Big data analytics on the impact of OMICRON and its influence on unvaccinated community through advanced machine learning concepts

New SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus Type-2) variant termed to be “B.1.1.529” subtype mutation, which is a primary concern, might heavily influence further transmission, virulence and even affect the functioning of test methods and efficacy medications (vaccines). It is still not clear on the timeline for the Omicron (B.1.1.529) subtype to develop protective immunity or even when normal activities will rebound in our everyday lives. Computational analysis on the available big dataset of the Omicron variants’ and their effects on the unvaccinated population indicate that the concerned variant seemed to have a stronger propensity for the vulnerable group (unvaccinated community). In consequence of the terrible COVID-19 epidemic, scientific research on vaccine development and their future enhancement throughout the world have been stepped up significantly. We assessed approved vaccines’ effect on morbidity, hospital stays, and fatalities worldwide. Through available big datasets, an Ensemble learning strategy was used to estimate the likelihood of an unvaccinated person contracting a virus. Overall incidence rates dropped from 18.56 per cent to 2.8 per cent for the vaccinated community during the observation period. People ≥ 60 years had the most remarkable percentage drop (~ 15 per cent). In addition, about 70.4 per cent, immunization through vaccines lowered the number of hospitalizations (both ICU and non-ICUs) and fatalities. Through our research observations, the facts clear that immunization through vaccination has a significant influence on decreasing COVID-19 rapid transmission, even if it provides only a modest level of protection. However, to accomplish this effect, non-pharmaceutical therapies must be maintained indefinitely.

Comorbidity Based Risk Prediction System for ARDS in COVID-19 Patients

The Coronavirus disease is an acute respiratory disease that has been designated as a pandemic by the WHO(World Health Organization).The rapid increase in the number of illnesses and death rates has put enormous strain on public health services. Hence, its critical to recognize the comorbidities in COVID-19 patients that led to ARDS(Acute Respiratory Distress Syndrome). In this paper, we use machine learning and deep learning methods to classify high risk COVID-19 patients with accurate results. This paper might speed up decisions made in public health services for predicting medical resources as well as early classification of high risk COVID-19 patients. © 2021 IEEE.

Analysis of origin, risk factors influencing COVID-19 cases in India and its prediction using ensemble learning

A genetically heterogeneous infectious virus recognized as COVID-19 (COronaVIrus Disease) has a significant influence on worldwide health. COVID-19 is an infection transmitted by a viral disease known as Severe Acute Respiratory Syndrome CoronaVirus-2. (SARS-CoV-2). In the current period, the instances of COVID-19 outbreaks are spreading significantly over the globe. Swallowed (through inhalation) or contact with contaminated droplets transmits the illness. Symptoms appear from two to fourteen days after exposure . Many individuals have a symptomless infection. The emphasis of therapy is on fundamental human needs;further research is needed on the risk analysis of the disease and use of antiviral medications. This research focuses on the case instances through the chronological dates in various parts of Indian states. The primary analysis of case instance is dependent on three stages;they are confirming stage, fatality stage, and recovered stage. The relevant datasets are obtained through Kaggle (from January 2020 to May 2021). The dataset has multiple categories that further intensify to perform high-end classifications. Initially, data preprocessing is done that include cleaning and feature selection on the prepared dataset, and then the prediction process is carried out using an Ensemble training approach. Approaches of Ensemble learning utilize many learning algorithms to achieve improved prediction efficiency. The stacking mechanism is used for aggregating accuracy. From the experimental observations, the suggested learning strategy is found to attain the maximum degree of precision for each stage (confirmed: 84.37%, fatality: 82.13%, and recovered: 88.67%) compared to the other approaches that are chosen to perform alone. Assessing the stability of the learning model is done by bootstrapping validation.

Efficacy of Radiofrequency Neurotomy in Chronic Low Back Pain: A Systematic Review and Meta-Analysis.

