Prognostic Accuracy of News 2 in Geriatric Patients with COVID-19 in a Tertiary Care Hospital

Introduction: COVID-19 is a widespread disease having more impact on elderly as compared to younger age group. [2] Although many parameters have emerged as predictors of prognosis of COVID-19, a simple clinical score at baseline can be used for early risk stratification. NEWS2 (National Early Warning Score) is one such scoring system which was originally developed to improve detection of deterioration in acutely ill patients.[8] Therefore, the present study has been conducted to assess the effectiveness of NEWS2 in predicting critical outcomes and mortality in geriatric patients with COVID-19. Material(s) and Method(s): A cross sectional Observational study was done on 200 Geriatric patients hospitalised with confirmed COVID-19 between December 2020 to November 2022. Baseline NEWS2 score was calculated. The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value were established for NEWS2 score of 5 or above. Result(s): In critical group, all 109 (100%) patients' deterioration was predicted, and in non-critical group, in 14 (15.4%) patients non deterioration was predicted while 77 (84.6%) patients' deterioration was predicted. Statistically significant association has been observed between the critical, non-critical groups and NEWS2 scale (P=0.001). Deterioration was predicted by NEWS2 scale in all the critical patients. Conclusion(s): NEWS2 score of 5 or more on admission predicts poor prognosis in geriatric patients with COVID-19 with good sensitivity and it can easily be applied for risk stratification at baseline. We recommend further studies in the Indian setting to validate this simple score and use it further in Geriatric patients with COVID-19.Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Neutrophil Lymphocyte Ratio (NLR) as a Predictor of Disease Severity and Mortality in Geriatric Patients with COVID-19

Introduction: COVID-19 pandemic affected 44,696,984 people in India Geriatric (age 60 years and above) population is increasing globally. Older adults have been affected badly with COVID-19 Neutrophil lymphocyte ratio (NLR) is used in several diseases as an inflammatory marker in predicting prognosis. According to a recent study patients with severe COVID-19 are reported to have higher Neutrophil lymphocyte ratio ( NLR). In this study we aimed to assess the accuracy of Neutrophil lymphocyte ratio (NLR) as a predictor of disease severity and mortality in geriatric patients with COVID-19. Material(s) and Method(s): 200 geriatric inpatients infected with COVID-19 were included in the study. Neutrophil lymphocyte ratio (NLR) at admission was recorded. Neutrophil lymphocyte ratio (NLR) cutoff was taken 3.5. Patients were categorized into mild, moderate, severe and critical cases according to criteria given by Maharashtra Task Force. Relationship between Neutrophil lymphocyte ratio (NLR) and disease outcome was assessed. A p value < 0.05 was taken as statistically significant. Result(s): The mean age of study sample was 69.00 +/-7.09 years. A significant association was found between Neutrophil lymphocyte ratio (NLR) and disease severity (p-0.048) as well as mortality (p-0.041).Copyright © 2023, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Did ESG Save the Day? Evidence From India During the COVID-19 Crisis

Investors have shown increasing interest in Socially Responsible Investments (SRI) in the past few years, especially during the financial crisis caused due to the outbreak of the COVID-19 pandemic. SRI are evaluated on the basis of Environmental, Social and Governance (ESG) criteria. ESG information allows investors to assess the risks associated with a particular firm and how the firm manages or intends to manage future risks. Amidst the increasing investor interest in ESG products, we attempt to study the value addition of ESG performance to investors during crisis period. Using a sample of ESG rated firms listed on the Bombay Stock Exchange (BSE), we examine the investment performance, trading volumes and return volatility of ESG stocks in an emerging market like India during the COVID-19 crisis. The results of our event study conducted around the important events that have occurred in India during the COVID-19 pandemic provide evidence that investors can use ESG information as a signal of future stock performance. Most importantly, ESG performance provides downside protection during crisis times. Our results show that ESG performance does not prove to be detrimental to investment performance during normal times. Also, ESG performance was found to reduce stock return volatility during the COVID-19 pandemic. Overall, our study attempts to establish an investment case for ESG stocks in emerging markets in India by providing support to the good management hypothesis.

