ABSTRACT
Background and Aims: Passive antibody administration through convalescent plasma has shown benefit in treating COVID-19 in the early stages of the disease in patients >65 years old, and in other viral outbreaks. A practical, rapid method to sterilize convalescent plasma while also maintaining antibody function would be valuable for safe treatment in future viral pandemics. Plasma sterilization by irradiation requires kGy of dose to deactivate bacteria and viruses of concern. Conventional lab-based irradiators would require days to reach such doses, while ultra-high dose rate irradiation (FLASH) would require minutes. We present a proof-of-concept on sterilizing plasma with 25 kGy in approximately 3 minutes without damaging the antibodies in the plasma. Methods: A Varian Trilogy LINAC was configured for 16 MeV FLASH electron irradiation. Frozen aliquots of convalescent plasma from patients with COVID-19 were placed in a 3D printed holder submerged in liquid aiming to preserve sample temperature (RT, 4°C or –20°C). The number of pulses was estimated with EBT-XD film. Samples were irradiated with a dose of 25 kGy in ~33,330 pulses over 185 seconds. Antibody binding against the receptor-binding domain (RBD) of the S1 region of SARS-CoV-2 was measured by ELISA pre- and post-irradiation. Results: Frozen plasma aliquots from 10 COVID-19 convalescent plasma donors were irradiated in frozen state to 25 kGy dose. IgG antibody binding against SARS-CoV-2 RBD after irradiation remained at 90.8% of non-irradiated samples (Fig. 1;OD 1.25 vs. 1.36, p<0.0003). (Figure Presented) Fig. 1 ( O034). Plasma aliquots from 10 convalescent plasma samples were irradiated at sterilizing 25-kGy doses. IgG binding to SARS-CoV-2 RBD antigen by ELISA is 90.8% compared to unirradiated. Conclusions: FLASH irradiation allows for rapid sterilization of blood plasma from potential pathogens while largely preserving antibody binding function and specificity.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is a global pandemic where several comorbidities have been shown to have a significant effect on mortality. Patients with diabetes mellitus (DM) have a higher mortality rate than non-DM patients if they get COVID-19. Recent studies have indicated that patients with a history of diabetes can increase the risk of severe acute respiratory syndrome coronavirus 2 infection. Additionally, patients without any history of diabetes can acquire new-onset DM when infected with COVID-19. Thus, there is a need to explore the bidirectional link between these two conditions, confirming the vicious loop between “DM/COVID-19”. This narrative review presents (1) the bidirectional association between the DM and COVID-19, (2) the manifestations of the DM/COVID-19 loop leading to cardiovascular disease, (3) an understanding of primary and secondary factors that influence mortality due to the DM/COVID-19 loop, (4) the role of vitamin-D in DM patients during COVID-19, and finally, (5) the monitoring tools for tracking atherosclerosis burden in DM patients during COVID-19 and “COVID-triggered DM” patients. We conclude that the bidirectional nature of DM/COVID-19 causes acceleration towards cardiovascular events. Due to this alarming condition, early monitoring of atherosclerotic burden is required in “Diabetes patients during COVID-19” or “new-onset Diabetes triggered by COVID-19 in non-Diabetes patients”.
ABSTRACT
COVID-19 is an infectious disease that has dramatically affected the world, causing a pandemic and changing many aspects of people's lives and how they interact. The condition is highly contagious and aims at a person's respiratory system. A ventilator, a medical device that helps patients breathe when they are unable to do it independently, is needed because COVID-19 inflames the airways in the lungs, making it difficult to breathe normally. Ventilators are not the cure for COVID-19 but are a piece of equipment to help people breathe until that body function can be done independently. Such equipment can be expensive to acquire and cumbersome to operate. The Spartan Ventilator uses off-the-shelf equipment, economic controls, and robust techniques to supply a patient's lungs with oxygen. The system is designed for oxygen tanks that are commonly found within hospitals. However, a mechanical pump will be used as a substitute. All processes are controlled and monitored by an LCD touchscreen attached to an Arduino. The user interface is presented with simple buttons and menus to maximize screen space, provide quick readings of pressure, and control breaths per minute (BPM). PVC pipes, a cheap and durable material suitable for the non-volatile transportation of gas, were used. The valves we use are not definitive;they can be replaced with any 12V valve. The significant differences with the Spartan Ventilator are the price and the simplicity that the new technology has. The Spartan Ventilator can be very cheap compared to other professional ventilators that can be found in hospitals. The ventilator can be ten times less expensive than different professional ventilators while having the same efficiency and power. Copyright copy;2021 by ASME.
