Virological profile of upper respiratory tract infections in children under 5 years of age- a cross sectional study in a tertiary care hospital in North India.

OBJECTIVE: To study the virological profile of URI among children under 5 years of age. Since, it is very difficult to distinguish between various viral etiologies solely on the basis of symptoms, this study was attempted to generate evidence that majority of URI are caused due to viral illness and no antibiotics should be prescribed in the management of the same. METHODS: This observational study was conducted over a period of one year (June 2021-May 2022) in a tertiary care teaching hospital in New Delhi. A total of 180 children between the age of 0-5 years with symptoms of URI were included. Nasopharyngeal swabs were taken and processed for detection of viruses using multiplex RT PCR. RESULTS: Presence of viruses were detected in 136 (75.6%) samples. A single virus was identified in 113 samples, whereas 21 were found to harbour two viruses and 2 were carrying three viruses. The most common virus isolated was Human Rhinovirus (HRV- 55.8%) followed by Respiratory Syncytial Virus (RSV- 23.5%). In samples showing coinfection with two viruses, most common was Human Corona Virus (HCoV)- NL63, 229E, OC43, HKU1. None of the patients were given antibiotics. None of the patients required any hospital admission for severe respiratory illness. CONCLUSIONS: Viruses are a major cause of URI in children under five years of age, with the most prevalent organisms being HRV and RSV. Antibiotic prescriptions in URI are not warranted.

Post-COVID Syndrome and Severity of COVID-19: A Cross-Sectional Epidemiological Evaluation From North India.

Background COVID-19 has now lasted for more than two years as a pandemic and has had enduring effects on the health of people as the post-COVID syndrome. Recent literature has shown the long-term effects of COVID-19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal systems. Methods and objectives We aimed to estimate the prevalence of post-acute COVID symptoms in a tertiary care center in northern India; observe the effects of the demographic profile of age, BMI, gender, and presence of comorbidities on the persistence of post-COVID syndrome, and explore any correlation between the severity of COVID-19 disease and the persistence of post-COVID symptoms. We designed a survey containing structured questions evaluating post-COVID symptoms beyond three weeks (post-acute COVID phase), six weeks (post-COVID phase), and 12 weeks of acute illness. It was administered online.  Results Prevalence of post-COVID symptoms both after three and six weeks was reported to be 16.67% and 7.37%, respectively. The most common symptoms to persist were musculoskeletal symptoms (fatigue), followed by upper respiratory symptoms. Disease severity (p<0.05), BMI (p<0.05), and comorbidities were seen to affect post-COVID symptoms significantly, whereas gender and age of the patient had no significant effect. Disease severity significantly affected the persistence of post-COVID symptoms up to 12 weeks; however, this effect does not hold true in long COVID haulers. Also, the risk of developing persistent post-acute COVID symptoms was more in moderate to severe disease than in mild disease. Conclusion The pandemic might be close to over, but it is not out of our lives yet, and the persistence of post-COVID symptoms is exigent.

SARS-CoV-2 B.1.617 Mutations L452R and E484Q Are Not Synergistic for Antibody Evasion.

The SARS-CoV-2 B.1.617 variant emerged in the Indian state of Maharashtra in late 2020. There have been fears that 2 key mutations seen in the receptor-binding domain, L452R and E484Q, would have additive effects on evasion of neutralizing antibodies. We report that spike bearing L452R and E484Q confers modestly reduced sensitivity to BNT162b2 mRNA vaccine-elicited antibodies following either first or second dose. The effect is similar in magnitude to the loss of sensitivity conferred by L452R or E484Q alone. These data demonstrate reduced sensitivity to vaccine-elicited neutralizing antibodies by L452R and E484Q but lack of synergistic loss of sensitivity.

Evaluation of Patterns of Trauma Reporting to the Emergency Department During the First COVID-19 Lockdown in India.

Background On March 24, 2020, the Government of India declared a nationwide lockdown and a series of measures aimed at limiting the spread of the coronavirus disease 2019 (COVID-19) infection. This led to dynamic changes in patient inflow and management in the emergency department.This study aims to evaluate the impact of the pre-lockdown and lockdown periods on the demography of trauma in a tertiary care teaching hospitaland to compare it with the homologous period of 2019. Methods The trauma caseloads between March 25, 2020, and April 14, 2020, and that of the homologous period of 2019 were thoroughly analyzed and compared retrospectively. Results There was an overall decrease in trauma patients. Elderly male patients had an increased incidence of injury during the lockdown period with a significant p-value (0.0009). There was a significant increase in the number of minor orthopedic procedures while there was a significant decrease in the number of major orthopedic procedures. Fractures of the proximal femur were significantly increased during the lockdown period (p-value0.011) and fractures of the femur and tibia shaft were significantly decreased during the lockdown period (p-value0.002). Fractures of the distal radius were significantly increased during the lockdown period (p-value0.005) and fractures of the shaft of humerus, radius, and ulna were significantly decreased during the lockdown period (p-value0.028). Injuries following fall, trivial trauma, and animal-induced trauma were significantly increased (p-values <0.0001, <0.0001, 0.014, respectively), whereas injuries following sports and motor vehicle accidents were significantly decreased (p-value 0.006, <0.0001, respectively). The number of patients reaching within the golden hour (<1 hour) was significantly increased (p-value 0.0003). The total number of patients presenting under the influence of alcohol during the lockdown period was significantly decreased (p-value- <0.0001). The use of government-sponsored ambulances for transport to the hospital was significantly increased during the lockdown period (p <0.0001). Conclusion Strict administrative measures had a high impact on the number and epidemiology of trauma with remarkable changes. There was a decreased number of trauma cases but the mechanism, type, and management of these cases were significantly altered from the homologous period of the previous year.