ABSTRACT
Background: Various studies have pinned longevity of protective Immunoglobulin-G (IgG) titres at 2-5 months. The robustness and longevity of the IgG antibody response to COVID-19 infection has been gauged in a cohort of 214 single institutional health care workers by serial quantitative immunometric tests. Currently no separate guidelines exist for vaccination of COVID-survivors and this study provides data to fill this lacuna in knowledge. Methodology: Prospective longitudinal panel survey administered to the same cohort of Health Care Workers (HCW) till such time they got vaccinated under Indian Government's free vaccination drive for HCW. Depending upon the date of contraction of infection the HCW could be longitudinally monitored for variable periods (2-9 months). The survey questionnaire comprising multiple-choice, dichotomous, matrix and Likert-scale questions was deployed to the respondents online via email/WhatsApp. Data was expressed as box-whisker plots, trendlines and trend areas. A p-value<0.05 was considered statistically significant. The composite index of 'Effective Immunity' was calculated. Result(s): The mean IgG antibody titre was 11.13+/-8.6AU at 1-2m, 9.68+/-8.9AU at 3-4m, 8.35+/-5.9 AU at 6-7m and 7.87+/-4.4 AU at 8-9m after first symptom, respectively. The lowest titre at all time points was 0 while the highest titres were 46.8 AU, 56.5 AU, 23.4 AU and 17.4 AU at 1-2m, 3-4m, 6-7m and 8-9m, respectively. Conclusion(s): Adaptive active immunity acquired through natural infection may last for at least 9 months post-initial exposure and lies in the moderate protection range in 77% HCW, which can be extrapolated to vaccination and immunity passports. Separate vaccination guidelines are required for COVID-survivors. The first shot of vaccine serves as a booster second exposure/booster dose in all COVID-survivors.HCW with low IgG-titre may suffer from a false sense of security. Periodic quantitative IgG-titre based serological tests can help guide timing of second shot of vaccination and predict likelihood of re-infection.Copyright © 2022 Indian Medical Association. All rights reserved.
ABSTRACT
The breakout of the COVID-19 infection caused a worldwide pandemic in recent years. Traditional healthcare measures and infrastructure are unable to properly manage the detection, prevention and treatment of the infection. Since the onset of the pandemic, researchers have tried to implement various deep learning approaches to counter COVID-19 with much success. Novel architectures and new ideas are being developed to this day. Motivated by this, we have reviewed the different ways deep learning can be applied in real-world COVID-19 problems. We present the challenges these implementations face. Finally, we discuss the future directions that can be taken to improve upon these DL methods to control the COVID-19 pandemic as well as future pandemics, which will result in a healthier and safer environment. © 2022 IEEE.
ABSTRACT
COVID-19 came with a sudden surge, harshly affecting the day-to-day lives of the entire world. Social and economic problems affected almost every nation, wreaking havoc on people's health, society, and economy everywhere. Although the pandemic is currently in control, the emergence of another pandemic is not unlikely. As technological breakthroughs accelerate, the possibility of controlling virological dangers becomes highly plausible. Better virus containment is attainable with the confluence of technologies such as Blockchain and AI. The newly growing fields and application cases of futuristic technologies for tackling upcoming pandemics are emerging. Several researchers are contributing to COVID-19 management with current and futuristic technologies, and such tools have room for additional improvement. This paper extensively highlights the work done in tackling COVID-19 using Blockchain and AI, illustrating the role of this collaborative approach in dealing with biological threats. We also discuss the prospects and obstacles in combining these technologies to tackle COVID-19-like situations. © 2022 IEEE.
ABSTRACT
Background: Aortic dissection is a new addition to the long COVID-19 complication catalog. We report this rare and novel complication, which can be missed without a high index of suspicion in the ever-burgeoning population of COVID-survivors presenting for un-related surgery. We emphasize the importance of recording blood pressure in both the upper limbs in COVID-survivors during pre-anesthetic checkup, especially in patients with a dilated aorta on the chest radiograph to identify any interarm blood pressure discrepancy characteristic of aortic dissection. Discontinuation of antihypertensive based on low/normal blood pressure in left upper-limb can precipitate concealed and catastrophic rise in blood pressure in the right upper-limb propagating the dissection of aorta to a fatal conclusion. The cardinal anesthetic consideration is to mitigate the effect of hemodynamic perturbations on the dissected aorta. Case presentation: We report the successful management of the case of a 76-year-old male prostatic cancer patient with COVID-induced aortic-dissection and acute urinary retention, posted for transurethral resection of prostate. CT angiography revealed an intimal flap in the ascending aortic lumen and aortic arch till the origin of left subclavian artery resulting in a double-barreled aorta. An arterial line was secured in right radial artery and non-invasive blood pressure recorded in left arm simultaneously (202/60 mmHg in right upper-limb and 92/70 mmHg in the left upper-limb on wheeling into the operation theatre). He underwent transurethral prostatic resection and bilateral orchidectomy under low-dose subarachnoid block with prophylactic use of labetalol infusion. Conclusions: The importance of recording blood pressure in both the upper limbs in COVID survivors maintaining a high index of suspicion for aortic dissection cannot be overemphasized. Transurethral prostatic resection surgery under low-dose subarachnoid block is possible under the umbrella of judicious selection and optimal use of cardiac medication with an interventional cardiologist as standby in patients with aortic dissection.
ABSTRACT
Background: COVID-19 has been linked to neuropsychiatric symptoms, including delirium, depression/anxiety, PTSD, and rarely, severe neuropsychiatric impairment. However, much remains unknown. We present a case of anti-NMDA receptor encephalitis in a patient with concurrent COVID-19 infection. Case History: A 27-year-old male who carried diagnoses of unspecified mood versus psychotic disorder was admitted with atypical psychosis and suicidal ideation. Patient initially presented to primary care with racing thoughts, delusions, depression (PHQ-9517), anxiety (GAD-7510), and new onset cognitive symptoms along with olfactory hallucinations. He endorsed daily suicidal ideations and reported using two cellphones to block suicidal waves and enhance his memory. He was admitted to inpatient psychiatry where he exhibited disorganized behavior and paranoid delusions, and reported visual hallucinations. Initial workup of EEG, brain MRI, and TSH were unremarkable. Two months after admission, he developed sore throat and fever and tested positive for COVID-19. Patient developed streaky opacites on chest X-ray, was transferred to the ICU, and intubated due to agitation. Once extubated, he experienced repeated epileptic seizures despite multiple antiepileptics, and lumbar puncture ultimately revealed anti-NMDA receptor antibodies. Symptoms slowly improved with plasmapheresis, steroids, and Rituximab. Conclusions: Case reports suggest that some patients may present with neuropsychiatric symptoms or experience neuropsychiatric sequelae following COVID-19 infection. Infection itself can precipitate an autoimmune encephalitis and may also cause neurological damage which can unmask other neuropsychiatric conditions. This case highlights that research is needed to understand the intersection between COVID-19 infection and mechanisms implicated in other neuropsychiatric disorders, including the spectrum of autoimmune encephalitides.