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Introduction: Information on the cardiac manifestations of coronavirus disease 2019 (COVID-19) is scarce. In this study we assessed the echocardiogram of consecutive patients with COVID-19 infection to assess the frequency of cardiac abnormalities. Materials and Methods: This retrospective descriptive study examined the echocardiographic study of 43 patients with severe and critical COVID-19 infection admitted at the ICU of Chitwan Medical College from May 16, 2021 to June 05, 2021. The study focused on left ventricle (LV) and right ventricle (RV) function. The results were then compared between severe and critical infections to examine if any differences exist between them. Results: The mean age of the study population was 54 years and predominately males. One-third were classified as critical COVID-19 while the remaining were severe COVID-19. Majority(83.7%) had a normal echocardiogram. Among the patients with abnormal reports, the distribution of echocardiographic pattern were biventricular dilation with biventricular dysfunction in two patients (4.6%), LV dialtion with LV dysfunction in two patients (4.6%) and isolated LV dysfunction (diastolic and systolic) in three patients (6.9%). None of the echocardiographic parameters were significantly different between the severe and the critical infection. Conclusion: COVID-19 in primarily a respiratory disease and the cardiac complications is largely attributed to the critical nature of the illness than the specific infection. Considering the risk of infection spread, routine echocardiography for all patients with COVID-19 infection is not advisable.
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Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (> or equel 3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (> or equal 2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients.
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COVID-19 Vaccines , COVID-19 , Humans , SARS-CoV-2 , ChAdOx1 nCoV-19ABSTRACT
Travel risk and management views of tourists have a key role in their choice of locations while the COVID-19 epidemic is still causing travel-related concerns. Despite many studies available in the western world, the effect of COVID-19 has been less explored in Nepal. Thus, this research aims to investigate travel risk and management perception in post-COVID tourism activities in Nepal. Based on pathogen stress theory and explanatory research design, this study seeks a causal relationship between Travel Risk and Management in Nepal. Following the purposive sampling technique, data collection is done using KOBO Toolbox through a structured questionnaire. Findings revealed that Risk Management, Transportation Patterns, Distribution Channel, Avoidance of Overpopulated destinations, Hygiene and Safety are significant to Travel risk and management perception whereas Risk Management, Travel risk and management perception, Service Delivery, Distribution Channel, Hygiene and Safety are significant to COVID-19 pandemic in Nepal which supports pathogen-stress theory. Furthermore, travel risk and management perception partially mediate the favorable association between avoidance of overpopulated destinations and the COVID-19 pandemic. Additionally, the primary problems faced by the traveler were securing a comfortable hotel and selecting a destination where COVID risk is minimum. However, the COVID-19 break has caused health concerns among visitors, causing many to cancel their holiday plans. Therefore, in the post-pandemic phase, tourists are more concerned about the influence of the COVID-19 pandemic on their travel activities and choice.
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Background Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) variants, which have emerged due to several mutations in spike protein, have a potential to escape immune protection provided by the first-generation vaccines, thereby resulting in breakthrough infections. Objective To identify the socio-demographic factors, clinical features, and outcomes in both vaccinated and unvaccinated hospitalized patients infected with SARS-CoV-2. Method Socio-demographic details, clinical features, and the outcomes among fully vaccinated (double for Covishield/AstraZeneca and BBIBP-CorV and single for Janssen), partially vaccinated, and unvaccinated hospitalized patients with coronavirus disease of 2019 (COVID-19) were collected and analyzed using SPSS version 17. Result Among the hospitalized COVID-19 patients (n=299), 175 (58.5%) patients received a single-dose, 82 (27.4%) double-dose, and 124 (41.5%) did not receive any dose of the COVID-19 vaccines. The risk of SARS-CoV-2 infection when compared between vaccinated and unvaccinated patients was found to be associated among professional degree holders (23.4% versus 9.7%) (p<0.05), professional workers (43.4% vs. 25.0%) (p<0.05), hospitalization to general ward (76.6% vs. 72.6%) (p<0.05), and presence of multiple symptoms (>=3) (86.8% vs. 75.0%) (p>0.05) and comorbidities (>=2) (15.5% vs. 13.7%) (p>0.05). Despite such approximate incidences, the risk of in-hospital mortality among the vaccinated patients was reduced (0.6% vs. 3.2%) (p>0.05), when compared to the unvaccinated patients. The risk of in-hospital mortality was associated with the older age and the presence of multiple comorbidities including bronchial asthma, diabetes, and hypertension. Conclusion Full or partial vaccination against the SARS-CoV-2 variants of concerns might be effective in preventing in-hospital mortality among COVID-19 patients. Copyright © 2022, Kathmandu University. All rights reserved.
