ABSTRACT
BackgroundRheumatoid arthritis (RA) and spondyloarthritis, including either Psoriatic Arthritis (PsA) and Ankylosing Spondylitis (AS), are some of the most diagnosed autoimmune rheumatic diseases (AIRDs) in rheumatologists' routine clinical practice [1]. Understanding patients' health and functional status is crucial to provide personalized management strategies to optimize disease control and enhance the quality of life.ObjectivesWe aimed to compare disease burden in patients with RA, PsA or AS by assessing Patient-Reported Outcome Measurement Information System (PROMIS) Physical Health, Global Mental Health, Physical Function and Fatigue 4a together with VAS Pain.MethodsData were obtained in the international COVID vaccination in autoimmune rheumatic diseases study second e-survey (COVAD study). Demographics, AIRD diagnosis, disease activity, PROMIS Global Physical health, PROMIS Global Mental Health, PROMIS Physical Function SF10 and PROMIS Fatigue 4a score were extracted from the COVAD study database. For this study, we only included patients with self-reported RA or spondyloarthritis (either PsA or AS) undergoing active treatment with conventional synthetic disease-modifying drugs (DMARDs) and/or biologic DMARDs, who answered all the survey questions. Active disease was defined as the patient's perception of their disease as active in the four weeks before their first COVID-19 vaccine shot. Analysis of Variance with Bartlett's and Tukey's test was used to compare continuous variables between groups.ResultsFrom January to June 2022, n.1907 patients with RA, female 87.62% (1671/1907), with mean age (±SD) 50.95 ±13.67, n.311 patients with PsA, female 67.20% (209/311), with a mean age of 50.42 ±12.70, and n.336 patients with AS, male 51.31% (209/311), with a mean age of 43.13 ±12.75 years, responded to the COVAD e-survey.In those with active disease, neither physical health, global mental health, physical function, fatigue, nor pain were different among groups (Table 1, Figure 1). Patients with inactive AS had higher mean global physical health scores than RA patients (13.13 ±2.93 VS RA 12.48 ±2.90, p=0.01, Table 1). Those with inactive RA or PsA showed more severe fatigue (PsA 10.58 ±2.22, RA 10.45 ±4.08 VS 9.4 ±4.13, p =0.01 for both). Patients with inactive RA also reported poorer physical function and more residual pain than those with AS (37.79 ±8.86 VS 41.13 ±7.79, p<0.001;3.87 ±2.45 VS 3.34 ±2.39, p=0.01, respectively). Similarly, residual pain was perceived as higher in patients with inactive PsA than those with AS (4.04 ±2.50 VS 3.34 ±2.39, p=0.01)ConclusionDisease burden is roughly comparable in patients with active RA, PsA or AS. Patients with inactive RA and PsA suffer higher disease burden than those with inactive AS.Reference[1]Mease PJ, Liu M, Rebello S, Kang H, Yi E, Park Y, Greenberg JD. Comparative Disease Burden in Patients with Rheumatoid Arthritis, Psoriatic Arthritis, or Axial Spondyloarthritis: Data from Two Corrona Registries. Rheumatol Ther. 2019 Dec;6(4):529-542.Table 1.Patient-Reported Outcome Measures between groups.Inactive diseaseAS (n.185)PsA (n.179)RA (n.1167)MeanSDMeanSDMeanSDPROMIS Global Physical Health13.13*2.9512.433.2712.482.90p=0.01, VS RAPROMIS Global Mental Health13.313.3612.973.3312.843.17PROMIS Fatigue 4a9.44.1310.58*4.2210.45*4.08p=0.01, bothPROMIS Physical Function SF10 Score41.137.3939.279.0137.79*8.86p<0.001, VS ASVAS Pain3.342.394.04*2.503.87*2.45p=0.01, bothActive DiseaseAS (n.35)PsA (n.38)RA (n.189)MeanSDMeanSDMeanSDPROMIS Global Physical Health11.053.1910.102.7611.243.41PROMIS Global Mental Health11.313.2610.843.6311.893.30PROMIS Fatigue 4a12.944.8712.844.4211.754.68PROMIS Physical Function SF10 Score35.829.6233.528.7634.909.80VAS Pain4.682.775.02.544.682.61Figure 1.Violin plots showing kernel densities, quartiles and median for Patient-Reported Outcome Measures for patients with RA, PsA and AS, stratified by disease activity status.[Figure omitted. See PDF]Acknowledgements:NIL.Disclosure of InterestsVincenzo Venerito: None declared, Marc Fornaro: None declared, Florenzo Iannone: None declared, Lorenzo Cavagna: None declared, Masataka Kuwana: None declared, Vishwesh Agarwal: None declared, Naveen Ravichandran: None declared, Jessica Day Grant/research support from: JD has received research funding from CSL Limited., Mrudula Joshi: None declared, Sreoshy Saha: None declared, Syahrul Sazliyana Shaharir: None declared, Wanruchada Katchamart: None declared, Phonpen Akarawatcharangura Goo: None declared, Lisa Traboco: None declared, Yi-Ming Chen: None declared, Parikshit Sen: None declared, James B. Lilleker Speakers bureau: JBL has received speaker honoraria/participated in advisory boards for Sanofi Genzyme, Roche, and Biogen. None is related to this manuscript., Consultant of: JBL has received speaker honoraria/participated in advisory boards for Sanofi Genzyme, Roche, and Biogen. None is related to this manuscript., Arvind Nune: None declared, John Pauling: None declared, Chris Wincup: None declared, Ai Lyn Tan Speakers bureau: ALT has received honoraria for advisory boards and speaking for Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Nelly Ziade Speakers bureau: NZ has received speaker fees, advisory board fees, and research grants from Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, and Pierre Fabre;none are related to this manuscript, Grant/research support from: NZ has received speaker fees, advisory board fees, and research grants from Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, and Pierre Fabre;none are related to this manuscript, Marcin Milchert: None declared, Abraham Edgar Gracia-Ramos: None declared, Carlo Vinicio Caballero: None declared, COVAD Study: None declared, Vikas Agarwal: None declared, Rohit Aggarwal Speakers bureau: RA has a consultancy relationship with and/or has received research funding from the following companies: Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, and Roivant., Grant/research support from: RA has a consultancy relationship with and/or has received research funding from the following companies: Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, and Roivant., Latika Gupta: None declared.
