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1.
5th International Conference on Emerging Technologies in Computer Engineering: Cognitive Computing and Intelligent IoT, ICETCE 2022 ; 1591 CCIS:79-89, 2022.
Article in English | Scopus | ID: covidwho-1899027

ABSTRACT

Since the corona virus has emerged, genuine clinical resources, such as a paucity of experts and healthcare workers, a lack of adequate equipment and medications, and so on, have reached their peak of inaccessibility. Several people have died as a consequence of the medical profession’s concern. Individuals began self-medicating due to a lack of supply, which exacerbated an already precarious health situation. A rise in new ideas for automation is being spurred by machine learning’s recent success in a varied variety of applications. In this paper, we have proposed a two-phase Decision Tree Classifier based on Artificial Neural networks (DTNN). The work is based on the satisfaction of the drugs among patients with the help of their comments as positive or negative polarity. The dataset of drugs used in this paper is Cymablta and Depopovera. The proposed results are compared with the existing methodology of Support Vector Machine Neural Network (SVMNN). The results are shown in graphical and tabular form which shows the efficiency of the proposed methodology. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

2.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1881057
3.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880123
4.
Lung India ; 39(SUPPL 1):S134-S135, 2022.
Article in English | EMBASE | ID: covidwho-1857583

ABSTRACT

Introduction: Coronavirus disease-19 (COVID-19)has become a global pandemic, giving rise to a serious health threat worldwide. So far, several countries have seen a two-wave pattern of reported cases. Methodology: This was a retrospective study of all hospitalized cases of SARS-CoV-2. All the patients admitted between March to December 2020 were considered to be in first wave and those admitted from April to June 2021were considered to be in second wave. All hospitalized patients had SARS-CoV-2 infection confirmed by RT-PCR. Results and Discussion: Total 4581 patients in first wave & 1565 in second wavetested positive for SARS-CoV-2 infection using RT-PCR at the hospital.In the first wave highest admissions occurred in the month of November 2020. In the second wave, the highest admissions occurred in the month of April 2021. In first wave 71% were male and 29% were female while in second wave 67% male and 33% were female. The mean age of first and second wave was 54.9±16.6 and 55.2±15.5. CT severity scores were 18.8±9.9 in wave 1 versus 21.4±10.4 in wave 2.(p=0.0001)A total of 54 (1.2%) deaths occurred in the first wave and 26 (1.7%) in the second wave. Conclusion: Lung involvement on CT scan was more extensive in wave 2 compared to wave. A large number of patients were admitted during the second wave, they were younger and fewer number of deaths was reported corresponding with results reported by previous research in several countries.

5.
Lung India ; 39(SUPPL 1):S1-S2, 2022.
Article in English | EMBASE | ID: covidwho-1857225

ABSTRACT

Background: In December of 2019 a new corona virus was identified by WHO, secondary to an unfamiliar pneumonia in Wuhan, China, which was initially named 2019 Novel Corona Virus (2019-nCoV), and later named Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). Diagnosis was made on the basis of RT-PCR test. Methods: With use of RT-PCR as the reference standard, the performance of chest CT in the diagnosis of COVID-19 was assessed. Findings of the investigations such as HRCT, D-dimer, Sr. Ferritin, CRP, and LDH are recorded and analysed. Results: Total patients included in the study are 217 persons of which 57.89% are males, 42.10% are females. The mean age was 45.14-years. CT severity score was found to be positively correlated with increased D-dimer, LDH and S. ferritin levels. It was found that with increasing HRCT chest severity, there was increase in inflammatory marker parameters. Conclusion: Our data suggest the potential role of D-dimer, S. Ferritin and LDH for predicting severity of disease and CT scan. CT score is highly correlated to laboratory findings and might be beneficial to speed up diagnostic workup in symptomatic patients and also play a vital role in predicting the severity in places where HRCT scan is not available.

