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1.
Pakistan Journal of Medical and Health Sciences ; 16(5):69-70, 2022.
Article in English | EMBASE | ID: covidwho-1885019

ABSTRACT

Aim: To observe the workload of fractures of the femur (shaft and distal femur) and their fixations along with complications in terms of infection and mortality at our hospital during COVID 19 pandemic. Study design: Prospective study. Place and duration of study: Dept of Orthopaedic, Ghurki Trust Teaching Hospital, Lahore from 01-03-2020 to 31-07-2020 Methodology: One hundred and thirty-one diagnosed patients with femur fracture (shaft and distal) during pandemic period of COVID were enrolled. Demographic data included (age, sex, implant type, surgical site infection (SSI) and mortality).Since study was done during COVID-19 pandemic, positivity of COVID symptoms was noted as yes/no on data collection proforma. Results: There were 105 (80.15%) males while 26 (19.84%) were females with mean age was 39.20±13.02 years. Majority of the surgical interventions were done based on Intramedullary nailing 74.05%, the second prevalent surgeries were done on AO external fixation 8.4%. Infection rate was observed in 7(5.32%) patients. No mortality was seen in any of the cases. Four infected cases were observed after intramedullary nailing procedure, two from AO external fixation and one after locking plate. Conclusion: There is no significant higher complication rate due to COVID-19 pandemic to patients whom femur fracture fixation was done. None of admitted patient suffered COVID-19 symptoms during hospitalization. It was only pointless fear about orthopaedic intervention during this interval.

2.
Ain Shams Engineering Journal ; 13(6):13, 2022.
Article in English | English Web of Science | ID: covidwho-1881694

ABSTRACT

Education has been one of the major areas disrupted by the COVID-19 pandemic. This study aims to assess the impact of the COVID-19 pandemic on users' (students and faculty members) learning in higher education, examining how engineering students and faculty perceived the abrupt transition in comparison to other colleges. The current research aims to investigate the outcomes of enforcing eLearning to facilitate teaching and learning processes in higher education after this unprecedented pandemic and identify the most significant challenges and opportunities the users face. This study uses a quantitative approach;it included 1713 respondents, 227 full-time faculty members, and 1486 students at the University of Sharjah. The survey analysis indicated general agreement that the most significant advantage of online learning implementation was its flexibility in place and time, with 77.2% of users providing positive feedback. Moreover, the accessibility and effectiveness of the assessment and communication methods used showed a positive trend in the hypotheses, 80.3% of the users. The sudden implementation of eLearning during the COVID-19 pandemic had discouraging implications for users' mental health and socialization, where 55.6% of the sample agreed that they had been affected negatively. 75% of the users prefer a flexible model blending face-to-face and e-learning techniques rather than solely depending on either of them. Therefore, A Hybrid-Flexible (HyFlex) is recommended for the university to apply based on the nature of the courses. (c) 2022 THE AUTHORS. Published by Elsevier BV on behalf of Faculty of Engineering, Ain Shams University This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

3.
American Journal of Respiratory and Critical Care Medicine ; 205:1, 2022.
Article in English | English Web of Science | ID: covidwho-1880927
4.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880733
5.
American Journal of Respiratory and Critical Care Medicine ; 205:1, 2022.
Article in English | English Web of Science | ID: covidwho-1880664
7.
Topics in Antiviral Medicine ; 30(1 SUPPL):296-297, 2022.
Article in English | EMBASE | ID: covidwho-1879908

