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1.
Journal of family medicine and primary care ; 11(6):2377-2380, 2022.
Article in English | EuropePMC | ID: covidwho-2033841

ABSTRACT

Objectives: To study the impact of lockdown during novel coronavirus disease-19 (COVID-19) pandemic on Pediatric Emergency visits. Methods: In this retrospective study, we compared the data regarding demographic details, triage category, underlying primary organ system involvement and outcomes among pediatric emergency visits of April-May 2019 and 2020. Results are expressed in means and proportions. Chi-square test was applied to compare the proportion in two groups. Results: We observed decrease in number of patients during lockdown period as compared to previous year (792 vs 506, decrease by 36%). There was significant increase in respiratory (P = 0.001, CI 2.66-11.6), and hematological emergencies (P < 0.001, CI 2.96-9.23) Road traffic accident (RTA) were decreased significantly (P = 0.005, CI 0.6-3.06). Unintentional injuries were comparable to previous year (P = 0.14, CI -0.86-6.19), though children being at home. Conclusion: During lockdown, number of pediatric emergency visits was reduced and also lead to delayed presentation. Parents should be informed about utilizing telemedicine services available during this period and avoid delaying in going to hospitals in emergency conditions.

2.
Int J Infect Dis ; 122: 693-702, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1936536

ABSTRACT

OBJECTIVES: India introduced BBV152/Covaxin and AZD1222/Covishield vaccines in January 2021. We estimated the effectiveness of these vaccines against severe COVID-19 among individuals aged ≥45 years. METHODS: We did a multi-centric, hospital-based, case-control study between May and July 2021. Cases were severe COVID-19 patients, and controls were COVID-19 negative individuals from 11 hospitals. Vaccine effectiveness (VE) was estimated for complete (2 doses ≥ 14 days) and partial (1 dose ≥ 21 days) vaccination; interval between two vaccine doses and vaccination against the Delta variant. We used the random effects logistic regression model to calculate the adjusted odds ratios (aOR) with a 95% confidence interval (CI) after adjusting for relevant known confounders. RESULTS: We enrolled 1143 cases and 2541 control patients. The VE of complete vaccination was 85% (95% CI: 79-89%) with AZD1222/Covishield and 71% (95% CI: 57-81%) with BBV152/Covaxin. The VE was highest for 6-8 weeks between two doses of AZD1222/Covishield (94%, 95% CI: 86-97%) and BBV152/Covaxin (93%, 95% CI: 34-99%). The VE estimates were similar against the Delta strain and sub-lineages. CONCLUSION: BBV152/Covaxin and AZD1222/Covishield were effective against severe COVID-19 among the Indian population during the period of dominance of the highly transmissible Delta variant in the second wave of the pandemic. An escalation of two-dose coverage with COVID-19 vaccines is critical to reduce severe COVID-19 and further mitigate the pandemic in the country.


Subject(s)
COVID-19 , Influenza Vaccines , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Case-Control Studies , ChAdOx1 nCoV-19 , Hospitals , Humans , SARS-CoV-2
3.
J Family Med Prim Care ; 11(6): 2377-2380, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1934367

ABSTRACT

Objectives: To study the impact of lockdown during novel coronavirus disease-19 (COVID-19) pandemic on Pediatric Emergency visits. Methods: In this retrospective study, we compared the data regarding demographic details, triage category, underlying primary organ system involvement and outcomes among pediatric emergency visits of April-May 2019 and 2020. Results are expressed in means and proportions. Chi-square test was applied to compare the proportion in two groups. Results: We observed decrease in number of patients during lockdown period as compared to previous year (792 vs 506, decrease by 36%). There was significant increase in respiratory (P = 0.001, CI 2.66-11.6), and hematological emergencies (P < 0.001, CI 2.96-9.23) Road traffic accident (RTA) were decreased significantly (P = 0.005, CI 0.6-3.06). Unintentional injuries were comparable to previous year (P = 0.14, CI -0.86-6.19), though children being at home. Conclusion: During lockdown, number of pediatric emergency visits was reduced and also lead to delayed presentation. Parents should be informed about utilizing telemedicine services available during this period and avoid delaying in going to hospitals in emergency conditions.

4.
Front Immunol ; 13: 859387, 2022.
Article in English | MEDLINE | ID: covidwho-1924095

ABSTRACT

Recent genome-wide association studies (GWASs) of COVID-19 patients of European ancestry have identified genetic loci significantly associated with disease severity. Here, we employed the detailed clinical, immunological and multi-omics dataset of the Human Functional Genomics Project (HFGP) to explore the physiological significance of the host genetic variants that influence susceptibility to severe COVID-19. A genomics investigation intersected with functional characterization of individuals with high genetic risk for severe COVID-19 susceptibility identified several major patterns: i. a large impact of genetically determined innate immune responses in COVID-19, with ii. increased susceptibility for severe disease in individuals with defective cytokine production; iii. genetic susceptibility related to ABO blood groups is probably mediated through the von Willebrand factor (VWF) and endothelial dysfunction. We further validated these identified associations at transcript and protein levels by using independent disease cohorts. These insights allow a physiological understanding of genetic susceptibility to severe COVID-19, and indicate pathways that could be targeted for prevention and therapy.