ABSTRACT
People's way of consuming media changed tremendously with rapid technological improvements and increased internet penetration levels across India due to emergence of over-the-top media services (OTT) platforms. COVID-19 outbreak has tremendously increased the demand for OTT streaming channels like Netflix, Amazon prime, Zee 5, Alt Balaji and Disney Hotstar which transformed the world of entertainment and media by contributing mind blowing services during the lockdown period.This research paper is an attempt to study the shift in media consumption patterns from old ways of entertainment like cinema, television to new ways of entertainment like OTT platforms, study and analyze the consumer preference towards choice of OTT platforms, watching habits of online over the top (OTT) applications among Indian viewers. © 2023 IEEE.
ABSTRACT
BackgroundAlthough many studies have been conducted on COVID-19 in recent years, there are still unanswered questions regarding breakthrough infections (BTIs), particularly in patients with systemic lupus erythematosus (SLE).ObjectivesThis study aimed to determine the occurrence of breakthrough COVID-19 infections in patients with SLE versus other autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs).MethodsThe study was based on data from the COVAD questionnaire which amassed a total of 10,783 complete responses from patients with SLE, AIRD, or nrAIRD, and HCs. After exclusion of individuals who were unvaccinated, those who received one vaccine dose only, and those with uncertain responses regarding the vaccine doses, a total of 9,595 patients formed the study population of the present investigation. If a COVID-19 infection occurred after the initial two vaccine doses and at least one booster dose (at least three doses in total, herein termed full vaccination), it was considered a BTI. Data were analysed using multivariable regression models. Statistically significant results were denoted by p values <0.05.ResultsA total of 7,016/9,595 (73.1%) individuals were fully vaccinated. Among those, 1,002 (14.2%) reported at least one BTI, and 166 (2.3%) reported at least two BTIs. Among SLE patients, 867/1,218 (71.2%) were fully vaccinated. Among fully vaccinated SLE patients, 137 (15.8%) reported at least one BTI while 28 (3.2%) reported at least two BTIs. BTI frequencies in fully vaccinated SLE patients were comparable to those of other AIRDs (OR: 1.0;95% CI: 0.8–1.3;p=0.447) and nrAIDS (OR: 0.9;95% CI: 0.6–1.3;p=0.856) but higher compared with HCs (OR: 1.2;95% CI: 1.0–1.6;p=0.022).For SLE patients with three vaccine doses, 113/137 (82.5%) reported at least one BTI while the corresponding number for four vaccine doses was 24/137 (17.5%). Compared with HCs (OR: 10.6;95% CI: 1.2–93.0;p=0.032) and other AIRDs (OR: 3.5;95% CI: 1.08–11.5;p=0.036), SLE patients showed higher frequencies of hospitalisation.AID multimorbidity was associated with a 15-fold increased risk for a need of advanced treatment for COVID-19 (OR: 15.3;95% CI: 2.6–88.2;p=0.002).ConclusionCOVID-19 BTIs occurred in nearly 1 every 6th fully vaccinated patient with SLE, and 20% more frequently in this patient population compared with fully vaccinated HCs. Moreover, BTIs in SLE patients were more severe compared with BTIs in HCs or patients with AIRDs other than SLE, resulting in a greater need for hospitalisation. AID multimorbidity contributed to a more severe COVID-19 BTI requiring advanced management. These insights call for greater attention to vaccination in the vulnerable group of SLE patients, with appropriate risk stratification towards optimised vaccination strategies.Figure 1.Survival analysis across patients with SLE, AIRDs, or nrAIDs, and HCs. SLE: systemic lupus erythematosus;AIRD: autoimmune rheumatic disease;nrAID: non-rheumatic autoimmune disease;HC: healthy control.[Figure omitted. See PDF]AcknowledgementsThe authors thank all survey respondents, as well as patient associations and all members of the COVAD study group for their invaluable role in the data collection.Disclosure of InterestsEmelie Kihlgren Olsson: None declared, Naveen Ravichandran: None declared, Elena Nikiphorou Speakers bureau: EN has received speaker honoraria/participated in advisory boards for Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, and Lilly., Consultant of: EN has received speaker honoraria/participated in advisory boards for Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, and Lilly., Grant/research support from: EN holds research grants from Pfizer and Lilly., Julius Lindblom: None declared, Sreoshy Saha: None declared, Syahrul Sazliyana Shaharir: None declared, Wanruchada Katchamart: None declared, Phonpen Akarawatcharangura Goo: None declared, Lisa Traboco: None declared, Yi-Ming Chen: None declared, Kshitij Jagtap: None declared, James B. Lilleker Speakers bureau:
ABSTRACT