PURPOSE: The objective of the systematic review and meta-analysis is to evaluate the efficacy of radiofrequency neurotomy as a therapeutic lumbar facet joint intervention. PATIENTS AND METHODS: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, a systematic review and meta-analysis was performed. A comprehensive literature search of multiple data sources from 1966 to September 2020 including manual searches of bibliography of known review articles was performed. The inclusion criteria were based on the selection of patients with chronic low back pain with diagnosis confirmed based on controlled diagnostic blocks and with the publication of at least 6 months of results of appropriate outcome parameters. Quality assessment of the trials was performed with Cochrane review criteria and interventional pain management techniques-quality appraisal of reliability and risk of bias assessment (IPM-QRB). The level of evidence of effectiveness is classified at five levels ranging from Level I to Level V. The primary outcome measure was a significant reduction in pain, eg, short term (up to 6 months) and long term (more than 6 months). The secondary outcome measure was an improvement in functional status. RESULTS: A total of 12 randomized controlled trials (RCTs) met the inclusion criteria for evaluating the efficacy of lumbar radiofrequency neurotomy. Radiofrequency neurotomy showed Level II evidence for efficacy for both the short term and long term. CONCLUSION: This systematic review of the assessment of the efficacy of radiofrequency neurotomy in managing chronic low back pain was based on the inclusion of 12 RCTs with a diagnostic block and at least 6 months of follow-up results that showed Level II evidence for both short-term and long-term improvement.

Insights from Genomes and Genetic Epidemiology of SARS-CoV-2 isolates from the state of Andhra Pradesh

Coronavirus disease (COVID-19) emerged from a city in China and has now spread as a global pandemic affecting millions of individuals. The causative agent, SARS-CoV-2, is being extensively studied in terms of its genetic epidemiology using genomic approaches. Andhra Pradesh is one of the major states of India with the third-largest number of COVID-19 cases with limited understanding of its genetic epidemiology. In this study, we have sequenced 293 SARS-CoV-2 genome isolates from Andhra Pradesh with a mean coverage of 13,324X. We identified 564 high-quality SARS-CoV-2 variants. A total of 18 variants mapped to RT-PCR primer/probe sites, and 4 variants are known to be associated with an increase in infectivity. Phylogenetic analysis of the genomes revealed the circulating SARS-CoV-2 in Andhra Pradesh majorly clustered under the clade A2a (20A, 20B and 20C) (94%), while 6% fall under the I/A3i clade, a clade previously defined to be present in large numbers in India. To the best of our knowledge, this is the most comprehensive genetic epidemiological analysis performed for the state of Andhra Pradesh. © 2021 BMJ Publishing Group. All rights reserved.

Contact tracing of covid-19 cases for early detection of infection in tertiary care hospital, Pune

Background: World Health Organization (WHO) declared COVID-19 as Public Health Emergency of International Concern (PHEIC) on 30th Jan 2020 and later declared it as pandemic on 11th March 2020. Community surveillance plays a significant role in the prevention of the spread of disease. The government of India’s focus has been on community surveillance activities which mainly comprises contact tracing and quarantine. Objective: To explore high risk and low-risk contacts of confirmed COVID-19 patients admitted to a Tertiary Care Center, Pune. To find out the secondary attack rate of COVID-19 cases and To study demographic characters of COVID-19 cases. Methods: Observational cross-sectional study was done in the Tertiary Care Center, where isolation of suspected cases and management of COVID-19 positive patients was done. Details about patients such as age, sex, residence, history of contact with COVID-19 patient, history of travel to COVID-19 affected case was taken by taking the interview. Data were analyzed by Epi-info version 7.2.1.0. The statistical Tests used was the chi-square test. Results: Male patients were more as compared to females. There was a significant association between co-morbidities and deaths of COVID-19 patients. Family members were the most affected contacts of cases(63.16%). 23 families have secondary cases in their homes. The highest secondary attack rate was found to be 83.33% in 2 families. Conclusion: Family members were the most affected contacts of cases (63.16%) followed by health care workers. There was no significant difference between deaths among male and female cases. 23 families(19%) had secondary cases in their homes. The secondary attack rate ranged from 9% to 83.33%, with a median of 24.26%. © IJCRR.

