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There has been a huge spike in the usage of social media platforms during the COVID-19 lockdowns. These lockdown periods have resulted in a set of new cybercrimes, thereby allowing attackers to victimise social media users with a range of threats. This paper performs a large-scale study to investigate the impact of a pandemic and the lockdown periods on the security and privacy of social media users. We analyse 10.6 Million COVID-related tweets from 533 days of data crawling and investigate users' security and privacy behaviour in three different periods (i.e., before, during, and after the lockdown). Our study shows that users unintentionally share more personal identifiable information when writing about the pandemic situation (e.g., sharing nearby coronavirus testing locations) in their tweets. The privacy risk reaches 100% if a user posts three or more sensitive tweets about the pandemic. We investigate the number of suspicious domains shared on social media during different phases of the pandemic. Our analysis reveals an increase in the number of suspicious domains during the lockdown compared to other lockdown phases. We observe that IT, Search Engines, and Businesses are the top three categories that contain suspicious domains. Our analysis reveals that adversaries' strategies to instigate malicious activities change with the country's pandemic situation. © 2013 IEEE.
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The aim of this research paper is to investigate the adoption of digital branding among specialty eatery start-ups in a post-pandemic environment. The study analyses the relevance of digital branding's advantages and drawbacks, and examines the intention of specialty eateries to adopt digital branding. Additionally, the research investigates the mediating influence of digital support and awareness on the adoption of digital branding. A detailed Google-form-based survey was conducted on 231 small cafés and restaurants in Maharashtra's major cities that opened after COVID-19 (Mumbai, Pune, Nagpur, and Thane) to collect primary data. The data was analysed using the AMOS (Analysis of Moment Structures) program. The study concludes that digital branding plays a crucial role as an independent branding strategy and enhances the performance of specialty eatery start-ups in the post-pandemic era. Furthermore, the study highlights the significant mediating effect of digital support and awareness on the adoption intention of digital branding. This research is the first of its kind to examine the intention of startups in the specialty eatery industry to use digital branding to reach their intended audience. The study utilizes a quantitative approach, contributing to the respective research area that has been predominantly qualitative in previous studies regarding digital branding adoption. The findings of this research provide valuable insights for specialty eatery start-ups and other related businesses to enhance their digital branding strategies. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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In 2019, a new virus-A novel virus, COVID-19, bought disaster across the globe. The people were in great panic, death tolls crossed millions in number. Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. It is a debilitating disease-causing post covid effects too. Many of the cases have not yet recovered from the after effects of the disease. Many of the patients recovered instantaneously without any treatment, whereas many lost their lives. There was a chaos in all the countries across the globe. The patients recovered with the help of proper treatment and were back to their schedule and lifestyle. After, one year from the recovery, few patients started coming up with muscular fatigue, neurological deficits such as tingling in lower limbs, sharp shooting pain travelling throughout the legs. The patient seek treatment for Sciatica or any other nerve suppling the lower limb. The clinical features were misguiding and confused the clinicians. Some diagnosed it as PIVD, few others were confused with compressed and inflamed muscles. The diagnostic tests, including Haematological tests, MRI, CT-Scan, all went in vain.Later, the haematological tests for COVID-19 antibodies and other tests helped in coming up to a conclusion and start with subsequent treatment.This article focuses on the neuropathy and treatment of the same.Copyright © 2022, Anka Publishers. All rights reserved.