BackgroundWe have previously reported short term safety of the COVID-19 vaccination in patients with Systemic sclerosis (SSc) but delayed adverse events (ADEs) (occurring >7 days post-vaccination) are poorly characterized in this rare yet vulnerable disease group.ObjectivesWe analyzed delayed COVID-19 vaccine-related ADEs among patients with SSc, other systemic autoimmune and inflammatory disorders (SAIDs) and healthy controls (HC) using data from the ongoing 2nd global COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) study [1].MethodsThe COVAD-2 study was a cross-sectional, patient self-reporting e-survey utilizing an extensively validated, pilot tested questionnaire, translated into 19 languages, circulated by a group of 157 physicians across 106 countries from February to June 2022.We captured data on demographics, SSc/SAID disease characteristics (including skin subset, treatment history and self-reported disease activity), autoimmune and non-autoimmune comorbidities, COVID-19 infection history and course, and vaccination details including delayed ADEs as defined by the CDC.Delayed ADEs were categorized into local injection site pain/soreness;minor and major systemic ADEs, and hospitalizations. We descriptively analyzed the risk factors for overall and specific ADEs in SSc and SAIDs, and further triangulated clinically significant variables in binominal logistic regression analysis with adjustment for age, gender, ethnicity, comorbidity, and immunosuppressive therapy to analyze the survey responses.ResultsFrom among 17 612 respondents, 10 041 patients (median age 51 (18-58) years, 73.4% females, 44.9% Caucasians) vaccinated against COVID-19 at least once (excluding incomplete responses and trial participants) were included for analysis. Of these, 2.6 % (n=258) had SSc, 63.7% other SAIDs, and 33.7% were HCs. BNT162b2 Pfizer (69.4%) was the most administered vaccine, followed by MRNA-1273 Moderna (32.25%) and ChadOx1 nCOV-19 Oxford/AstraZeneca (12.4%) vaccines.Among the patients with SSc, 18.9% reported minor while 8.5% experienced major delayed ADEs, and 4.6% reported hospitalization. These values were comparable to those of the ADEs reported in other SAIDs and HCs. Patients with SSc reported higher frequency of difficulty in breathing than HCs [OR=2.3 (1.0-5.1), p=0.042].Individuals receiving Oxford/AstraZeneca reported more minor ADEs [OR=2.5 (1.0-6.0), p=0.045];whereas patients receiving Moderna were less likely to develop myalgia and body ache [OR=0.1 (0.02-1.0), p=0.047 and OR=0.2 (0.05-1.0), p=0.044 respectively].Patients with diffuse cutaneous SSc experienced minor ADEs and specifically fatigue more frequently [OR=2.1 (1.1-4.4), p=0.036, and OR=3.9 (1.3-11.7), p=0.015] than those with limited cutaneous SSc. Self-reported active disease pre-vaccination did not confer any increased risk of vaccine ADEs in the adjusted analysis. Unlike our previous observations in myositis, autoimmune and non-autoimmune comorbidities did not affect the risk of delayed ADEs in SSc. SSc patients with concomitant myositis reported myalgia [OR=3.4 (1.1-10.7), p=0.035] more frequently, while those with thyroid disorders were more prone to report a higher frequency of joint pain [OR=5.5 (1.5-20.2), p=0.009] and dizziness [OR=5.9 (1.3-27.6), p=0.024] than patients with SSc alone. Patients with SSc-interstitial lung disease did not report increased frequency of ADEs.ConclusionA diagnosis of SSc did not confer a higher risk of delayed post COVID-19 vaccine-related ADEs than other SAIDs and HCs. Diffuse cutaneous phenotype and certain co-existing autoimmune conditions including myositis and thyroid disease can increase the risk of minor ADEs. These patients may benefit from pre-vaccination counselling, close monitoring, and early initiation of appropriate care in the post COVID-19 vaccination period.Reference[1]Fazal ZZ, Sen P, Joshi M, Ravichandran N, Lilleker JB, et al. COVAD survey 2 long-term outcomes: unmet need and protocol. Rheumatol Int 2022 Dec;42(12):2151-2158AcknowledgementsCOVAD Study Team.Disclosure of InterestsBo dana Doskaliuk: None declared, Parikshit Sen: None declared, Mrudula Joshi: None declared, Naveen Ravichandran: None declared, Ai Lyn Tan Speakers bureau: Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Consultant of: Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, UCB, Samuel Katsuyuki Shinjo: None declared, Sreoshy Saha: None declared, Nelly Ziade Speakers bureau: Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis,Boehringer Ingelheim, Janssen, and Pierre Fabre, Consultant of: Pfizer, Roche, Abbvie, Eli Lilly,NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, and Pierre Fabre, Grant/research support from: Pfizer, Roche, Abbvie, Eli Lilly, NewBridge, Sanofi-Aventis, Boehringer Ingelheim, Janssen, and.Pierre Fabre, Tulika Chatterjee: None declared, Masataka Kuwana: None declared, Johannes Knitza: None declared, Oliver Distler Speakers bureau: 4P-Pharma, Abbvie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi and Topadur, Consultant of: 4P-Pharma, Abbvie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi and Topadur, Grant/research support from: 4P-Pharma, Abbvie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi and Topadur, Rohit Aggarwal Consultant of: Mallinckrodt, Octapharma, CSL Behring, Bristol Myers-Squibb, EMD Serono, Kezar, Pfizer, AstraZeneca, Alexion, Argenx, Boehringer Ingelheim, Corbus, Janssen, Kyverna, Roivant, Merck, Galapagos, Actigraph, Abbvie, Scipher, Horizontal Therapeutics, Teva, Biogen, Beigene, ANI Pharmaceutical, Nuvig, Capella, CabalettaBio, Grant/research support from: Mallinckrodt, Pfizer, Bristol Myers-Squibb, Q32, EMD Serono, Janssen, Boehringer Ingelheim (BI), Ashima Makol: None declared, Latika Gupta: None declared, Vikas Agarwal: None declared.
