High-Dose Prophylactic Anticoagulation for COVID-19 Pneumonia: A Review of Benefits and Risks.

The COVID-19 pandemic has had a devastating impact on a global scale, causing significant morbidity and mortality. The virus affects multiple organ systems, including the respiratory, cardiovascular, and coagulation systems, leading to severe pneumonia in some patients. Moreover, COVID-19 patients with severe pneumonia have a high incidence of thrombotic events, which can result in significant morbidity and mortality. Given the potential benefits of anticoagulation therapy in COVID-19 patients with thrombotic complications, recent studies have proposed high-dose prophylactic anticoagulation (HD-PA) therapy as a potential treatment option. In fact, some studies have suggested that HD-PA therapy may be more effective in reducing thrombotic events and mortality rates than other treatment options. This review aims to provide a comprehensive overview of the benefits and risks of HD-PA therapy for COVID-19 pneumonia patients. By synthesizing and analyzing the latest available research, we highlight patient selection criteria and discuss the optimal dosage, duration, and timing of therapy. Additionally, we review the potential risks associated with HD-PA therapy and provide recommendations for clinical practice. Ultimately, this review provides valuable insights into the use of HD-PA therapy in COVID-19 pneumonia patients and paves the way for further research in this critical area. By exploring the benefits and risks of this treatment option, we hope to provide healthcare professionals with the information they need to make informed decisions about the best course of treatment for their patients.

Emergence of a novel SARS-CoV-2 Pango lineage B.1.1.526 in West Bengal, India.

BACKGROUND: Since its inception in late 2019, SARS-CoV-2 has been evolving continuously by procuring mutations, leading to emergence of numerous variants, causing second wave of pandemic in many countries including India in 2021. To control this pandemic continuous mutational surveillance and genomic epidemiology of circulating strains is very important to unveil the emergence of the novel variants and also monitor the evolution of existing variants. METHODS: SARS-CoV-2 sequences were retrieved from GISAID database. Sequence alignment was performed with MAFT version 7. Phylogenetic tree was constructed by using MEGA (version X) and UShER. RESULTS: In this study, we reported the emergence of a novel variant of SARS-CoV-2, named B.1.1.526, in India. This novel variant encompasses 129 SARS-CoV-2 strains which are characterized by the presence of 11 coexisting mutations including D614G, P681H, and V1230L in S glycoprotein. Out of these 129 sequences, 27 sequences also harbored E484K mutation in S glycoprotein. Phylogenetic analysis revealed strains of this novel variant emerged from the GR clade and formed a new cluster. Geographical distribution showed, out of 129 sequences, 126 were found in seven different states of India. Rest 3 sequences were observed in USA. Temporal analysis revealed this novel variant was first collected from Kolkata district of West Bengal, India. CONCLUSIONS: The D614G, P618H and E484K mutations have previously been reported to favor increased transmissibility, enhanced infectivity, and immune invasion, respectively. The transmembrane domain (TM) of S2 subunit anchors S glycoprotein to the virus envelope. The V1230L mutation, present within the TM domain of S glycoprotein, might strengthen the interaction of S glycoprotein with the viral envelope and increase S glycoprotein deposition to the virion, resulting in more infectious virion. Therefore, the new variant having D614G, P618H, V1230L, and E484K may have higher infectivity, transmissibility, and immune invasion characteristics, and thus need to be monitored closely.

Role of a Nurse in COVID-19 Pandemic

BACKGROUND The role of nurse changes as the health care is needed in the hospitals, society or community. Nurses are providing essential health care services throughout the health care system. In response to COVID-19 pandemic, the role of nurse changes to care or respond to the needs of the patients, their families and their caregivers. They also should take part in policies making, doing procedures and taking care of necessary supply of the material and equipment in the hospitals. All over the world nurses are demonstrating their kindness, care, courage, values and professional responsibility as nursing personnel. Prior to the COVID-19 pandemic in many institutions / organizations, there was a focus on nurses, mental health, physical health and wellbeing such as workload, anxiety, anger, irritability, burnout etc. They have to follow the rules, regulations, ethics and standard of nursing. However, while working in the isolation units or intensive care unit with COVID-19 patients, the nurse has to decide how much quality care they can provide to the patients while taking care of themselves. Hospital authorities have the responsibility to provide optimal work environments for all staff involved in the care of COVID-19 patients and health care professionals must follow the protocols that protect their ethical rights as a health care professional. In a 2018 policy brief, the American Nurses Association, said "nurse leaders are the key to preventing and containing widespread illnesses. They have the skills and education to develop coordinated global networking and properly identifying of infectious diseases".