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India is a country where majority of the population resides in rural areas. For the development of India, it is necessary to focus on the core of India, i.e., the villages. Now, for developing villages, demand needs to be generated and supply chains to be put in place for ensuring fast-paced development. There are a plethora of employment opportunities and a million plus one can be created but villagers generally tend to relocate to metro cities for better facilities, resulting in overburdening of cities as well as slow development of villages. During the pandemic, India witnessed a large-scale migrant crisis. To bridge the gap between employers and employees, primarily focused on villages, we have developed an application—Atamnirbhar Gaon. Using this application, the workers can get equitable employment prospects like entrepreneurship, businesses, and skill set enhancement in their respective hometown. This venture can boost the development of villages and hence the development of the nation. This is a bilingual application—supports both Hindi and English;any illiterate person can also avail the functionality of this application through voice, know about the places near him where a person can learn new technologies or update his skills, weather updates for sowing the crops, latest updates in farming, and lastly can also get the importance of vaccination against Covid-19 and the available slots for vaccination. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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To stop the spread of COVID-19 in this outbreak, diagnostic testing is essential. Quick diagnostic tests must be employed in this pandemic, which is brought on by the severe acute respiratory syndrome (SARS)-CoV-2 virus, to successfully treat and manage COVID-19. There are several problems with the present RT-PCR system that the lateral flow assay (LFA), a kind of clinically sensitive diagnostic test, may be able to fix, especially in low-and middle-income nations. Gold nanoparticle-(AuNP-LFA) is a practical method for detecting COVID-19 in basic hospitals and laboratories, particularly in emergency situations where many samples must be quickly examined. Safe, accurate, and non-toxic diagnostic tests must be employed during the pandemic, to successfully treat and manage COVID-19. Recombinant SARS-CoV-2 nucleocapsid monoclonal antibody was employed to detect COVID-19 antigens in the presence of patients to establish a fast LFA for COVID-19. Synthesis of colloidal gold particles and antibody colloidal gold conjugates was evaluated by using UV/Vis spectroscopy. A capture line made of anti-SARS-CoV-2 antibody was coated on nitrocellulose membrane. To create the control line, goat anti-mouse IgG monoclonal antibody was coated. On a polystyrene backing board, the immunochromatographic strip was constructed in the ideal order. Using ELISA as the standard procedure, the strips' sensitivity and specificity were assessed. The results' stability and repeatability were evaluated over a 9-month period. Colloidal gold nanoparticle-based LFAs created in this study can be employed for quicker and more accurate detection of SARS-CoV-2. © 2023 Singh, et al.
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The corona virus disease 2019 (COVID-19), caused by severe acute respiratory syndrome corona virus type 2 (SARS-CoV-2), belongs to emerging and reemerging diseases, which was first identified and reported in Wuhan, China, during December 2019. The genetic sequence of SARS-CoV-2 was similar to SARS virus, a ß-corona virus. The epidemiologicalstudies suggest that the transmission of SARS-CoV-2 mainly occurs from an infected person to others through close contact with the respiratory droplets or by having contact with SARS-CoV-2adhering toobjects and surfaces. The incubation period ranges from 5 to14 days. During COVID-19, the occurrence of fever, dry cough, tiredness, aches, chest pain, conjunctivitis, diarrhea, headache, difficulty in breathing or short breath, loss of taste, smell, rashes on the skin,andsore throat.Some reports indicated that males exhibited lower scores than females, the younger populations displayed increased symptoms, Chinese/Taiwanese people registered only scarce symptoms and Canadians experienced more symptoms. The results of some studiesindictaed that COVID-19 significantly impacted on depression whereas job insecurity impacted on anxiety and depression. The risk factors of COVID-19 pandemic include steep rise in the degree of fear, worry, mainly the health care providers, infants, pregnant ladies, older adults, patients receiving treatment in hospitals, development of psychosomatic disorders including depression with serious immunological consequences in infectedindividuals. The diagnostics to detect the presence of corona virus involves ELISA and RT-PCR. There is no specific treatment available to eradicate COVID-19. The therapeutics used to treat COVID 19 exhibited severe side effects. Recently, some Indian traditional medicinal plants have shown promises to reduce the risk of viral infection and also boost immunity of an invidual.This paper presents an overview of the current status of depression in the SARS CoV2 infected people and the measures required to overcome COVID-19 induced depression in patients even after recovery.