ABSTRACT
BackgroundViral infections are known triggers of disease flares in idiopathic inflammatory myopathies (IIMs). Reports of post-COVID-19 flares of IIMs have raised suspicion of a possible role of SARS-COV-2 in their onset [1,2]. However, despite rising flare rates in this vulnerable patient group during the pandemic, the risk factors for post-COVID-19 IIMs flares remain unknown [3,4].ObjectivesDisease flares among patients with idiopathic inflammatory myopathies (IIMs) can lead to significant disability, though are poorly explored in the post-COVID-19 period. We analysed risk factors for post-COVID-19 flares in a global sample of IIM patients in a subset analysis as part of the ongoing COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.MethodsA cross-sectional patient self-reporting survey was circulated by the international COVAD study group (157 collaborators, 106 countries) to patients with autoimmune diseases and healthy controls from February-June 2022. Data was collected on demographics, autoimmune disease details, treatment history, comorbidities, COVID-19 history and course and COVID-19 vaccination details. Patients with IIMs who flared post COVID-19 were compared to those who did not using the χ2 test, factors found significant in univariate analysis and deemed clinically important, underwent multivariable analysis (binary logistic regression using the Enter method) with adjustment for age, gender, ethnicity, vaccine type, immunosuppression, autoimmune and non-autoimmune comorbidities, COVID-19 antibody status, and clinical symptoms of COVID-19. Statistical analyses were performed using IBM SPSS version 28.0, with statistical significance considered at p<0.05.Results15,165 respondents completed the survey of whom 1,169 contracted COVID-19. Of these, 207 had IIMs [median (IQR) age 57.0 (47.0-67.0), 71% female, 74.4% Caucasian]. We noted with concern that nearly a third of patients with IIMs (63/207, 30.4%) reported experiencing a flare. A past medical history significant for Asthma, (34.9% vs 6.9%, multivariable OR: 7.1;95%CI: 3.1-16.4, p<0.001) and specific clinical symptoms during COVID-19 including joint pains (multivariable OR: 6.05;95%CI: 1.60-22.9, p=0.008), and difficulty in breathing (multivariable OR: 3.43;95%CI: 1.09-10.8, p=0.036) were found to confer conferred a higher risk of flares (Table 1).Table 1Patient Reported Flares following COVID-19 infection among IIM patientsTotal IIMs (n=207)IIMs with flare after COVID-19 (n=63)IIMs without flare after COVID-19 (n=144)OR (95%CI)PAge (median, IQR) years57.0 (47.0-67.0)53.0 (47.0-62.0)59.0 (47.0-69.0)-0.024GenderMale Female60 (29.0) 147 (71.0)7 (11.1) 56 (88.9)53 (36.8) 91 (63.2)0.2 (0.09-0.5)< 0.001ComorbiditiesAsthma ILD32 (15.5) 31 (15.0)22 (34.9) 11 (17.5)10 (6.9) 20 (13.9)7.1 (3.1-16.4) 1.3 (0.5-2.9)<0.001 00.508Clinical features in previous COVID-19 infectionFatigue Myalgia Arthralgia Difficulty in breathing134 (64.7) 94 (45.4) 56 (27.1) 41 (19.8)52 (82.5) 44 (69.8) 36 (57.1) 27 (42.9)82 (56.9) 50 (34.7) 20 (13.9) 14 (9.7)3.5 (1.7-7.4) 4.3 (2.3-8.2) 8.2 (4.1-16.4) 6.9 (3.3-14.6)<0.001 <0.001 <0.001 <0.001ConclusionWe observed a high frequency of patients with IIM experiencing post-COVID-19 disease flares. A past history of Asthma and those with certain acute COVID-19 symptoms were at higher risk.References[1]Saud A, Naveen R, Aggarwal R, Gupta L. COVID-19 and Myositis: What We Know So Far. Curr Rheumatol Rep 2021;23:63.[2]Gokhale Y, Patankar A, Holla U, Shilke M, Kalekar L, Karnik ND, et al. Dermatomyositis during COVID-19 Pandemic (A Case Series): Is there a Cause Effect Relationship? J Assoc Physicians India 2020;68:20–4.[3]Gupta L, Lilleker JB, Agarwal V, Chinoy H, Aggarwal R. COVID-19 and myositis - unique challenges for patients. Rheumatology (Oxford) 2021;60:907–10.[4]Naveen R, Sundaram TG, Agarwal V, Gupta L. Teleconsultation experience with the idiopathic inflammatory myopathies: a prospective observational cohort study during the COVID-19 pandemic. Rheumatol Int 2021;41:67–76.Acknowledgements:NIL.Disclosure of InterestsSa dia Sasha Ali: None declared, Naveen Ravichandran: None declared, Parikshit Sen: None declared, Jessica Day Grant/research support from: JD has received research funding from CSL Limited., Mrudula Joshi: None declared, Sreoshy Saha: None declared, Rohit Aggarwal Consultant of: RA has a consultancy relationship with and/or has received research funding from the following companies: Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, and Roivant., Grant/research support from: RA has a consultancy relationship with and/or has received research funding from the following companies: Bristol Myers-Squibb, Pfizer, Genentech, Octapharma, CSL Behring, Mallinckrodt, AstraZeneca, Corbus, Kezar, Abbvie, Janssen, Alexion, Argenx, Q32, EMD-Serono, Boehringer Ingelheim, and Roivant., Vikas Agarwal: None declared, Hector Chinoy Speakers bureau: Speaker for UCB, and Biogen. HC was supported by the National Institution for Health Research Manchester Biomedical Research Centre Funding Scheme., Grant/research support from: Has received grant support from Eli Lilly and UCB, consulting fees from Novartis, Eli Lilly, Orphazyme, Astra Zeneca, Oliver Distler Speakers bureau: OD has consultancy relationships with and/or has received research funding from or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, Baecon, Blade, Bayer, Boehringer Ingelheim, ChemomAb, Corbus, CSL Behring, Galapagos, Glenmark, GSK, Horizon (Curzion), Inventiva, iQvia, Kymera, Lupin, Medac, Medscape, Mitsubishi Tanabe, Novartis, Roche, Roivant, Sanofi, Serodapharm, Topadur and UCB. Patent issued "mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Consultant of: OD has consultancy relationships with and/or has received research funding from or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, Baecon, Blade, Bayer, Boehringer Ingelheim, ChemomAb, Corbus, CSL Behring, Galapagos, Glenmark, GSK, Horizon (Curzion), Inventiva, iQvia, Kymera, Lupin, Medac, Medscape, Mitsubishi Tanabe, Novartis, Roche, Roivant, Sanofi, Serodapharm, Topadur and UCB. Patent issued "mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Grant/research support from: OD has consultancy relationships with and/or has received research funding from or has served as a speaker for the following companies in the area of potential treatments for systemic sclerosis and its complications in the last three years: Abbvie, Acceleron, Alcimed, Amgen, AnaMar, Arxx, Baecon, Blade, Bayer, Boehringer Ingelheim, ChemomAb, Corbus, CSL Behring, Galapagos, Glenmark, GSK, Horizon (Curzion), Inventiva, iQvia, Kymera, Lupin, Medac, Medscape, Mitsubishi Tanabe, Novartis, Roche, Roivant, Sanofi, Serodapharm, Topadur and UCB. Patent issued "mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Carlo Vinicio Caballero: None declared, Carlos Enrique Toro Gutierrez: None declared, Dey Dzifa: None declared, Ashima Makol: None declared, Ai Lyn Tan Speakers bureau: Has received honoraria for advisory boards and speaking for Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Consultant of: has received honoraria for advisory boards and speaking for Abbvie, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB., Samuel Katsuyuki Shinjo: None declared, Vishwesh Agarwal: None declared, Latika Gupta: None declared.
