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1.
Journal of Clinical and Diagnostic Research ; 16(10):LC34-LC39, 2022.
Article in English | EMBASE | ID: covidwho-2114376

ABSTRACT

Introduction: Pandemics and subsequent lockdowns affect mental health of different subgroups of populations. In Coronavirus Disease-2019 (COVID-19), caregivers of those patients who have respiratory complaints is one such subgroup which is more vulnerable to disturbances in mental health, because of the fear that their patient's respiratory symptoms could be because of COVID-19. Aim(s): To assess the psychosocial impact of COVID-19 and subsequent state imposed lockdown on the caregivers of patients presenting with respiratory complaints and also to evaluate the effect of relaxation of lockdown after following-up them over a period of time. Material(s) and Method(s): This prospective observational study was conducted in the Department of Pulmonary Medicine, Government Medical College, Patiala, Punjab, India (tertiary care institute), from April 2020 to June 2020. Baseline assessment was done using socio-demographic performa, lockdown related questionnaire {3 domains, summed as total score (Lockdown)}, COVID-19 related questionnaire {Total score (COVID-19)} and General Health Questionnaire-12-Hindi version (GHQ-12). Reassessment was done twice i.e., at 11-15 days and 41-45 days after relaxation of lockdown. Quality Of Life (QOL) at first and second follow-up versus pre-lockdown times (score A and C) and first follow-up versus un-lockdown (score B) was also noted. Analysis was conducted using Statistical Package for Social Sciences (IBM, SPSS)version 22.0. Result(s): Mean age of the participants was 40.2+/-11.812 years with maximum caregivers 25 (41.7%) aged between 31-40 years. Majority (83.3%) were men. Psychological distress was experienced in 50% of caregivers at baseline and 23.7% caregivers at first follow-up (p-value=0.001). Worry for COVID-19 (p-value=0.035), Domain 1 scores (p-value <0.001), Domain 2 scores (p-value=0.003), Domain 3 scores (p-value=0.001), and Total score Lockdown (p-value <0.001) decreased significantly at first follow-up. Mean C score was significantly better than mean A score (p-value <0.001). Baseline psychological distress was significantly more in those with worry for COVID-19 (p-value=0.018), poorer scores of domains 1 (p-value=0.005), domains 2 (p-value <0.001), domains 3 (p-value <0.001), total score (Lockdown) (p-value <0.001) and total score (COVID-19) (p-value=0.010). Follow-up psychological distress was more in those with "worry for COVID-19" (p-value <0.001), negative thoughts (p-value=0.001), poorer follow-up scores of three domains, total score (Lockdown), mean A, B and C scores (p-value <0.001). Conclusion(s): Caregivers experienced extreme levels of psychological distress, which decreased, but persisted even after relaxation in lockdown. Copyright © 2022 Journal of Clinical and Diagnostic Research. All rights reserved.

2.
Lung India ; 39(SUPPL 1):S155, 2022.
Article in English | EMBASE | ID: covidwho-1857234

ABSTRACT

Background: COVID-19 and dengue infection both are caused by single-stranded RNA viruses of the families' coronaviridae and flaviviridae respectively. Both diseases share various clinical and laboratory parameters, making them difficult to distinguish from one another. In these times of covid-19 where dengue is already a public health concern, this co-infection poses great threat to already burdened healthcare system. Case Study: So, here we report a case of 76 year old male with complaints of high grade fever and dyspnea for 2 days diagnosed with COVID-19 who was simultaneously diagnosed with dengue infection and later died of ARDS and sepsis delineating the rarity and severity of this coinfection. Discussion: In the tropical counties, there is an emerging threat of dengue-covid co-infection. They have overlapping clinical presentations, also share several laboratory parameters like elevated liver enzymes, leukopenia and thrombocytopenia. Aggressive fluid resuscitation has a key role in dengue which may worsen oxygenation in COVID-19 patients. Also, the use of LMWH in COVID-19 settings can have a devastating effect in the setting of thrombocytopenia in case of dual infection. Conclusion: As we wait for more data, it is emphasized the need for early detection of the dual infection by testing all covid 19 patients for dengue in endemic areas as the disease can be more severe or one pathology can be misdiagnosed for the other.

