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1.
EAI Endorsed Transactions on Scalable Information Systems ; 9(35), 2022.
Article in English | Scopus | ID: covidwho-1744789

ABSTRACT

INTRODUCTION: Contact tracing is a method to track the victims, which have been infected from the host with any particular disease. Therefore, clustering based machine learning techniques can be employed for contact tracing. Contact tracing can be automated by using technology and thus helps us in producing much more accurate and efficient results. OBJECTIVES: This work aims at finding usefulness of clustering techniques for contact tracing. Two different clustering techniques namely density-based clustering and partitioning-based clustering have been used to analyse corresponding results for COVID-19 infected cases. The dataset is generated from a mock data generator with certain assumptions. RESULTS: The paper compares DBSCAN and K-means for contact tracing for COVID-19 Pandemic. The comparative analysis of two algorithms is presented. CONCLUSION: The effectiveness of certain clustering algorithms in COVID-19 contact tracing is analysed. DBSCAN performs well for clustering tasks. This work only focuses on possible techniques useful for contact tracing and does not claim any medical accuracy © 2021. Meenu Gupta et al., licensed to EAI. This is an open access article distributed under the terms of the Creative Commons Attribution license, which permits unlimited use, distribution and reproduction in any medium so long as the original work is properly cited

2.
Critical Care Medicine ; 50(1 SUPPL):571, 2022.
Article in English | EMBASE | ID: covidwho-1691818

ABSTRACT

INTRODUCTION: AS is an autoimmune condition, characterized by antibodies directed against an aminoacyl transfer RNA synthetase. AS has a highly heterogenous disease pattern due to different organ involvement. The initial clinical presentation can be variable. We present an atypical case of AS with ARDS. DESCRIPTION: A 72-year-old female, retired teacher, with no significant past medical history presented to the emergency department with complaints of progressively worsening shortness of breath for 3 to 4 weeks, associated with fever, nausea, vomiting, and diarrhea. Otherwise review of symptoms was negative. Patient was hypotensive, tachycardic and hypoxic requiring hi-flow nasal canula (FiO2 90%). A chest CT was negative for thromboembolic disease but did show bilateral patchy ground glass opacities with traction bronchiectasis and confluent consolidation in both upper lobes. Patient was admitted to the medical intensive care unit and initiated on antibiotics, but her hypoxemia progressively worsened requiring mechanical ventilation for ARDS. She required multiple proning sessions. Her bronchoscopy with bronchoalveolar lavage was negative for infectious etiology including COVID test. Given her persistent hypoxia, patient was started on methylprednisolone due to concerns for interstitial lung disease (ILD). Patient's oxygenation significantly improved, and she was extubated 10 days later. Further investigations revealed positive anti-PL-7 directed against threonyl t-RNA synthetase. Case was discussed in the ILD multidisciplinary conference with pulmonary and thoracic surgery. In the light of her ongoing oxygen requirements, there was high suspicion of rapidly progressive form of antisynthetase syndrome. Therefore, she was started on 60 mg prednisone, tacrolimus, and cyclophosphamide. Patient was discharged to a skilled-nursing facility. DISCUSSION: AS can be a challenging diagnosis, especially in patients without any muscular or rheumatological symptoms that present with ARDS. It is critical to have a broad differential for patients with non-resolving ARDS. ILD as the initial presentation of AS is a major cause of mortality. Currently there is limited evidence-based recommendations to guide therapy. Additional randomized clinical trials would be needed to support guidelines directing the management of AS ILD flare.

