ABSTRACT
Background and Aims: Mechanical ventilation in prone position was associated with a reduction in mortality and increase in arterial oxygenation in acute respiratory distress syndrome (ARDS) patients. However, physiological effects of prone position in COVID ARDS patients are unknown. Material and Methods: In this prospective observational study, data of n = 47 consecutive real time RT- PCR confirmed SARS-CoV-2-infected patients with severe ARDS were included. Respiratory mechanics and oxygenation data of recruited patients were collected before and after prone position. Results: Median (Interquartile range, IQR) age of the recruited patients was 60 (50-67) years and median (IQR) PaO2/FiO2 ratio of 61.2 (54-80) mm Hg with application of median (IQR) positive end expiratory pressure (PEEP) of 12 (10-14) cm H2O before initiation of prone position. Out of those patients, 36 (77%) were prone responders at 16 hours after prone session, evident by increase of PaO2 by at least 20 mm Hg or by 20% as compared to baseline, and 73% patients were sustained responders (after returning to supine position). Plateau airway pressure (p < 0.0001), peak airway pressure (p < 0.0001), and driving pressure (p < 0.0001) were significantly reduced in prone position, and static compliance (p = 0.001), PaO2/FiO2 ratio (p < 0.0001), PaO2 (p = 0.0002), and SpO2 (p = 0.0004) were increased at 4 hours and 16 hours since prone position and also after returning to supine position. Conclusion: In SARS-CoV-2-infected patients, mechanical ventilation in prone position is associated with improvement in lung compliance and oxygenation in almost three-fourth of the patients and persisted in supine position in more than 70% of the patients.
ABSTRACT
BACKGROUND AND AIMS: Vitamin C has been used as an anti-oxidant in various diseases including viral illnesses like coronavirus disease (COVID-19). METHODS: Meta-analysis of randomized controlled trials (RCT) investigating the role of vitamin C supplementation in COVID-19 was carried out. RESULTS: Total 6 RCTs including n = 572 patients were included. Vitamin C treatment didn't reduce mortality (RR 0.73, 95% CI 0.42 to 1.27; I2 = 0%; P = 0.27), ICU length of stay [SMD 0.29, 95% CI -0.05 to 0.63; I2 = 0%; P = 0.09), hospital length of stay (SMD -0.23, 95% CI -1.04 to 0.58; I2 = 92%; P = 0.57) and need for invasive mechanical ventilation (Risk Ratio 0.93, 95% CI 0.61 to 1.44; I2 = 0%; P = 0.76). Further sub-group analysis based on severity of illness (severe vs. non-severe), route of administration (IV vs. oral) and dose (high vs. low) failed to show any observable benefits. CONCLUSION: No significant benefit noted with vitamin C administration in COVID-19. Well-designed RCTs with standardized control group needed on this aspect.
Subject(s)
Antioxidants/therapeutic use , Ascorbic Acid/therapeutic use , COVID-19 Drug Treatment , COVID-19/mortality , Dietary Supplements , Humans , Length of Stay , Randomized Controlled Trials as TopicABSTRACT
The second wave of Coronavirus disease (COVID-19) has wreaked havoc across the globe resulting in 3,985,022 case fatality till 06.07.2021. Due to the overburdened nature of our health care system, a sudden increase in demand for medical attention, especially, with the fast-growing number of cases every day, the present review aims to highlight the importance of yoga-based interventions as an integrative approach during COVID-19 as an add-on therapy for the treatment. A review was carried out to summarize the impact of yoga-based interventions during the pandemic COVID-19. Literature searches were conducted in PubMed from the inception of the COVID-19 pandemic till April 2021 to identify all the relevant studies. A total of 8 studies were included in the present review, which analysed heterogeneous effects of yogic exercise and breathing therapies on multitude of health benefits like respiratory muscle training, reduction of stress and depression and improvement of quality of life. This review suggests the incorporation of complementary therapies (yoga, meditation, & pranayama) for overall health improvement and well-being of patients diagnosed with COVID-19, healthcare providers, and the general public.
ABSTRACT
Background and aims Vitamin C has been used as an anti-oxidant in various diseases including viral illnesses like coronavirus disease (COVID-19) Methods Meta-analysis of randomized controlled trials (RCT) investigating the role of vitamin C supplementation in COVID-19 was carried out. Results Total 6 RCTs including n = 572 patients were included. Vitamin C treatment didn't reduce mortality (RR 0.73, 95% CI 0.42 to 1.27;I2 = 0%;P = 0.27), ICU length of stay [SMD 0.29, 95% CI -0.05 to 0.63;I2 = 0%;P = 0.09), hospital length of stay (SMD -0.23, 95% CI -1.04 to 0.58;I2 = 92%;P = 0.57) and need for invasive mechanical ventilation (Risk Ratio 0.93, 95% CI 0.61 to 1.44;I2 = 0%;P = 0.76). Further sub-group analysis based on severity of illness (severe vs. non-severe), route of administration (IV vs. oral) and dose (high vs. low) failed to show any observable benefits. Conclusion No significant benefit noted with vitamin C administration in COVID-19. Well-designed RCTs with standardized control group needed on this aspect.
ABSTRACT
BACKGROUND: Vitamin-D is an immune-modulator which might be linked to disease severity by SARS-CoV-2. METHODS: Meta-analysis of RCTs and quasi-experimental studies, evaluating the role of vitamin-D supplementation in COVID patients was done. RESULTS: Total 5 studies (3 RCTs and 2 Quasi-experimental) including n = 467 patients were included. Vitamin D didn't reduce mortality (RR 0.55, 95%CI 0.22 to 1.39, p = 0.21), ICU admission rates (RR 0.20, 95% CI 0.01-4.26, p = 0.3) and need for invasive ventilation (RR 0.24, 95% CI 0.01-7.89, p = 0.42). CONCLUSION: No significant difference with vitamin-D supplementation on major health related outcomes in COVID-19. Well-designed RCTs are required addressing this topic.