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1.
6th International Conference on Computational Intelligence in Data Mining, ICCIDM 2021 ; 281:635-650, 2022.
Article in English | Scopus | ID: covidwho-1872358

ABSTRACT

COVID-19 (novel coronavirus disease) is a serious illness that has killed millions of civilians and affected millions around the world. Therefore, numerous technologies that enable both the rapid and accurate detection of COVID-19 illnesses will provide much assistance to healthcare practitioners. A machine learning-based approach is used for the identification of COVID-19. In general, artificial intelligence (AI) approaches have yielded positive outcomes in healthcare visual processing and analysis. CXR is the digital image processing method that plays a significant role in the analysis of corona disease. In this research article, at the initial phase of the process, a median filter is used for the noise reduction from the image. Edge detection is an essential step in the process of COVID-19 detection. The canny edge detector is implemented for the detection of edges in the CXR images. The principal component analysis (PCA) method is implemented for the feature extraction phase. There are multiple features extracted through PCA. The essential features are optimized by an optimization technique known as swarm optimization is used for feature optimization. For the recognition of COVID-19 through CXR images, a hybrid multi-class support vector machine technique is implemented. The particle swarm optimization (PSO) technique is used for feature optimization. The proposed system has achieved an accuracy of 97.51%, specificity (SP) of 97.49%, and 98.0% of sensitivity (SN). © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

2.
Embase; 2022.
Preprint in English | EMBASE | ID: ppcovidwho-337497

ABSTRACT

We previously interrogated the relationship between SARS-CoV-2 genetic mutations and associated patient outcomes using publicly available data downloaded from GISAID in October 2020 [1]. Using high-level patient data included in some GISAID submissions, we were able to aggregate patient status values and differentiate between severe and mild COVID-19 outcomes. In our previous publication, we utilized a logistic regression model with an L1 penalty (Lasso regularization) and found several statistically significant associations between genetic mutations and COVID-19 severity. In this work, we explore the applicability of our October 2020 findings to a more current phase of the COVID-19 pandemic. Here we first test our previous models on newer GISAID data downloaded in October 2021 to evaluate the classification ability of each model on expanded datasets. The October 2021 dataset (n=53,787 samples) is approximately 15 times larger than our October 2020 dataset (n=3,637 samples). We show limitations in using a supervised learning approach and a need for expansion of the feature sets based on progression of the COVID-19 pandemic, such as vaccination status. We then re-train on the newer GISAID data and compare the performance of our two logistic regression models. Based on accuracy and Area Under the Curve (AUC) metrics, we find that the AUC of the re-trained October 2021 model is modestly decreased as compared to the October 2020 model. These results are consistent with the increased emergence of multiple mutations, each with a potentially smaller impact on COVID-19 patient outcomes. Bioinformatics scripts used in this study are available at https://github.com/JPEOCBRND/opendata-variant-analysis. As described in Voss et al. 2021, machine learning scripts are available at https://github.com/Digital-Biobank/covid_variant_severity.

3.
International Journal of Noncommunicable Diseases ; 7(1):3-12, 2022.
Article in English | Web of Science | ID: covidwho-1856017

ABSTRACT

The proportion of coronavirus disease 2019 (COVID-19) patients having a chronic respiratory disease (CRD), and its impact on COVID-19 related patient outcomes, is unclear. We conducted this systematic review to evaluate the proportion of patients with asthma or chronic obstructive pulmonary disease (COPD) among COVID-19 patients, and to assess if comorbid CRD worsens COVID-19 outcomes, in developing countries. We queried PubMed database for studies conducted in developing countries and provided data on the proportion of COVID-19 patients with CRD, or severe disease or mortality among COVID-19 patients with and without CRD. We calculated proportion of CRD patients and relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. We retrieved 1947 citations and included 22 studies from developing countries in our review. The pooled estimate for proportion of asthma and COPD was 2.32% (95% confidence interval [CI] 1.86%-2.83%) and 3.52% (95% CI 2.14%-5.20%), respectively. COVID-19 patients with asthma had a higher risk of severe COVID-19 (summary RR 1.21, 95% CI 1.17-1.25), but not of mortality (summary RR 1.01, 95% CI 0.80-1.28), as compared to COVID-19 patients without asthma. COVID-19 patients with COPD had a higher risk of severe COVID-19 (summary RR 1.48, 95% CI 1.30-1.69) and mortality (summary RR 2.69, 95% CI 1.57-4.61), as compared to COVID-19 patients without COPD. Patients with asthma (but not COPD) in developing countries may be less likely to acquire COVID-19. Both diseases may increase the risk of severe COVID-19, and COPD may increase risk of COVID-19-related mortality.

