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Objective: To compare the effect of different doses of methylprednisolone and dexamethasone on in-hospital mortality in severe COVID-19 pneumoniaMethods: This retrospective chart review was done by reviewing old medical reports of patients with severe disease admitted to COVID-19 Intensive Care and High Dependency Unit from October 2020 to September 2021. Those with suspected COVID-19 infection (suggestive radiological findings but negative PCR for SARS- CoV-2 on at least two occasions) were excluded. Patients requiring high flow oxygen (> 6 liters per minute) or higher levels of respiratory support were classified as having severe disease. We recorded the type of steroids used and the doses. Methylprednisolone in doses up to 40mg per day, or other steroids in equivalent doses, were considered low dose. Primary outcome of interest was in-hospital mortality.Results: There were 279 patients aged 52.53 +/- 11.31 years, including 216 (77.42%) males. Mean hospital stay was 10.18 +/- 3.13 days. During hospital stay, 96 (34.41%) patients died. Amongst patients receiving dexamethasone, 70 (44.87%) expired, whereas 26 (21.14%) out of 123 patients who received methylprednisolone expired (p < 0.001;hazard ratio 3.037). With high dose steroids, 52 (41.27%) out of 126 patients expired, whereas 44 (28.76%) out of 153 patients treated with low dose steroids expired (p=0.029;hazard ratio 1.741). In multivariate binary logistic regression, in-hospital mortality was related to the type of steroid but not the steroid dose.Conclusion: Methylprednisolone is superior to dexamethasone for treatment of severe COVID-19 pneumonia.
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Introduction: Children appear to be less commonly and less severely affected by COVID-19 than adults, accounting for 1% to5% of all COVID-19 cases. The COVID-19 pandemic has challenged pediatric kidney transplant programs to provide safe and consistent care during this difficult and unprecedented time. Method(s): So far during this pandemic, best practices being delivered to pediatric kidney transplant patients are based on available information from published literature and expert opinions. The key areas of pediatric kidney transplant care that may be affected by the COVID-19 pandemic include transplant activity, outpatient clinic activity, monitoring, multidisciplinary care, medications(immunosuppression and others), patient/family education/support, school and employment, and care of pediatric kidney transplant patients who areCOVID-19 positive Results: It has been presumed that children with chronic kidney disease and/or those who take immunosuppressants may be at increased risk for complications from COVID-19 infection;however, available evidence has now suggested that immunosuppressed children with kidney transplant are not at increased risk of severe COVID-19 disease. Clinicians should remain aware that transplant recipients may present with atypical symptoms. In addition, because evidence-based reports to support specific adjustments to immunosuppressive medications in relation to COVID-19 are not yet available, decisions on reduction or discontinuation of immunosuppression should be on a case-by-case basis for kidney transplant recipients who are COVID-19positive. Conclusion(s): Reports to support evidence-based management of pediatric kidney transplant patients during the COVID-19 pandemic are lacking;therefore, expert opinion and available knowledge and experience remain subject to biases. No conflict of interestCopyright © 2023
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In this study, we aimed to evaluate the knowledge and practices of the individuals in the UAE, to enhance the immune system during the COVID-19 comparing with before the pandemic period. We use a cross-sectional online questionnaire was administered to (n=1530) UAE participants. The questionnaire included four aspects: demographic characteristics, Knowledge questions, practice questions before the COVID-19, practice questions during the COVID-19. The findings revealed that the total score of the correct answers of the knowledge was (78%), while the total score of practices was moderate and increased from (1.90 ±0.776) to (2.15±0.80) before and during the pandemic, respectively. There was a statistically significant between knowledge and practices with gender, employment status, age group, education, marital status, and participants with positive COVID-19 test, while there was no significance with marital status and practices. females, employed people, individuals aged ≤50, high educational degree, other marital status, and negative COVID-19 test, had a higher level of knowledge than others, while females, employed people, individuals aged 40-49, college educational degree, other marital status, and positive COVID-19 test, had a higher level of practices than others. The Conclusions of this study showed that United Arab Emirates (UAE) residents showed high levels of knowledge and positive change in the practices to enhance the immune system during the COVID-19 pandemic. Continuing the health education programs by the UAE health authorities toward COVID 19 while focusing more on how to strengthen the body's immunity is recommended. © 2022 NSP Natural Sciences Publishing Cor.