3.
Journal of Clinical and Diagnostic Research ; 16(3):LC26-LC32, 2022.
Article in English | EMBASE | ID: covidwho-1780260

ABSTRACT

Introduction: Coronavirus Disease 2019 (COVID-19) appropriate behaviour and vaccination are two critical defenses in the fight against this pandemic. As these need to be followed religiously, this preventive behaviour should be thoroughly investigated. Aim: To examine the COVID-19 vaccine behaviour amongst people attending tertiary care centre at Patiala, Punjab, India. Materials and Methods: A cross-sectional study was conducted on 200 individuals attending the Outpatient Department of Government Medical College at Patiala, Punjab, India, from 15th July to 22nd July 2021. Individuals were administered socio-demographic questionnaire, General Health Questionnaire-12Hindi version (GHQ-12), and COVID-19 vaccine related and COVID-19 appropriate behavior related questionnaire. Actual observation by the clinician regarding proper use of face masks, hand hygiene and social distancing was done and objectively scored on 0-10 for each item with a scale interval of 2. Analysis was conducted using IBM Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Only 40% individuals were vaccinated. After eligibility, there was a mean delay of 4.20±3.51 weeks (median: 4 weeks) and 13.40±3.33 weeks (median: 12 weeks) in the vaccinated and unvaccinated individuals. Out of 120, 86 unvaccinated participants planned to get vaccinated in future. Significantly lower scores were obtained for actually observed COVID-19 appropriate behaviour (proper mask usage, hand hygiene and social distancing) as noted by the clinician vs the scores as reported by the participants. Conclusion: There were few takers for the COVID-19 vaccine, even weeks after eligibility. The COVID-19 appropriate behaviour was largely not being followed properly and the false sense of following the same complicated issues further. With multiple waves of the pandemic one after the other, and booster doses of vaccination, there is still an urgent need to sensitise the population at the grass root level regarding the COVID-19 vaccine behaviour to fight this pandemic.

4.
Journal of Association of Physicians of India ; 70(1):28-32, 2022.
Article in English | Scopus | ID: covidwho-1728241

ABSTRACT

Background: Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its role in asymptomatic and mildly symptomatic disease needs better elucidation. Methods: This multi-centre cohort study included asymptomatic and mildly symptomatic, RT-PCR confirmed COVID-19 cases between 30 March and 20 May, 2020. Patients were categorized into two groups (HCQ-treated and untreated) based on exposure to HCQ. Dose of HCQ used was 400 mg twice daily (day one) followed by once daily for seven days. HCQ-untreated patients were managed supportively without any active antiviral or immunomodulatory therapy. Nasopharyngeal SARS-CoV-2 clearance by RT-PCR (primary outcome) was compared between HCQ-treated and untreated patients using Kaplan-Meier analysis and Cox proportional-hazards regression. Clinical efficacy and safety profile of HCQ were assessed (secondary outcomes). Results:162 patients [84 (51·9%) males;mean age 38·2 (15·2) years] were included. Forty-four (27·2%) patients had mild disease, rest 118 (72·8%) were asymptomatic. Seventy-five (46·3%) patients received HCQ. Median time to virological negativity was lesser in HCQ-treated (13 days) versus untreated patients (15 days) (log-rank<0·001) in both asymptomatic and mildly symptomatic patients. Treatment with HCQ was the only independent predictor of virological negativity (hazard-ratio=2·24;adjusted p-value<0·001). Two (5·4%) mildly symptomatic patients progressed to severe disease within 24 hours (two doses) of HCQ initiation, compared to none in the HCQ-untreated group. Five HCQ-treated patients developed minor gastrointestinal side effects, not requiring drug discontinuation. Conclusion: HCQ reduced the time to virologic negativity (by 2 days) in asymptomatic and mildly symptomatic COVID-19, without any serious adverse events. However, no obvious clinical benefit was noted. © 2022 Journal of Association of Physicians of India. All rights reserved.

