ABSTRACT
Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection risks in co-morbid patients are still unknown two years after the pandemic began. The prevalence of antibodies against SARS-CoV-2 infection is crucial for determining disease preventive and mitigation strategies. Obesity, type 2 diabetes, and chronic cardiovascular disease can raise the risk of Coronavirus Disease-2019 (COVID-19), which has a greater morbidity and fatality rate. Aim(s): To determine the seroprevalence of SARS-CoV-2 (COVID-19) antibodies and their relationship to co-morbidities in Kashmir's ethnic population. Material(s) and Method(s): The present observational cohort study was done in the Department of Pulmonary Medicine at Chest Disease Hospital Srinagar, Jammu and Kashmir, India, from September 2020 to September 2021 and 1,846 co-morbid unvaccinated patients were chosen for the study. As per standard methodology, a cohort study was undertaken, a questionnaire was prepared, and demographic and associated parameters were recorded. All participants had their immune profiles tested, and the existence of Immunoglobulin G (IgG) antibodies for SARS-CoV-2 was determined using the chemiluminisence immunoassay technique. Chi-square and Fischer exact test were used for stastical analyses and p-value <0.05 were taken as statistically significant. Result(s): As per the present study estimates, demographic and socio-economic characteristic affected test attendants. The SARS-CoV-2 IgG antibody response among co-morbid patients were found to be 54.3%. The hypertension and diabetes were most prevalent co-morbidity found in the individuals (p<0.001). Conclusion(s): Co-morbidities including hypertension and diabetes in an individual are more likely have COVID-19 which can lead to death. COVID-appropriate conduct is required to limit infection transmission in the community, and immunisation is of paramount importance for all individuals. More research is needed to determine the risk of co-morbidities among Kashmir's ethnic community. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.
ABSTRACT
Introduction: As the use of CAR-T cell therapy grows, there is an increased need to understand its impact on the patient experience, especially symptom burden and cognitive function. While the immediate side-effects of CAR-T therapy have been reported, our study aims to describe the longitudinal impact of CAR-T therapy on patients' quality of life (QoL), including patient-reported cognitive function and performance-based cognition, which are not well understood. Methods: Patients with hematologic malignancies undergoing CAR-T therapy were prospectively recruited from two academic centers. The primary endpoint was feasibility of completing longitudinal PRO assessments and PBM of cognition. NIH PROMIS measures assessed physical, mental, cognitive, and social health. PROMIS measures use the t-score metric, where 50 is the average in the U.S. population and a 5 point (0.5 SD) change was considered clinically meaningful. The NIH Toolbox Cognition Battery measured 6 constructs of cognition, scored on the t-score metric (10 point = 1SD, change considered clinically meaningful). Exploratory analyses described change from baseline. PROMIS measures were completed at baseline, 7 and 14 days, 1, 3, 6, and 12 months (mo) after CAR-T. The Toolbox was assessed at baseline, 1 month, and 12 months. Due to COVID restrictions on in person research, the Toolbox could not be assessed for the first 13 patients. Results: From 8/2020 to 6/2021, 28 patients have been enrolled. Baseline, day 7, day 14, 1 mo, 3 mo, and 6 mo data were available in 27, 20, 21, 23, 15 (10 not yet reached), and 9 (16 not yet reached) patients, respectively. The mean age was 57 years (range 27-78);44% were female. Race distribution was: Caucasian 75%, Asian 8%, Hawaiian/Pacific Islander 4% and other race 8%;21% were Hispanic ethnicity. Patients received CAR-T for diagnoses of NHL (75%), MM (17%), and ALL (13%). CRS was seen in 86% (all grade 1-2), neurotoxicity (ICANS) in 34% (grade 1-2: N=5 and grade > 3: N=5). PROMIS questionnaires were completed in >70% of patients across all timepoints with current follow-up;thus it was feasible to collect these data at frequent intervals after CAR-T. Mean baseline PROMIS t-scores (N=27) were similar to the average US population in all domains (fatigue: 53, sleep: 52, pain: 52, anxiety: 53, depression: 49) except for decreased physical function (44) among patients (Fig 1a-b). Physical function, fatigue, and pain interference worsened during the first month but returned to baseline by month 3 (Fig 1a-b). PBM of cognition (NIH Toolbox) were assessed at baseline in 15 pts and 1 mo in 8 patients (4 incomplete, 3 not reached timepoint). The toolbox requires in-person administration and takes 35 minutes, but has been completed in 75% of evaluable patients. At baseline, the mean total composite score was 65 th percentile and t-score was 57;mean fluid composite score was 50 th percentile and t-score was 50;mean crystallized composite score was 69 th percentile and t-score was 58 (fluid composite score measures ability to reason, crystallized composite score measures accrual of knowledge over time, Weintraub et al Neurology 2013). Little change in scores was seen in language domains and some increase (not clinically significant) was seen in constructs on attention, executive function, and episodic memory. While not significant, a trend towards worsening working memory and processing speed and a trend towards worsening t-scores for all composite scores was seen (Figure 1c). 