Screening activity matters: Evidence from social and governance portfolio performance from an emerging market

Socially Responsible Investments (SRI) have recently generated much interest among asset owners, managers and academicians. Though the Efficient Market Theory suggests that stock prices fully reflect all available information, few existing studies indicate that Environmental, Social and Governance (ESG) portfolios deliver superior risk-adjusted performance. ESG investing is at a nascent stage in India but is growing rapidly, especially after the COVID-19 pandemic. Asset managers always face the dilemma of choosing between different screening methods, screening intensities and stock weighting schemes to deliver outperformance. Our study attempts to investigate the impact of these portfolio construction criteria on the risk-adjusted performance of ESG portfolios in India. Our results show that there exists a trade-off between superior investment performance and unsystematic risk of ESG portfolios. Investors can benefit from investing in equally-weighted best-in-class portfolios constructed using ESG scores. We highlight the implications of our findings for asset owners, managers, index providers and regulators, and also provide directions for future research in the area of ESG portfolio management. © 2023 John Wiley & Sons Ltd.

The Impact of the Covid19 Pandemic on Patients with Peripheral Artery Disease

Background The impact of COVID-19 on major adverse lower extremity (MALE) and cardiovascular events (MACE) in patients with peripheral artery disease (PAD) is unknown. Methods Using the VA Corporate Data Warehouse, Veterans with PAD were identified. Rates of MALE (amputation or lower extremity revascularization [LER]), and MACE (death, MI, or coronary revascularization) were assessed in pre-pandemic (3/11/2019-3/10/2020), early-pandemic (3/11/2020-3/10/2021), and late-pandemic (3/11/2021-3/10/2022) periods. Outcomes were compared using Kaplan-Meier method. Results Of 418,042 Veterans (mean age 72 yrs) with PAD, 76.7% were white and 96.8% male. Furthermore, 89.2% had HTN, 60.4% diabetes, 49.3% CAD, 21.6% heart failure, and 20.5% atrial fibrillation. From 3/11/2019 to 3/10/2022, 3,100 had amputation, 8,187 had LER, & 2,229 had MACE. Amputation rates declined and continued to decline in early- and late-pandemic period (306 to 268 to 235;p<0.001;rates per 100k). Rates of LER declined initially and stabilized in late-pandemic period (951 to 587 to 609;p < 0.001;rates per 100k). MACE did not change significantly. (215 to 168 to 202;p<0.001;rates per 100k). Conclusion Amputation rates in Veterans with PAD did not increase despite a clinically significant decline in LER. Given the known efficacy of noninvasive therapies in PAD, these data suggest that there is a need to re-evaluate appropriate indications for LER and amputation. [Formula presented]Copyright © 2023 American College of Cardiology Foundation

Impact of COVID-19 pandemic on chicken meat and egg consumption patterns in rural and urban areas

A cross-sectional study was conducted in first and second week of May, 2020 for impact assessment on eggs and chicken consumption during the COVID-19 lockdown period of phase I and II (24th March-3rd May, 2020). Data were collected through semistructured interview schedule among randomly selected 77 consumers from 11 states of India. During the lockdown period 26.9% families left consumption of chicken meat and 20.8% families left eating egg due to panic of COVID 19, non-availability due to supply chain disruption, restrictions of containment zones. The chicken consumption significantly (Pd"0.05) reduced during the COVID lockdown period from 2.5 kg to 1.9 kg per week per family. There was significant decrease in consumption of chicken by 26.9% and eggs by 28% in families who continue to take chicken and eggs during lockdown period. The weekly chicken consumption reduced by 40.7% in high, 4.9% in medium and 15.4% low consumption groups. The impact was visible in low consumption level group, in which majority of Indian consumers fall. Consumers were shifted to other vegetarian source of protein during the lockdown period. The government needs to focus on the creation self-sustaining nutrition centric micro-enterprises/start-ups with emphasis and support to the local production and supply chain.