ABSTRACT
The effects of the coronavirus disease 2019 (COVID-19) are not only limited to health, they also impinge on the social life and economy of communities around the globe. Challenges faced by developing countries such as Bangladesh were multi-factorial and its rural population was highly vulnerable in this situation due to their cultural and sociodemographic context. Preventive behavioral changes were considered the best way to fight against the virus in absence of specific treatment and vaccines. This study has tried to explain preventive health practices during the COVID-19 pandemic, and aimed to explore the causal relationships of its major determinants through structural equation modeling (SEM) based on reasoned action approach (RAA). This cross-sectional study was conducted in 2020 among 810 rural Bangladeshi respondents aged 18-55 years. Around half of the respondents showed poor knowledge, motivation and practice regarding COVID-19 and its prevention. Along with socio-demographic factors, information, attitude, motivation, and intention of the people were found to be associated with the adoption of preventive health practices. The causal model of the COVID-19 prevention behaviors was assessed and justified through SEM. The model fits well with the empirical data (GFI=0.94, CFI=0.97, NFI=0.97, RMSEA=0.05, SRMR=0.04). Intention significantly influenced COVID-19 prevention behavior directly, showing the highest effect (β=0.89, p<0.001). Attitude (β=0.83, p<0.001) and motivation (β=0.15, p<0.001) also showed significant direct effects on intention. All the predictors together explained 79.6% of the variance for COVID-19 preventive behaviors. Adequate knowledge, a positive attitude, proper motivation, and positive intention can encourage rural adults to adopt healthy behaviors against COVID-19. The theoretical model of the study effectively explained COVID-19 preventive behaviors rationally and provided a roadmap for policy-makers to formulate strategies to combat COVID-19 and any future similar pandemic. © 2023, Mahidol University - ASEAN Institute for Health Development. All rights reserved.
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Background/Aims Post COVID-19 syndrome (PCS) is an emerging cause of morbidity and poor quality of life in COVID-19 survivors. We aimed to assess the prevalence, risk factors, outcomes, and association with disease flares of PCS in patients with autoimmune rheumatic diseases (AIRDs) and non-rheumatic autoimmune diseases (nrAIDs), both vulnerable groups understudied in the current literature using data from the 2nd COVID-19 Vaccination in Autoimmune Diseases (COVAD) global multicentre patient self-reported e-survey. Methods The survey was circulated from February to July 2022 by the international COVAD Study Group (157 collaborators from 106 countries), and demographics, comorbidities, AIRD/nrAID status, COVID-19 history, vaccination details, and PROMIS physical and mental function were recorded. PCS was defined as symptom resolution time >90 days following acute COVID-19. Predictors of PCS were analysed using regression models for the different groups. Results 7666 total respondents completed the survey. Of these, 2650 respondents with complete responses had positive COVID-19 infection, and 1677 (45.0% AIRDs, 12.5% nrAIDs, 42.5% HCs) completed the survey >90 days post acute COVID-19. Of these, 136 (8.1%) had PCS. Prevalence of PCS was higher in AIRDs (10.8%) than healthy controls HCs (5.3%) (OR: 2.1;95%CI: 1.4-3.1, p=0.002). Across the entire cohort, a higher risk of PCS was seen in women (OR: 2.9;95%CI: 1.1-7.7, p=0.037), patients with long duration of AIRDs/ nrAIDs (OR 1.01;95%CI: 1.0-1.02, p=0.016), those with comorbidities (OR: 2.8;95%CI: 1.4-5.7, p=0.005), and patients requiring oxygen supplementation for severe acute COVID-19 (OR: 3.8;95%CI: 1.1- 13.6, p=0.039). Among patients with AIRDs, comorbidities (OR 2.0;95%CI: 1.08-3.6, p=0.026), and advanced treatment (OR: 1.9;95%CI: 1.08-3.3, p=0.024), or intensive care (OR: 3.8;95%CI: 1.01-14.4, p=0.047) for severe COVID-19 were risk factors for PCS. Notably, patients who developed PCS had poorer PROMIS global physical [15 (12-17) vs 12 (9-15)] and mental health [14 (11-16) vs 11 (8-14)] scores than those without PCS. Conclusion Individuals with AIRDs have a greater risk of PCS than HCs. Associated comorbid conditions, and advanced treatment or intensive care unit admission for severe COVID-19 confer a higher risk of PCS. It is imperative to identify risk factors for PCS for immediate multidisciplinary management in anticipation of poor physical and mental health.