2 patients with neurotoxicity grade 3 and available baseline and 1-mo Toolboxes were noted to have decreases in all composite scores (clinically significant in 1). Patients did not self-report changes in cognitive function over 6 months (Fig 1d). Conclusion: This study reports early data from longitudinal neurocognitive assessments and PROs in patients undergoing CAR-T. It is feasible for patients undergoing CAR-T to complete PROMIS surveys (PROs) and NIH cognitive Toolboxes (performance-based test). Early and frequent PRO surveys captured initial worsening in hysical function, fatigue, and pain interference that returned to baseline by month 3. There was no change in patient-reported cognitive function over time, but using PBM cognition testing, we noted a trend towards worsening cognition in some domains. Continued patient accrual and longer follow up will allow assessment of degree and persistence of worsened PBM cognition associated with CAR-T. [Formula presented] Disclosures: Frank: Allogene Therapeutics: Research Funding;Kite-Gilead: Membership on an entity's Board of Directors or advisory committees;Adaptive Biotechnologies: Research Funding. Shah: Lily: Consultancy, Honoraria, Research Funding;Miltenyi Biotec: Consultancy, Honoraria, Research Funding;Epizyme: Consultancy;Legend: Consultancy;Kite: Consultancy;Incyte: Consultancy;Umoja: Consultancy. D'Souza: Imbrium, Pfizer, BMS: Membership on an entity's Board of Directors or advisory committees;Janssen, Prothena: Consultancy;Sanofi, Takeda, Teneobio, CAELUM, Prothena: Research Funding. Miklos: Pharmacyclics: Patents & Royalties;Kite, a Gilead Company, Amgen, Atara, Wugen, Celgene, Novartis, Juno-Celgene-Bristol Myers Squibb, Allogene, Precision Bioscience, Adicet, Pharmacyclics, Janssen, Takeda, Adaptive Biotechnologies and Miltenyi Biotechnologies: Consultancy;Pharmacyclics, Amgen, Kite, a Gilead Company, Novartis, Roche, Genentech, Becton Dickinson, Isoplexis, Miltenyi, Juno-Celgene-Bristol Myers Squibb, Allogene, Precision Biosciences, Adicet, Adaptive Biotechnologies: Research Funding;Adaptive Biotechnologies, Novartis, Juno/Celgene-BMS, Kite, a Gilead Company, Pharmacyclics-AbbVie, Janssen, Pharmacyclics, AlloGene, Precision Bioscience, Miltenyi Biotech, Adicet, Takeda: Membership on an entity's Board of Directors or advisory committees. Muffly: Pfizer, Amgen, Jazz, Medexus, Pfizer: Consultancy;Adaptive: Honoraria, Other: fees for non-CME/CE services:, Research Funding;Astellas, Jasper, Adaptive, Baxalta: Research Funding. Sidana: Janssen: Consultancy, Research Funding;Magenta Therapeutics: Consultancy, Research Funding;Allogene: Research Funding;BMS: Consultancy.
ABSTRACT
Background: The data on medium-term follow-up of coronavirus disease-19 (COVID-19) pneumonia survivors is scarce. Medium-term follow-up will generate knowledge and help in devising a structured follow-up plan and to facilitate enrolment in clinical trials assessing the role of antifibrotic drugs in modifying the course of disease in order to avert long-term pulmonary sequelae of disease. The study was aimed to evaluate the lung findings on a medium-term follow-up (3 months or more) chest computed tomography (CT) in COVID-19 pneumonia survivors, assess the rate of resolution or persistence of lung abnormalities and to identify the initial demographic, clinical, and imaging characteristics that could potentially predict the persistence of lung abnormalities on follow-up. Results: Out of the total study cohort of 81 patients, 46 (56.8%) demonstrated complete resolution of lung findings and the remaining 35 (43.2%) had residual lung opacities on follow-up CT. The most common type of residual abnormality was ground glass opacity (GGO) (16/35;45.7%), followed by parenchymal bands (9/35;25.7%), mixed pattern of GGO and parenchymal bands (6/35;17.2%), bronchiectasis (6/35;17.2%), and interlobular septal thickening (4/35;11.4%). Patients with residual abnormalities were older, had higher BMI, more comorbidities, lower SpO2, longer hospital stay, higher rate of intensive care unit (ICU) admission, higher WBC count, a higher CT severity score, and lower rate of steroid administration with all p values < 0.05. Conclusion: Nearly half of post-COVID-19 survivors had residual lung abnormalities after ≥ 3 months of follow-up. Certain clinico-radiological characteristics have the potential to identify the individuals at risk of having residual lung abnormalities on medium-term follow-up. © 2021, The Author(s).
ABSTRACT
Homoeopathy has to play major role in future of World’s health as the whole world is worst hit by pandemic of CORONA VIRUS.Homeopathic prophylactic medicines are based on the ability to prevent infective diseases & boost one’s immunity when chosen according to the principle of similarity.This historicreview was the ground for evaluating the response to treatment including homeopathy in the former epidemics and also try to emphasize on future role Homoeopathy. © 2020 Ubiquity Press. All rights reserved.