Predicting the Vulnerability of Covid-19 using Machine Learning Algorithm

In this research, a quantitative model is developed to predict people's susceptibility to Covid-19 supported by their comorbid diseases and factors associated with Covid19. Researchers have found that individuals with comorbid diseases have higher chance of being infected and developing more severe Covid-19 conditions. However, these patterns are only observed through correlational analyses between patient phenotypes and the severity of their Covid-19 infection. The research reported in this paper presents a comprehensive approach to determine the impact of pre-existing disorders on Covid-19. This might be substantiated by a complete study of the patient level dataset, which includes their prior conditions, vital health information, and age group, as well as the influence of Covid-19 on them. The analysis revolves around how each disease affects a patient's immunity, which includes endpoints such as admission of patients to a regular ward, semi-ICU, or ICU. Monitoring the patient's current conditions, supports the final outcome. © 2022 IEEE.

Acute Kidney Injury Associated with Leptospirosis and/or COVID-19 Pneumonia

Aim and objectives: To compare the mortality and outcome of patients with acute kidney injury (AKI) associated with leptospirosis and/or COVID-19 pneumonia. Materials and methods: The study was conducted by the Department of Nephrology in a tertiary care setup with 97 patients with acute kidney injury over a period of 3 months from July 2020 to September 2020. All the patients were divided into 3 main categories: 1. Leptospirosis with AKI. 2. COVID-19 pneumonia with AKI and 3. Patients having both leptospirosis and COVID-19 pneumonia with AKI. AKI was defined and staging was done as per KDIGO guidelines. Need for renal replacement therapy as well mechanical ventilation was noted. Thereby, the outcome and mortality were compared among the three groups. Results: Out of 97 patients included in the study, 57 (53.6%) patients had leptospirosis with AKI (group I), 25 (25.8%) patients had COVID-19 pneumonia with AKI (group II), whereas 20 (20.6%) patients suffered from leptospirosis and COVID-19 pneumonia with AKI (group III). There was a statistically significant difference between mortality rates in patients with leptospirosis, COVID, and both infections (χ2 = 6.210, p = 0.045). The mortality rate was 25% in leptospirosis patients and 52% in patients with COVID. This difference was statistically significant (p = 0.019). The mortality rate among patients with both leptospirosis and COVID was 45%. 15.4% of patients of group I required renal replacement therapy (RRT) in comparison to 16% of patients of group II and 35% of patients of group III. There was no statistically significant difference noted between the 3 groups (p value = 0.149). Mechanical ventilation requirement: Group I - 14/52 patients (26.9%). Group II - 7/25 (28%). Group III - 13/20 (65%). There was a significant difference in the number of patients requiring mechanical ventilation among the three groups (χ2 = 9.930, p = 0.007) with group III requiring the highest. Conclusion: AKI in patients with dual infection with leptospirosis and COVID-19 results in an increased need for mechanical ventilation without a concomitant increase in the need for RRT. Despite this, the mortality remains the highest in patients with COVID-19 and AKI as compared to those with dual infection and AKI.

Predictors of adherence to oral endocrine therapy in racial and ethnic minority patients with low socioeconomic status before and during the COVID-19 pandemic

Introduction: Medication adherence is important in ensuring the maximum effect of oral endocrine therapy (OET) in hormone receptor-positive breast cancer (HR+ BC) patients. Low medication adherence is more seen in racial and ethnic minority patients of lower socioeconomic status. COVID-19 pandemic has further introduced complexities that have impacted patients' medication-use behaviors. Our goal was to (1) assess the medication adherence to OET in racial and ethnic minority patients of lower socioeconomic status with HR+ BC and (2) assess the impact of the COVID-19 pandemic on their OET adherence. Patients and Methods: A retrospective, single-center study from September 2019 through September 2020 was conducted. The primary endpoint was adherence rate during the 6 months prior (September 2019-February 2020) and 6 months after (April 2020-September 2020) the COVID-19 pandemic started in the United States. The following three racial/ethnic groups were compared: Non-Hispanic White/Caucasian, Black/African American, and Hispanic/Latino. Chi-Square and Student's t-tests were used to compare the adherent and nonadherent groups. The secondary endpoint was to identify predictors of nonadherence to OET. Multivariable logistic regression model was used to assess predictors of S nonadherence. Results: Out of 270 patients, a total of 251 patients had a refill for an OET before COVID-19 with a mean proportion of days covered (PDC) of 0.72%. Of these, 140 (55.78%) were adherent and 111 (44.22%) were nonadherent. A total of 194 patients had a refill for an OET during COVID-19 with a mean PDC of 0.67%. Of these, 83 (42.78%) were adherent and 111 (57.22%) were nonadherent. A total of 187 patients had a refill for OET before and during the COVID-19 pandemic. There was a significant difference in the adherence before and during the pandemic when PDC was used as a continuous (p <0.0001, Student's paired t-test) or a categorical variable (p <0.0001, McNemar chi-square test). In a multivariate analysis of data before the pandemic, Black/African American and White/Caucasian were less likely to be adherent compared to Hispanic/Latino (Black/African American: odds ratio [OR], 0.36;95% confidence interval [CI], 0.18-0.723;White/Caucasian: OR, 0.25;95% CI, 0.074-0.853). Patients with diabetes mellitus (DM) were more likely to be adherent compared to patients without DM (OR, 2.364;95% CI, 1.199-4.662), and patients with hypertension (HTN) were less likely to be adherent compared to patients without HTN (OR, 0.481;95% CI, 0.236-0.981). Patients who were prescribed aromatase inhibitors were more likely to be adherent compared to patients that were prescribed tamoxifen (OR, 0.484;95% CI, 0.235-0.998). Patients diagnosed with invasive BC (stages 1-4) were more likely to be adherent compared to those diagnosed with non-invasive (in situ) tumors or ductal/lobular hyperplasia. During the pandemic, patients who used home delivery were more likely to be adherent compared to those who did not use home delivery (OR, 11.574;95% CI, 2.45-54.55). There was no significant difference in the proportion of patients using home delivery between different racial and ethnic groups. Conclusion: OET adherence was reduced during the COVID-19 pandemic in racial and ethnic minority patients with low socioeconomic status. Tamoxifen therapy, Black/African American, and White/Caucasian origin, not having DM, having HTN, and diagnosed with non-invasive BC were associated with OET nonadherence in patients before the COVID-19 pandemic. Whereas, not using home delivery for OET medications predicted nonadherence in patients during the COVID-19 pandemic.