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Background/Aims Flares following COVID-19 vaccination are an emerging concern among patients with rare rheumatic disease like idiopathic inflammatory myositis (IIMs), whereas data and understanding of this is rather limited. We aimed to study the prevalence, characteristics and determinants of IIM flares following COVID-19 vaccination. Methods CoVAD (COVID-19 Vaccination In Autoimmune Diseases) surveys are global patient self-reported e-surveys from 109 countries conducted in 2021 and 2022. Flares of IIM were defined by 4 definitions;a. patient self-reported, b. physician and immunosuppression (IS) denoted, c. sign directed (new erythematous rash, or worsening myositis or arthritis), d. MCID worsening of PROMISPF10a score between the patients who had taken both surveys. Descriptive statistics and multivariate regression were used to describe the predictors of flare. Cox-regression analysis was used to differentiate flares by IIM subtypes. Results Among the 1,278 IIM patients, aged 63 (50-71) years, 276 (21.5%) were dermatomyositis, 237 (18.5%) IBM, 899 (70.3%) were female and most were Caucasian (80.8%). Flares of IIM were seen in 123/1278 (9.6%), 163/1278 (12.7%), 112/1278 (8.7%), and 16/96 (19.6%) by definitions a-d respectively with median time to flare being 71.5 (10.7- 235) days. Muscle weakness (69.1%), and fatigue (56.9%) were the most common symptoms of flare. The predictors of self-reported flare were: inactive/disease in remission prior to first dose of vaccine (OR=4.3, 95%CI=2.4-7.6), and anxiety disorder (OR=2.2, 95%CI=1.1-4.7). Rituximab use (OR=0.3, 95%CI=0.1-0.7) and IBM (OR=0.3, 95%CI=0.1-0.7) were protective. Physician defined flares were seen more often in females, mixed ethnicity, and those with asthma, ILD, and anxiety disorder (OR ranging 1.6-7.0, all p<0.05). Notably, overlap myositis (OM) had higher HR for flare compared to polymyositis (HR=2.3, 95%CI=1.2-4.4, p=0.010). Conclusion Nearly one in ten individuals with IIM develop flares after vaccination, more so among women, those with overlap myositis, and inactive disease prior to vaccination. Formal definition of flares in IIM is needed.
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Corona viruses (CoVs) are enveloped RNA viruses that infect a broad array of avian and mammalian species, including humans. The existence of these viruses is believed to have occurred thousands of years ago as animal CoVs;bats, birds, rodents were reported to be natural reservoirs. They garnered scientific attention after their emergence as human pathogens, till date, seven corona viruses were reported to infect humans, with mild to moderate and/or severe respiratory illness. The ongoing pandemic COVID-19 is caused by one of such Corona viruses named Severe Acute Respiratory Syndrome Corona Virus -2 (SARS-CoV-2), which surprised all with its unprecedented transmission dynamics and etiology. This virus surged twice within a gap of a year all over the world and became a major health concern to many nations. Most of these Corona viruses transferred to humans through intermediate hosts. Here, in this chapter, we summarized the structural and genomic features of the Coronaviruses in general and emphasizing the SARS CoV-2 and added an account of the different vaccines and their production platforms in combating the pandemic. We briefly discussed the evolution of new variants of SARS-CoV-2 and their role in the surge of COVID-19 infections. We tried to give a brief account of the historical aspects, cross-species transmission, mutations/recombinations scenarios of CoVs with a note on their emergence as human pathogens and future prospects of recurrence. © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2021.
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Recent studies have proven that the shape of the stenosis greatly affects the flow characteristics. The 2D rigid wall model examined in this research is analyzed mathematically using various principles and results of functional analysis for the existence and uniqueness of the solution. The model taken into consideration for the current study has also been used to examine the consequences of hyperviscosity in COVID-19 cases. The results of the investigation surmise that the maximum peak velocity of 3.155m/s and the minimum trough pressure of 7041.538Pa were manifested in the high slope geometry. Also, the number of spots over the upper wall of high slope geometry bearing the least wall shear stress was considerably high when compared to the other geometries. The study deduced that the arterial segment bearing dual high slope stenosis was more susceptible to new plaques, plaque ruptures, and hyper viscous syndrome. © 2023 THE AUTHORS
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We are in the half past of 2022, but still, we are facing the coronavirus pandemic situation. When a patient is hospitalized, only some FDA-approved drugs were administered to cure the patient. In treating coronavirus infection, nitazoxanide, granulocyte-macrophage colony-stimulating factor inhibitors, and various monoclonal antibodies are present. But all the molecules used in the treatment were not so effective in fully curing the patient. So, to break this jinx to develop of newer generation anti-SARS-CoV-2 drug molecules, computational approaches played an essential role. 2D QSAR studies related to anti-SARS-CoV-2 molecule development, some QSAR models observed with good statistical parameters such as R2: 0.748, cross-validated Q2 (LOO): 0.628, external predicted R2: 0.723 and another model suggested with R2: 0.764, Q2: 0.627 and Rm2: 0.610, Q2 (F1): 0.727, Q2 (F1): 0.652, MAE score: 0.127. We developed a new 2D QSAR model with a higher number of molecules and greater statistical parameters. A dataset of 84 anti-SARS-CoV2 molecules was obtained from literature followed by descriptor calculation PADEL software;the QSAR model was generated using the Modelability index, dataset pretreatment, division, MLR equation, validation, and Y randomization test. The model was pIC50 = -1.79268(+/-0.3652) +0.07995(+/-0.03551) naaaC -0.4051(+/-0.09672) nsssN -0.45945(+/-0.11025) SHsOH +1.23189(+/-0.28144) ETA_BetaP with R2 and Q2 values were 0.87028 and 0.70493 with MAE fitness score value: 0.14298. Atoms E-state and electronic features of the molecules directly related to anti-SARS-CoV-2 drug activity. It can be easily concluded that we want to develop a small molecule effective against SARS-CoV-2 disease in the near future.Copyright All © 2023 are reserved by International Journal of Pharmaceutical Sciences and Research.