Subject(s)
COVID-19 , Genome-Wide Association Study , COVID-19/genetics , Genetic Predisposition to Disease , Humans , Immunity , von Willebrand Factor/genetics , von Willebrand Factor/metabolism
5.
Front Immunol ; 13: 838132, 2022.
Article in English | MEDLINE | ID: covidwho-1809394

ABSTRACT

The majority of COVID-19 patients experience mild to moderate disease course and recover within a few weeks. An increasing number of studies characterized the long-term changes in the specific anti-SARS-CoV-2 immune responses, but how COVID-19 shapes the innate and heterologous adaptive immune system after recovery is less well known. To comprehensively investigate the post-SARS-CoV-2 infection sequelae on the immune system, we performed a multi-omics study by integrating single-cell RNA-sequencing, single-cell ATAC-sequencing, genome-wide DNA methylation profiling, and functional validation experiments in 14 convalescent COVID-19 and 15 healthy individuals. We showed that immune responses generally recover without major sequelae after COVID-19. However, subtle differences persist at the transcriptomic level in monocytes, with downregulation of the interferon pathway, while DNA methylation also displays minor changes in convalescent COVID-19 individuals. However, these differences did not affect the cytokine production capacity of PBMCs upon different bacterial, viral, and fungal stimuli, although baseline release of IL-1Ra and IFN-γ was higher in convalescent individuals. In conclusion, we propose that despite minor differences in epigenetic and transcriptional programs, the immune system of convalescent COVID-19 patients largely recovers to the homeostatic level of healthy individuals.


Subject(s)
COVID-19 , Convalescence , Disease Progression , Humans , Leukocytes, Mononuclear , SARS-CoV-2
6.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-316396

ABSTRACT

The authors have requested that this preprint be removed from Research Square.

7.
J Prev Med Hyg ; 62(3): E628-E634, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1575254

ABSTRACT

The number of outbreaks have progressively increased since many years in India. In this era of globalization and rapid international travel, any infectious disease in one country can become a potential threat to the entire globe. Outbreaks of Nipah, Zika, Crimean-Congo Haemorrhagic Fever and Kyasanur Forest Disease have been reported since a decade and now we are facing COVID-19 pandemic. One of the challenges in the prevention of these outbreaks is that as the cases decrease, the felt need declines, the public demand decreases and the mitigation responses get overshadowed by the need of emergency responses elsewhere. The One Health approach is a movement to promote alliance between medicine field, veterinary medicine and environmental sciences to upgrade the health of humans, animals, and ecosystem. The data in this article is compiled from different websites and publications of World Health Organization (WHO), Centre for Disease Control and Prevention (CDC), Integrated Disease Surveillance Programme (IDSP), grey literature and media. There is an urgent need for better surveillance and disease burden assessments in the country and to gain detailed insights into vector biology, factors of environment influencing the diseases, mapping of endemic areas, strengthen intersectoral coordination, infection control practices, and ensure use of Personal Protective Equipment's (PPE) and availability of drugs and vaccines to handle the outbreaks in a better way.


Subject(s)
COVID-19 , Hemorrhagic Fever, Crimean , Zika Virus Infection , Zika Virus , Animals , Disease Outbreaks/prevention & control , Ecosystem , Hemorrhagic Fever, Crimean/epidemiology , Humans , India/epidemiology , Pandemics , SARS-CoV-2
8.
2021.
Preprint in English | Other preprints | ID: ppcovidwho-294850