3.
Journal of Pharmaceutical Research International ; 33(45B):30-39, 2021.
Article in English | Web of Science | ID: covidwho-1497877

ABSTRACT

Aims: To assess medical students' perception of online teaching to suggest transforming the future curriculum in low-economic countries. Study Design: Cross-sectional online interview study. Place and Duration of Study: A team of collaborators interviewed final year medical and dental students of Pakistan from 07/08/2020 till 17/09/2020. Methodology: A questionnaire was developed based on open and close-ended questions in Google forms;focusing on institutional preparedness, views on online education, the institute's closure and COVID-19, and long-term effects of closure of the institute. Independent fellow researchers systematically analyzed the unaltered transcripts of the responses, and themes were then identified and coded to conclude the results. SPSS version 23 used for analysis. As this study was based on final year students. Results: In response to an invitation email, 2442/2661 (91.77%) students voluntarily participate in this qualitative study. Most participants were females (1614, 66.10%). Closing down institutes was directly linked to a lack of motivation and feel of helplessness. As most showed dissatisfaction with online teaching compounded by psychological effects, students feared losing clinical skills and life during the pandemic. Conclusion: The psychological impact of the crisis led to resistance to accepting the change for a better outcome. Incorporating telemedicine, different interactive learning style to online teaching, and resilience training would result in fruitful outcomes. Developed countries may also guide build infrastructure in developing countries to develop a more robust online teaching methodology in the long-run.

4.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407426
5.
Transfus Clin Biol ; 29(1): 60-64, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1322364

ABSTRACT

BACKGROUND AND OBJECTIVES: Seroprevalence estimation of COVID-19 is quite necessary for controlling the transmission of SARS-CoV-2 infection. Seroprevalence rate in recovered COVID-19 patients help us to identify individual with anti-SARS-CoV-2 antibodies and its protective nature. The objective of present study was to evaluate seroprevalence of SARS-CoV-2 among potential convalescent plasma donors and analysis of their deferral reasons. MATERIALS AND METHODS: A total 400 potential convalescent plasma donors were enrolled over five-month period for this prospective study. Inclusion criteria were lab confirmed COVID-19 recovered patients and 14 days of symptoms free period. All prospective plasmapheresis donors were tested for IgG SARS-CoV-2 antibody through chemiluminescent microparticle immunoassay, CBC, serum protein, blood grouping along with other required test for normal blood donation as per Drugs & Cosmetics Act. After pre donation testing and medical examination if donor was found to be ineligible for plasmapheresis was deferred. Seroprevalence rate was calculated by positive IgG antibody test results among the potential plasma donors. RESULTS: Seroprevalence rate was 87% for IgG SARS-CoV-2 antibodies in prospective convalescent plasma donors (recovered COVID-19 patients). There was no significant difference in seroprevalence rate between different sub-groups with respect to gender, age, blood groups, Rh factor, mode of treatment, day of Ab testing and repeat plasma donation. Most common reason for their deferral was absent IgG SARS-CoV-2 antibodies (13%) followed by absenteeism of eligible screen donors (6.7%), low Hb (1.7%) and poor veins for plasmapheresis (1.7%). Till five-month study period none of the plasmapheresis develop symptoms of reinfection with COVID-19. CONCLUSION: In all, 13% recovered patients did not develop IgG antibodies after SARS-CoV-2 infection. SARS-CoV-2 IgG antibodies persist for quite some time and are protective against reinfection. More long-term serology studies are needed to understand better antibody response kinetics and duration of persistence of IgG antibodies.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Blood Donors , COVID-19/therapy , Humans , Immunization, Passive , Prospective Studies , Seroepidemiologic Studies , Tertiary Care Centers
8.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277459

