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1.
GERMS ; 12(2):253-261, 2022.
Article in English | EMBASE | ID: covidwho-2033512

ABSTRACT

Introduction Prior evidence found that bloodstream infections (BSIs) are common in viral respiratory infections and can lead to heightened morbidity and mortality. We described the incidence, risk factors, and outcomes of BSIs in patients with COVID-19. Methods This was a single-center retrospective cohort study of adults consecutively admitted from March to June 2020 for COVID-19 with BSIs. Data were collected by electronic medical record review. BSIs were defined as positive blood cultures (BCs) with a known pathogen in one or more BCs or the same commensal organism in two or more BCs. Results We evaluated 290 patients with BCs done;39 (13.4%) had a positive result. In univariable analysis, male sex, black/African American race, admission from a facility, hemiplegia, altered mental status, and a higher Charlson Comorbidity Index were positively associated with positive BCs, whereas obesity and systolic blood pressure (SBP) were negatively associated. Patients with positive BCs were more likely to have severe COVID-19, be admitted to the intensive care unit (ICU), require mechanical ventilation, have septic shock, and higher mortality. In multivariable logistic regression, factors that were independent predictors of positive BCs were male sex (OR=2.8, p=0.030), hypoalbuminemia (OR=3.3, p=0.013), ICU admission (OR=5.3, p<0.001), SBP<100 mmHg (OR=3.7, p=0.021) and having a procedure (OR=10.5, p=0.019). Patients with an abnormal chest X-ray on admission were less likely to have positive BCs (OR=0.3, p=0.007). Conclusions We found that male sex, abnormal chest X-ray, low SBP, and hypoalbuminemia upon hospital admission, admission to ICU, and having a procedure during hospitalization were independent predictors of BSIs in patients with COVID-19.

2.
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003110

ABSTRACT

Background: Coronavirus disease (COVID-19) caused by SARSCOV2 represents global public health concern, with varied severity of illness in different ages and racial groups. This study aims to describe clinical presentation and outcomes of children aged 0-21 years diagnosed with MIS-C in a community hospital setting in the United States. Methods: This is a retrospective medical record review of pediatric patients admitted to the ICU with confirmed diagnosis of MIS-C. Results: We identified 24 cases of MIS-C at two community hospitals during period of March 2020- June 2021. Fever (92%) and nausea/vomiting (79%) were the most frequent symptoms identified, followed by red eyes (54%) and rash (54%). Additional symptoms included diarrhea (46%), abdominal pain (46%), headache (42%), shortness of breath (13%), myalgia (13%), and chest pain (4%). Of the 24 patients, 15 (63%) were male, and 9 (37%) were female. Race and ethnic distribution was African American/Black (66%), Hispanic origin (29%) and Other/not reported (4%). The majority of patients were aged 6-10 years (38%), followed by 1-5 years (25%) and 11-15 years (25%), and over 15 years (12%). Echocardiogram findings showing decreased cardiac function and/or pericardial effusion was found in 38% of patients, with complete recovery of cardiac function in 100%. Management included IVIG administration (92%), with 4 patients requiring second dose, and 1 patient also requiring Anakinra. Additional treatment included steroids (92%) and aspirin (96%). Two patients received Lovenox. Conclusion: As shown in various other studies, minorities seem to be disproportionately impacted and prompt recognition of clinical presentation and management is critical for this population. Ongoing longitudinal studies are needed to determine factors affecting why certain ethnicities are impacted more than others.

