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The study was conducted between 2021 and 2022 among the post-COVID patients in Ernakulam district of Kerala by assessing Dietary Diversity Score (DDS), comorbidities, symptoms during COVID and post-COVID, fatigue, stress, and insomnia. The research was a six-month community-based prospective cohort study comprising 250 patients. Out of the 250 patients, 41.6% were male and 58.4% were female. On studying the age-wise distribution of patients, the majority (38%) belonged to the 18-29-year age group. Among the patients, 26% had a high Dietary Diversity Score. The most common comorbidities observed were hypertension (24%), followed by obesity (20.8%), diabetes mellitus (19.2%), and cardiovascular disease (16.8%), respectively. During the period of infection, the most common symptom among patients was tiredness (89.2%), followed by fever (83.2%), headache (78.8%), dry cough (67.6%), and loss of taste or smell (56.4%). Breathlessness (30%), chest pain (26%), and diarrhea (9.2%) were the other significant symptoms. The most prevalent post-COVID symptoms in various systems among patients were loss of appetite (89%), weakness (62.4%), sore throat (51.6%), dry cough (40.4%), joint pain (26.8%), and pain/burning in the chest (14.8%). During COVID, 42.4% of the patients were severely fatigued, 61.2% of the patients had a moderate level of perceived stress, and 44.4% of the patients had subthreshold insomnia. During post-COVID, 80.4% were severely fatigued;moderate stresswas found in 40%, of the subjects;and 22.8% of the study subjects had subthreshold insomnia. The Pearson's coefficient of correlation, 'r', between stress and insomnia among study subjects was 0.37. The obtained t-value for stress (7.14 > 2.58), fatigue (8.31 > 2.58), and insomnia (10.97 > 2.58) were significant. Post-COVID is associated with comorbidities and disease severity. The prevalence of new-onset fatigue, perceived stress, and insomnia was significant among COVID-19 survivors.
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INTRODUCTION: Patients supported on extracorporeal membrane oxygenation (ECMO) due to COVID-19 are at an increased risk of both thromboembolic complications and thrombocytopenia. Bivalirudin, a direct thrombin inhibitor, is increasingly being utilized for anticoagulation in the ECMO patient though there is largely a lack of literature within the COVID-19 population. The objective of our study was to evaluate the safety and efficacy of alternative anticoagulation with bivalirudin in patients on ECMO with COVID-19 respiratory failure. METHOD(S): This was a non-interventional retrospective chart review conducted at a single center large community hospital between January 2020 - November 2021. We included both venovenous (VV) and venoarterial (VA) adult ECMO patients anticoagulated with bivalirudin that tested positive for COVID-19. Patients were excluded if their duration of ECMO cannulation was less than 48 hours. Descriptive statistical analyses were performed utilizing median with interquartile range and frequency with percent as appropriate. RESULT(S): Overall, 180 ECMO patients were included in the study. The duration of ECMO cannulation was 29 (9-54) days and our cohort experienced a 42% mortality rate. The rate of thrombotic events including in-circuit thrombosis, arterial and venous thrombotic events was 22%. The median initial platelet count on ECMO was 206 (157-274) and the median nadir was 85 (48-121). ELSO defined major bleeding occurred at a rate of 53% within this cohort. CONCLUSION(S): To our knowledge, this study describes the largest number of patients anticoagulated with bivalirudin for ECMO secondary to COVID-19. Our results suggest similar rates of thrombotic events compared to ELSO registry data. While the half-life of bivalirudin is short, clinicians should still be cautious of bleeding due to lack of a specific reversal agent. Retrospective studies with a comparator cohort, as well as randomized trials are warranted to further evaluate the selection of intravenous anticoagulants in the ECMO population with and without COVID-19.