4.
12th International Conference on Computer Communication and Informatics, ICCCI 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1831796

ABSTRACT

This paper presents a brief review on the developments of computer aided diagnosis system using image processing approaches. The rapid increase in lung infections which was in multiple during the current Corona virus infection has outcome with the need of automation system for an early detection of lung infection. Early detection of lung infection can avoid the spread of infection further and also act as an alarming intimation under critical cases. The need of such system has outcome with many researches in recent past towards developing new approaches toward improving the decision accuracy to reducing the system response time. This article review the past developments made in the area of developing automation systems with an analysis of attainted accuracy and methodology of image processing and classification system for automated lung infection detection. © 2022 IEEE.

5.
2021 International Conference on Science and Applied Science, ICSAS 2021 ; 2424, 2022.
Article in English | Scopus | ID: covidwho-1788362

ABSTRACT

The infectious disease caused by novel coronavirus (2019-nCoV) has been widely spreading since last year and has shaken the entire world. It has caused an unprecedented effect on daily life, global economy and public health. Hence this disease detection has life-saving importance for both patients as well as doctors. Due to limited test kits, it is also a daunting task to test every patient with severe respiratory problems using conventional techniques (RT-PCR). Thus implementing an automatic diagnosis system is urgently required to overcome the scarcity problem of Covid-19 test kits at hospital, health care systems. The diagnostic approach is mainly classified into two categories-laboratory based and Chest radiography approach. In this paper, a novel approach for computerized coronavirus (2019-nCoV) detection from lung x-ray images is presented. Here, we propose models using deep learning to show the effectiveness of diagnostic systems. In the experimental result, we evaluate proposed models on publicly available data-set which exhibit satisfactory performance and promising results compared with other previous existing methods. © 2022 Author(s).

6.
Lecture Notes on Data Engineering and Communications Technologies ; 101:251-263, 2022.
Article in English | Scopus | ID: covidwho-1750625

ABSTRACT

Millions of individuals have been affected by coronavirus illness. The coronavirus epidemic offers a significant medical danger to the wider range of population. The COVID-19 disease outbreak and subsequent control strategies have created a global syndrome that has impacted all aspects of human life. The initial stage detection of COVID-19 has become a difficult task for all researchers and scientists. There exist various ML and Deep Learning techniques to detect COVID-19 disease. There are various stages of COVID-19, initially, it was spread by people who travelled from countries which were severely affected by Corona Virus. After some time, it entered the community transmission phase. The virus has different impact on different individuals and there is no known cure found for this disease. The virus shows immediate affect on certain individuals whereas on others it takes few days to weeks for the symptoms to show but on some people it does not show any symptoms. The most common symptoms are dry cough, fever, lung infection, etc. This paper provides information about the several tests available for the detection of COVID-19. This paper provides a detailed comparison among the deep learning (DL) and AI (artificial intelligence) based techniques which are used to detect COVID-19 diesease. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

7.
Journal of Association of Physicians of India ; 70(1):98, 2022.
Article in English | Scopus | ID: covidwho-1727988
8.
European Heart Journal ; 43(SUPPL 1):i8-i9, 2022.
Article in English | EMBASE | ID: covidwho-1722385