3.
Journal of Health Management ; 2022.
Article in English | Scopus | ID: covidwho-1962651

ABSTRACT

The coronavirus disease is a respiratory tract disorder which causes pneumonia-like symptoms in severe patients and mild flu-like symptoms in mild symptomatic cases first noticed in Wuhan, China. DNA sequencing and further analysis shows it to be 79% like the 2002 SARS-CoV and 50% like the 2012 MERS-CoV. It was also observed that the novel coronavirus’s spike protein was larger and very different from its previously known strains. For diagnosis, multiple strategies were developed and real time reverse-transcriptase-polymerase chain reaction (RT-PCR) technique was determined to be the best technique. The CT scan was also found effective majorly for the continuous assessment of the disease. Treatment strategies used in previous outbreaks were looked into and put to trial like convalescent plasma therapy. Vaccine development using various genetic engineering strategies are going on across the world. To contain the spread of the disease, countries with positive cases were put under lockdown to break the chain of spread. These lockdowns forced industries, offices, schools, religious places, stadiums, travel, and many more to close which impacted the economies of all the major countries. Lesser human interaction and more use of social media has impacted the social aspects of human life. Cases of domestic violence and mental stress increased among households. Economic stimulus package was announced by various countries to curb the socio-economic impact of the COVID-19 pandemic. © 2022 SAGE Publications.

4.
Virologie ; 26(2):120, 2022.
Article in English | EMBASE | ID: covidwho-1913246

ABSTRACT

Bulk transcriptomic analyses of virus-cell interactions are commonly performed on mixed populations of infected and uninfected bystander cells and may thus lead to inaccurate interpretations. Moreover, they generally focus on the expression of the coding genome and not on the total transcriptome, which is largely composed of long non-coding RNAs (lncRNAs). We performed polyA+ and whole transcriptome analysis of lung epithelial A549 cells infected with SARS-CoV-2, which were sorted based on the expression of the viral protein Spike (S). To increase the sequencing depth and ameliorate the robustness of the analysis, the samples were depleted of viral transcripts, which constituted up to 85% of total reads in the S-positive cells. Results highlighted a high number of down-regulated genes upon infection, an indication of massive host transcription shutdown. We also noticed an increased level of intronic reads in infected cells as compared to control cells, suggesting a defect in mRNA splicing. Among the upregulated coding genes in S-positive cells, we recovered candidates previously identified by analysis performed on non-sorted cells, such as CXCL8 and CCL20, but also novel candidates, including IL- 32, ITGAM and the down-regulated FEN1. Comparison of mRNA abundances of few coding, non-coding and unannotated genes between non-sorted cells and sorted ones confirmed the accuracy of the approach. We also observed that S-negative bystander cells and mock-infected control cells exhibited very similar transcriptomic profiles. This was not due to a lack of communication between infected and bystander cells: transcripts related to inflammatory cytokines underwent normal splicing and maturation in infected cells, with concomitant high levels of protein secretion. The observed lack of major transcriptomic changes in the bystander population can be linked to the insufficient interferon response in infected cells. Finally, we explored the functional implications of genes selectively upregulated in the infected subpopulation and observed previously uncharacterized proviral activities of lncRNA ADIRFAS1 and endogenous Interleukin 32 (IL-32), making them attractive targets for putative therapeutic strategies. Thus, analyzing the whole transcriptome of pure populations of infected lung cells allowed the accurate identification of cellular functions that are directly affected by infection and recovery of coding and non-coding genes relevant for SARS-CoV-2 replication.

5.
International Journal of Early Childhood Special Education ; 14(3):2350-2362, 2022.
Article in English | English Web of Science | ID: covidwho-1884714

ABSTRACT

Prior experience of both thefinancial crisis and the first signs of the social and labour market consequences during the present pandemic give idea that the COVID 19 crisis is going to have a diverse impact on migrants and the children of them.This reviewexplores the impact of the COVID 19 pandemic on migration. The speedy spread of the pandemic has captured shocked nations around the world, leading to widespread lockdowns that limit mobility, business activity and social interaction. In India, pandemics have created a serious "mobility crisis" and migrant workers in many major cities are returning to their places of origin. Thiers is desperate endeavours to come back to home by available means invalidated the blockade in some areas, leading to clashes with authorities and ultimately transportation arrangements. This article is aimed to point out on the vulnerabilities of Indian migrants and their children in terms of gender, and mental health. Apart from this, it critically analyses the impediments of public policies in bargaining with immigrants and implies future recommendations.

