ABSTRACT
Background It is critical to identify high-risk groups among children with COVID-19 from low-income and middle-income countries (LMICs) to facilitate the optimum use of health system resources. The study aims to describe the severity and mortality of different clinical phenotypes of COVID-19 in a large cohort of children admitted to tertiary care hospitals in India, Methods Children aged 0-19 years with evidence of SARS-CoV-2 infection (real time polymerase chain reaction or rapid antigen test positive) or exposure (anti-SARS-CoV-2 antibody, or history of contact with SARS-CoV-2) were enrolled in the study, between January 2021 and March 2022 across five tertiary hospitals in India.. All study participants enrolled prospectively and retrospectively were followed up for three months after discharge. COVID-19 was classified into severe (Multisystem Inflammatory Syndrome in Children (MIS-C), severe acute COVID-19, ‘unclassified') or non-severe disease. The mortality rates were estimated in different phenotypes. Findings Among 2468 eligible children enrolled, 2148 were hospitalised Signs of illness were present in 1688 (79%) children with 1090 (65%) having severe disease. High mortality was reported in MIS-C (18·6%), severe acute COVID-19 (13·3%) and the unclassified severe COVID-19 disease (12·3%). Mortality remained high (17·5%) when modified MIS-C criteria was used. Non-severe COVID-19 disease had 14·1% mortality when associated with comorbidity. Interpretation Our findings have important public health implications for low resource settings. The high mortality underscores the need for better preparedness for timely diagnosis and management of COVID-19. Children with associated comorbidity or coinfections are a vulnerable group and need special attention. MIS-C requires context specific diagnostic criteria for low resource settings. It is important to evaluate the clinical, epidemiological and health system-related risk factors associated with severe COVID-19 and mortality in children from LMICs. Funding Department of Biotechnology, Govt of India and Department of Maternal, Child and Adolescent Health and Aging, WHO, Geneva.
ABSTRACT
CONTEXT: A healthy lifestyle has been the need of the hour during the COVID 19 pandemic. Analyzing the current lifestyle patterns of many individuals can be the basis for finding solutions toward building a healthy future for India. OBJECTIVES: The study intended to evaluate the current lifestyles of adults in an urban setting in the midst of a pandemic and to examine the diseases that people could face with respect to their current lifestyles. DESIGN: The research team performed a cross-sectional study. SETTING: The survey was conducted in an urban setting in the Pimpri Chinchwad area of Pune, India. PARTICIPANTS: Participants were 500 men and women between the ages of 18 and 25. OUTCOME MEASURES: The research team created a survey with 13 multiple-choice questions. RESULTS: The pandemic has taken a toll on people's mental and physical health. Social distancing and staying indoors for long periods are factors that have affected people's mental health. CONCLUSIONS: Efforts need to be made by individuals to focus not only on their physical health but also on their mental health.
ABSTRACT
CONTEXT: A healthy lifestyle has been the need of the hour during the COVID 19 pandemic. Analyzing the current lifestyle patterns of many individuals can be the basis for finding solutions toward building a healthy future for India. OBJECTIVES: The study intended to evaluate the current lifestyles of adults in an urban setting in the midst of a pandemic and to examine the diseases that people could face with respect to their current lifestyles. DESIGN: The research team performed a cross-sectional study. SETTING: The survey was conducted in an urban setting in the Pimpri Chinchwad area of Pune, India. PARTICIPANTS: Participants were 500 men and women between the ages of 18 and 25. OUTCOME MEASURES: The research team created a survey with 13 multiple-choice questions. RESULTS: The pandemic has taken a toll on people's mental and physical health. Social distancing and staying indoors for long periods are factors that have affected people's mental health. CONCLUSIONS: Efforts need to be made by individuals to focus not only on their physical health but also on their mental health.
ABSTRACT
BACKGROUND: Few COVID-19 vaccines were anticipated in India in early 2021. However, little was known about COVID-19 vaccination acceptance among the public. We conducted a nationwide study to understand the public's perception about COVID-19 vaccines in December 2020. METHOD: An online survey was deployed using a multi-item validated questionnaire via social media websites and networking platforms for adults in India. We asked participants about vaccination willingness, concerns about vaccination, and their sociodemographic characteristics. RESULTS: Nationwide, 1638 participants from 27 states/union territories took the survey where the majority of the participant were males (55%), 18-30 years old (52%), urban dwellers (69%), college-educated (81%), without a history of COVID-19 infection (92%). More than a fifth were either unaware of the vaccines (20.63%) or were not sure if they will get the vaccine (27%), and 10% refused to obtain the vaccine. Almost 70% of the population had concerns regarding the vaccines. Statistically significant differences (p<0.01) in awareness about vaccine and acceptability were observed based on age, educational qualifications, and employment status. CONCLUSION: While the majority of Indians would accept the vaccine, given the large population of India, even a small proportion of hesitant individuals would translate to millions of unvaccinated individuals. Strategic measures and policy decisions to enhance the rate of COVID-19 vaccination should be continuously planned and implemented in India.
ABSTRACT
Clinical and epidemiological characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now widely available, but there are few data regarding longitudinal serology in large cohorts, particularly those from low-income and middle-income countries. We established an ongoing prospective cohort of 3,840 SARS-CoV-2-positive individuals according to RT-PCR in the Delhi-National Capital Region of India to document clinical and immunological characteristics during illness and convalescence. The immunoglobulin G (IgG) responses to the receptor binding domain (RBD) and nucleocapsid were assessed at 0 to 7 days, 10 to 28 days, and 6 to 10 weeks after infection. The clinical predictors of seroconversion were identified by multivariable regression analysis. The seroconversion rates during the postinfection windows of 0 to 7 days, 10 to 28 days, and 6 to 10 weeks were 46%, 84.7%, and 85.3%, respectively (N = 743). The proportion with a serological response increased with the severity of coronavirus disease 2019 (COVID-19). All participants with severe disease, 89.6% with mild to moderate infection, and 77.3% of asymptomatic participants had IgG antibodies to the RBD antigen. The threshold values for the nasopharyngeal viral RNA RT-PCR of a subset of asymptomatic and symptomatic seroconverters were comparable (P = 0.48) to those of nonseroconverters (P = 0.16) (N = 169). This is the first report of longitudinal humoral immune responses to SARS-CoV-2 over a period of 10 weeks in South Asia. The low seropositivity of asymptomatic participants and differences between assays highlight the importance of contextualizing the understanding of population serosurveys.