COVID-19 and Its Impact on the Indian Economy

Pessimism looms large all over. COVID-19 has been projected as worse than the Great Depression of 1930. Everyday analyst and agency reports are diving into new bottoms of a fall-down in economic activities. Indian economy, however, has a slightly different story to tell at this hour of crisis. The silver lining for the Indian economy comes from a steep fall in the crude oil prices from around $70 per barrel to a record 18 years low of $22 per barrel. This windfall gain can, to some extent, offset the direct losses due to COVID-19. At the same time, dreams like a $5 trillion economy no longer look even a remote possibility. This article takes stock of the likely impact of COVID-19 on the Indian economy in the short term and the long term. A decision-tree approach has been adopted for doing the projections.

Recovery of endoscopy services in the era of COVID-19: recommendations from an international Delphi consensus.

The COVID-19 pandemic has had a profound impact on provision of endoscopy services globally as staff and real estate were repurposed. As we begin to recover from the pandemic, a cohesive international approach is needed, and guidance on how to resume endoscopy services safely to avoid unintended harm from diagnostic delays. The aim of these guidelines is to provide consensus recommendations that clinicians can use to facilitate the swift and safe resumption of endoscopy services. An evidence-based literature review was carried out on the various strategies used globally to manage endoscopy during the COVID-19 pandemic and control infection. A modified Delphi process involving international endoscopy experts was used to agree on the consensus statements. A threshold of 80% agreement was used to establish consensus for each statement. 27 of 30 statements achieved consensus after two rounds of voting by 34 experts. The statements were categorised as pre-endoscopy, during endoscopy and postendoscopy addressing relevant areas of practice, such as screening, personal protective equipment, appropriate environments for endoscopy and infection control precautions, particularly in areas of high disease prevalence. Recommendations for testing of patients and for healthcare workers, appropriate locations of donning and doffing areas and social distancing measures before endoscopy are unique and not dealt with by any other guidelines. This international consensus using a modified Delphi method to produce a series of best practice recommendations to aid the safe resumption of endoscopy services globally in the era of COVID-19.

Adoption of Multi-society Guidelines Facilitates Value-Based Reduction in Screening and Surveillance Colonoscopy Volume During COVID-19 Pandemic.

BACKGROUND: COVID-19 has caused a backlog of endoscopic procedures; colonoscopy must now be prioritized to those who would benefit most. We determined the proportion of screening and surveillance colonoscopies appropriate for rescheduling to a future year through strict adoption of US Multi-Society Task Force (USMSTF) guidelines. METHODS: We conducted a single-center observational study of patients scheduled for "open-access colonoscopy"-ordered by a primary care provider without being seen in gastroenterology clinic-over a 6-week period during the COVID-19 pandemic. Each chart was reviewed to appropriately assign a surveillance year per USMSTF guidelines including demographics, colonoscopy history and family history. When guidelines recommended a range of colonoscopy intervals, both a "conservative" and "liberal" guideline adherence were assessed. RESULTS: We delayed 769 "open-access" screening or surveillance colonoscopies due to COVID-19. Between 14.8% (conservative) and 20.7% (liberal), colonoscopies were appropriate for rescheduling to a future year. Conversely, 415 (54.0%) patients were overdue for colonoscopy. Family history of CRC was associated with being scheduled too early for both screening (OR 3.9; CI 1.9-8.2) and surveillance colonoscopy (OR 2.6, CI 1.0-6.5). The most common reasons a colonoscopy was inappropriately scheduled this year were failure to use new surveillance colonoscopy intervals (28.9%), incorrectly applied family history guidelines (27.2%) and recommending early surveillance colonoscopy after recent normal colonoscopy (19.3%). CONCLUSION: Up to one-fifth of patients scheduled for "open-access" colonoscopy can be rescheduled into a future year based on USMSTF guidelines. Rigorously applying guidelines could judiciously allocate colonoscopy resources as we recover from the COVID-19 pandemic.