ABSTRACT

Rationale:Acute respiratory failure (ARF) is the leading cause of intensive care admission for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Noninvasive respiratory support devices assist select patients with worsening ARF. However, delaying intubation may be associated with an increased mortality rate which stems from cardiovascular complications and volume induced lung injury.Prior research has shown correlations between point of care ultrasound measurements and success or failure of weaning intubated patients. There is a paucity of data analyzing the relationship between ultrasound measurements and the requirement of intubation in patients on non-invasive respiratory support. This study evaluates whether ultrasound measurements of diaphragm movement (diaphragm inspiratory time (TI), diaphragm excursion time index (E-t index)) and lung ultrasound score (LUS) among SAR-CoV-2 patients on non-invasive respiratory support would identify those at risk for failure necessitating intubation. Method: Prospective single center observational study. Recruitment was considered for patients with SAR-CoV-2 on noninvasive respiratory support: non-rebreather face mask (NRB), high flow nasal cannula (HFNC), or noninvasive positive pressure ventilation (NIPPV). Independent observers measured E-t index, TI and LUS. The clinical care team was blinded to the involvement of the patient in the study. Welch's two-sample t-tests detected differences in the lung ultrasound parameters distribution between the intubated and non-intubated groups. Association between lung ultrasound parameters and intubation events were evaluated by using a multivariable logistic regression analysis and fitting the lung ultrasound parameters and time component on the likelihood of intubation. Results were statistically significant if p<0.05. Result: 89 LUS and diaphragm measurements were performed from March 2020 to May 2020. Patients requiring intubation had higher mean LUS but lower mean inspiratory time (TI) and lower mean E-T index. (Table 1). Higher LUS was associated with higher odds of being intubated by a factor of 1.17. Conversely, a higher TI was associated with lower odds of intubation. Area under curve for a receiver operator curve of 0.85 with a sensitivity of 86% and specificity of 75% for TI and LUS. Conclusion: Our data shows that among SAR-CoV-2 infected patients with ARF, a reduced E-t index and TI and an elevated LUS are associated with intubation. A lower TI is independently associated with intubation. Among the intubated, the mean LUS was higher than those who were not. LUS more than or equal to15 predicted receipt of invasive ventilation with a sensitivity of 92% and a specificity of 45 % (AUC = 0.72).

9.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-8350

ABSTRACT

Purpose: In March-April 2020, New York City was overwhelmed by COVID-19 infections, leading to substantial disruptions in nearly all aspects of care and operations at most local hospitals. This qualitative study of a quaternary, urban oncology hospital investigated the effects of these disruptions upon a professionally diverse cohort of its employees, including physicians, nurses, respiratory therapists, pharmacists, security guards, histology technicians, and environmental services workers. Methods : The participant pool were selected through a combination of purposive and random sampling methodology and coders performed a thematic content analysis of open-ended responses.

10.
Indian Journal of Community Health ; 32(3):564-568, 2020.
Article in English | ProQuest Central | ID: covidwho-908457

ABSTRACT

On 31st December 2019, China informed local WHO office of "cases of pneumonia of unknown etiology detected in Wuhan. As of 6th May 2020, there are nearly 3.6 million cases of corona virus infection and approximately 0.25 million deaths worldwide. The real-time data regarding the actual number of cases, as it originates from the epicenter is the key to the estimation of the case fatality rate, hospitalization rates, expected timeline of arrival of contagion, and other epidemiological data. The novel virus has no available literature pertaining to its epidemiological parameters, on which experts can base their estimates and hence the challenge in planning for epidemic management. Bolstering this challenge are the reports alleging under-reporting by Chinese authorities. Alleged toned down numbers could have led to erroneously low estimates contributing to inadequate public health response globally. We conducted a simulation on epidemiological model of COVID-19 to find out expected time off arrival of infections and mortality in different countries and compared this to actual data. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.