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SESSION TITLE: COVID-Related Critical Care Cases SESSION TYPE: Case Reports PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm INTRODUCTION: Thrombotic thrombocytopenic purpura (TTP) is a rare medical emergency with mortality rates reported to be as high as 90% if untreated. We report a case of severe TTP in an immunocompetent patient diagnosed with COVID 19 infection. CASE PRESENTATION: A 34-year-old morbidly obese female not vaccinated for COVID presented to PCP 2 weeks prior with complaints of fatigue. CBC showed Hb 12.2, platelet count 108 (baseline > 200), and covid resulted positive. The patient was reluctant for further workup at the time. After 2 weeks she felt short of breath prompting ICU admission for high flow oxygen with blood work showing hemoglobin of 8.8, platelet count of 11, Reticulocyte count 3.9%, LDH 763, fibrinogen 639, schistocytes on peripheral smear, MCV < 90, INR<1.5, Creatinine 1 giving her a PLASMIC Score of 7. For concerns of TTP, she was urgently started on plasmapheresis, prednisone 1 mg/kg, and remdesivir for COVID. ADAMTS13 was sent prior to the initiation of plasmapheresis resulted at 5% indicating severe deficiency and a high risk of relapse. She underwent 3 cycles of plasma exchange and was also started on Caplacizumab. Rituximab was not started in the setting of active COVID infection and negative COVID IgG. Repeat ADAMTS13 level at 2-week interval increased to 43%. The patient was discharged on steroids and completed 1 month of Caplacizumab. On outpatient follow up the patient was asymptomatic but repeat ADAMTS13 declined to 16%. COVID IgG now resulted positive, and she was started on Rituximab. Ultimately patient was treated with 4 months of steroids and 4 doses of weekly Rituximab with the final two ADAMTS 13 levels normalized above 100. DISCUSSION: TTP is caused by decreased activity of the plasma metalloproteinase ADAMTS 13, the key enzyme involved in the cleavage of ultra-large von Willebrand Factor (vWF) multimers into smaller less procoagulant multimers. It is reported that COVID-19 infection is associated with almost a five-fold increase in vWF levels which the body's ADAMTS-13 enzyme activity cannot adequately regulate, resulting in an excess of unchecked ultra-large vWF, diffuse microthrombi, and systemic ischemia. The presentation of this disease is often characterized by the pentad of fever, thrombocytopenia, hemolytic anemia, renal dysfunction, and neurologic dysfunction. However, the full pentad is often not present in many patients Plasma exchange and immunosuppression are the mainstays of treatment for TTP. A high index of suspicion is required for a timely diagnosis. Early diagnosis is crucial as without treatment TTP is associated with a high mortality rate. CONCLUSIONS: Health care providers should be aware of this life-threatening complication of COVID-19 so that prompt and appropriate interventions can be undertaken if it is suspected or confirmed. Rituximab should be delayed until the acute COVID-19 infection has cleared, and neutralizing antibodies have been produced. Reference #1: Hindilerden F, Yonal-Hindilerden I, Akar E, Kart-Yasar K. Covid-19 associated autoimmune thrombotic thrombocytopenic purpura: Report of a case. Thromb Res. 2020;195:136-138. doi:10.1016/j.thromres.2020.07.005 DISCLOSURES: No relevant relationships by Hanish Jain No relevant relationships by Dragos Manta No relevant relationships by Parth Sampat No relevant relationships by Garima Singh No relevant relationships by Simant Thapa
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Technology has revolutionized our world and everyday life over the years. In all these revolutions, technology our lives easier faster, better fun made. To withdraw or transfer money to someone you no longer have to enter the bank. Many banks have already made online transactions possible, everywhere. With your cell phone and banking application, you can manage all your bills online. Moreover, it is clear that COVID-19 million workers have been forced to stay home for the past eight months. There is a need to quickly transform digital technology into a 2020 vision. This adaptation came into effect almost immediately with the lockout, especially for India digital payments. The Government of been actively promoting online payments since 2016, starting with monetization. 'Digital India' was the driving force behind many digital and Indian economic decisions. There are different methods of digital payments in India, bank cards, Unstructured Support (AEPS) Data (USSD), Aadhaar Enabled Payment System, Integrated Payment (UPI), Bank Prepaid Cards etc. Therefore, overall Govt-19 has provided incentives for digital payment in India. © 2022 Author(s).