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International Journal of Early Childhood Special Education ; 14(2):1474-1483, 2022.
Article in English | Web of Science | ID: covidwho-1856283

ABSTRACT

During Pandemic, the education has become little difficult for children. Family and professional collaboration is salutary to scholars, families, and preceptors. The significance of similar collaboration was honoured for families of scholars with disabilities, performing in vittles' in the Individualities with Disabilities Education Act (IDEA) that dictate maternal participation in educational planning. Despite the benefits of family and professional collaboration and the IDEA accreditation, numerous parents differ with the educational planning opinions handed to their children and request due process sounds. Parents perceive a lack of occasion to give input and/or to differ with seminaries' perspectives. Parents of early nonage scholars report significant enterprises about their child's readiness for the transition to kindergarten and their limited part in transition planning as their children prepared to enter preschool programs. The purpose of this paper was to examine the issues linked in maternal complaints in early childhood special education (ECSE) through a qualitative content analysis of recent courtcases.Childhood and adolescence are without mistrustfulness the most important phase of one's experimental life, which is why focus on internal and physical well-being is the only way to insure holistic development. Internationally, several developed and developing nations have espoused wide- grounded internal healthcare practices in educational institutions. It's time for India to pay attention to this aspect of its public health problem.

8.
Journal of the American College of Cardiology ; 79(9):2088-2088, 2022.
Article in English | Web of Science | ID: covidwho-1848816
9.
Open Forum Infectious Diseases ; 8(SUPPL 1):S26-S27, 2021.
Article in English | EMBASE | ID: covidwho-1746803

ABSTRACT

Background. Little is known about risk factors for readmission after COVID-19 hospitalizations. Knowledge of these factors may help to identify patients at increased risk and may help to prevent these rehospitalizations. Methods. This historical cohort study was conducted at a tertiary care academic medical center. We included COVID-19 cases diagnosed by reverse-transcriptase polymerase-chain-reaction (RT-PCR) assay between March 8th and June 14th, 2020. Patients readmitted within 30 days were identified. Using the electronic medical record, we collected data on demographic and clinical information. Data were analyzed using Student's t-test, the chi-squared test and multivariable logistic regression. Results. We included 391 patients who survived after the index hospitalization for COVID-19. The readmission rate was 13.3% (52/391). The mean time to readmission was 9.2 ± 7.9 days. The mean age (±SD) was 66.3 ± 18.6 years, 44.2% were male, and 78.8% were black/African-American. The most common presenting complaint was shortness of breath (50%). The most frequent diagnosis during the readmission was infectious process (57.7%). The mortality rate on readmission was 11.5%. Patients with a 30-day readmission were older than those not readmitted, mean age (±SD) 66.3 ± 18.6 vs. 61.0 ± 16.0, respectively (p=0.03). Readmitted patients also had a higher prevalence of heart failure and renal disease as comorbidities. Elevated alanine aminotransferase (AST) and low albumin level were also associated with readmission (Table 1). Intensive care unit (ICU) admission or mechanical ventilation during the index admission did not increase the risk of readmission. From multivariable analysis, independent predictors of 30-day readmission were higher Charlson score (p=0.004), higher creatinine on admission in the index hospitalization (p=0.009), and presence of rhabdomyolysis during the index hospitalization (p=0.039) (Table 2). Table 2. Multivariable Analysis of Predictors for Readmission within 30 days from COVID-19 Infection Conclusion. In our cohort, infectious etiologies were common among those readmitted within 30 days of COVID-19. A higher Charlson score, acute renal failure, and rhabdomyolysis during the index admission were independent predictors of a 30-day readmission. Further studies are required to investigate these contributing factors.