6.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333523

ABSTRACT

IMPORTANCE: Case series without control groups suggest that Covid-19 may cause ischemic stroke, but whether Covid-19 is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection is uncertain. OBJECTIVE: To compare the rate of ischemic stroke between patients with Covid-19 and patients with influenza, a respiratory viral illness previously linked to stroke. DESIGN: A retrospective cohort study. SETTING: Two academic hospitals in New York City. PARTICIPANTS: We included adult patients with emergency department visits or hospitalizations with Covid-19 from March 4, 2020 through May 2, 2020. Our comparison cohort included adult patients with emergency department visits or hospitalizations with influenza A or B from January 1, 2016 through May 31, 2018 (calendar years spanning moderate and severe influenza seasons). Exposures: Covid-19 infection confirmed by evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nasopharynx by polymerase chain reaction, and laboratory-confirmed influenza A or B. Main Outcomes and Measures: A panel of neurologists adjudicated the primary outcome of acute ischemic stroke and its clinical characteristics, etiological mechanisms, and outcomes. We used logistic regression to compare the proportion of Covid-19 patients with ischemic stroke versus the proportion among patients with influenza. RESULTS: Among 2,132 patients with emergency department visits or hospitalizations with Covid-19, 31 patients (1.5%;95% confidence interval [CI], 1.0%-2.1%) had an acute ischemic stroke. The median age of patients with stroke was 69 years (interquartile range, 66-78) and 58% were men. Stroke was the reason for hospital presentation in 8 (26%) cases. For our comparison cohort, we identified 1,516 patients with influenza, of whom 0.2% (95% CI, 0.0-0.6%) had an acute ischemic stroke. After adjustment for age, sex, and race, the likelihood of stroke was significantly higher with Covid-19 than with influenza infection (odds ratio, 7.5;95% CI, 2.3-24.9). CONCLUSIONS AND RELEVANCE: Approximately 1.5% of patients with emergency department visits or hospitalizations with Covid-19 experienced ischemic stroke, a rate 7.5-fold higher than in patients with influenza. Future studies should investigate the thrombotic mechanisms in Covid-19 in order to determine optimal strategies to prevent disabling complications like ischemic stroke.

7.
Annals of Emergency Medicine ; 78(4):S135-S136, 2021.
Article in English | EMBASE | ID: covidwho-1748242

ABSTRACT

Background: This research leverages Clinical Emergency Data Registry (CEDR) data collected from 2019 to 2020. Developed by ACEP, CEDR is the first Emergency Medicine (EM) specialty-wide registry to measure acute care quality, outcomes, practice patterns, and trends in emergency care. ACEP began CEDR in 2015 focusing on quantifying and enhancing quality of emergency care through collection of quality data and development of EM-specific quality metrics. CEDR has collected data for 50 million visits representing 30 million unique patients. Study Objectives: Early in the pandemic, impact on emergency departments (ED) was substantial. By May, ED visits declined nearly 40%. CDC data indicated ED visits for patients younger than 14 declined by 70%. While several studies evaluated pandemic impact on pediatric cases, most focused on children’s hospitals or particular illnesses. This research assesses the impact on pediatric visits to all US EDs over the more extended timeline of the pandemic, including total visits, visits for influenza, and visits for COVID-19. Methods: The database was queried for visit data on patients 18 years and younger from January 2019 to December 2020. Visits were counted, not individuals, so two visits by the same individual count as two visits. Percentage of visits in this cohort with a diagnosis of influenza (ICD 10 Codes: J09.X2, J10.-, J11.-) and COVID-19 (ICD 10 Code: U07.1) were calculated. Data were compared to age-agnostic ED visits and percentage of visits for COVID-19 and influenza in the general public. This data was obtained from the National Syndromic Surveillance Program (NSSP), run by the CDC. NSSP received data from 93% of US hospitals and is provided to ACEP through an agreement with the CDC. It includes data on the number of ED visits and percentage of those visits made for COVID-19 and influenza. Simple descriptive analysis was used. Results: Pediatric ED visits experienced a 72% decline starting week 11 of 2020, coinciding with the WHO characterization of COVID-19 as a pandemic. Sharp decline continues for six weeks before plateauing. However, pediatric visits remain 38% below previous visit rates (Figure 1). General population ED visits decline significantly over an identical period, however, only decrease by 42%. These ED visits make a quicker recovery, returning to 88% of previous patient volume. When reviewing influenza and COVID-19 data, general public visits indicated a considerable lack of influenza cases during COVID-19 surges. Conversely, pediatric visits do not demonstrate the same surges. Instead, data showed repeated smaller COVID-19 spikes during the year. In addition, pediatrics did not reveal influenza suppression seen in the general public. Spiking in pediatric influenza was proportional to COVID-19 spikes, offset in time (Figure 2). Conclusion: This study reveals pediatric ED visits sharply decreased in early weeks of the pandemic. Recovery of ED visits is slower in pediatric populations compared to the general population. Further, percentage of visits for influenza and COVID-19 remain low in this population and do not show typical “waves” seen in the general population. The reduction in 2020 influenza cases seen in the adult population is not reflected in the pediatric population. Influenza spiked uniquely in the pediatric population throughout 2020. Isolation of children at home during the COVID-19 pandemic may account for limited vaccination resulting in equal exposure risks. [Formula presented] [Formula presented]