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Background. A major outbreak of COVID19-associated mucormycosis (CAM) in India in spring 2021 aggravated the death toll of COVID19. As the causes of that CAM outbreak remain unclear, we performed a multifaceted study of host, pathogen, environmental, and heath care-related factors in adult CAM patients (pts) in the metropolitan New Delhi area. Methods. We reviewed the records of all pts diagnosed with culture- or biopsyproven CAM at 7 hospitals in the New Delhi area (April 1 - June 30, 2021). We used a multivariate logistic regression model to compare clinical characteristics of either all CAM cases (analysis 1, n = 50) or only pts with CAM after moderate or severe COVID19 (analysis 2, n = 31). As controls for both analyses, we used 69 COVID19-hospitalized contemporary pts. Selected hospital fomites were cultured for Mucorales. Additionally, we compared meteorological data and fungal spore concentrations in outdoor air before the CAM outbreak (January-March 2021) and during the outbreak (April-June 2021). Mucorales isolates from CAM pts were identified by MALDI-TOF-MS and ITS sequencing. A subset of 15 isolates underwent whole genome sequencing (WGS). Results. Risk factors for CAM in both analyses were newly diagnosed diabetes mellitus (odds ratio [OR] 8.26/5.67) and active cancer (OR 5.98/5.68) (Figure 1). Supplemental oxygen for COVID19 was associated with a lower CAM risk in both analyses (OR 0.13/0.17). Another significant CAM risk predictor identified only in analysis 1 was severe COVID19 (WHO score >= 6, OR 4.09), while remdesivir therapy (OR 0.40) and ICU admission for COVID19 were protective (OR 0.41) (Figure 1). No Mucorales were cultured from hospital fomites. The CAM incidence peak coincided with a significant uptick in environmental spore concentrations but was not linked to specific meteorological factors. Rhizopus was the predominant Mucorales genus (64%) identified by MALDI-TOF-MS and ITS sequencing;WGS found no clonal population of isolates but detected 2 cases of the rare pathogen Lichtheimia ornata. Figure 1 Conclusion. An intersection of host, environmental, pathogen and healthcare-related factors might have contributed to the emergence of CAM. Surrogates of access to advanced treatment of COVID19 were associated with lower CAM risk.
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Background: COVID-19 has become a global concern as it has ended the lives of lakhs of people. The study done by. Lin proposed the results of an analysis of a theoretical computational model of epidemiology taking into account the crucial components such as response of an individual behavior, measures taken by government, rapid transmission and emigration of fever virus to a huge extent of human population. Simple model framework has been used by them to examine the requirements of essential elements.Problem: We claim the perfect validation of the assumptions stated for the purpose of modeling and its analysis, however, the analytical solution of the presented model is not discussed. And thus have a poor potential to make computational estimates.Methodology adopted: We have tried to present and validate the mathematical/analytic solution of the developed model, considering their assumptions.Conclusion: We have reached to the outcome that the work presented by Q. Lin should be demonstrated adequately with a cautionary advice of not to consider the results and analysis of such numerical models.The current study proposed the results of an analysis of a theoretical computational model of epidemiology taking into account the crucial components such as response of an individual behavior, measures taken by government, rapid transmission and emigration of fever virus to a huge extent of human population. Simple model framework has been used by them to examine the requirements of essential elements. We claim the perfect validation of the assumptions stated for the purpose of modeling and its analysis, however, the analytical solution of the presented model is not discussed. The decision point of this work is to adequately demonstrate along with the cautionary advice of not to use the outcomes and analysis of such numerical models. © 2022 Author(s).
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India is a country where majority of the population resides in rural areas. For the development of India, it is necessary to focus on the core of India, i.e., the villages. Now, for developing villages, demand needs to be generated and supply chains to be put in place for ensuring fast-paced development. There are a plethora of employment opportunities and a million plus one can be created but villagers generally tend to relocate to metro cities for better facilities, resulting in overburdening of cities as well as slow development of villages. During the pandemic, India witnessed a large-scale migrant crisis. To bridge the gap between employers and employees, primarily focused on villages, we have developed an application—Atamnirbhar Gaon. Using this application, the workers can get equitable employment prospects like entrepreneurship, businesses, and skill set enhancement in their respective hometown. This venture can boost the development of villages and hence the development of the nation. This is a bilingual application—supports both Hindi and English;any illiterate person can also avail the functionality of this application through voice, know about the places near him where a person can learn new technologies or update his skills, weather updates for sowing the crops, latest updates in farming, and lastly can also get the importance of vaccination against Covid-19 and the available slots for vaccination. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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In a post-pandemic world, factors, such as the migration of urban population out of the city center, decreased buying power of the customer, online shopping for public safety, and brand closures that may have been catalyzed by COVID-19, have altered the retail landscape. Austerity measures, or the ‘lipstick effect,’ are applicable to pandemic retail. Grocery stores and the retail of essential items and small luxury items, such as the lipstick, continue to thrive in the pandemic. Traditionally, retail design is centered on a multisensory user experience, storytelling of the brand, and engaging with the customer at a visceral level. This experiential facet of retailing has adopted a digital avatar in recent times. In a post-pandemic world of sneeze guards and sanitizer stations, contactless points of sale, and regulatory compliance, how do we create an experience that puts the user at the center of this? How do we create an experiential environmental design for the retail space that makes the user remember the experience and not the extraneous elements necessary for safety? Understanding how our current spatial layouts contribute to both experience and infection can also help us identify methods to control the spread of infection while maintaining the experience. In this chapter, the author explores how the pandemic is reinventing retail spaces. The author studies the post-pandemic design ideas (materials, space planning, technology, social distancing) required to avoid future spread of disease and facilitate the return of the customer to retail. © 2023 selection and editorial matter, AnnaMarie Bliss and Dak Kopec;individual chapters, the contributors.