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INTRODUCTION COVID-19 has placed excess stress on the antenatal health care system and added additional complexity to expecting mothers. This study aimed to study the attitude and precautionary practices of non-infected pregnant women during the COVID-19 pandemic in Nepal. METHODS A cross-sectional study was carried out interviewing all 195 pregnant women attending an antenatal care outpatient department in Nepal, between 15 March and 16 April 2021, using a pretested questionnaire. Precautionary practices were defined as the practice of social distancing, wearing masks, and sanitizing or washing hands, by the mothers during the antenatal period with a 5-point Likert scale for each item Precautionary practices were categorized into good (≥ median score) and poor(< median score). RESULTS The majority of the women who participated in this study were from aged 20–29 years (71.7%), were Brahmin (48.2%) and 84.6% Hindu. Since 46.2% of women assumed the close contact of mother to child as safe practice with specific precautions, only 17.9% were willing to isolate themselves if infected by COVID-19. Overall, 35.9% of the respondents were only willing to breastfeed their newborn, even with specific precaution if infected. Nearly half of the respondents (47.2%) had poor precautionary practice during the COVID-19 pandemic and the level of precautionary practices was found significantly associated with age and occupational status. CONCLUSIONS Most of the respondents were concerned about the threats of mother to child transmission but found to have poor precautionary practices towards COVID-19. Thus, adequate counselling regarding COVID related issues during an antenatal checkup is required to be provided by health workers to break their perceived stigma for better maternal and neonatal outcomes © 2022 Thapa T. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License. (http://creativecommons.org/licenses/by-nc/4.0)
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Purpose: The purpose of this paper is to investigate how consumers’ luxury purchase behavior has been affected by COVID-19. A theoretical framework is proposed to determine how isolation leads to intention to purchase luxury brands through bandwagon luxury consumption behavior. Additionally, the moderating effects of COVID-19 anxiety and social capital on the relationship between bandwagon luxury consumption behavior and subjective well-being and intention to purchase luxury brands are tested. Design/methodology/approach: Survey responses from a national sample of 261 luxury consumers in the USA were collected. The data were analyzed using a covariance-based structural equation modeling technique. Findings: The results confirm that the feeling of isolation leads to a higher intention to purchase luxury brands. Both COVID-19 anxiety and social capital moderate the relationship between bandwagon luxury consumption behavior and intention to purchase luxury brands/subjective well-being related to the luxury brand purchase. Research limitations/implications: Luxury marketers should focus on highlighting bandwagon elements of their brands, such as their popularity and how they enhance social connectedness when tailoring their brand communication to isolated consumers. The data is limited to luxury consumers in the USA;thus, the findings are specific to the US market. Originality/value: Given the paucity of research on luxury consumption for isolated consumers, this study adds to the literature on luxury brands by examining how the feeling of isolation affects the intention to purchase luxury brands. © 2022, Emerald Publishing Limited.
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Introduction-The coronavirus COVID-19 illness makes a very unpredictable future the main psychological effect is elevated rates of anxiety, because of pandemic and the lockdown. Aim-The aimed of the study was to Assess the level of anxiety during COVID-19 among general population in India. Methodology-A Snowball sampling technique was used to collect the samples from different state and union territory of India. Total 829 participants respond and enrolled themselves in the study. Participants in the study belong to 27 states or union territories of India and majority of them are from Delhi. Result-Most of the Participant in the study was female (54%), graduate (51%), age between 18-28 (60%) and Hindu (89.3%). Half of the participant were having minimal anxiety (57.1%) nearly one fourth of the participant were having Mild anxiety (28.5%) and least number of participants were having Moderate anxiety (11.0%) and Severe anxiety (3.5%).There was no significant association of Anxiety scores with Socio-demographic variable except place of stay, suffering from any health problem and During lockdown period time spent in watching news related to corona (COVID-19) on mobile, laptop, television etc. Conclusion-The study concluded the outbreak of coronavirus disease 2019 (COVID-19) Cause anxiety among the people. Understanding the risk to yourself and people you care about can make an outbreak less adverse effect on mental and physical health of the people.
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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), has become an unprecedented public health crisis. To tackle this crisis in an effective way different computational solutions involving artificial intelligence and machine learning have been propounded by researchers across the world. Artificial Intelligence has changed the landscape of the healthcare industry and is being used by many corporations and governments around the world to tackle health care issues and hence, it finds applications in these troubling times as well. The internet specially google scholar scoured for relevant and accurate applications of machine learning and deep learning in solving the issues of this pandemic. The different applications include diagnosis, mortality rate prediction, vaccine development, drug development, sentiment analysis regarding COVID-19 comments and misinformation detection. A systematic study presents the best working models in the respective field. © 2020 IEEE.