Digestive Manifestations in Patients Hospitalized with COVID-19 (preprint)

BackgroundThe prevalence and significance of digestive manifestations in COVID-19 remain uncertain. MethodsConsecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset until discharge or death were manually abstracted from electronic health records to characterize the prevalence, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19. ResultsA total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least one gastrointestinal symptom at any time during their illness, most commonly diarrhea (34%), nausea (27%), vomiting (16%), and abdominal pain (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were elevated to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio 0.93, 95% confidence interval 0.76-1.15) or liver test abnormalities on admission (odds ratio 1.31, 95% confidence interval 0.80-2.12) were not independently associated with mechanical ventilation or death. ConclusionsAmong patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common but the majority were mild and their presence was not associated with a more severe clinical course

An epidemiological study of laboratory confirmed COVID-19 cases admitted in a tertiary care hospital of Pune, Maharashtra.

BACKGROUND: India has reported more than 70,000 cases and 2000 deaths. Pune is the second city in the Maharashtra state after Mumbai to breach the 1000 cases. Total deaths reported from Pune were 158 with a mortality of 5.7%. To plan health services, it is important to learn lessons from early stage of the outbreak on course of the disease in a hospital setting. OBJECTIVES: To describe the epidemiological characteristics of the outbreak of COVID-19 in India from a tertiary care hospital. METHODS: This was a hospital-based cross-sectional study which included all admitted laboratory confirmed COVID19 cases from March 31, to April 24, 2020. The information was collected in a predesigned pro forma which included sociodemographic data, duration of stay, family background, outcome, etc., by trained staff after ethics approval. Epi Info7 was used for data analysis. RESULTS: Out of the total 197 cases, majority cases were between the ages of 31-60 years with slight male preponderance. Majority of these cases were from the slums. Breathlessness was the main presenting symptom followed by fever and cough. More than 1/5th of patients were asymptomatic from exposure to admission. The case fatality rate among the admitted cases was 29.4%. Comorbidity was one of the significant risk factors for the progression of disease and death (odds ratio [OR] = 16.8, 95% confidence interval [CI] = 7.0 - 40.1, P < 0.0001). CONCLUSION: Mortality was higher than the national average of 3.2%; comorbidity was associated with bad prognosis.

Plans to Reactivate Gastroenterology Practices Following the COVID-19 Pandemic: A Survey of North American Centers.

BACKGROUND & AIMS: Practices dramatically reduced endoscopy services due to the COVID-19 pandemic. Because practices now are considering reintroduction of elective endoscopy, we conducted a survey of North American practices to identify reactivation barriers and strategies. METHODS: We designed and electronically distributed a web-based survey to North American gastroenterologists consisting of 7 domains: institutional demographics, impact of COVID-19 on endoscopy practice, elective endoscopy resumption plans, anesthesia modifications, personal protective equipment policies, fellowship training, and telemedicine use. Responses were stratified by practice type: ambulatory surgery center (ASC) or hospital-based. RESULTS: In total, 123 practices (55% ASC-based and 45% hospital-based) responded. At the pandemic's peak (as reported by the respondents), practices saw a 90% decrease in endoscopy volume, with most centers planning to resume elective endoscopy a median of 55 days after initial restrictions. Declining community prevalence of COVID-19, personal protective equipment availability, and preprocedure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing availability were ranked as the 3 primary factors influencing reactivation timing. ASC-based practices were more likely to identify preprocedure testing availability as a major factor limiting elective endoscopy resumption (P = .001). Preprocedure SARS-CoV-2 testing was planned by only 49.2% of practices overall; when testing is performed and negative, 52.9% of practices will continue to use N95 masks. CONCLUSIONS: This survey highlights barriers and variable strategies for reactivation of elective endoscopy services after the COVID-19 pandemic. Our results suggest that more widespread access to preprocedure SARS-CoV-2 tests with superior performance characteristics is needed to increase provider and patient comfort in proceeding with elective endoscopy.