ABSTRACT

Background: The neutrophil to lymphocyte ratio (NLR) is an inflammatory biomarker with prognostic value in several cardiovascular conditions. Hyperinflammation contributes to severe coronavirus disease 2019 (COVID-19), which is characterized by a multi-organ dysfunction. Cardiovascular complications of COVID-19 include arrhythmias, myocardial damage, acute heart failure, and acute coronary syndrome. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively. Purpose: To investigate the association between NLR at admission and TTE abnormalities in hospitalised adults with COVID-19. Methods: This single-centre retrospective study was conducted at a COVID-19 referral hospital in Indonesia. All consecutive hospitalised adults with confirmed COVID-19 who underwent TTE assessments between 3 April 2020 to 6 April 2021 were included. Comprehensive data including NLR at admission, demographics, co-morbidities, peak severity of COVID-19, and TTE parameters were extracted from electronic medical records. A receiver operating characteristic (ROC) curve analysis was conducted to determine the optimal NLR cut-off for prediction of severe-critical COVID-19. Patients with high and low NLR were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%. Results: A total of 487 patients were included in this study. From ROC curve analysis, the area under curve was 0.80 (95% CI: 0.76-0.84). The optimal NLR cut-off was determined as 4.42, which predicted severe-critical COVID-19 with a sensitivity of 74.5% and a specificity of 74.6%. Based on this, the low NLR and high NLR groups had 223 and 264 patients, respectively. Male sex, diabetes, and chronic kidney disease occurred more frequently in the high NLR group (P < 0.05). On TTE assessment, the high NLR group had higher odds of left ventricular (LV) systolic dysfunction (OR: 2.49;95% CI: 1.14-5.45), LV wall motion abnormalities (OR: 2.62;95% CI: 1.41-4.87), valve abnormalities (OR: 2.04;95% CI: 1.35-3.07), and right ventricular (RV) dysfunction (OR: 10.55;95% CI: 2.46-45.25). Conclusions: COVID-19 patients with a high NLR at admission had higher odds of abnormal TTE findings, including LV systolic dysfunction, LV wall motion abnormalities, valve abnormalities, and RV dysfunction. This indicates a possible link between inflammation and cardiovascular dysfunction in COVID-19, which must be confirmed in larger prospective studies. (Figure Presented).

9.
European Heart Journal ; 43(SUPPL 1):i6-i7, 2022.
Article in English | EMBASE | ID: covidwho-1722384

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) is an ongoing global pandemic with more than 220 million cases and 4.5 million deaths reported worldwide. Its clinical spectrum varies widely, and non-invasive prognostic markers are valuable as they can guide efficient resource allocation. Cardiovascular complications of COVID-19 include myocardial injury, acute heart failure, and arrhythmias. Both de novo cardiovascular complications and pre-existing cardiovascular co-morbidities are associated with a poor prognosis. Transthoracic echocardiography (TTE) can be used to assess cardiovascular structure and function non-invasively. Purpose: To investigate the association between TTE parameters and severity of disease in hospitalised adults with confirmed COVID-19 Methods: This single-centre retrospective analysis was conducted at a COVID-19 referral hospital in Indonesia. All consecutive adults hospitalised with confirmed COVID-19 who underwent TTE assessment between 3 April 2020 to 6 April 2021 were included. Comprehensive data including demographics, peak COVID-19 severity, pre-existing co-morbidities, and TTE findings were extracted from electronic medical records. Patients with mild-moderate and severe-critical disease were compared using the chi-square test and odds ratios (OR), with a confidence level of 95%. Results: A total of 488 patients were included in this study;202 with mild-moderate disease and 286 with severe-critical disease. Frequency of old age (>60 years), obesity, diabetes, chronic kidney disease, and congestive heart failure were higher in the severe-critical group (P < 0.05). On TTE assessment, Patients with severe-critical disease had higher odds of left ventricular hypertrophy (LVH) (OR: 2.20;CI: 1.49-3.24), LV wall motion abnormality (OR: 3.33;CI: 1.68-6.60), diastolic dysfunction (OR: 1.46;CI: 1.02-2.11), valve abnormality (OR: 1.93;CI: 1.27-2.92), and right ventricular (RV) dysfunction (OR: 5.53;CI: 1.63-18.73). After matching for age, obesity, and diabetes, patients with severe-critical COVID-19 continued to have higher odds of LVH (OR: 1.91;CI: 1.21-3.02), LV wall motion abnormality (OR: 2.76;CI: 1.28-5.96), diastolic dysfunction (OR: 1.55;CI: 1.00-2.38), and RV dysfunction (OR: 3.86;CI: 1.06-14.08). Conclusions: The presence of LVH, LV wall motion abnormality, diastolic dysfunction, and RV dysfunction on TTE assessment were associated with severe-critical disease in hospitalised adults with COVID-19. These findings must be validated in a larger prospective study. (Figure Presented).