ABSTRACT
In the summer of 2020, as the COVID-19 pandemic continued to spread around the world, institutions of higher education were faced with three options in terms of their teaching modality for fall 2020: resume in-person education, switch to online delivery, or adopt a hybrid approach. This observational research study aims to tease out the variables that explain the decisions announced in summer 2020 by various colleges and universities in the United States for their planned instruction for fall 2020. We propose and test eight hypotheses related to the decision. The study found statistical confirmation that universities with higher financial stability and/or prestige tended to select the online delivery option, while lower financial stability/prestige showed a preference to stay with in-person delivery. We also found public institutions were more likely to go online than private ones. Additionally, we found statistical support for our hypotheses that universities located in Republican leaning states and also those with a religious affiliation would prefer the in-person modality. The results also confirmed our hypothesis that universities offering a higher percentage of humanities degrees would have a greater probability of choosing the in-person modality. Interestingly, we did not find statistical support for our hypothesis that the level of COVID spread in the geographical area of a university's location would affect its decision. © The Authors 2021, CC BY-NC
ABSTRACT
The recent pandemic due to Corona virus more popularly known as COVID 19 has reassessed the usefulness of historic convalescent plasma transfusion. (CPT) The CPT is one of the promising therapies in the current pandemic situation. This review was conducted to evaluate the effectiveness of CPT therapy in COVID 19 patients based on the publications reported till date. PubMed, EMBASE and Medline databases were screened up to 30 April 2021. All the records were screened as per the protocol eligibility criteria. The main features of the studies reviewed were, convalescent plasma can reduce mortality in severely ill patients, an increase in neutralizing antibodies titre and disappearance of SARS CoV 2 RNA was observed in all the patients on CPT therapy and over all a beneficial effect on clinical symptoms after administration of CP. Based on the review findings and the limited scientific data, CPT therapy in COVID 19 patients appear safe, clinically effective and reduces mortality. However, the need of a multicentre clinical trials, unequivocal proof of efficacy, effectiveness and the need for the standardisation of the CPT needs to be addressed immediately for the full utilisation of potential of CPT.
ABSTRACT
Although, recently convolutional neural networks (CNNs) based prognostic models have been developed for COVID-19 severity prediction, most of these studies have analyzed characteristics of lung infiltrates (ground-glass opacities and consolidations) on chest radiographs or CT. However, none of the studies have explored the possible lung deformations due to the disease. Our hypothesis is that more severe disease results in more pronounced deformation. The key contributions of this work are three-fold: (1) A new lung deformation based biomarker analyzing regions of differential distensions between COVID-19 patients with mild and severe disease. (2) Integrating 3D-CNN characterization of lung deformation regions and lung infiltrates on lung CT into a novel framework (LuMiRa) for prognosticating COVID-19 severity. (3) Validating LuMiRa on one of the largest multi-institutional cohort till date (N = 948 patients). We found that majority of the shape deformations were observed in the mediastinal surface of both the lungs and in left interior lobe. On a testing cohort based on two institutions, Av (N = 419) and Bv (N = 113), LuMiRa yielded an area under the receiver operating characteristic curve (AUC) of 0.89 and 0.77 respectively showing significant improvement over a 3D-CNN trained over just lung infiltrates (AUC = 0.85 (p < 0.001), AUC = 0.75 (p = 0.01)). Additionally, LuMiRa performed significantly better than machine learning models trained on clinical and radiomic features (0.82, 0.78 and 0.72, 0.72 on Av and Bv respectively). © 2021, Springer Nature Switzerland AG.
ABSTRACT
In light of the rapidly spreading COVID-19 virus, the FDA has suggested pooling of samples in order to reduce the cost of testing a large population. Under this approach, several samples are pooled, and the pooled samples are first tested. If the pool tests negative, then the lab would have successfully tested many samples while consuming only the resources needed for a single test. If the pooled sample tests positive, then each sample that comprised the pool is individually tested. In this context, an important question for people in the field is “Given a certain overall infection rate among the population, what is the optimum pool size so that we can minimize the overall number of tests for a given number of individual samples?” In this paper, we derive this number both empirically and analytically. We also address the related question “Given a certain pool size, what is the maximum infection rate for which we can still gain in terms of the number of tests?”. © by author(s).
ABSTRACT
Purpose: To study the relationship of Differential Leucocyte Count (DLC) with glycemic status in new cases of Type 2 Diabetes Mellitus (T2D) having normal Total Leucocyte Count (TLC) after it was noted that macrophages and monocytes have possible role in genesis of new diabetes in Covid-19 cases.Patients and Methods: Adult subjects with no history of T2D or any comorbidity having normal TLC were selected and classified as normal, prediabetes or T2DM based on OGTT. Demographics, glycemic status and hematological parameters were measured. Statistical analysis of the data was done using SPSS version 21.Results: 102 cases of new T2D mellitus and 164 non-diabetes controls (73 newly diagnosed prediabetes and 91 normal subjects) were compared. Absolute Monocyte Count (AMC) was significantly higher in T2D as compared to normal and PDM though values were within normal limits. Lymphocyte Monocyte Ratio (LMR) showed a decrease from normal to PDM to T2D;however only T2D was significantly different from normal. Monocytes and AMC showed significant but weak association with T2D. There was significant correlation between 1hrPG and AMC (r= 0.176, p<0.01), 1hrPG and LMR (r= - 0.169, p<0.01);2hrPG and AMC (r= 0.179, p<0.01), 2hrPG and LMR (r= - 0.142, p<0.05). Conclusion: Early T2D cases with normal TLC have shown that immunological and inflammatory profile in early T2D is definitely different from established T2D of long duration and has few similarities with findings in Covid-19 cases: 1) Neutrophil Lymphocyte Ratio (NLR) is not raised in early T2D, 2) LMR is not increased in early T2D but definitely decreased, 3) absolute counts of monocytes are significantly increased in early T2D though the values are within normal limits, 4) abnormal glycemic status need not influence leucocyte counts. © 2020 Wolters Kluwer Medknow Publications. All rights reserved.