8.
Open Forum Infectious Diseases ; 8(SUPPL 1):S344, 2021.
Article in English | EMBASE | ID: covidwho-1746510

ABSTRACT

Background. Remdesivir is a nucleotide analogue antiviral that was FDA approved for the treatment of hospitalized patients with coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2). Remdesivir has been associated with elevations in serum aminotransferase levels but most cases being mild to moderate and reversible upon discontinuation. Although national COVID-19 guidelines and the American Association for the Study of Liver Diseases (AASLD) currently recommend remdesivir for use in hospitalized patients requiring supplemental oxygen, data is limited using remdesivir in patients with chronic liver disease. Here, we describe our experience with remdesivir in patients with liver cirrhosis. Methods. Patients with liver cirrhosis who received remdesivir were identified either prospectively or retrospectively by primary or secondary ICD-10 codes indicating liver disease. Data collected included patient demographics, underlying cause of cirrhosis, co-morbidities, Child-Pugh score, laboratory values (serum aminotransferase levels, serum creatinine) during and following remdesivir, adverse reactions attributed to remdesivir, and mortality (in-hospital, 30-day, and 90-day). Results. A total of 4 patients with underlying liver cirrhosis completed a 5-day course of remdesivir treatment. On admission, Child-Pugh class was A for 1 patient, B for 2 patients, and C for 1 patient. Causes for cirrhosis were nonalcoholic steatohepatitis (NASH), hepatic amyloidosis, and chronic hepatitis B. There were no acute elevations in aminotransferase levels or adverse events attributed to remdesivir therapy. Mortality was high with 50% in-hospital mortality. Of the 2 other patients who survived to discharge, one was discharged to home hospice and the other was readmitted within 30 days and expired during that admission. Conclusion. Since there is limited data available using remdesivir in patients with advanced liver disease, we did not identify any safety concerns related to remdesivir in our cirrhotic patients. Mortality was high illustrating the poor outcomes of patients with advanced liver disease and COVID-19. Patients with cirrhosis should be offered remdesivir if clinically appropriate.