10.
3rd IEEE Bombay Section Signature Conference, IBSSC 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1714000

ABSTRACT

Covid-19 has quickly emerged as a global threat, tipping the world into a new phase. The delay in medical care because of the quickly rising Covid-19 cases makes it necessary to overcome the manual and time taking technique such as RTPCR. This paper implements different pre-trained CNN feature extraction models using various Machine Learning (ML) classifiers on chest CT scans to analyze Covid-19 infected patients. It may be observed from the obtained results that accuracy of 96.4% was obtained using the VGG16 model and neural network classifier. The implementation of pre-trained models and classifiers reduce the time taken for manual detection of disease and helps doctors to prevent life of a patient. © 2021 IEEE.

11.
Blood ; 138:4253, 2021.
Article in English | EMBASE | ID: covidwho-1582411

ABSTRACT

Introduction: Type I cryoglobulinemia (Type I CG) usually develops in the setting of protein-secreting monoclonal gammopathies [1,2]. The estimated frequency of renal involvement is 30% in Type 1 CG. Thrombotic Thrombocytopenic Purpura (TTP) is a life-threatening disease in which there is a deficiency in ADAMTS13, a protease which normally functions to cleave von Willebrand factor (vWF). A deficiency leads to persistence of large vWF multimers and the formation of platelet-rich thrombi in the microvasculature. We present a case of 52 years old female with Type 1 CG and acquired autoimmune TTP secondary to mild Covid-19 disease. Case Report: A 52-year-old woman with medical history significant for CKD stage 2, with baseline creatinine (Cr) of 2.5, Diffuse Large B-Cell Gastric Lymphoma (DLBCL), in complete remission, and recent diagnosis with COVID-19 presented to the ED for evaluation of three days of a petechial rash on her bilateral extremities. Significant labs on arrival included hemoglobin (Hgb) 8.9, platelet count 65, Cr of 3.65, and K+ 6.6, meeting criteria for acute kidney injury (AKI). Peripheral blood smear showed thrombocytopenia and normochromic normocytic anemia with no schistocytes or microangiopathic changes. ADAMTS13 was 43% and there was no clinical suspicion for TTP. The patient's Cr continued to worsen up to 8.1 during admission, prompting renal biopsy. Renal biopsy showed Type 1 cryoglobulinemic glomerulonephritis with vasculitis and 30 to 40% fibrosis of glomeruli. The patient was started on systemic steroids, plasma exchange every 2-3 day (completed 6 sessions) and hemodialysis. Her platelet counts steadily increased to 212 but had a significant drop to 32 when rechecked seven days later, prompting further investigation. ADAMTS13 was rechecked and found to be 5% with presence of inhibitor, Hgb was 7.7, haptoglobin was <20, and a diagnosis of TTP was made. The patient was started on daily plasmapheresis, rituximab, Caplacizumab and high dose systemic steroid therapy. Our patient had prior history of DLBCL and was treated with radiation therapy. Restaging PET/CT and EGD with biopsy showed no evidence of recurrence. Bone marrow biopsy was negative for evidence of lymphoma. Several serologic tests were used to rule out other etiologies of Type I CG and came back negative including: SLE, HIV, hepatitis C, multiple myeloma, and Waldenstrom's macroglobulinemia. The patient had elevations in multiple immune markers including IgG, IgM, free kappa light chains, and free lambda light chains. She also had hypocomplementemia of both C3 and C4. Discussion: The relationship of Type I CG and COVID-19 is unclear, though viral infections can trigger autoimmune diseases [3]. Previously, all patients with Type I CG had either a hematologic malignancy, solid-organ malignancy, infection, or autoimmune syndromes. Interestingly, in our patient, several serologic tests were performed and negative, which ruled out these etiologies of Type I CG. Our patient's manifestation of Type I CG was petechial rash on extremities and acute on chronic renal disease. Specific treatment of CG can include plasma exchange, corticosteroids, rituximab, and hemodialysis, depending on underlying cause. Our patient was started on systemic steroids, plasma exchange every 2-3 days, and hemodialysis due to worsening renal functions. Despite cases of covid-19 and TTP being reported, the relationship between the disease processes remains unclear. COVID-19 infection can cause disproportionate activation of the complement system and lead to excessive coagulation and thrombotic events. Systemic infection can decrease ADAMTS-13 activity, and this has also been noted in COVID studies. ADAMTS-13 deficiency has no pathophysiologic relevance specific to Type 1 CG. Our patient developed anemia and thrombocytopenia, and ADAMTS13 activity testing was found to be 5% with presence of an inhibitor. Considered as high-risk disease, our patient was started on steroids, rituximab, Caplacizumab and daily plasmapheresis. Repeated weekly ADAMTS13 level was 26% and p atelets were stabilized at 69k/microL. Conclusion: Suggests that Covid-19 virus has the capability to induce cryoglobulinemia through an unknown mechanism • There are two other case reports of an association between Covid-19 and TTP. • May be the first case indicating a possible association of Covid-19 with cryoglobulinemia. Disclosures: No relevant conflicts of interest to declare.

