A silent march-Post covid fibrosis in asymptomatics - A cause for concern?

We report a case series of patients presenting with undiagnosed pulmonary fibrosis as a primary manifestation. On evaluation, after excluding other causes, the fibrosis was attributed to asymptomatic or mild COVID illness in the past. This case series serves to highlight the difficulties posed to clinicians while evaluating pulmonary fibrosis in the post-COVID era, more so in mild to asymptomatic COVID-19. The intriguing possibility of fibrosis setting even in mild to asymptomatic COVID is discussed.

Predictive accuracy of neutrophil-to-lymphocyte ratio on severity and outcomes in COVID-19 patients: A retrospective study

Background/Aims: Neutrophil-to-lymphocyte ratio (NLR) is a proven marker in coronavirus disease 2019 (COVID-19) severity and mortality. However, the utility of a sequential NLR 2 (on day 5) in comparison to baseline NLR in predicting clinical outcomes and severity remains largely unexplored. Methods: This was a hospital-based retrospective observational study. Results: Higher mortality (19.9% vs. 48%) and a more severe disease (14.8% vs. 21%) were observed with elevated NLR 1 and NLR 2, respectively. NLR 2 at a cutoff of 9.88 was a better predictor of mortality, when compared to NLR 1 at 5.67, and NLR 2 has a strong correlation with mortality rates in COVID-19. Conclusion: Our study demonstrated that NLR 1 and NLR 2 were more reliable predictors of mortality than disease severity;in comparison, NLR 2 is a more accurate predictor of mortality than NLR 1. The study unravels the potential role of a sequential NLR 2, to have a better correlation in predicting the clinical severity and outcomes. The potential role of NLR 2 in assessing the interim progression of the disease and thereby initiating specific interventions at critical junctures to influence the outcome is unveiled and merits exploration in detail by larger studies. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Public health dentist: An untapped potential during covid-19 pandemic

To date, the 21st century has encountered various outbreaks, causing global disruption and highlighting our vulnerability to epidemics. Coronavirus disease (COVID-19) is a highly infectious respiratory illness. Approximately 15% of the affected individuals show severe symptoms requiring oxygen, and of these, 5% require ventilation. This pandemic has affected more than 216 countries or territories (by 20th September 2020), infecting more than 30.6 million people;hitherto, 950000 deaths have been reported. This public health emergency has created a disproportionate burden on the health care system worldwide. Therefore, the management and resolution of this critical situations require the mobilisation of excessive human resources for rapid response, and time is essential in the management of this crisis. Together, these factors contribute to the rapid capacity development with the minimal investment of time and resources, which requires the deployment of an existing skilled workforce, such as public health dentists. These dentists have administrative capabilities and can work in coherence with the community and other health professionals. The present review aims to highlight the areas in which the untapped potential of Public Health Dentists can be explored to tackle the COVID-19 pandemic.

Knowledge, awareness and perception of covid-19 pandemic among health care workers in a tertiary care teaching hospital in coastal South India

Background: It is crucial for the frontline force such as health care workers to be up-to-date with the knowledge of the trend of COVID-19 pandemic and its epidemiology. We conducted this study to assess the knowledge, awareness and perception of health care workers towards the COVID-19 pandemic. Methods: We performed a cross-sectional survey in the hospitals of coastal Karnataka among health care workers from February to May 2020. Results: A total of 197 Health care workers responded. Most of them were females (64%), physicians (45%), with a working experience of 1-10 years (77%). Five percent had a prior experience of the outbreak. The survey showed that the study participants had knowledge about treatment and precautions to be taken. However, some of them were not aware of the recent updates on quarantine and sample testing. Most of them perceived this pandemic as an important public health issue and were concerned that they might get infected in the course. Conclusion: There is a partial knowledge among HCWs regarding recent updates on COVID-19 pandemic and its related epidemiology. Hence, frequent sessions with the help of virtual media may be utilized to provide updates, and counseling sessions by experts may be arranged to reduce the fear of the pandemic. © 2021 Unnikrishnan et al.