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This handbook offers a comprehensive understanding of the use of technology in education. With a focus on the development of Education Technology in India, it explores innovative strategies as well as challenges in incorporating technology to support learning.The volume examines diverse learning approaches such as assistive technology and augmentative and alternative communication for learners with disabilities and creating more social and accessible environments for learning through Collaborative Learning Techniques (CoLTS), massive open online courses (MOOCs), and the use of AI (Artificial Intelligence) in modern classrooms. Enriched with discussions on recent trends in ET (Education Technology), university curriculum and syllabi, and real-life examples of the use of ET in different classroom settings, the book captures diverse aspects of education technology and its potential. It also discusses the challenges of making technology and resources available for all and highlights the impact technology has had in classrooms across the world during the COVID-19 pandemic.This book will be of interest to students, researchers, and teachers of education, digital education, education technology, and information technology. The book will also be useful for policymakers, educationalists, instructional designers, and educational institutions. © 2023 Santoshi Haldar and Sanju Saha.
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Domestic violence or intimate partner violence, can be defined as a pattern of behaviors which could be physical, sexual, emotional, economic or psychological actions or threats of actions in any relationship that is used to gain or maintain power and control over an intimate weaker partner that influence another person. Domestic abuse can happen to anyone regardless of age, race, gender, sexual orientation, religion or socioeconomic background and education levels. It can occur within a range of relationships and not just those who live with us in our homes. These incidents are seldom isolated and escalate in frequency and severity if not opposed initial stage itself and may harm physically as well as emotionally and at times even endangers lives. Statistics for this is grave be it our country be it abroad and it became more grim covid times when staying home was not always safe. There are various factors involved from genesis to the maintainence of this menace medicolegal aspects and many more. Multidisciplinary approach for awareness that one needs to seek help, that one is not alone and various measures for curbing this grave issue is required at all levels. Domestic violence is the outcome of cumulative irresponsible behaviour which a section of society demonstrates. It is also important to note that solely the abuser is not just responsible but also those who allow this to happen and act as mere mute spectators. In this era of rights-based mental health services, such 'hidden shades' of mental wellbeing form potent challenges, which face unique conditions of demographics, prevalence of mental disorders and awareness related to this grave issue of domestic violence. Human rights are universal and are vital for promoting mental health and dignity. With this premise, this symposium intends to unfold the various factors involved and highlight the intersections of Domestic volence and approaches required to bring about and discuss strategies to curb it in light of the lessons learnt from experiences across the globe.
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Background: The COVID-19 pandemic caused by the novel Corona virus has impacted more than 200 countries.COVID-19 patients are frequently isolated and quarantined due to high infectivity thus adding to further mental stress in addition to physical symptoms, uncertainty, anger, stress and insecurity. It has given rise to various psychological problems such as anxiety, depression, fear of isolation, fear of dying, feeling of helplessness, insomnia and many more. The aim of this study is to investigate stress, anxiety, and depression in COVID-19 positive patients during the Corona pandemic in West Bengal. Aim(s): To study the prevalence of psychiatric comorbidities lie stress, anxiety, depression in moderate and severely affected COVID 19 patients admitted in a tertiary care hospital in West Bengal. Settings and Design: This cross sectional study was conducted at post COVID follow up clinic on 100 COVID-19 infected patients who were admitted in COVID ward of College of Medicine and Sagore Dutta Hospital, West Bengal. Subjects and Methods: those EWS score more than equals to 5 and gave consent were selected as subjects and data was collected on socio demographic parameters and SRQ 24 was applied followed by assessment was done using the HAM-D for depression, HAM-A for anxiety, and PSS for stress in post COVID-19 patients at post COVID follow up clinic in the hospital. Statistical Analysis Used: SPSS 27.0 version for Microsoft Windows. Result(s): 78% patients were suffering from moderate (N=78) and 22% from severe (N=22) COVID 19 infection. 57.0 % patients (N=57) were women and 43.0% (N=43) were men. The mean age of the patients was more in severe (50.6+/-12.8) compared to moderate (42.6+/-12.5) COVID-19 infection .Mean depression was more in severe (14.0+/-3.8) compared to moderate (5.57+/-2) (p<0.0001). Mean Anxiety was more in severe (16.72+/-11.6) compared to moderate (8.0+/-10.6.) (p=0.0014). Mean Stress was more in severe (20.18+/-3.36) compared moderate infection (19.0+/-3.2) (p=0.1397). Conclusion(s): out of 100 COVID-19 patients majority were women and suffered from moderate COVID infection. Higher the age more the infection was found. Depression, Anxiety, Stress were more associated with the severe infection, low educated, lower socioeconomic status. Severe infection was commonly found among female, less educated, higher age, from rural area, lower economic status.
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The COVID-19 pandemic has wreaked havoc on people all across the world. Even though the number of verified COVID-19 cases is steadily decreasing, the danger persists. Only societal awareness and preventative measures can assist to minimize the number of impacted patients in the work environment. People often forget to wear masks before entering the work premises or are not careful enough to wear masks correctly. Keeping this in mind, this paper proposes an IoT-based architecture for taking all essential steps to combat the COVID-19 pandemic. The proposed low-cost architecture is divided into three components: one to detect face masks by using deep learning technologies, another to monitor contactless body temperature and the other to dispense disinfectants to the visitors. At first, we review all the existing state-of-the-art technologies, then we design and develop a working prototype. Here, we present our results with the accuracy of 97.43% using a deep Convolutional Neural Network (CNN) and 99.88% accuracy using MobileNetV2 deep learning architecture for automatic face mask detection. © 2023 by the authors.