12.
Blood ; 138:4257, 2021.
Article in English | EMBASE | ID: covidwho-1582337

ABSTRACT

Introduction: Microscopic polyangiits (MPA) is a rare ANCA-associated necrotizing vasculitis that affects the small vessels, often involving the lung or kidney. When presenting with diffuse alveolar hemorrhage, this disease warrants emergent treatment, often with plasma exchange. Here, we present a rare case of a patient presenting with alveolar hemorrhage in the setting of MPA and concurrent thrombotic thrombocytopenic purpura (TTP) with an extremely reduced ADAMTS13 activity. Case Report: A 77 y/o woman with HTN and PUD presented to outside facility with new onset anemia (Hb 6.3 g/dL). Positive Coombs test gave her a tentative diagnosis of hemolytic anemia, and she was transfused 2 U RBCs. Ten days later, she presented to our hospital with respiratory distress. Hb remained stable at 10.7 but had leukocytosis with WBC 22,000 with left shift, platelets 439. Vitals not consistent with sepsis though saturating 70-80% on room air. In the ED, she developed frank hemoptysis and was emergently intubated. CTA chest was negative for pulmonary embolus but demonstrated diffuse ground-glass opacities. COVID test negative. Bronchoscopy was consistent with diffuse alveolar hemorrhage (DAH), and she received tranexamic acid, crystalloids, 1 U RBCs. Suspicious for underlying vasculitic process, she was given pulse dose IV steroids (1 g methylprednisolone daily) and started plasma exchange. Creatinine on presentation was elevated at 1.77 but she continued to have adequate urine output and appropriate volume status. Her hospital course was marked by progressive thrombocytopenia with schistocytes appreciated on peripheral smear. ADAMTS13 activity <5% with inhibitor detected, consistent with TTP. Vasculitic workup revealed positive myeloperoxidase antibodies and p-ANCA consistent with MPA. Other rheumatologic workup ANA positive 1:640 and positive IgM cardiolipin antibodies;she had no personal autoimmune history but some family autoimmune disease including one daughter with systemic lupus erythematosus and another relative with Guillian-Barre. She remained intubated for 4 days and post-extubation experienced some short-lived ICU delirium but after made a remarkable recovery. She completed 12 total sessions of of plasma exchange and 3 of 4 planned doses of rituximab, to continue on oral steroids outpatient and prophylactic TMP-SMX. She was discharged to rehab facility on hospital day 20. Discussion: With diffuse alveolar hemorrhage on presentation, initial differential remained broad including delayed presentation of transfusion-related lung injury (TRALI) given recent history of transfusion. She had recently started hydralazine outpatient. Along with positive ANA, this could suggest drug-induced lupus. However, histone antibodies were negative, but results may have been compromised by steroids and plasma exchange. Both MPA and TTP can be deadly but are managed with similar treatment. Luckily, our patient was rapidly initiated on plasma exchange following hospitalization. Although further workup including ADAMTS13 and vasculitis labs were pending at the time, it is important to not delay treatment while awaiting results. Cased of concurrent TTP and ANCA-associated vasculitis have been described in the literature, but the full relationship between these two entities remains unclear. TTP may develop after starting glucocorticoids in the setting of ANCA vasculitis, so close monitoring is recommended. Disclosures: No relevant conflicts of interest to declare.