ABSTRACT

Background: Remdesivir (RDV) has been shown to shorten time to recovery in hospitalized adults with COVID-19. Some children who develop COVID-19 require hospitalization. Here we characterize the safety profile of RDV in 53 pediatric patients age 28 days to <18 years and describe clinical and virologic outcomes. Methods: CARAVAN (NCT04431453) is an ongoing open-label, single arm study of RDV in hospitalized patients <18 years with PCR-confirmed COVID-19. IV RDV was given for up to 10 days: 200mg on Day 1 followed by 100mg daily in Cohort 1 and 8 (<18y, weight ≥40kg) or 5mg/kg on Day 1 followed by 2.5mg/kg daily in Cohorts 2-4 (28 days to <18y, stratified by weight). Safety was assessed by adverse events (AEs) and lab tests (hematology, chemistry, urine, inflammatory, coagulation). Clinical outcomes included improvement on a 7-point ordinal scale, time to discharge, and oxygenation modality. Virologic outcomes included days to confirmed negative SARS-CoV-2 PCR (defined as 2 consecutive negative results). Results: At enrollment, median (IQR) age was 7y (2, 12) and weight was 24.6 (12.8, 55.1) Kg, 57% were female, 76% required supplemental oxygen, including 23% on invasive ventilation and 34% on high-flow oxygen (Table). Median number of RDV doses was 5 (4,8). Most patients (72%) experienced ≥1 AE;most common was constipation (17%). Serious AEs were reported for 21% of patients and none were study-drug related. Two patients with baseline transaminitis had non-serious AE of increased ALT contributing to premature discontinuation. Two patients died within the 30-day study period. Grade ≥ 3 lab abnormalities were reported in 42%;most common being decreased haemoglobin (n=9) and decreased eGFR levels (n=7). No safety trends related to RDV were apparent. In total, 85% showed clinical improvement on the 7-point ordinal scale by last assessment. Median (IQR) time to discharge was 8 (5, 17) days. By last assessment, 8% required supplemental oxygen, all of whom were invasively ventilated. Time to confirmed negative SARS-CoV-2 PCR CoV-2 PCR was 5 and 7 days from nasal/oropharyngeal samples in cohort 2 and 3, respectively, and not estimable in the other cohorts. Conclusion:RDV was safe and well tolerated among children 28 days to <18y treated for COVID-19. Overall, no safety trends for RDV were apparent and a high proportion, 85%, had clinical improvement. The study is ongoing with enrolment of full term and preterm neonates pending dose determination.

8.
Medicines (Basel) ; 9(5)2022 Apr 21.
Article in English | MEDLINE | ID: covidwho-1875703

ABSTRACT

This study provides epidemiologic and clinical characteristics of 492 consecutive patients diagnosed with SARS-CoV-2 infection at King Faisal Specialist Hospital and Research Centre in Saudi Arabia between March and September 2020. Data were collected from electronic case reports. The cohort was 54% male, with 20.4% aged >60 years, 19.9% aged 31-40 years, and 17% aged 41-50 years. The median incubation period was 16 days, with upper and lower 95% quartiles of 27 and 10 days, respectively. Most patients (79.2%) were symptomatic. Variables significantly different between symptomatic and asymptomatic patients were age, blood oxygen saturation percentage, hemoglobin level, lymphocyte count, neutrophil to lymphocyte (NTL) ratio, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level. Asymptomatic patients were mostly younger, with lower body mass index and ALT and AST levels but higher lymphocyte counts, NTL ratio, and CD4, CD8, natural killer cell, IgG, and IgM levels. Factors associated with increased risk of mortality were age (>42 years) and comorbidities, particularly diabetes mellitus and hypertension. Patients who were not given an antiviral regimen were associated with better prognosis than patients who received an antiviral regimen (HR, 0.07; 95% CI, 0.011-0.25). These findings will help clinicians and policymakers adopt best management and treatment options for SARS-CoV-2 infection.

9.
Am J Perinatol ; 2022 May 31.
Article in English | MEDLINE | ID: covidwho-1873578

ABSTRACT

OBJECTIVE: We aimed to perform a meta-analysis of the literature concerning histopathologic findings in the placentas of women with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection during pregnancy. STUDY DESIGN: Searches for articles in English included PubMed, Web of Science, Google Scholar, and reference lists (up to April 2021). Studies presenting data on placental histopathology according to the Amsterdam Consensus Group criteria in SARS-CoV-2 positive and negative pregnancies were identified. Lesions were categorized into: maternal (MVM) and fetal (FVM) vascular malperfusion, acute placental inflammation with maternal (MIR) and fetal (FIR) inflammatory response, chronic inflammatory lesions (CILs), and increased perivillous fibrin deposition (PVFD). RESULTS: A total of 15 studies reporting on 19,025 placentas, n = 699 of which were derived from women who were identified as being infected with SARS-CoV-2 and 18,326 as SARS-CoV-2-negative controls, were eligible for analysis. No significant difference in incidence of MVM (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 0.73-1.90), FVM (OR: 1.23, 95% CI: 0.63-2.42), MIR (OR: 0.66, 95% CI: 0.29-1.52) or FIR (OR: 0.85, 95% CI: 0.44-1.63), and CILs (OR: 0.97, 95% CI: 0.55-1.72) was found between placentae from gravida identified as being SARS-CoV-2 infected. However, placenta from gravida identified as being infected with SARS-CoV-2 were associated with significantly increased occurrence of PVFD (OR: 2.77, 95% CI: 1.06-7.27). After subgroup analyses based on clinical severity of COVID-19 infection, no significant difference was observed in terms of reported placental pathology between symptomatic or asymptomatic SARS-CoV-2 gravidae placenta. CONCLUSION: Current evidence based on the available literature suggests that the only pathologic finding in the placentae of women who are pregnant identified as having been infected with SARS-CoV-2 was an increased prevalence of PVFD. KEY POINTS: · No association between SARS-CoV-2 and maternal or fetal placental malperfusion.. · No association between SARS-CoV-2 and maternal or fetal inflammatory response.. · SARS-CoV-2 is associated with increased perivillous fibrin deposition in placenta..

