ABSTRACT
OBJECTIVE: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. METHODS: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. RESULTS: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) CONCLUSIONS: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.
ABSTRACT
Purpose : COVID-19, a highly contagious respiratory virus, presents unique challenges to the practice of ophthalmology as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety, while maintaining necessary clinical operations. The aims of this study were two-fold: to evaluate how measures adopted during the pandemic period affected the performance of the retina clinic and patient satisfaction;and to build a model from lessons learned for regulating future clinic operational performance, when the number of patients and providers returns to pre-pandemic levels. Methods : Timestamps were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys returned by randomly selected outpatients. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. Results : Retina clinic volume declined by 62% during the COVID-19 health emergency. Average check-in-to-technician time declined by 79%, total visit length declined by 46%, and time in the provider phase of care declined by 53%. Interestingly, patient satisfaction with access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients per provider in a 1- provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. Conclusions : Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID- era. The changes implemented enhanced the delivery of eye care and improved patients' sense of wellbeing, thus potentially becoming a new standard of care.
ABSTRACT
Smart home security and safety systems have gained more importance in recent years. This is attributable to their significant impact in reducing and preventing loss of assets and human life. The COVID-19 pandemic adds a new dimension to home security as potentially infected people or those not taking necessary precautions such as sanitization or wearing masks may enter homes and cause further transmission. The traditional security systems are effective in conventional scenarios but require human intervention and contact which can lead to the spread of the virus. This necessitates the development of smart security systems that are autonomous and contactless. This paper presents a novel IoT enabled home security system that restricts unauthorized access and at the same time ensures that permitted users are normothermic and are following proper COVID hygiene. The proposed system is a smart edge device that does not require a cloud platform for its computational needs. Facial recognition is used to authenticate and allow approved users to get access. If an unfamiliar person tries to enter the premises, the system takes a photo, computes mask detection on the image, measures temperature and sends these three data points as a WhatsApp notification to the administrative user. The door lock can then be controlled automatically or remotely using a WhatsApp bot. © 2021 IEEE.