10.
Open Forum Infectious Diseases ; 8(SUPPL 1):S262-S263, 2021.
Article in English | EMBASE | ID: covidwho-1746679

ABSTRACT

Background. Long term sequelae across multiple medical domains, including the respiratory, psychiatric, and neurocognitive have been reported after COVID-19. Studies evaluating the impact of this symptom burden, however, are lacking. We aimed to describe the self-reported occurrence of symptoms and their effect on patient functioning six months after their acute hospitalization for COVID-19. Methods. From a historical cohort study of patients hospitalized for COVID-19 between March 8, and June 14, 2020, we identified patients discharged home. The purpose of the study was explained, and they were asked to consent to a telephone questionnaire. We used a modified version of a previously validated general symptom questionnaire (GSQ-30) to assess multi-system symptom burden. The Patient Health Questionnaire-2 (PHQ-2) was used to screen for major depression. Results. Of the original 565 patients, 258 patients were discharged home (45%). Of these, 57 (22%) patients were able to be contacted and agreed to participate in the survey. The mean (SD) age of the respondents was 55.1 (14.8) years, and 37 (64.9%) were female. The most common symptoms at follow-up were fatigue (60.0%), dyspnea (57.1%), feeling irritable, sad or decreased pleasure (56.4%), and memory difficulty (56.4%). Females had a significantly higher GSQ score (0.02) than males. Patients ages < 60 years tended to experience similar, if not greater, impaired functioning (p=0.07) compared with those ages ≥ 60 years (Table 1). Females were more likely to be irritable or sad (p=0.007), not feel rested on awakening (p=0.04), have shooting, stabbing and burning pain (p=0.02), have discomfort with normal light and sound (p=0.04), and have memory difficulty (p=0.04) than males (Table 2). Conclusion. Our study describes the clinical burden of post-acute sequelae of COVID-19 (PASC) in four core domains: fatigue, neurologic, neuro-psychiatric and viral-like symptoms. Over 45% of patients ages < 60 years suffered impaired functioning, compared with 21.1% of patient's ages 60 years and above. Females had significantly higher GSQ scores than men which strongly corelates with the functional impairment among the females. Larger studies are needed to further validate our findings.

11.
Open Forum Infectious Diseases ; 8(SUPPL 1):S323, 2021.
Article in English | EMBASE | ID: covidwho-1746554

ABSTRACT

Background. Mortality from COVID-19 is associated with male sex, older age, black race, and comorbidities including obesity. Our study identified risk factors for in-hospital mortality from COVID-19 using survival analysis at an urban center in Detroit, MI. Methods. This was a single-center historical cohort study. We reviewed the electronic medical records of patients positive for severe acute respiratory syndrome coronavirus 2 (the COVID-19 virus) on qualitative polymerase-chain-reaction assay, who were admitted between 3/8-6/14/20. We assessed risk factors for mortality using Kaplan-Meier analysis and Cox proportional hazards models. Results. We included 565 patients with mean age (standard deviation) 64.4 (16.2) years, 52.0% male (294) and 77.2% (436) black/African American. The overall mean body mass index (BMI) was 32.0 (9.02) kg/m2. At least one comorbidity was present in 95.2% (538) of patients. The overall case-fatality rate was 30.4% (172/565). The unadjusted mortality rate among males was 33.7% compared to 26.9% in females (p=0.08);the median time to death (range) for males was 16.8 (0.3, 33.9) compared to 14.2 (0.32, 47.7) days for females (p=0.04). Univariable survival analysis with Cox proportional hazards models revealed that age (p=< 0.0001), admission from a facility (p=0.002), public insurance (p< 0.0001), respiratory rate ≥ 22 bpm (p=0.02), lymphocytopenia (p=0.07) and serum albumin (p=0.007) were additional risk factors for mortality (Table 1). From multivariable Cox proportional hazards modeling (Table 2), after controlling for age, Charlson score and qSofa, males were 40% more likely to die than females (p=0.03). Conclusion. After controlling for risk factors for mortality including age, comorbidity and sepsis-related organ failure assessment, males continued to have a higher hazard of death. These demographic and clinical factors may help healthcare providers identify risk factors from COVID-19.

