ABSTRACT
Introduction: COVID-19 pandemic has been the most challenging global health concern that the world has ever seen and is the focus of active research around the world. The interaction of the SARS CoV2 virus with the target cells, their action on the immune system and the subsequent reaction has all been linked to the inflammatory processes that are taking place in the human body mainly the oxidative stress.Objective: Through this article we aim to analyse the effect of oxidative stress in the pathogenesis of COVID-19, highlighting the role of the same in the oral manifestations that are being reported in literature and its subsequent impact in the transmission and propagation of SARS-CoV2. The role of antioxidants in the control of the SARS-CoV2 infection has also been explored.Materials and Methods: Four reviewers independently collected the data pertaining to the topic from case reports and review articles published in electronic databases like PubMed, Scopus, Science Direct and Research gate.Conclusion: Increased release of cytokines known as cytokine storm has been associated with disease progression, oral manifestation as well as adverse effects in patients with COVID 19. However, as this is an ongoing pandemic with new mu-tations occurring frequently, further clinical trials are required to evaluate the exact mechanisms that may be at play in the pathogenesis of SARS-CoV2 infection.
ABSTRACT
Background and Aim: We aimed to study the healthcare disparity among elderly patients with cirrhosis and its impact on composite outcomes during the COVID pandemic. Methods: We conducted a prospective observational study between July 21- May 2022 via telephonic interview or physical consultations at 2 large tertiary care centers in India. The data was captured using pre-validated questionnaires to assess healthcare disparity amongst elderly patients with cirrhosis. Results: Of 475 elderly (≥65years) patients with cirrhosis (based on imaging) were included with mean age of 72.1years, male:female(3.8:1) with aetiology of cirrhosis being NAFL/NASH (58%), alcohol(32%) in majority. 323 (69%) had access to internet, however amongst them only 247 (52%) were conversant with use of WhatsApp, the preferred platform for tele-consultations in most hospitals in India. 147(31%) had walkability and accessibility to hospitals and 223(47%) had access to a family physician or community nurse, 271 (67%) had laboratory access. 295(62%) had taken both Covid vaccines, 349(74%) had first dose alone and only 38(8%) had booster dose. 213 (45%) felt that they needed admission/ expert opinion at least once during the period with 137 (29%) needed inpatient treatment. 266 (56%) missed at least 15 days doses of drugs with 85(32%) citing unavailability and 48(18%) unaffordability. Cancellation/rescheduling of medical services was widely prevalent with 74(15.5%) needing to reschedule endoscopy, 132 (28%) had cancellation of imaging of any form at least once, loco-regional therapy was rescheduled in 14(18%) patients of HCC. Advanced age, presence of >1 co-morbidity, tense ascites, hepatic encephalopathy, lack of caregivers were signi cantly associated with poor quality of life, restricted access and utilization of healthcare Conclusions: Elderly patients with cirrhosis had significant barriers in seeking healthcare during Covid19 pandemic highlighting the disparity and need for concerted e orts to improve their access to care.