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European Respiratory Journal Conference: European Respiratory Society International Congress, ERS ; 60(Supplement 66), 2022.
Article in English | EMBASE | ID: covidwho-2277257


Background: Severe COVID-19 has been attributed to a hyperimmune response mediated by cytokines. The mainstay of therapy remains largely supportive along with steroids. Co-trimoxazole in addition to having antimicrobial properties has immunomodulatory and anti-inflammatory properties and could potentially improve outcomes in patients with severe COVID-19 . Hypothesis: We hypothesised that Co-trimoxazole given to patients with severe COVID-19 could prevent progression to critical illness, mortality and reduce time to recovery. Method(s): We conducted an interim analysis in our single center open-label randomised control trial, in which hospitalised patients with severe COVID-19 requiring supplemental oxygen via non-rebreathe mask between 10 -15 Litres per minute and maintaining saturations between 92-96% were assigned in a 1:1 ratio to receive either oral Cotrimoxazole in addition to standard therapy or standard therapy alone. Result(s): 111 patients were recruited into the study, of which 56 patients received Co-trimoxazole and 55 received standard therapy alone. The mean age was 50 years in the Co-trimoxazole group versus 53 years in the standard therapy group (p=0.083). In-hospital mortality was 11% in the Co-trimoxazole group vs 29% in the standard therapy group (p=0.020). Mechanical ventilation was offered to 9% of the patients in the Co-trimoxazole group versus 13% of the patients in the standard therapy group. Time to recovery was 6 days in the Co-trimoxazole group versus 7 days in the standard therapy group (p=0.466). Conclusion(s): In this interim analysis oral Co-trimoxazole reduces mortality in patients with severe Covid-19. Further recruitment is underway.

Caregiver Burden ; 2022(Dementia e Neuropsychologia)
Article in English | WHO COVID | ID: covidwho-2079867


Due to the disruption of normal flow of treatment during the restrictions related to the coronavirus disease 2019 (COVID-19) pandemic, the health status of persons with dementia (PwD) and their caregivers’ burden might worsen. Objective: The article aims to find out the health status of PwD and caregivers’ burden during the peak of second wave of COVID-19 and make a comparison with the preceding trough phase. Methods: The study was conducted with 53 PwD and their caregivers in two phases. On their visit to the hospital during the unlock phase (phase 1), data were collected for CDR from PwD, and NPI-Q and ZBI from their caregivers. During the peak of second wave (phase 2), data were collected for NPI-Q, ZBI, and DASS-21 through telephonic communication, and statistical analyses were performed on the collected data. Results: Significantly higher caregiver burden (p=0.001) and neuropsychiatric symptoms (NPSs) [both in severity (p=0.019) and distress (p=0.013)] were observed among the respondents during the peak of second wave of the pandemic as compared to the preceding trough phase. Positive correlations were observed between the caregiver burden and depression, anxiety, and stress of the caregivers (p<0.001) and between the severity of dementia in PwD and caregiver burden (p<0.001) for both the first and second phases. Positive correlation was also observed between the severity of dementia in PwD and depression (p=0.042) and stress (p=0.023) of caregivers. Conclusions: Significant increase in the burden and distress was observed among caregivers due to increased NPSs of PwD during the second wave of COVID-19 pandemic. © 2022, Associacao Arquivos de Neuro-Psiquiatria. All rights reserved.