Pre-procedural Sars-CoV-2 testing and pulmonary function testing

Background: CF Foundation guidelines encourage quarterly pulmonary function testing (PFTs) for all patients as part of routine care. The COVID-19 pandemic significantly affected our ability to obtain PFTs at recommended intervals, as patients were reluctant to come to the hospital and being advised to shelter in place to avoid unnecessary exposure to the Sars-CoV-2 virus. To obtain PFTs at our center during this time, we required negative Sars-CoV-2 testing for asymptomatic patients in the preceding 48–72 hours.We hypothesized that the extra trip away from home for viral testing affected our ability to adhere to the recommended PFT testing intervals.We sought to analyze the number of patients who did not have any PFTs completed since the start of the testing requirement. We also sought to analyze the positivity rate for Sars-CoV-2 associated with PFTs. Methods: All charts of CF patients ordered for PFTs and Sars-CoV-2 PCR testing from July 2020 to March 2021 were retrospectively queried for viral test results and either the subsequent completion or cancelation of a PFT appointment. Charts were ed for patient age, number of PFTs completed, and Sars-CoV-2 status. Results: Patient ages ranged from 6 years to 55 years. Of the 110 patients, 37 (34%)were under 18 years old. PFTswere ordered 134 times on 110 patients during the 9-month period, along with antecedent viral testing. Thirty-five patients (32%) did not have any PFTs completed in that time frame. None of the viral testing for Sars-CoV-2 prior to each PFT returned positive (0%). Nine patients (9%) tested positive independent of their PFT appointments and were tested due to symptoms, only 1 of whomwas a pediatric patient. Conclusion: At our single center of 121 patients, we found a 0% positivity rate of Sars-CoV-2 PCR in asymptomatic CF patients preparing for PFTs.We also found that since the implementation of this extra testing requirement, nearly one-third of our patients did not have any PFTs during the pandemic. With vaccination rates steadily increasing among both hospital staff and CF patients, we believe this low positivity rate argues for the removal of preprocedural viral testing in this population when asymptomatic, provided that we continue to utilize symptom screening questions, appropriate PPE, and appropriate room cleaning procedures as outlined by the American Thoracic Society. The removal of the pre-procedural viral testing would eliminate a significant barrier to obtaining routine care for our CF patients.

Measuring real activity using a weekly economic index(1)

This paper describes a weekly economic index (WEI) developed to track the rapid economic developments associated with the onset of and policy response to the novel coronavirus in the United States. The WEI is a weekly composite index of real economic activity, with eight of 10 series available the Thursday after the end of the reference week. In addition to being a weekly real activity index, the WEI has strong predictive power for output measures and provided an accurate nowcast of current-quarter GDP growth in the first half of 2020, with weaker performance in the second half. We document how the WEI responded to key events and data releases during the first 10 months of the pandemic.

Covid-19: impact and dealings in orthodontic Practice design Post viral outbreak and Lockdown

Covid-19 or corona virus is a novel virus causing an infectious disease which is responsible for causing respiratory discomforts like difficulty in breathing along with cough and fever. orthodontic workstation is no different than any other situation where a disease like Covid-19 can be transmitted as there are high probability of transmission of this deadly virus through coughing and sneezing or by coming in contact with object or a surface and indirectly exposing the doctor treating the patient and vice versa. dealing with an orthodontic emergency should be planned in advance along with the preventive measures in cases of emergencies have to be the mainstay as patient and the orthodontist are not allowed to visit the each other during the Covid-19 outbreak. Hence a virtual approach has to be ready on the orthodontist’s part to deal with an orthodontic emergency. Taking into consideration the duration of an orthodontic treatment, a periodic follow up is very necessary normally and also in emergencies as the patient needs to be assured every now and then to have confidence in the orthodontist. importance should be given to the overall orthodontic process so that an individual can benefit from it in the best possible way.