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Objective: This study aimed to assess the outcomes experienced by patients diagnosed with mucormycosis linked with COVID-19 while they were hospitalized. Study Design: Retrospective study Place and Duration: This study was carried out at Sardar Begum Dental College from January, 2022 to June 2022. Method(s): There were 215 patients of both genders had age 18-80 years were presented in this study. Included patients had confirmed coronavirus disease with symptoms of mucormycosis. Patients were provided informed written consent for detailed demographics. Clinical and laboratory outcomes among all cases were assessed. We used SPSS 22.0 to analyze all data. Result(s): There were majority males 165 (76.7%) and 50 (23.3%) females in this study. Mean age of the patients was 45.6+/-17.53 years and had mean BMI 26.13+/-8.17 kg/m2. We found that diabetes mellitus was the most common co morbidity in 140 (65.1%) cases, followed by hypertension in 85 (39.5%) cases. Frequency of rhino orbital mucormycosis was found in 110 (51.2%) cases, sinuses in 70 (32.6%) cases and cerebral in 35 (16.3%) cases. Majority of the cases were treated by steroid. Mean hospitalization was 16.8+/-7.67 days. Frequency of died patients was 28 (13.02%) because of CKD, renal dysfunction and orbital involvement. Conclusion(s): We concluded in this study that rhino-orbital involvement, CKD and renal dysfunction were a significantly risk factors for mortality among patients of COVID-19 with mucormycosis. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.
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Objective: To comprehend the evolution and spread of the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) virus and also to prevent the future spread of the same, sequencing and analyzing the genomic data of SARS CoV-2 are essential. The objective of the present study is to describe the scope of improvement identified by the state of Madhya Pradesh in the data flow chain and the methodology designed to address the identified shortcomings. Methods: The number of sources of sample data collection was altered as well as a series of Google Sheets were formulated as an open-source tool, to implement an efficient sample data-sharing platform. The application of the proposed tool (Google Sheets as a source of data collection and information sharing) was within the state of Madhya Pradesh, India. Result: After utilizing this mechanism, the state was able to trace more than 80% VOCs and 3341 primary contacts and was also able to communicate this result to all stakeholders without much delay. Conclusion: Based on successful implementation and results, the authors suggest widening the domain of the proposed tool to other states.
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Background: A scoring system to predict patient's prognosis may aid clinicians in deciding patient's treatment continuation. This study aimed to investigate the reliability of Acute Physiology and Chronic Health Evaluation (APACHE) II score in predicting mortality in critically ill COVID-19 patients in intensive care unit (ICU). Patients and Methods: This retrospective observational study included the data from medical records of critically ill patients from April to November 2020. The collected data were patient's identity, age, gender, comorbid, Glasgow coma scale (GCS) score, temperature, mean arterial pressure, heart rate, hematocrit, leukocyte, natrium, kalium, serum creatinine, blood pH, PaO 2 level, and history of organ insufficiency or immunocompromised within 24 h after ICU admission. Patient's outcome (survival and nonsurvival) was recorded. Results: A total of 120 patients were included in the study. APACHE II score was significantly higher in nonsurvival compared to survival group (19.12 vs. 12.33;P < 0.001). The area under curve value was 0.955 (P < 0.001) which indicated APACHE II score as a good predictive value for mortality. The cutoff value of the APACHE II score for mortality prediction in this study was 15, with sensitivity, specificity, positive prediction value, negative prediction value, and accuracy of 94%, 79.4%, 80.6%, 94.3%, and 86.7%, respectively. GCS score, heart rate, age, and serum kalium level were related to mortality. Conclusion: The APACHE II score is reliable in predicting mortality in critically ill COVID-19 patients in ICU. © 2020 Bali Journal of Anesthesiology ;Published by Wolters Kluwer-Medknow.
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Background: Middle East Respiratory Syndrome MERS has high pandemic potential and mortality. However, since its appearance in 2012, MERS neurological symptoms have rarely been reported. So, we aimed this study to determine the neurological complications among patients of Corona virus. Place and Duration: In the Department of Pulmonology, Neurology, ICU and Emergency department of Mayo Hospital Lahore for three months duration from March 2020 to May 2020.