5.
Indian Heart J ; 73(4): 464-469, 2021.
Article in English | MEDLINE | ID: covidwho-1293827

ABSTRACT

AIM: This retrospective study compares admissions and outcomes due to acute decompensated heart failure (ADHF) during the COVID-19 pandemic from 25 March to 25 July 2020 with the historical patient control who were admitted during the same period in 2019. METHODS AND RESULTS: Data of the participating hospitals was collected and analysed from the ICC NHFR (Indian College of Cardiology National Heart Failure Registry) for 2019 and 2020. Total number of ADHF admissions, demographics, aetiology, co-morbid conditions and in-hospital mortality was compared and analysed. A significant decrease in the number of hospital admissions due to ADHF from 2019 to 2020 (1056 vs. 526 respectively) was noted. Incidence of admissions with <40% ejection fraction (EF) reduced in 2020 (72.4% and 80.2% in2020 and 2019)and >40% (EF) increased (27.6% and 19.8% in 2019 and 2020 respectively, p = 0.0005). Ischemic heart disease (IHD) was the most common aetiology (78.59% in 2019 and 80.98% in 2020, p = 0.268). The in-hospital mortality was numerically higher in 2020 (10%) than in 2019 (8%), but not statistically significant (p = 0.161). CONCLUSION: This study from the registry shows that the incidence of ADHF admissions during COVID-19 lockdown significantly reduced compared to the previous year. Demographic patterns remained similar but patients presenting with de-novo HF increased; IHD was the most common cause. The in-hospital mortality was numerically higher during the lockdown. The impact of lockdown perhaps led to fewer hospitalisations and this is to be factored in future strategies to address health care delivery during such crises.


Subject(s)
COVID-19 , Heart Failure , Acute Disease , Aged , Aged, 80 and over , Communicable Disease Control , Female , Heart Failure/epidemiology , Humans , India/epidemiology , Male , Middle Aged , Pandemics , Retrospective Studies , Stroke Volume
6.
Open Forum Infectious Diseases ; 7(SUPPL 1):S167-S168, 2020.
Article in English | EMBASE | ID: covidwho-1185706

ABSTRACT

Background: Antibiotic therapy has no known benefit against COVID-19, but is often initiated out of concern for concomitant bacterial infection. We sought to determine how common early empiric antibiotic therapy and community-onset bacterial co-infections are in hospitalized patients with COVID-19. Methods: In this multi-center cohort study of hospitalized patients with COVID-19 discharged from 32 Michigan hospitals during the COVID-19 Michigan surge, we describe the use of early empiric antibiotic therapy (within the first two days) and prevalence of community-onset bacterial co-infection. Additionally, we assessed patient and hospital predictors of early empiric antibiotic using poison generalized estimating equation models. Results: Between 3/10/2020 and 5/10/2020, data were collected on 951 COVID-19 PCR positive patients. Patient characteristics are described in Table 1. Nearly two thirds (62.4%, 593/951) of COVID-19 positive patients were prescribed early empiric antibiotic therapy, most of which (66.2%, 393/593) was directed at community-acquired pathogens. Across hospitals, the proportion of COVID-19 patients prescribed early empiric antibiotics varied from 40% to 90% (Figure 1). On multivariable analysis, patients were more likely to receive early empiric antibiotic therapy if they were older (adjusted rate ratio [ARR]: 1.01 [1.00-1.01] per year), required respiratory support (e.g., low flow oxygen, ARR: 1.16 [1.04-1.29]), had signs of a bacterial infection (e.g., lobar infiltrate, ARR: 1.17 [1.02-1.34]), or were admitted to a for-profit hospital (ARR: 1.27 [1.11-1.45]);patients admitted later were less likely to receive empiric antibiotics (April vs. March, ARR: 0.72 [0.62-0.84], Table 2). Community-onset bacterial co-infections were identified in 4.5% (43/951) of COVID-19 positive patients (2.4% [23/951] positive blood culture;1.9% [18/951] positive respiratory culture). Conclusion: Despite low prevalence of community-onset bacterial co-infections, patients hospitalized with COVID-19 often received early empiric antibiotic therapy. Given the potential harms from unnecessary antibiotic use, including additional personal protective equipment to administer antibiotics, judicious antibiotic use is key in hospitalized patients with COVID-19. (Figure Presented).

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