13.
International Journal of Noncommunicable Diseases ; 6(1):10-28, 2021.
Article in English | Web of Science | ID: covidwho-1534379

ABSTRACT

We conducted this systematic review to evaluate whether comorbid chronic obstructive pulmonary disease (COPD) increases the risk of severe disease and adverse outcomes among patients with coronavirus disease (COVID-19). We queried the PubMed and Embase databases for studies indexed till December 2020. We included studies that provided data on severe disease, hospitalization, intensive care unit (ICU) care, need for mechanical ventilation, or mortality among COVID-19 patients with and without COPD. We calculated the relative risk (RR) for each reported outcome of interest from each study and used a random-effects model to summarize our data. We retrieved 997 citations and included 110 studies published in 2020, in our review. Most publications reported the data retrieved from electronic records of retrospective patient cohorts. Only 27 studies were judged to be of high quality. COPD patients with COVID-19 had a significantly higher risk of severe disease (summary RR 2.44, 95% confidence interval [CI] 1.93-3.09), hospitalization (summary RR 1.91, 95% CI 1.70-2.14), ICU admission (summary RR 1.81, 95% CI 1.35-2.43), mechanical ventilation (summary RR 1.75, 95% CI 1.35-2.28), and mortality (summary RR 2.40, 95% CI 1.93-2.51), as compared to COVID-19 patients without COPD. All analyses showed significant between-study heterogeneity. We conclude that comorbid COPD significantly increases the risk of severe disease and adverse outcomes among COVID-19 patients.

14.
Hepatology ; 74(SUPPL 1):335A-336A, 2021.
Article in English | EMBASE | ID: covidwho-1508754

ABSTRACT

Background: There is a prolonged RT-PCR positivity seen in COVID-19 infected patients up to 2-3 months.It is assumed that this virus is usually non-infective but there are hardly any study on the reactivation of this virus within the respiratory tract. We aim to investigate the presence of viral particles inside Extracellular vesicles (EV) and its role in underlying liver disease patients. Methods: SARS CoV2 nasal and throat swab RT-PCR positive n=64 {n=12(18.7%) chronic liver disease (CLD);n=52 (81.3%) non-liver disease} n=5 RT PCR negative subjects (HC) were studied. SARS CoV2 patients were also followed up for day(d) 7 and 14. Nasal swab [collected in viral transport media (VTM)] and plasma samples were investigated at each time point. Extracellular vesicles were isolated using differential ultracentrifugation. SARS CoV2 RNA was measured using qRT-PCR by Altona Real Star kit. Cellular origin of EV was confirmed using epithelial cells (Epcam+ CK19+ CDh1+), endothelial cells (CD31+CD45-), hepatocytes (ASGPR+) surface markers by Flow cytometry. Results: The COVID19 patients {Mean age 54±23 years;41 males} were having severity between moderate to severe. In patients with cirrhosis, the most common aetiology of liver disease was alcohol (MELD 22±8). In baseline RT-PCR positive patients, SARS-CoV2 RNA inside the EV was present in 53/64 (82%) patients with comparable viral load between VTM and EV (mean 1CT - 0.033±0.005 vs. 1CT- 0.029±0.014, p=ns). On follow-up at day 7, of the 24 patients negative for COVID19, 10 (41%) had persistence of virus in the EV (1CT - 0.028±0.004) and on day 14, 14 of 40 (35%) negative RT-PCR had EVs with SARS CoV2 RNA (1CT - 0.028±0.06). The mean viral load decreased at day7 and day14 in EV from baseline (p=0.008;0.002 respectively). The probability of detecting SARS-CoV2 in EVs in the VTM negative patients was significantly (p=0.001) greater { relative risk ratio 2.25 (95% of CI 1.08 to 4.67;p=0.02, odds ratio 28.1(95% of CI -1.27 to 619.9;p=0.03)}.SARS-CoV2 RNA otherwise undetectable in plasma, was found to be positive in EV in 12.5% of COVID19 positive patients. Interestingly, significantly prolonged and high viral load was found in EV at day 14 in CLD-COVID19 patients compared to COVID19 alone (p=0.002). The high cellular injury was seen in CLDCOVID19 infected patients with significant high levels of EV associated with epithelial cells and hepatocytes than COVID19 alone (p=0.004;0.001). Conclusion: Identification of SARS-CoV2 RNA in EV, in RT-PCR negative patients indicates persistence of infection for and likely recurrence of the infection. It is suggestive of another route of transmission as EV harbour SARS CoV2 RNA. EV associated RNA may determine the ongoing inflammation and clinical course of subjects with undetectable SARS-CoV2 virus and this may also have relevance in management of chronic liver disease patients.