11.
Chest ; 158(4):A350, 2020.
Article in English | EMBASE | ID: covidwho-866530

ABSTRACT

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Bacterial and fungal infections in COVID-19 patients have been inadequately studied and reported. The purpose of this study is to determine the incidence and outcomes of superinfections in patients with COVID-19. METHODS: A retrospective observational study of all patients diagnosed with COVID-19 at Fairview Hospital-Cleveland Clinic. Main outcomes were incidence of bacterial, viral and fungal infections among COVID-19 patients and in-hospital mortality. RESULTS: There were 82 patients diagnosed with COVID-19. Fifty-one (62.2%) were male and median age was 64.5 years. On admission, 48 (58.5%) patients were admitted to ICU and 13 (15.9%) required mechanical ventilation. Of all patients, 22 (26.8%) developed superinfection during admission. Only three had positive PCR for other viruses;two had respiratory syncytial virus and one had influenza A. Methicillin resistant staphylococcus aureus (MRSA) was detected in 5 (6.1%) patients. Superimposed bacterial pneumonia were detected in 13 (12.2%) patients;2 MRSA, 2 methicillin sensitive staphylococcus aureus, 2 Corynebacterium striatum, 2 pseudomonas aeruginosa, 2 mycoplasma pneumoniae, 1 legionella, 1 serratia marcescens and 1 klebsiella pneumoniae. Only one patient had aspergillus fumigatus lung infection. Positive blood cultures were detected in 4 (4.9%) patients and included a case of candidemia. Urinary tract infection was diagnosed in 10 (72%) patients, and only 2 had a foley’s catheter. Corticosteroids were used in the treatment of 37 (45.1%) patients, with only 8 of the 22 patients who developed superinfections. Compared to the no superinfection cohort, patients who developed superinfection were more likely to require ICU admission (77.3% vs 53.3%, p 0.05), develop circulatory shock (59.1% vs 30.0%, p 0.016), require mechanical ventilation (63.6% vs 33.3%, p 0.014) and had lower median absolute lymphocytes count (1455/mm3 vs 5700/mm3, p 0.006). In multivariate analysis, circulatory shock (p 0.046) and need for mechanical ventilation (p 0.037) remained significantly associated with superinfection. Median time to superinfection development was 5 days with an overall mortality of 19.5%. The mean overall survival time among patients who developed superinfections was not significantly different compared to no superinfection group, 53.5 days (95% CI: 46.7-60.3) and 48.5 days (95% CI: 42.6-54.5) respectively, (p 0.278). CONCLUSIONS: In our COVID-19 cohort the rate of superinfection was 26.8%. Superinfection was associated with higher rates of circulatory shock and mechanical ventilation. The use of corticosteroids was not associated with higher rates of infections. CLINICAL IMPLICATIONS: This study will help in identifying frequent infections among COVID-19 patients in an attempt to predict and treat superinfections early in the course of the disease. DISCLOSURES: No relevant relationships by Saira Afzal, source=Web Response No relevant relationships by Sura Alqaisi, source=Web Response No relevant relationships by Sanchit Chawla, source=Web Response No relevant relationships by Tariq Kewan, source=Web Response No relevant relationships by Aisha Saand, source=Web Response No relevant relationships by Talha Saleem, source=Web Response