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AIM: The primary care response to the coronavirus disease 2019 (COVID-19) pandemic in early 2020 required significant changes to the delivery of healthcare by general practices. This study explores the experiences of New Zealand general practice teams in their use of telehealth during the early stages of the COVID-19 pandemic in New Zealand. METHOD: We qualitatively analysed a subtheme on telehealth of the General Practice Pandemic Experience New Zealand (GPPENZ) study, where general practice team members across the country were invited to participate in five surveys between 8 May 2020 to 27 August 2020. RESULTS: 164 participants enrolled in the study during survey one, with 78 (48%) completing all surveys. Five telehealth themes were identified: benefits, limitations, paying for consults, changes over time and plans for future use. Benefits included rapid triage, convenience and efficiency, and limitations included financial and technical barriers for practices and patients and concerns about clinical risk. Respondents rapidly returned to in-person consultations and wanted clarification of conditions suited to telehealth, better infrastructure and funding. CONCLUSION: To equitably sustain telehealth use, the following are required: adequate funding, training, processes communicated to patients, improved patient access to technology and technological literacy, virtual physical examination methods and integration with existing primary health care services.
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Fasting the month of Ramadan is one of five obligatory pillars of the Islamic creed, observed strictly by hundreds of millions of Muslims every year. The fasting process includes absolute abstinence from eating and drinking for an average of around 15 hours daily for one month. As the coronavirus disease 2019 (COVID-19) pandemic has been ongoing during the month of fasting, there are public concerns that fasting may increase the susceptibility for infection of COVID-19. According to Islamic jurisdiction, if adequate scientific evidence of harm on health is available, fasting is discouraged and should not be practiced. Such concern is not only relevant to the Muslim population but is becoming increasingly relevant to other populations due to the practice of intermittent fasting which is a popular current health trend worldwide. There is no direct evidence of any disadvantage effect of Ramadan fasting during the COVID-19 pandemic on healthy people, for this purpose, we performed a systematic review of 37 articles published between 2005 and April 2020 which investigated the effect of fasting on markers of the respiratory system function and immune response. Our main findings from this analysis show that there is no evidence that fasting the month of Ramadan have a negative impact on the respiratory function and the immune system of healthy individuals.
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Background: The coronavirus disease (COVID-19) pandemic is a highly infectious viral disease that has spread to over one hundred and eight countries, including Nigeria. Governments across the globe have been implementing preventive measures towards curbing the spread and impact of the virus. These measures have continued to interfere with the general lifestyle of the people. Hence, this study was aimed at examining the socio-demographic predictors of adherence to prescribed recommendations and the psychological impacts of COVID-19 pandemic lockdown among Nigerian social media users.
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INTRODUCTION: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the pre-existing worldwide sexual and reproductive health environment. The provision and supply of contraceptives, and a wide variety of sexual health, new-born, and maternal health services have been seriously affected. Thus, this scoping review mapped the available evidence on the impacts of the COVID-19 outbreak on sexual and reproductive health. METHODS: Arksey and O'Malley's methodological framework guided this scoping review. A search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) chart and PRISMA extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The McMaster critical review checklist was used to determine the quality of the included studies. Thematic analyses were conducted using NVivo version 12. RESULTS: Three studies showed evidence on the impact of COVID-19 and family planning services, six studies reported on maternal and child services and eleven studies reported on sexual health (sexual behavior). Limited access to family planning use, reduction in multiple sexual partnership, decreased transactional sex, and maternal and child services disruption were some impacts reported in the included studies. CONCLUSION: This study has demonstrated the impacts of COVID-19 on family planning access, multiple sexual partnership, transactional sex, and disruption of maternal and child health services. Interventions that will consider the immediate availability of and access to all sexual and reproductive health services should be prioritized.