12.
Open Forum Infectious Diseases ; 8(SUPPL 1):S326, 2021.
Article in English | EMBASE | ID: covidwho-1746545

ABSTRACT

Background. Virus-specific antibodies help to understand the prevalence of infections and the course of the immune response. Humans produce antibodies against the spike and nucleocapsid proteins of SARS-COV-2 virus. Patients with COVID-19 who recover from the infections have higher levels of antibodies to spike proteins. Our study aimed to find the levels of antibodies to spike and nucleocapsid proteins in severe COVID-19. Methods. A single center prospective study was done at Ascension St John Hospital, Detroit, MI. We included COVID-19 cases diagnosed by reverse-transcriptase polymerase-chain-reaction (RT-PCR). Quantitative measurements of plasma or serum antibodies to nucleocapsid and spike proteins were done in hospitalized patients with acute COVID-19. Using the electronic medical record, we collected data on demographic and clinical information. Results. A total 24 patients were studied. Of which, 15 patients were suffering from severe and critical COVID 19 and 9 patients were suffering from mild to moderate COVID 19. The mean age (standard deviation) of our cohort was 69 ± 10 years and 60% were males. Common comorbid conditions were hypertension, obesity, and type 2 diabetes. We also noted that severe to critical COVID 19 expressed higher level of antibody to nucleocapsid. Conclusion. These results display the seroconversion in COVID 19 patients. Our study shows antibody level remain high in severe COVID 19 patients but those are against nucleocapsid protein instead of spike protein.

13.
Open Forum Infectious Diseases ; 8(SUPPL 1):S687, 2021.
Article in English | EMBASE | ID: covidwho-1746318

ABSTRACT

Background. COVID-19 impacted nearly 4 million children, accounting for 14% of total cases in the US, 1.3-3.2% of total reported hospitalizations and less than 1% deaths attributed to COVID-19. Many studies report persistent symptoms in adults several months after acute COVID-19. Similar findings have been reported from a small cohort of children in Italy. To date there are no studies reviewing long haul symptoms in children in the US. Methods. With the goal of defining long haul in pediatric population, and providing comprehensive care to these patients, RWJBarnabasHealth launched a post-COVID CARE program in October 2020 for children. The program has provided care for approximately 16 patients with COVID related Multisystem Inflammatory Syndrome (MIS-C) and 48 pediatric patients with COVID. The goal of the Pediatric Post-COVID CARE program was to provide a multidisciplinary approach for children ages 0-21 years impacted with COVID-19. This included patients who experienced ongoing symptoms >4 weeks from initial COVID-19 illness. All children were assessed by a pediatric infectious disease physician and triaged to appropriate subspecialties, all part of the long-haul care team. In addition, physical therapy and psychology support services were provided to facilitate return to normalcy. Results. To date, our program has evaluated 64 patients. 28% experienced at least 1 symptom 4 weeks after acute COVID-19. Median age was 14 years and 77.8% were female. The follow-up study was conducted from October 2020 to May 2021. Data was collected 2 weeks, 6 weeks, 3 months, and 6 months post discharge or initial evaluation in clinic. 28% of patients were antibody positive, 55.6% experienced fatigue, 50% experienced shortness of breath or cough, 50% experienced 'brain fog',33% chest pain and 44.4% experienced anxiety and/or depression. Conclusion. Early identification of patients and comprehensive protocols may facilitate return to normalcy for children with lingering somatic symptoms worsened by impact of social isolation, economic stresses, lost parental jobs, and food insecurity among many other contributing factors. Further research is needed to determine why children of certain ethnicities are impacted differently.

14.
SAE 2021 17th Symposium on International Automotive Technology, SIAT 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1478304

ABSTRACT

According to research studies, epidemics such as SARS, COVID-19 spread have caused huge negative impacts on population, health and the economy around the globe. The outbreak places a huge burden on international health systems that were already straining to address AIDS, tuberculosis, malaria, and a host of other conditions. Research has proven that incase infected person is not traced timely then the spread of infection in society will take the shape of large-scale community transmission. Most of the infections spread because they got unnoticed by the infected person. One part of the access checker scans is a person's body temperature by measuring infrared radiation emitted by their skin. Fever screening by infrared thermal imaging has become more widespread following the SARS infection, and particularly during the pandemic H1N1 and COVID-19 outbreak. Skin temperature is measured without contact by monitoring the emitted infrared radiation. The infrared thermal camera that monitors radiations, and human body heat. Presently there is no passenger and commercial vehicles equipped with "thermal detection device"in the market, which monitors the thermal variations of passengers and helps to restrict the spread of the virus in pandemic circumstances. In the current situation "thermal detection device"is a need of an hour for society. This paper deals with the design and development of the "thermal detection device"for passengers in public transport vehicles. This paper also comprises the scenario, where if a passenger is having a high body temperature at that time "thermal detection device"will activate the alarm. Further it explains the type of "thermal detection device"design, logical programming and system packaging. The system has been validated on the vehicle to check the response time and accuracy of the "thermal detection device"of the electronically controlled system. Safety features include temperature range and voice call-based alerts. © 2021 SAE International. All Rights Reserved.