10.
Fordham Law Review ; 90(6):2541-2559, 2022.
Article in English | Scopus | ID: covidwho-1871110
11.
Journal of Global Health Reports ; 6(e2022021), 2022.
Article in English | CAB Abstracts | ID: covidwho-1865745

ABSTRACT

Contact tracing can play an important role in controlling infectious disease outbreaks such as the COVID-19 pandemic. Containing the spread of COVID-19 is crucial in humanitarian settings such as in the Rohingya camps in Cox's Bazar, Bangladesh. This manuscript describes the COVID-19 contact tracing activities undertaken by a group of researchers and implementers in Cox's Bazar, Bangladesh. The paper details the design and development of the Commcare 'Contact tracing and case monitoring app', subsequent implementation of the contact tracing activity, challenges faced during the implementation process, and the strategies adopted by the research team to overcome these challenges. The research team leveraged the suite of template applications for COVID-19 response developed by Dimagi in response to the COVID-19 pandemic. Research partners organized a series of brainstorming meetings and workshops with relevant stakeholders to finalize the 'COVID- 19 contact tracing and case monitoring app' for final implementation. This app was implemented in 10 Rohingya camps from Ukhiya and Teknaf sub-districts of Cox's Bazar for 4.5 months from 1st January 2021 to 15th May 2021. Due to a restriction on internet availability in the Rohingya camps by the government of the host country, the research team had to adopt a manual approach to implement the contact tracing activity. During these 4.5 months, 249,452 individuals from 10 Rohingya camps were screened for COVID-19 case registration. Of all the screened individuals, 431 were identified as COVID suspected cases, and 77 were identified as confirmed cases. The research team experienced several implementation challenges such as inexperience of contact tracers with the nature of the work, convincing the community to register in a digital system, obtaining information around COVID-19 symptoms, and many cultural, linguistic, gender, and other social barriers. The team adopted challenge-specific mitigation strategies for the effective implementation of the activity. The modalities of operation adopted by the team engaged with this present intervention to overcome the difficulties experienced in its conduction can hopefully provide some guidance to future parties attempting to conduct similar activities in complex humanitarian settings.

12.
Psychol Res Behav Manag ; 15: 1221-1234, 2022.
Article in English | MEDLINE | ID: covidwho-1862433

ABSTRACT

Purpose: This study aimed to determine the stress levels and identify various factors responsible for causing high-stress scores during the COVID-19 pandemic in the Saudi population. Patients and Methods: This cross-sectional study was conducted at Imam Abdulrahman Bin Faisal University, Dammam, from June 2020 until December 2020 on 4052 respondents from the Eastern province of Saudi Arabia. An online survey was used to collect information about various stress factors. The psychological impact of COVID-19 was measured by using the COVID-19 impact event scale (COVID-19 IES), whereas general stress levels were assessed by K10 Kessler Psychological Distress Scale (K10). Results: The psychological impact of the COVID-19 outbreak revealed that 35.4% of participants suffered from moderate or severe psychological impact (score>33); 19.7% had a mild psychological impact (scores24-32), whereas 44.9% reported minimal psychological impact (score <23). The factors significantly associated with higher stress scores and COVID-19 IES included male gender, low monthly income, having a private business, living in apartments/residential complexes, poor general health status, visit hospital/doctor in the past three months, presence of chronic disease, direct/indirect contact with someone diagnosed with/suspected to have COVID-19, contact with surfaces/tools infected with COVID-19, getting screened or quarantined for COVID-19, follow-up of the latest news about COVID-19 and knowledge of a greater number of people infected and died with COVID-19 (p < 0.05). In contrast, being an elementary school student, having 4-10 children, observing various protective measures, and staying home for 4-12 hours were associated with lower COVID-19 IES (p < 0.05). Conclusion: During the initial six months of the COVID-19 outbreak in Saudi Arabia, 35.4% participants suffered from moderate to the severe psychological impact. This study identified various factors responsible for high COVID-19 IES and K10 stress scores. These findings can help formulate psychological interventions for improving the stress scales in vulnerable groups during the COVID-19 pandemic.