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Introduction: The aim of the study is to determine the patient's outcome and mortality rate of COVID-19 patients requiring hemodialysis in Anwar Khan Modern Medical College & Hospital. Method(s): Retrospective cohort study of medical record of patients with COVID-19 hospitalized at Anwar Khan Modern Medical College & Hospital during the months of September 2020 to January 2021. The dependent variable was in patient's outcome and mortality rate and independent variables included clinical conditions, physical examination results, oxygen requirements, diagnosis, clinical features, and complications. Result(s): Total 98 patients were included. Among them 97 patients were treated with hemodialysis and 1 was pre-dialysis patient. Median age was 59 years and 52 (53.06%) were male and 46 (46.94%) were female. The most frequent comorbidities were chronic kidney disease (CKD), hypertension (HTN), and diabetes mellitus (DM). Patients were diagnosed with different clinical manifestation when they arrived at hospital. Major manifestations were cough, breathlessness, fatigue, fever and body ache. The patients showed some other complications including fluctuated blood pressure (50.1%), vomiting (19.38%), shivering (37.76%), chest pain (16.33%).Treatment was given according to WHO and Bangladesh Government Covid-19 treatment guideline. We observed lower mortality rate. 11 (11.23%) patients died during this observation period. Mortality rate of male patients were 7(7.14%) and female patient were 4(4.08%). Another 87(88.79%) patients were alive according to the observations. Conclusion(s): We found low mortality rate in our cohort study. Dead patients had severe clinical manifestations and complications i.e. DM, HTN, CKD with cough, breathlessness and fatigue. Close monitoring, guideline medication and patient care reduces mortality. No conflict of interestCopyright © 2023
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Introduction: Thromboembolic manifestations is a common phenomenon in patients affected by Corona virus (SARS CoV-2). Recent studies have shown that patients with Acute Renal Failure are also at a greater risk of venous and arterial thromboembolism, 15-30% in ICU, 7% inpatient care. However, frequently unjudicial use of anticoagulant may develop severe life-threatening hematoma. In our Hospital settings we had a dedicated COVID Unit with Hemodialysis facility. Our Nephrology department had managed 381 patients being COVID positive along with renal impairment from March 2020 to January 2022. Among these patients, four patients developed spontaneous non traumatic hematoma in unusual sites. On admission all the patients received treatment according to our national guidelines for Covid-19. Method(s): It is a retrospective analysis in a single-centered hospital. Four cases with confirmed COVID-19 with acute kidney injury and on anticoagulant therapy had developed sudden concealed bleeding. These patients had no previous history of anticoagulant therapy before admission. Case 1: Developed hemorrhage in Right lower anterior paramedian deep parietal wall of abdomen, Case 2: Had hematoma in retroperitoneal space and in lower third of Iliopsoas, Case 3: Developed hemorrhage in left cerebral hemisphere, Case 4: Had Intramuscular Hematoma in left rectus abdominis. Out of these four patients two of them required Hemodialysis and one of them went into shock. Result(s): All patients included were male. The mean age was 57+/-19.64 years. All the four patients were initially managed conservatively with keen monitoring and with proper volume resuscitation, blood transfusion and discontinuation of the anticoagulants. Three of the patients survived with conservative management and one patient died due to sudden massive cardiac arrest. Conclusion(s): The use of therapeutic anticoagulant can increases the risk of bleeding in atypical sites and may exhibit higher patient death with COVID-19 if not identified at early stage. So a risk-benefit ratio of usage of anticoagulants should be kept in mind and further clinical trials needed to justify its random use in COVID-19. No conflict of interestCopyright © 2023
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With the COVID-19 pandemic serving as a trigger, 2020 saw an unparalleled global expansion of tele-health [23]. Tele-health successfully lowers the need for in-person consultations and, thus, the danger of contracting a virus. While the COVID-19 pandemic sped up the adoption of virtual healthcare delivery in numerous nations, it also accelerated the creation of a wide range of other different technology-enabled systems and procedures for providing virtual healthcare to patients. Rightly so, the COVID-19 has brought many difficulties for patients (https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide ) who need continuing care and monitoring for mental health issues and/or other chronic diseases. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Scrub typhus is a form of bacterial Zoonosis caused by Orintia tsutsugamushi usually presents as Acute febrile illness with multiorgan involvement as a complication and is associated with significant mortality. This study aims to document the clinico-demographic profile, laboratory parameters and complication of Scrub Typhus in North Eastern Hilly State of Tripura with background of tropical climate. This retrospective study was conducted at Tripura Medical College, including 42 patients admitted with acute febrile illness between June, 2020 to December, 2021 during the era of COVID-19 Pandemic. The diagnosis was established by Rapid card test, Lateral Flow Metry Assay (LFA) followed by confirmation through IgM, ELISA test and pathognomic Eschar where feasible. The clinlical, demographic and laboratory profile were documented and analysed. Post rainy season and people from rural area with farming background were mostly affected population. Apart from Fever and Flu like symptom, respiratory and Gastrointestinal (GI) symptoms were more prominent feature. Pathognomic skin lesion eschar was found in maximum cases followed by shortness of breath, GI involvement and Renal failure. Acute Respiratory Distress Syndrome (ARDS), Acute Kidney Injury (AKI), Hepatic encephalopathy and meningitis were the serious complications. While evaluating cases of acute febrile illness with multiorgan involvement clinician should have high index of suspicion for Scrub typhus specially resource poor areas of North Eastern (NE) state of India so that early detection and time bound intervention may help to reduce the mortality.Copyright © 2022 Indian Medical Association. All rights reserved.
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Ceiling fans are the ubiquitously used electrical appliance in indoor spaces that affect the local airflow pattern and, consequently, transmission of airborne pathogens and respiratory droplets. This study numerically investigated the effect of airflow induced by the ceiling fan and ventilation rate on aerosol distribution to mitigate exposure to airborne pathogens and COVID-19. A full-scale room with a ceiling fan, natural ventilation and an occupant was modelled through transient computational fluid-particle dynamics (CFPD). To analyze the relationship between the ceiling fan rotation speed and the aerosol distribution, a ceiling fan was operated with 160, 265 and 365 revolutions per minute (RPM). The effect of the ceiling fan on particles was analyzed for particles of different sizes. The increasing ceiling fan rotation speed, the percentage deposition of the aerosol particles with diameters >40 μm was increased. The effect of different ventilation rates on aerosol distribution was evaluated. The increased ventilation rate, the percentage of the total aerosol particles flushed out was increased. The effectiveness of the mask in mitigating the exposure risk of airborne pathogens was also investigated. In combination with the natural ventilation and mask, the ceiling fan was demonstrated to have the potential to reduce airborne pathogen transmission in indoor spaces.