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Background: Patients with End Stage Kidney Disease (ESKD) on dialysis are extremely vulnerable to SARS-CoV-2 infection. Antibody levels decline in the months following the standard two-dose vaccination series with Pfizer BioNTech (BNT162b2) mRNA SARS-CoV-2 vaccine in hemodialysis patients. Current guidelines recommend boosters of SARS-CoV-2 mRNA-based vaccines. The aim of this study was to determine the humoral response of hemodialysis patients to a third dose of the BNT162b2 vaccine. Method(s): Prospective cohort study measuring the serologic response of hemodialysis patients to a booster dose of BNT162b2 vaccine at an average of 2, 6 and 11 weeks post vaccination. The Anti-SARS-CoV-2 QuantiVac ELISA (IgG) from Euroimmun (EUROIMMUN US, Inc.) was used in all assessments. Differences in antibody levels over time were compared non-parametrically using the Friedman test, then tested pairwisely with Bonferroni correction at alpha of < 0.05. A linear mixed model was used to estimate the decline in slope after vaccination. Result(s): Of 35 hemodialysis patients in the original cohort, 27 (77.1%) received a third dose of BNT162b2. Antibody level significantly increased from pre-booster to 2 weeks post-booster (median (25th, 75th percentile) from 59.94 (29.69, 177.8) to 6216 (3806, 11730)), an average increase of 112 fold. Antibody levels dropped an average of 36.3% to a median of 2654 BAU/mL (1650, 8340) at 6 weeks post-booster. From weeks 6 to 11 post-booster, antibody levels dropped to a median of 1444 BAU/mL (1102, 2020), corresponding to a 52.4% average decrease. Overall, antibody levels declined 47% month to month post-booster. Still, antibody levels at 11 weeks remained an average of 40 fold higher than pre-booster levels. Nine (33%) patients had negative or borderline detectable antibody levels pre-booster and 8 of 9 developed positive (>35.2 BAU/mL) antibody levels post-booster. Those with prior infection had a lower proportional increase in antibody level (51 fold) compared with the median change in COVID naive patients (144 fold) from pre-booster to 2 weeks post-booster. Conclusion(s): Following a third dose of the BNT162b2 vaccine, hemodialysis patients obtain a robust humoral response although antibody levels wane over time.