13.
Sci Rep ; 12(1): 8688, 2022 May 23.
Article in English | MEDLINE | ID: covidwho-1860390

ABSTRACT

The COVID-19 pandemic has contributed to an increase in psychological distress. However, protective factors such as social support, psychological flexibility, and coping mechanisms can help individuals cope with the effects of psychological distress. This study aimed to test a recent hypothesis suggesting that psychological flexibility is not necessarily a coping strategy but a mechanism that can influence the coping strategies an individual employs during stressful events. We tested a mediation model that COVID-19 concerns would contribute to higher levels of perceived social support, which would directly increase psychological flexibility, and finally test if the effect of psychological flexibility on distress was mediated by approach and avoidant coping strategies. The results show that social support facilitates higher levels of psychological flexibility. Further, that psychological flexibility indirectly reduces psychological distress by reducing avoidant coping and increasing approach coping strategies. Within the context of COVID-19, we have shown the importance of social support and psychological flexibility for reducing distress. We have provided further evidence that psychological flexibility might not be a coping mechanism but a strategy that leads individuals to engage in more approach coping strategies and fewer avoidant coping strategies.


Subject(s)
COVID-19 , Psychological Distress , Adaptation, Psychological , Humans , Pandemics , Social Support , Stress, Psychological/psychology
14.
Health Sci Rep ; 5(3): e542, 2022 May.
Article in English | MEDLINE | ID: covidwho-1858806

ABSTRACT

Background and Aims: Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID-19 patients in Qatar and explore the early mortality predictors. Methods: We retrospectively studied the clinical characteristics and outcomes in patients admitted to the ICU at the national referral hospital for COVID-19 patients in Qatar. Logistic regression analysis was used to determine factors associated with mortality. Results: Between March 7 and July 16, 2020, a total of 1079 patients with COVID-19 were admitted to the ICU. The median (IQR) age of patients was 50 (41-59) years. Diabetes (47.3%) and hypertension (42.6%) were the most common comorbidities. In-hospital mortality was 12.6% overall and 25.9% among those requiring mechanical ventilation. Factors independently associated with mortality included older age ([OR]; 2.3 [95% CI; 1.92-2.75] for each 10-year increase in age, p < 0.001), chronic kidney disease (OR; 1.9 [95% CI; 1.02-3.54], p = 0.04), active malignancy (OR; 6.15 [95% CI; 1.79-21.12], p = 0.004), lower platelet count at ICU admission (OR; 1.41 [95% CI; 1.13-1.75] for each 100 × 103/µl decrease, p = 0.002), higher neutrophil-to-lymphocyte ratio at admission (OR; 1.01 [95% CI; 1-1.02] for each 1- point increase, p = 0.016), higher serum ferritin level at admission (OR; 1.05 [(95% CI; 1.02-1.08] for each 500 µg/L increase, p = 0.002), and higher serum bilirubin level at admission (OR; 1.19 [95% CI; 1.04-1.36] for each 10 µmol/L increase, p = 0.01). Conclusions: The mortality rate among critically ill COVID-19 patients is low in Qatar compared to other countries. Older age, chronic kidney disease, active malignancy, higher neutrophil-to-lymphocyte ratios, lower platelet counts, higher serum ferritin levels, and higher serum bilirubin levels are independent predictors of in-hospital mortality.

15.
Biomark Med ; 16(8): 589-597, 2022 06.
Article in English | MEDLINE | ID: covidwho-1855268

ABSTRACT

Aim: To investigate the change in a serum level of copeptin, a neuroendocrine biomarker, in differentiating grades of COVID-19 severity on admission time and to find its diagnostic potential. Materials & Methods: 160 COVID-19 patients were classified according to disease severity into 80 mild to moderate and 80 severe patients. Serum copeptin level was assessed by ELISA on their admission time. Besides, serum CRP, ferritin and D-dimer were estimated. Results: Severe COVID-19 patients showed higher serum copeptin level in comparison to mild to moderate cases, with diagnostic potential to distinguish disease severity with 93.33% sensitivity and 100% specificity at cutoff value >18.5 Pmol/l. Conclusion: Serum copeptin was remarkably increased with COVID-19 severity with reasonable differentiation potential for recently admitted patients.


We conducted a biochemical study on the role of copeptin ­ a biomarker of acute stress due to COVID-19 infection ­ in classification of COVID-19 severity on admission over 160 adult patients. Copeptin was highly elevated in severe cases more than the mild to moderate ones. So, it may be an early marker in admission departments to ease early clinical decisions and medical intervention.