15.
Journal of Clinical Oncology ; 39(28 SUPPL), 2021.
Article in English | EMBASE | ID: covidwho-1496276

ABSTRACT

Background: Research shows that healthcare professionals' personal hopefulness is associated with burnout and life satisfaction, highlighting the value of hope-enhancement interventions. Feldman and Dreher developed a single-session hope intervention, but this has been used rarely with oncology professionals, and only in in-person format (Shah, Ferguson, Corn et al.). Given SWOG Cancer Research Network's commitment to assessing hopeenhancement approaches and the need for online interventions given COVID-19, we report a feasibility study of a virtual hope workshop in SWOG members. Methods: The workshop was a single 2-hour session delivered live via Zoom to 6-8 participants at a time. The workshop comprises 3 components: A brief lecture on hope and two exercises-a "hope mapping" exercise (aided by a smartphone app created for the workshop) and a hope visualization exercise-both designed to build hope for a life goal of each participant's choosing. 29 SWOG members participated. A link to post-workshop measures was sent to participants, which they were given a week to complete. Measures included Thanarajasingamet al's 5-item Was-itWorth-it (WIWI) measure;Kirkpatrick's 4-item Training Evaluation Model (TEM;reaction, learning, behavior, results);and an item assessing the degree to which participants believe concepts from the workshop should be integrated into SWOG studies. Results: In all, 25 participants (86%) completed measures. Participants were physicians (n = 8), nurses (n = 4), patient advocates (n = 3), research staff (n = 3), and others (n = 7);mostly female (n = 17), mostly white (n = 18), with a mean age of 55.5 (SD = 13.95). Results for the WIWI items are as follows: "Was it worthwhile to participate in the Hope Workshop?" (23 Yes, 2 No/Undecided/Missing Answer);"If you had to do over, would you participate in the Hope Workshop again?" (22 Yes, 3 No/Undecided/Missing Answer);"Would you recommend participating in the Hope Workshop to others?" (22 Yes, 3 No/Undecided/Missing Answer). Two additional items on the WIWI asked participants to rate on a 3-point scale the degree to which they believe their quality of life had increased due to the workshop (M = 2.52, SD =.51) and their overall experience in the workshop (M = 2.70, SD =.64). Ratings for Kirkpatrick's TEM items likewise were high, ranging from 6.91 (SD = 1.31) to 7.70 (SD =.70) on an 8-point scale. Finally, participants gave a mean rating of 4.44 (SD =.59) on a 5-point scale to the item "To what degree do you believe it may be useful to integrate concepts from this workshop into SWOG trials/studies?" Conclusions: It is feasible to implement hope-enhancement workshops in an online platform that includes a smartphone app. Data obtained from two validated tools (WIWI instrument and Kirkpatrick's TEM) attest to an array of positive outcomes. Participants also overwhelmingly advocated integrating hope concepts into SWOG's research.