11.
Palgrave Studies of Cross-Disciplinary Business Research, in Association with EuroMed Academy of Business ; : 247-268, 2022.
Article in English | Scopus | ID: covidwho-1680567

ABSTRACT

Crisis opens the doors for innovation and a business needs to form cross-functional teams to find a balanced way to transform and bring about a revolutionary change in the organizations. This chapter focuses on challenges faced by the logistics industry in India and the measures taken to address these challenges and convert them into an opportunity to sustain and thrive in these pandemic times. Interviews of global leaders were conducted to gain an insight on what are the measures and changes made in the organization to deal with the current crisis in areas like operations, sales, HR, finance, and new client acquisition and how these activities have become a part of change management. In the present chapter, we have discussed the effect of COVID-19 on supply chains and economy of India. It was found that there has been a huge amount of reduction in the overall imports and exports during the lockdown period. Many small logistic services providers have gone out of business, whereas on the other hand some entrepreneurs with their entrepreneurial spirit were able to make the best use of the opportunities that the pandemic offered. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

12.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1638041

ABSTRACT

Introduction: Although home health aides (HHAs) often care for adults with heart failure (HF), studies have found that the majority have not received HF training and lack confidence with HF caregiving. To address this, we tested the feasibility, acceptability, and effectiveness of a virtual HF training course for HHAs. Methods: We partnered with the Education Fund of the 1199SEIU United Health Care Workers East, the largest healthcare union in the US, which provides training to 55,000 HHAs in NYC. HHAs typically receive in-person training, but due to COVID-19, we conducted this course virtually. The 2- hour course, taught in English and Spanish, utilized case-based learning and motivational interviewing to engage HHAs in interactive discussions on HF signs, symptoms, and HF self-care. HHAs with access to Zoom (via smartphone, computer, or tablet) were eligible. We conducted pre/post surveys and semi-structured interviews. Measures included: a) feasibility (attendance, retention), b) acceptability (modality, technological ease, satisfaction);and c) effectiveness (change in knowledge [Dutch Heart Failure Knowledge Scale, range 0-15] and caregiving self-efficacy [HF Caregiver Self-efficacy Scale, range 0-100]). Results: 48 HHAs employed by 15 distinct home care agencies enrolled and completed the course;course size ranged from 4-9 participants. The majority were middle-age women (60% Hispanic, 10% non-Hispanic Black). To participate, 59% used a smartphone, 32% a computer, and 10% a tablet. Compared to prior in-person courses, 83% participants reported that the course ran more smoothly and was more convenient;only 7% reported technical problems. Participants and course instructors reported high levels of satisfaction and engagement. Post-course data showed significant and clinically meaningful improvements in HF knowledge (11.21 [1.90] v. 12.21 [1.85];p = 0.0000) and HF caregiving self-efficacy (75.21 [16.57] v. 82.29 [16.49];p = 0.0017). Conclusions: A virtual HF training course was feasible and acceptable among HHAs and improved their HF knowledge and caregiving confidence. Efforts to scale and disseminate the course may be warranted. Future studies are needed to test the effect of the course among HHAs and their patients.

13.
Anesthesia and Analgesia ; 133(3 SUPPL 2):1060, 2021.
Article in English | EMBASE | ID: covidwho-1444865

ABSTRACT

Background: In this pandemic of covid 19 Parturient patients are facing double problem of carrying foetus with lung involvement leading to hypoxia to both mother and baby. Case Report: A young 31 years old lady, primi with 34 weeks pregnancy presented with 5 days history of covid 19 with acute SOB, fever, HRCT-Corad 6 and RTPCR +VE. Her SPO2 was 65%despite receiving oxygen @20L/mt. Looking to the hypoxemia to the patient and the foetus, the pulmonologist advised to terminate the pregnancy so that foetus can be saved and patient can be ventilated better. Looking to the lungs condition GA was avoided. Patient was given sub arachnoid block with 2.2ml bupivacaine 0.5% heavy. When she laid down, she developed dyspnoea (B.P. remained normal) for which she was given positive ventilation through mask. Her saturation remained 65% and respiratory rate 45. As soon as the baby was delivered, her saturation improved to 80% & and respiratory rate declined to 24. Patient stood surgery well and shifted back to ICU at SPO2 80%. The patient deteriorated later on with almost 95% lung involvement. Even after 50 days post surgery she is on oxygen support. Conclusion: The covid 19 has detrimental effects on Lung Parenchyma and conduction of anaesthesia in such morbid patients is always challenging. Choice of anaesthesia and selection of drugs is always tricky. A good outcome cannot always be guaranteed.

