ABSTRACT
In March 2020, a large number of people moved from cities to their homes in rural areas, and a few months later, many returned to cities. These journeys were undertaken not only during the COVID-19 pandemic against the advisory of governments and public health experts, but the circumstances of travel were also under extreme hardship. How may we understand this intense response by people? By drawing on the migration theory and the roles of social ties or social organisation, we can better explain peoples' reactions during this pandemic. Notably, we find non-material values, such as the dignity of labour or responsibilities to family, are significant to decision -making, and there is a desire not to compromise on these values. Further, our analyses find that the distinction between pre-disaster and post-disaster situations may not be helpful.
ABSTRACT
Introduction: The persistence of symptoms beyond 4 weeks of SARS-CoV-2 infection is referred to as long COVID. There is lack of data about the clinical determinants and natural history of this condition. Aims & objectives: We aimed to determine the risk factors, symptomatology, spirometric abnormalities and evolution of long COVID over a 1-year period. Method(s): We enrolled adult patients at 1-4 months after diagnosis of COVID-19. The demographics, COVID-19 history, clinical symptoms and spirometric results were recorded. Follow-up assessments were done in-person or telephonically at 4-8 months and 8-12 months, respectively. Result(s): We enrolled 128 patients (69% male) with median (IQR) age of 49 (37-56) years. Among these, 99 (77%) needed hospitalization, and 47 (37%) received oxygen for COVID-19. At the 1st assessment at median (IQR) of 64.5 (39.5-90) days after COVID-19 onset, 86 (67%) patients had symptoms, most commonly dyspnea (34%), fatigue (19%) and cough (19%). Reduced FVC (<80% of predicted) was found in 61% subjects. On multivariate analysis, the predictors of symptomatic long COVID were female gender (OR, 4.1;95% CI: 1.5-11;p=0.006) and dyspnea during acute COVID-19 (OR, 3.6;95% CI:1.1-11.3;p=0.03). The predictors of reduced FVC were dyspnea (OR, 4.4;95% CI: 1.6-12;p=0.004) and oxygen therapy (OR, 5.6;95% CI: 1.5-21;p=0.01) during acute COVID-19. The proportion of symptomatic patients reduced between 1st and 2nd assessment (67% vs 37%, p<0.001) and then plateaued at 3rd assessment (42%). Conclusion(s): Persistent symptoms are common over a 1-year follow-up among survivors of COVID-19. Female gender and dyspnea during acute COVID-19 may predict development of long COVID.
ABSTRACT
While combating the second wave of COVID-19, India has now been afflicted by another epidemic caused by mucormycosis, a life-threatening opportunistic infection. Due to their immune-suppressed status, COVID-19 patients in India are now more likely to develop mucormycosis during or after treatment. Uncontrolled diabetes, irrational use of steroids, as well as the severity of COVID-19 can all contribute to the growth of mucormycosis. Risk mitigation strategies that could be used to control the rise of mucormycosis-related COVID-19 patients should be evaluated. The purpose of this article is to explore the modifiable risk variables that are involved in the medical management of COVID-19 patients, as well as the mechanisms through which they raise the risk. This overview also includes a brief discussion of mycology and how the disease pattern varies depending on the regions of the body affected. In this article, we detailed about the early detection and treatment of mucormycosis in COVID-19 patients.
ABSTRACT
The COVID-19 pandemic has brought about an unprecedented shift towards Telehealth since physicians are overwhelmed by the huge patient load in hospitals. This has forced policy makers to advise home quarantine for mild and moderate COVID patients. Additionally, even non-COVID patients with diabetes and cardiovascular or pulmonary diseases who do not need hospitalization are currently being monitored at home for any changes in their severity that may require a home to hospital transfer. Our research team has developed an Internet of Medical Things wearable Heart Lung Health monitor for patients with cardiovascular and pulmonary risk factors so as to enable hospitals to remotely track patient health status. Our system consists of a credit-card sized wearable 3-lead ECG device interfaced with smartphone that analyzes ECG and extracts heart and respiratory parameters, and transmits these to a dashboard for remote monitoring. We present the architecture, device, respiratory rate extraction algorithm, and its validation on 50 patients. Encouraged by these results we are readying deployment of our system for home monitoring of at-risk patients.
ABSTRACT
Introduction: Mucormycosis is a life-threatening angio-invasive infection caused by fungi of the order Mucorales. In India, the second wave of the COVID pandemic, primarily driven by the delta variant, led to a surge in cases of mucormycosis. The majority of these cases occurred following recovery from COVID, and resulted in increased morbidity and mortality. Here we present a series of five kidney transplant recipients (KTR’s) who presented with COVID-related mucormycosis. Methods: This is a single-centre, prospective, observational study that included all KTRs who presented to Madras Medical College with COVID-related mucormycosis between May 2021 and August 2021. Relevant clinical details and laboratory data were collected, therapeutic interventions were recorded, and outcomes of hospitalization were noted. Results: Five patients developed COVID-related mucormycosis during the study period. Their clinical details and hospital course are summarized in Table 1. Only one patient had received COVID vaccination (2 doses of covishield). All patients had underlying post-transplant diabetes mellitus, with severe hyperglycemia at admission. They all received intravenous dexamethasone for COVID pneumonia. Mucormycosis developed 10-21 days after recovery from COVID in four patients;one patient developed both infections concurrently. All patients received liposomal Amphotericin B, with four patients also undergoing functional endoscopic sinus surgery (FESS). Acute graft dysfunction occurred in all five patients;three had complete renal recovery, one had partial renal recovery, and one patient died during hospitalisation. [Formula presented] Conclusions: All five KTR’s in our series who developed COVID-related mucormycosis had acute graft dysfunction. They all had multiple risk factors that included elements of hyperglycemia, sepsis and nephrotoxic drugs (amphotericin B). Four of our five patients recovered, with only one case succumbing to the infection No conflict of interest