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Background: Vaccines against SARS-CoV-2 are effective in the general population. Dialysis patients are vulnerable to SARS-CoV-2 infection with high morbidity and mortality. Beginning in January of 2021, the University of Virginia Dialysis Program initiated a program wide vaccination campaign administering Pfizer BioNTech mRNA SARS-CoV-2 (BNT162b2) vaccine. The aim of this study was to characterize the long term time-dependent decline in humoral immunity in hemodialysis patients. Method(s): 35 adult hemodialysis patients were recruited to receive two doses of the BNT162b2 vaccine. From 2 to 6 months post vaccination, monthly semi quantitative IgG antibody levels to the SARS-CoV-2 spike protein receptor binding domain were obtained. To analyze the change in antibody levels over time, a linear mixed model with random slope and random intercept was used for longitudinal antibody levels. A multivariable model was used to estimate the slope of antibody levels by adjusting for selected patient characteristics. Based on the estimated intercepts and slopes for each subject from the unadjusted model, 10-month antibody levels were projected. Result(s): The mean baseline antibody level was 647.59 BAU/mL and 87.88% (29/33) of patients were considered qualitatively positive. Two patients were negative at baseline and an additional two had borderline results. Patient antibody levels declined at an adjusted average rate of 31% per month. At 6 months post vaccination, 40% of patients remaining in the cohort possessed either negative or borderline IgG antibody levels. Immune suppressed patients, on average, had a 65% lower antibody level compared to patients without immune suppression and patients with prior COVID-19 infection had 5 times higher antibody levels than infection naive patients. Projecting future antibody levels based on the slopes of antibody level decay suggests 65% of the cohort will progress to borderline or negative antibody levels at 10 months post full vaccination if additional doses are not administered. Conclusion(s): The long term vaccine response of hemodialysis patients vaccinated with the BNT162b2 mRNA vaccine was characterized. Our data demonstrates the decline in humoral immunity over time and emphasizes the crucial need for vaccine boosters in this population.
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Objective: SARS- CoV-2 has developed many variants that are responsible for causing the coronavirus pandemic over the past two years. Sequencing of the variants provides valuable clinical, epidemiological, and public health information. The aim of the study was to sequence positive SARSCoV- 2 cases to examine the variants circulating in Grenada. Method(s): This study was conducted from the outbreaks of SARS-CoV-2 in Grenada during August/September 2021 and December/January 2022. Nasopharyngeal samples were obtained from persons stored on ice, transported to the laboratory and processed within a few hours using qRTPCR, targeting the E gene. Aliquots of samples were stored at -80. and sequencing was performed using the MinIon MK1C sequencing platform. Only samples with a Ct value of = 25 were included in the study. Result(s): A total of 104 samples were sequenced (57 samples the from first wave, 47 from the second wave), variants were detected in 52 of these samples with their lineage. In the first wave, 20 samples (35.08%) were found to be the Delta variant (Ct values 11.3-21.15), whilst in the second wave, 32 samples (68.08%) were found to be of the Omicron variant (Ct values 11.57-24.66). Conclusion(s): Our data demonstrates that the first wave of COVID-19 in Grenada was due to the Delta variant in August/September 2021 and by the Omicron variant in December/February 2022. It also confirms that the 2022 wave of infection in Grenada was due to the omicron variant;the same variant predominates globally.
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Objective: Rapid antigen tests became an important surveillance method to identify individuals who were considered to be infective to others during the COVID-19 pandemic. Negative tests facilitated entry to large events and to access academic campuses. The sensitivity and specificity of the rapid test lent credibility to their role in helping to prevent transmission. Method(s): A voluntary and free rapid antigen test was implemented as a surveillance tool for individuals accessing a campus for a tertiary educational institution in Grenada following two mass screening programs in August/September 2021. Confirmatory diagnostic PCR tests were initially used for all rapid test positives. This practice was discontinued following a 100% concordance of positive results between the tests. Result(s): On suspicion of false-positive rapid tests, PCR tests were reinstituted in January 2022. Sixty-five percent of 42 rapid tests were discovered to be false-positive when using a new batch of rapid tests. Conclusion(s): Two outbreaks caused by the Delta and BA. 1 clade of the Omicron variant of SARS-CoV-2 were documented in Grenada in August/September 2021 and December/ February 2022, respectively. Mass screening programs, with isolation of positive cases and quarantine for contacts who were subsequently tested, were introduced. Initially, these were PCR tests, but subsequently, the rapid antigen test was used. The discovery of a large number of falsepositive rapid antigen tests reminds us that these tests are for surveillance and PCR tests remain the Gold Standard diagnostic test. All false-positive rapid test results came from a single batch of rapid antigen tests and are attributed to a manufacturing issue. Testing and subsequent isolation of positive cases and quarantine of contacts provided one of the non-pharmaceutical approaches to control COVID-19 in Grenada. Confidence in positive results, due to their implications remains paramount.