Subject(s)
COVID-19 , Biomarkers , COVID-19/diagnosis , Glycopeptides , Humans , Prognosis , Severity of Illness Index
16.
Beni Suef Univ J Basic Appl Sci ; 11(1): 57, 2022.
Article in English | MEDLINE | ID: covidwho-1854889

ABSTRACT

Background: Continuous Positive Airway Pressure (CPAP), BiPhasic Positive Airway Pressure (BiPAP), and high flow nasal cannula (HFNC) show some evidence to have efficacy in COVID-19 patients. Delivery during noninvasive mechanical ventilation (NIV) or HFNC gives faster and more enhanced clinical effects than when aerosols are given without assisted breath. The present work aimed to compare the effect of BiPhasic Positive Airway Pressure (BiPAP) mode at two different pressures; low BiPAP (Inspiratory Positive Airway Pressure (IPAP)/Expiratory Positive Airway Pressure (EPAP) of 10/5 cm water) and high BiPAP (IPAP/EPAP of 20/5 cm water), with HFNC system on pulmonary and systemic drug delivery of salbutamol. On the first day of the experiment, all patients received 2500 µg salbutamol using Aerogen Solo vibrating mesh nebulizer. Urine samples 30 min post-dose and cumulative urinary salbutamol during the next 24 h were collected on the next day. On the third day, the ex-vivo filter was inserted before the patient to collect the delivered dose to the patient of the 2500 µg salbutamol. Salbutamol was quantified using high-performance liquid chromatography (HPLC). Results: Low-pressure BiPAP showed the highest amount delivered to the lung after 30 min followed by HFNC then high-pressure BiPAP. But the significant difference was only observed between low and high-pressure BiPAP modes (p = 0.012). Low-pressure BiPAP showed the highest delivered systemic delivery amount followed by HFNC then high-pressure BiPAP. Low-pressure BiPAP was significantly higher than HFNC (p = 0.017) and high-pressure BiPAP (p = 0.008). No significant difference was reported between HFNC and high-pressure BiPAP. The ex-vivo filter was the greatest in the case of low-pressure BiPAP followed by HFNC then high-pressure BiPAP. Low-pressure BiPAP was significantly higher than HFNC (p = 0.033) and high-pressure BiPAP (p = 0.008). Also, no significant difference was found between HFNC and high-pressure BiPAP. Conclusions: Our results of pulmonary, systemic, and ex-vivo drug delivery were found to be consistent. The low BiPAP delivered the highest amount followed by the HFNC then the high BiPAP with the least amount. However, no significant difference was found between HFNC and high BiPAP.

17.
Journal of the American College of Cardiology ; 79(9):3339-3339, 2022.
Article in English | Web of Science | ID: covidwho-1848297
18.
Journal of the American College of Cardiology ; 79(9):1822-1822, 2022.
Article in English | Web of Science | ID: covidwho-1848267
19.
Journal of the American College of Cardiology ; 79(9):2124-2124, 2022.
Article in English | Web of Science | ID: covidwho-1848266
20.
Pakistan Armed Forces Medical Journal ; 72(1):91-96, 2022.
Article in English | Scopus | ID: covidwho-1841856

ABSTRACT

Objective: To share the epidemiological, clinical and laboratory -based evidence of severe acute respiratory syndrome Corona Virus-2 with focus on the cases of re-infection;an update after one year of the ongoing pandemic. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, in collaboration with Department of Medicine, Combined Military Hospital, Malir, from Mar 2020 to Feb 2021. Methodology: Total 5190 nasopharyngeal swabs were collected and transported to the laboratory in viral transport media for severe acute respiratory syndrome Corona Virus-2, from all symptomatic patients with a history of exposure/traveling from endemic areas and those requiring admission in hospital and were screened for COVID-19 as per hospital standing protocols. Results: 561(10.8%) patients were PCR positive for severe acute respiratory syndrome Corona Virus-2. The mean age of patients was 39.45±31.9 years and a majority of patients were males 426 (76%). The most common symptoms were fever and dry cough followed by myalgia and shortness of breath. 37 (9%) patients died due to the severity of the illness. Total 6 (1.46%) cases of laboratory-confirmed reinfection of severe acute respiratory syndrome Corona Virus-2 were reported. 2(33%) cases of reinfection were observed in health care workers, mortality was seen in a single patient associated with old age and comorbidities. Conclusion: In our study, the severity of the disease was directly related to the age of patients and underlying comorbidities. Reinfection was associated with increased viral load and exposure to the infected environment. © 2022, Army Medical College. All rights reserved.

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