16.
International Journal of Pharmacy and Pharmaceutical Sciences ; 13(10):12-19, 2021.
Article in English | EMBASE | ID: covidwho-1468934

ABSTRACT

To study fungal infections such as Mucormycosis, Aspergillosis, Candidiasis, Cryptococcosis associated with Covid-19. A detailed study was done with the information gathered from the articles in specified databases, online sources, and online published materials to have current details of the situation of fungal infections in covid patients. Fungal infections were seen among covid-19 patients mostly due to opportunistic fungal pathogens such as Mucor, Candida, Aspergillus, and Cryptococcus. The reason behind rising opportunistic fungal infections among covid-19 patients may be the immunocompromised host. The most common species responsible for fungal infections in covid-19 were noticed to be of genus Mucor, A. flavus, and A. fumigatus species of genus Aspergillus, C. albicans species of genus Candida, C. neoformans, and C. gattii species of genus Cryptococcus. Patients suffering or recovered from covid-19 are now facing numerous Secondary Infections. The majority of secondary infections associated with covid-19 are Fungal Infections. Mucormycosis, candidiasis, aspergillosis, cryptococcosis as opportunistic infections are seen widely in the covid-19 treated patients. Rapid progression of such fungal infections is required to be controlled by early diagnosis of infection and by identifying the underlying risk parameters. Protocols for disease management will be beneficial too.

17.
Indian Journal of Ophthalmology ; 68(6):962-973, 2020.
Article in English | CAB Abstracts | ID: covidwho-1409404

ABSTRACT

The COVID-19 pandemic has brought new challenges to the health care community. Many of the super-speciality practices are planning to re-open after the lockdown is lifted. However there is lot of apprehension in everyone's mind about conforming practices that would safeguard the patients, ophthalmologists, healthcare workers as well as taking adequate care of the equipment to minimize the damage. The aim of this article is to develop preferred practice patterns, by developing a consensus amongst the lead experts, that would help the institutes as well as individual vitreo-retina and uveitis experts to restart their practices with confidence. As the situation remains volatile, we would like to mention that these suggestions are evolving and likely to change as our understanding and experience gets better. Further, the suggestions are for routine patients as COVID-19 positive patients may be managed in designated hospitals as per local protocols. Also these suggestions have to be implemented keeping in compliance with local rules and regulations.

18.
Blockchain and Machine Learning for e-Healthcare Systems ; : 417-441, 2021.
Article in English | Scopus | ID: covidwho-1407595

ABSTRACT

From the first case in December 2019 to more than 2.92 million cases in just 3 months, COVID-19 became a pandemic. COVID-19 is spreading all around the world, and due to this pandemic situation, humans’ life is at risk. On one side, healthcare and sanitization workers are stretching themselves to deal with this situation at the frontline, and on the other, data scientists and machine learning (ML) experts are researching to provide data in an understandable form to the world. This chapter provides the details of different ways of processing and visualizing the huge amount data generated on this pandemic. This includes the clusters on the basis of symptoms in different age groups, effects of COVID-19 on different countries, etc. © The Institution of Engineering and Technology 2021.

19.
Ann R Coll Surg Engl ; 103(8): 589-598, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1379815

ABSTRACT

INTRODUCTION: Otolaryngology health personnel are at high risk of acquiring COVID-19 disease and, hence, are likely to have high stress levels. This study was designed to evaluate the feedback of otolaryngology healthcare workers in ENT departments who are managing patients in the coronavirus pandemic. METHODS: A questionnaire focused on all aspects of healthcare delivery was completed by otolaryngology healthcare workers. RESULTS: The findings, based on statistical analyses, included high stress levels and inadequate disease-related information in these workers. CONCLUSIONS: Healthcare authorities need to take care of issues related to mental health in healthcare professionals in addition to spreading awareness about safe practices. Further studies are needed to continuously monitor feedback from personnel as the coronavirus pandemic unravels in the future.


Subject(s)
COVID-19 , Clinical Competence , Health Personnel , Otolaryngology , Adult , Attitude of Health Personnel , Female , Humans , Male , Middle Aged , Occupational Stress/epidemiology , Pandemics , Personal Protective Equipment , Personnel, Hospital , Surveys and Questionnaires , United Kingdom/epidemiology , Young Adult
20.
QJM ; 114(11): 830, 2022 01 05.
Article in English | MEDLINE | ID: covidwho-1243507

Subject(s)
COVID-19 , SARS-CoV-2 , Humans
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