14.
Journal of Clinical and Diagnostic Research ; 15(8):OR05-OR07, 2021.
Article in English | EMBASE | ID: covidwho-1362743

ABSTRACT

The novel Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection can present with a multitude of clinical symptoms. The virus, disease symptomatology, pathogenesis and complications are being studied and new concepts are evolving rapidly. The current worldwide situation caused by the disease makes it exceedingly important to recognise varied presentations of the disease. Three cases are being discussed hereby, wherein the patients presented with altered sensorium secondary to hyponatremia as the initial and only presentation of SARS-CoV-2 infection, in the absence of fever or any respiratory involvement. Acute symptomatic hyponatremia is an under-recognised presentation with only a few cases reported till date and needs further awareness and understanding.

15.
2nd International Conference on Recent Advances in Mechanical Engineering, RAME 2020 ; : 1143-1155, 2021.
Article in English | Scopus | ID: covidwho-1340417

ABSTRACT

Solid waste management (SWM) including biomedical waste in this Covid-19 pandemic is one of the biggest challenges in India in terms of economical as well as environmental aspect. Improper practices for handling and management of solid waste drain natural resources which pollute an environment, and in turn, it causes threat to inhabitants. The purpose of the given review is to enhance understanding the concept of municipal solid waste management planning, infrastructure, components and strategies that are useful in the current Covid-19 outbreak. This paper aims to review rules and practical problem and implementation of various practices of SWM and biomedical waste. Appropriate management of solid waste could be quiet expensive in terms of resources and time as well. Systematic review has been done for the biomedical waste management system for its disposal and treatment for Covid-19. During this crisis, it is very important to find out various feasible options for properly managing and handling the waste in an effective manner which should be sustainable and safe too. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

16.
Economic and Political Weekly ; 55(45), 2020.
Article in English | GIM | ID: covidwho-1308676

ABSTRACT

The Epidemic Diseases Act, 1897 is a colonial era legislation that is still used as the primary law to control a mass epidemic. The act, most recently, has been invoked by a number of Indian states to fight the COVID-19 pandemic. This article aims to understand the existing scheme under the act, its limitations, judicial scrutiny and the need for a new holistic law from a public health perspective.

17.
Topics in Antiviral Medicine ; 29(1):139, 2021.
Article in English | EMBASE | ID: covidwho-1250555

ABSTRACT

Background: Remdesivir (RDV), a direct-acting nucleotide pro-drug inhibitor of viral RNA-dependent RNA polymerases, was approved by the FDA for the treatment of hospitalized patients (pts) with COVID-19 infection and has been shown to shorten time to recovery and improve clinical outcomes in randomized clinical trials. We present the final Day 28 (D28) analysis of RDV vs standard of care (SOC) (interim Day 14 [D14] analysis published [Olender et al. Clin Infect Dis 2020]). Methods: Final comparative analysis from two studies: a prospective phase 3, randomized study of RDV (RDV cohort) and a real-world retrospective cohort study of SOC (non-RDV cohort). Both studies enrolled pts with SARS-CoV-2 infection confirmed by polymerase chain reaction, who had oxygen saturation ≤94% on room air or required supplemental oxygen and had pulmonary infiltrates. Pts in the RDV cohort were randomized 1:1 to receive IV RDV for 5 or 10 days (200 mg on Day 1 followed by 100 mg/day on Days 2-5 or 2-10), plus SOC;the two randomized dose-groups were combined for analysis. Pts in the non-RDV cohort received SOC as determined by local treatment practices (excluding RDV). Analysis populations were balanced using propensity score (PS) matching. The coprimary endpoints were D14 clinical recovery (determined using a 7-point ordinal scale) and D28 all-cause mortality. Factors associated with D28 mortality were assessed using a multivariable logistic regression model. Results: After PS matching, baseline characteristics were generally similar in the RDV and non-RDV cohorts;median age 61 years, 63% male, 42% obese, 12% Black, 71% no/low-flow oxygen use, 25% high-flow oxygen, 3% ventilated. Pts in the RDV cohort had significantly higher D14 clinical recovery rates (65% vs 57%) and significantly lower D28 mortality rates (12% vs 16%) compared with the non-RDV cohort (Table). In the multivariable analysis, in addition to RDV use, a lower risk of death at D28 was associated with: younger age;being female;being White (versus being Black/African American);receiving an HIV protease inhibitor prior to baseline;not having cardiovascular disease or COPD;more days of symptoms prior to baseline;and being on room air or low-flow oxygen at baseline (versus being on invasive mechanical ventilation). Conclusion: RDV was associated with significantly higher rates of clinical recovery at Day 14 and lower Day 28 mortality compared with SOC in hospitalized pts with severe SARS-CoV-2 infection.