15.
Open Forum Infectious Diseases ; 7(SUPPL 1):S343, 2020.
Article in English | EMBASE | ID: covidwho-1185917

ABSTRACT

Background: During the early COVID-19 pandemic a large number of investigational agents were utilized due to lack of therapeutic options. We evaluate the utility of commonly-used investigational agents combined with hydroxychloroquine (HCQ). Methods: This multicenter observational cohort study included patients admitted with COVID-19 between March - May 2020 in Detroit, Michigan who received at least 2 doses of HCQ. Our primary outcome was the change in Sequential Organ Failure Assessment (SOFA) score from presentation to day 5 of HCQ therapy with a secondary outcome of in-hospital mortality. Data collected included demographics, Charlson Comorbidity index (CCI), daily SOFA score, laboratory data and COVID-directed therapies. Multiple linear regressions were performed to control for potential confounders between different therapies and change in SOFA score. Results: Three hundred thirty-five patients receiving HCQ were included. Patients were 62 ± 14.8 years of age, male (54%) and African-American (82%) with a mean CCI of 1.7 ± 1.9. In our cohort, 32% were admitted to the intensive care unit and 35% expired. Therapies received by more than 20% of patients in addition to HCQ included azithromycin (80%), zinc (76%) and vitamin D (29%). In our unadjusted analysis, a significant improvement in SOFA score was observed with zinc (0.76) while no significant change was observed with azithromycin (-0.46) or vitamin D (0.05). However, there was no significant change in SOFA score after adjusting for confounders for azithromycin, zinc and vitamin D. No difference in mortality was observed between the groups. Conclusion: Overall, no benefit in end-organ damage or mortality was observed with the addition of azithromycin, zinc or vitamin D to HCQ. Further studies are needed to confirm this observation.

16.
International Journal of Research in Pharmaceutical Sciences ; 11(Special Issue 1):822-831, 2020.
Article in English | EMBASE | ID: covidwho-846457

ABSTRACT

Today, our understanding towards COVID-19 pandemic is that it is contagious and based on the behaviour of the virus, the signs and symptoms of this viral resemble the viral infection like Severe Acute-Respiratory Syndrome-coronavirus (SARS-CoV) and Middle East Respiratory Syndrome (MERS-CoV). Currently, documented vaccines or drugs are not available for the treatment of COVID-19, SARS-CoV-2 viral infection. The main objective of this article is to compile the available literature on the treatment modalities for COVID-19, currently being advocated. Furthermore, there is no time to wait for evidence-based treatment, hence in such a scenario;an attempt has been made to col-lect the available scientiic literature and understand the treatment of the disease with this insight. A MEDLINE-PUBMED search was performed in the surge of the treatment strategies for COVID-19 using the keywords ”COVID-19”, ”nCoV”, ”novel coronavirus”, ”treatment of coronavirus” and ”therapies”. We have reviewed the multiple articles from recently published literature and various pre-print proofs from up-to-date journals. Based on the reviewed lit-erature, various categories of drugs are under trial or have been tried for the treatment of nCoV infection, which are categorised as medications (anti-viral agents, chloroquine and hydroxychloroquine, ACE-2 inhibitors, etc.), immune therapy, traditional Chinese medicine, plasma exchange therapy, and blood puriication therapy, etc. We attempted to go through the literature available for the treatment of COVID-19 and tried to compile it all together. Still, clinical trials are under process, and there are no evidence-based treatment strategies available to manage the cases of COVID-19 patients.

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