12.
Chest ; 158(4):A596-A597, 2020.
Article in English | EMBASE | ID: covidwho-860856

ABSTRACT

SESSION TITLE: Lessons from the ICU: What have We Learned about the Management of COVID-19 SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: The purpose of this study is to describe the characteristics and outcomes of critically ill patients with cancer and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We reviewed the clinical characteristics and outcomes of adult patients (> 18 yrs) with active or recent history of cancer and confirmed COVID-19 who developed acute hypoxemic respiratory insufficiency/failure with radiographic opacities and were consecutively admitted to two intensive care units (ICU) at Memorial Sloan Kettering Cancer Center between March 16 and May 27, 2020. The hospital adopted an early-intubation strategy during the first 4 weeks and a waiting period of 4 weeks before considering a tracheostomy. Pressure control ventilation and targeted tidal volume of 6 ml/kg predicted body weight and moderate to high PEEP was standard practice. Cases were confirmed through reverse-transcriptase–polymerase-chain-reaction assays performed on nasopharyngeal swab specimens. Data were manually abstracted from electronic health records. RESULTS: During the study period, a total of 290 patients were admitted to the two ICUs;90 (31%) patients with active (n=87) or recent (n=3) history of cancer had COVID-19 pneumonia. Mean age was 65 years;60% were male, 67% were White;49% had hypertension, 29% had diabetes mellitus;and 50% had a smoking history. 52 (63%) had solid tumors and 38 (37%) had hematologic malignancies. Advanced stage non-small cell lung carcinoma and breast carcinomas were the most frequent solid tumors and leukemia and lymphoma were the most common hematologic cancers. Vasopressors were required in 38 (42%) and CRRT in 8 (9%). In-hospital treatments for COVID-19 included remdesivir in 20%, convalescent plasma in 12%, hydroxychloroquine in 37%, azithromycin in 35%, corticosteroids in 56%, IL-6 inhibitors (tocilizumab, siltuximab) in 6% and IL-1 receptor antagonist in 1%. Acute respiratory failure (ARF) leading to invasive mechanical ventilation (MV) developed in 61 patients (68%) with a mean of 25 days on MV. Prone positioning (self or during MV) was implemented in 44 patients (49%). 18 patients (30%) were extubated after a mean of 11.5 days and 16 (26%) underwent a tracheostomy, 10 of whom (63%) were successfully liberated from MV. Thirty-six patients (40%) had a Do-Not-Resuscitate Order during their ICU stay. As of May 27, 24 (39%) of the 61 patients who required MV have died compared to 5 (17%) of the 29 non-ventilated patients. 40 patients (44%) were discharged home and 25 (28%) remain hospitalized. CONCLUSIONS: Over a third of cancer patients who developed ARF due to COVID-19 requiring MV in the ICU did not survive. CLINICAL IMPLICATIONS: Critically ill cancer patients with COVID-19 are at high risk of severe disease and mortality. DISCLOSURES: No relevant relationships by Christine Ammirati, source=Web Response No relevant relationships by Melissa Barzola, source=Web Response No relevant relationships by Sanjay Chawla, source=Web Response No relevant relationships by Michael Dang, source=Web Response Advisory Committee Member relationship with Pronia Medical Please note: $1001 - $5000 Added 06/02/2020 by Neil Halpern, source=Web Response, value=stock options Advisory Committee Member relationship with Airstrip Please note: $1-$1000 Added 06/02/2020 by Neil Halpern, source=Web Response, value=stock options No relevant relationships by James Isbell, source=Web Response Advisory Committee Member relationship with Jazz Pharmaceuticals Please note: $1-$1000 Added 07/17/2020 by Stephen Pastores, source=Web Response, value=Consulting fee Grant Support for Clinical Trial relationship with Biomerieux Please note: $5001 - $20000 Added 07/17/2020 by Stephen Pastores, source=Web Response, value=Grant/Research Support No relevant relationships by Kate Tayban, source=Web Response

13.
EAI Endorsed Transactions on Pervasive Health and Technology ; 6(22):1-9, 2020.
Article in English | Scopus | ID: covidwho-823568

ABSTRACT

INTRODUCTION: SARS-CoV-2 is the latest virus responsible for an outburst of a unique respiratory infection identified as COVID-19. The virus popularly known as Corona Virus has spread quickly in recent days from China to several other countries around the world. Health is always of prime concern for mankind. Computing is playing an important role in improving the current state of the healthcare industry. OBJECTIVES: This paper focuses on summarizing the happenings about the coronavirus and the disease spread. This review study concentrates on the history of the virus, its technical details, the disease caused by the virus, its symptoms and precautions. The study also tries to develop an understanding of the role of technology in dealing with the outbreak, its impact in diverse fields, and the current state of the pandemic. METHODS: This work is an attempt towards presenting a perspective of computing and technology in fighting against the COVID-19 pandemic. RESULTS: This work presents a perspective showing technology in healthcare as a rescuer in such situations. In this survey, we simply discuss SARS-COV2 and COVID-19 from different perspectives in order to serve as a quick reference for the readers and to achieve a better insight into the fast-evolving pandemic. CONCLUSION: Social distancing, staying home and lockdowns are some known solutions to combat the pandemic in the absence of the vaccine, and technology can play a significant role in combating the pandemic. © 2020 Sunil Chawla et al., licensed to EAI.

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