2 is an emerging infectious pandemic. The preemptive measures taken to curtail the spread has its effects far and wide across different sectors and all age groups. The most unspoken sufferers are adolescents. In this article, we have reflected on how adolescent issues addressed by the government's dynamism, have had collateral damage due to the COVID initiatives. Globally, around 89% are currently not in school because of COVID-19. They will pave a way to unforeseen collateral effects on the physical, social, psychological health, and future of the young minds. From an increase in school drop-outs, interrupted learning, worsening of the gender gap in education to technology dependence and addictions, this pandemic is going to unravel the uninvited social evils. The regular benefits of adolescents from the government have not been paid heed to. Supply of IFA tablets, sanitary napkins, provision of supplementary nutrition, health education, and implementation of immunization activities are a few of the services to mention which are being hampered. We have recommended a few strategies like establishing the peer educator system in disseminating COVID-related awareness, engaging them in a smooth public distribution system, and act as a potential linkage for the families in distress. We have proposed a few modus operandi like direct cash transfer or food supplements as take-home rations will be able to sustain the nutrition of the adolescents to keep the flow of uninterrupted amenities to adolescents in education, nutrition, mental health, personal hygiene, and other such sectors.