18.
Ieee Consumer Electronics Magazine ; 10(3):49-55, 2021.
Article in English | Web of Science | ID: covidwho-1236319

ABSTRACT

COVID-19 has been announced as a Global Communal Health Extremity by WHO on January 2020. Meaningful preventive solutions have been taken with smartphone selfie/geofencing apps toward managing mandatory home quarantine and physical distancing. In the post-COVID world, fast screening and strict quarantine can play a crucial role in bringing back normality. Quarantine being offered at home can be a comfortable solution for both government and patients. On the other hand, it can be hazardous if not strictly followed and adequately realized. However, the existing geofencing/face selfie apps take static photographs and location data at certain time intervals that can allow patients to violate the rules between those periods, thus failing to ensure active user identity. To realize unbreached home quarantine policies, this article introduces a CUBA-HQM smartphone app that performs continuous user biometric authentication (CUBA) augmented with geofencing using AI technology. The purpose of continuous tracking is to strictly control the spread of infectious diseases in society by monitoring the individual move in/out in the quarantine zone.

19.
Journal of the American College of Cardiology ; 77(18):3096, 2021.
Article in English | EMBASE | ID: covidwho-1223047

ABSTRACT

Background Biomarker-evidenced myocardial injury is common among patients with COVID-19 infection and confers an increased risk of mortality. Prevalence and incremental prognostic impact of myocardial dysfunction is unknown. Methods Consecutive COVID-19 patients undergoing clinical echocardiography during their index hospitalization at three New York City hospitals were studied. Images were analyzed by a central core lab blinded to all clinical data. LV dysfunction was defined as LVEF < 55% and RV dysfunction as TAPSE <1.6 cm or S’<10 mm/s. Results 733 patients (64 ± 15 years, 61% men) were studied. Myocardial injury (elevated troponin) occurred in 21% of patients, among whom either LV or RV myocardial dysfunction occurred in 72% (LV: 54%, RV:24%). Myocardial dysfunction was more common among patients with myocardial injury vs. without (LV: 54 vs. 32% p<0.001;RV: 24 vs. 10% p=0.001). During inpatient follow-up (median 15 [IQR 6-35] days), in-hospital mortality occurred in 34% with myocardial injury and 44% with LV or RV dysfunction vs. 23% without myocardial injury (p<0.001). Risk for death was greatest among patients with combined myocardial dysfunction and myocardial injury, and less with myocardial injury alone [Figure]. Conclusion Echo-evidenced myocardial dysfunction occurs in nearly three quarters of patients with myocardial injury and is a powerful predictor of in-hospital mortality. [Formula presented]

20.
Journal of the American Geriatrics Society ; 69:S266-S266, 2021.
Article in English | Web of Science | ID: covidwho-1194927
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