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Objective: To provide an overview on the screening, diagnostic methods, sample collection and compare the cycle threshold values from RT-qPCR testing from March 2020 - January 2022 in Grenada. Method(s): Samples were collected through the SARSCoV- 2 surveillance/ screening programmes at St. George's University or through the Government of Grenada. Samples were collected via nasopharyngeal swabs or saliva collection devices and were tested via RT-qPCR or lateral flow antigen testing. Subsequent samples were taken the same day from individuals who tested positive on rapid antigen testing for RT-qPCR testing. The cycle threshold values were recorded for each positive sample identified through RT-qPCR testing. Result(s): The first mandated screening session from August - September 2021, showed a positivity rate of 1.3% followed by no positive cases in the second mandated screening session in October 2021. The prevalence corresponded closely within the wider Grenadian community. Exposed individuals during the Omicron wave had a higher viral load in comparison to other infected individuals in the previous Alpha and Delta waves. Conclusion(s): The developments in technology and increase in knowledge for the screening and diagnostic tools for SARS-CoV-2 continue to evolve. Screening and surveillance outcomes assist with public health decision making in a small island developing state.
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This article examines how Linguistic Landscapes in the Covid-19 pandemic construct the borders of place and people. We build on 'semiotic ideology' (Keane, 2018) and 'semiotopology' (Peck, Stroud & Williams, 2018) to analyze the bordering practices in citizen Linguistic Landscapes during the pandemic in Nepal. Our analysis shows that citizens combine multiple semiotic resources, both linguistic and non-linguistic, to create physical boundaries to restrict the mobility of people during the pandemic. However, the findings show that such practices are ideological;they promote the othering of the tenants, returnees from abroad/outside the valley, and non-locals. We argue that keeping place and people at the centre of analysis provides a critical framework to widen the scope of Linguistic Landscapes as a broad visual and semiotic space that embodies the bordering practices and categorization of people and their impacts on emotions, identities, and sense of belonging. © John Benjamins Publishing Company.
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SESSION TITLE: Late Breaking Posters in Critical Care SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Discontinuing mechanical ventilation is a difficult process and takes time. Some patients succeed while others fail and remain on full ventilator support for a longer period. Extubation failure can result in many complications for the patient and a prolonged stay in the ICU. It's a common practice to have an SAT and SBT protocol in the majority of ICUs. Spontaneous awakening trial (SAT) is a nurse-driven protocol for discontinuation of sedation hypnotic drug to facilitate recovery to her baseline level of consciousness/responsiveness and assessment of intrinsic respiratory drive in the critical care setting. In general SAT protocol is followed and most ICUs are in the morning hours. If the patient needs the initial safety screening for SAT the sedative infusion is interrupted with a goal to awaken the patient or SAS 3-4. If the patient is showing signs of SAT failure with either tachypnea or desaturation or cardiac dysrhythmia or unacceptable ventilator asynchrony that the patient is resumed sedation/analgesia at 50% of the previous dose and bolus as needed dose of sedation is also utilized to achieve stability. A spontaneous breathing trial (SBT) is a protocol for systematic weaning of a patient from a mechanical ventilator in preparation for extubation. Before SBT protocol again safety screening is done and if the patient meets the criteria for SBT protocol, the patient is placed on spontaneous breathing mode that his CPAP of 5 to 8 cm of water for 30 to 120 minutes at the same FiO2. Various tools are utilized to analyze the success of the SBT trials including the RSBI index. Each institution has its own assessment of the average length of ventilator stay and the average length of ICU stay. The majority of hospital does SAT/SBT trials once a day for evaluation and successful liberation from ventilator. This project was done with the assumption that if compliance of SAT/SBT huddle is improved and if it is done twice in a day rather than only once the outcome in terms of length of ventilator stay, length of ICU stay, and rate of successful extubation improves METHODS: This is a prospective quality improvement study done at Einstein Medical Center Philadelphia. This is a 16-bed MICU unit and we implemented twice daily hurdle from August 2021 to April 2022. ( Study Period) This project was happening during the COVID pandemic during which the average length of ICU stay and the average length of ventilator stay was already high due to the natural course of COVID ARDS. The SAT/SBT Huddle involved interaction between our respiratory therapist, ICU fellow, and the nurse involved in the patient care. It had a checklist of SAT SBT protocol which needed a signature (electronic or manual) to consider it completed. This was done twice a day from the period of August 2021 to April 2022 (STUDY PERIOD). This study period was compared to the control period (August 2020 to April 2021). The reason for selecting this control period was to remove outlier and increased length of stay due to the COVID pandemic itself with the assumption that the COVID pandemic was present throughout the study and control period. RESULTS: In the control period- ie August 2020 to April 2021 the average ventilator length of stay is 6.85 days. In the study period from August 2021 to April 2022, the average length of a ventilator was 6.21. There is a clear decrease in ventilator length of stay with the intervention and no other change in the sample size. It should be noted that the COVID pandemic with the third surge was happening in both the control and study period. This is approximately a 10% decrease in length of stay. This is a Pilot study and with better compliance with a huddle, the length of stay will decrease further is our assumption. Here the huddle compliance ranged from 60-65% and out estimate is for better power we need at least 70% or more compliance with huddle CONCLUSIONS: Conclusion- This q ality improvement project aims to improve communication amongst healthcare providers with the ultimate goal of patient safety and decreased length of ventilator stay for every patient in MICU. Clearly, the minimal intervention of documenting each huddle and doing it twice a day had a decrease in ventilator length of stay. The greatest challenge for this compliance project is to have documentation of having a twice-daily hurdle. During this period to improve her compliance we have done various methods that included paper signatures electronic signatures and also QR code signatures. Of this, the maximum Complan success rate was achieved with a QR code signature for the huddle members. CLINICAL IMPLICATIONS: Limitation to the study–due to the COVID pandemic the average length of ventilator stay has increased in all hospitals which are affected by the COVID pandemic. Though the reflection of decreased length of ventilator stay is small this gives a glimpse of how her daily communication between a respiratory therapist, nursing staff, and the physician taking care of the patient makes a difference in the patient's overall length of stay and mortality. DISCLOSURES: No relevant relationships by Raminder Cheema No relevant relationships by Megan Dondarski No relevant relationships by Yasmeen Hassan No relevant relationships by Mahwish Hussain No relevant relationships by Myriam Poindijour No relevant relationships by Arnaldo Rodriguez No relevant relationships by Kumar Sarvottam No relevant relationships by Bhavna Sharma No relevant relationships by Teresa Vizak
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Purpose : OCTA is a non-invasive imaging technique for assessment of retino-choroidal vasculature. It allows for the quantitative assessment of retinal microvasculature. This study evaluates macular vessel density (VD), foveal avascular zone (FAZ) area, subfoveal choroidal thickness (SFCT) and retinal layer metrics by optical coherence tomography angiography (OCTA) in COVID-19 recovered patients. Additionally we studied the correlation of OCTA parameters with severity and duration of COVID-19 disease, steroid administration, and vaccination status. Methods : It is a case-control study of 180 patients. OCTA parameters namely-superficial and deep VD in various sectors-total, superior, inferior, central, inner, superior-inner, inferior-inner, full;superficial and deep FAZ area;SFCT: central subfield thickness (CST) were measured. Additionally, retinal layer metrics, including nerve fiber layer, ganglion cell layer-inner plexiform complex, inner nuclear layer, outer plexiform layer, and outer nuclear layer were compared between cases and controls. A correlation analysis of OCTA parameters was done with severity and duration of disease. Results : FAZ area (superficial and deep);retinal layer metrics including ganglion cell layer and inner plexiform layer, outer plexiform layer and outer nuclear layer showed significant reduction while there was a significant increase in SFCT in COVID-19 patients. Corticosteroid treatment resulted in significant decrease in VD. A positive correlation was elicited between FAZ area and disease duration;while VD correlated negatively with the duration of disease. Multivariate analysis showed significant relationship between superficial FAZ area, deep FAZ area and SFCT. Conclusions : OCTA showed alteration in retinal microvasculature and metrics in COVID-19 patients. Choroid being a highly vascular structure was also affected. There was a resultant alteration in FAZ area and SFCT. Moreover, thrombotic phenomenon associated with COVID could alter retinal layer metrics. Additionally, corticosteroids also appear to alter retinal microvasculature. This study could help understand the wide-spread thrombotic phenomenon often associated with COVID infection and predisposition for the same among specific patients.