ABSTRACT

Background Since the outbreak of COVID-19 pandemic, the world began a frantic search for possible prophylactic options. While trials on hydroxychloroquine (HCQ) prophylaxis are ongoing, concrete evidence is lacking. The study aimed to determine the relative efficacy of various doses of oral HCQ in prophylaxis and mitigating the severity of COVID-19 in healthcare workers. Methods This was a prospective cohort with four arms (high, medium, low dose, and control) of HCQ prophylaxis, used by healthcare workers at a tertiary care center in India. Participants were grouped as per their opting for any one arm on a voluntary basis as per institute policy under the Government guidance. The outcomes studied were COVID-19 positivity by RT-PCR and its severity assessed by WHO COVID-19 severity scale. Results Total 486 participants were enrolled, of which 29 (6%) opted for low dose, 2 (<1%) medium dose, and none for high dose HCQ while 455 (93.6%) were in the control arm. Of the 164 participants who underwent RT-PCR, 96 (58.2%) tested positive. Out of these 96 positive cases, the majority of them (79 of 96 [82.3%]) were ambulatory and were managed conservatively at home. Only 17.7% (17 of 96) participants, all of them from the control group, required hospitalization with the mild-moderate disease. None of the participants had severe disease, COVID-related complications, ICU stay, or death. The difference in the outcome assessed amongst the various arms was statistically insignificant (p value >0.05). Conclusion This single-center study demonstrated that HCQ prophylaxis in healthcare workers does not cause a significant reduction in COVID-19 as well as mitigating its severity in those infected. At present, most of the trials have not shown any benefit. The debate continues to rage, should HCQ prophylaxis be given to healthcare workers for chemoprophylaxis?

9.
Bhatnagar, Tarun, Chaudhuri, Sirshendu, Ponnaiah, Manickam, Yadav, Pragya, Sabarinathan, R.; Sahay, Rima, Ahmed, Faheem, Aswathy, S.; Bhardwaj, Pankaj, Bilimale, Anil, Muthusamy, Santhosh Kumar, Logaraj, M.; Narlawar, Uday, Palanivel, C.; Patel, Prakash, Rai, Sanjay, Saxena, Vartika, Singh, Arvind, Thangaraj, Jeromie Wesley Vivian, Agarwal, Ashwini, Alvi, Yasir, Amoghashree, Ashok, P.; Babu, Dinesh, Bahurupi, Yogesh, Bhalavi, Sangita, Behera, Priyamadhaba, Biswas, Priyanka Pandit, Charan, Jaykaran, Chauhan, Nishant Kumar, Chetak, K. B.; Dar, Lalit, Das, Ayan, Deepashree, R.; Dhar, Minakshi, Dhodapkar, Rahul, Dipu, T. S.; Dudeja, Mridu, Dudhmal, Manisha, Gadepalli, Ravisekhar, Garg, Mahendra Kumar, Gayathri, A. V.; Goel, Akhil Dhanesh, Gowdappa, Basavana, Guleria, Randeep, Gupta, Manoj Kumar, Islam, Farzana, Jain, Mannu, Jain, Vineet, Jawahar, Lanord Stanley, Joshi, Rajendra, Kant, Shashi, Kar, Sitanshu Sekhar, Kalita, Deepjyoti, Khapre, Meenakshi, Khichar, Satyendra, Kombade, Sarika Prabhakar, Kohli, Sunil, Kumar, Abhinendra, Kumar, Anil, Kumar, Deepak, Kulirankal, Kiran, Leela, K. V.; Majumdar, Triparna, Mishra, Baijayantimala, Misra, Puneet, Misra, Sanjeev, Mohapatra, Prasanta Raghab, Murthy, Narayana, Nyayanit, Dimpal, Patel, Manish, Pathania, Monika, Patil, Savita, Patro, Binod Kumar, Jalandra, Ramniwas, Rathod, Pragati, Shah, Naimesh, Shete, Anita, Shukla, Deepak, Shwethashree, M.; Sinha, Smita, Surana, Ashish, Trikha, Anjan, Tejashree, A.; Venkateshan, Mahalingam, Vijaykrishnan, G.; Wadhava, Sarita, Wig, Naveet, Gupta, Nivedita, Abraham, Priya, Murhekar, Manoj.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-294258

ABSTRACT

Background: India introduced BBV152/Covaxin and AZD1222/Covishield vaccines from January 2021. We estimated effectiveness of these vaccines against severe Coronavirus disease 2019 (COVID-19) among individuals aged >=45 years.<br><br>Methods: We did a multi-centric, hospital-based, case–control study between May and July 2021. Cases were severe COVID-19 patients and controls were COVID-19 negative individuals from 11 hospitals. Vaccine effectiveness (VE) was estimated for full (2 doses ≥14days) and partial (1 dose ≥21 days) vaccination;duration between two vaccine doses and against the Delta variant. We used a random effects logistic regression model to calculate adjusted odds ratios (aOR) with 95% CI after adjusting for relevant known confounders.<br><br>Findings: We enrolled 1,143 cases and 2,541 controls. The VE of full vaccination was 80% (95% CI: 73%-86%) with AZD1222/Covishield and 69% (95% CI: 54%-79%) with BBV152/Covaxin. The VE was highest for a gap of 6-8 weeks between two doses of AZD1222/Covishield (92%, 95% CI: 82%-96%) and BBV152/Covaxin (92%, 95% CI: 26%-99%). The VE estimates were similar against the Delta strain and sub-lineages.<br><br>Interpretation: BBV152/Covaxin and AZD1222/Covishield were effective against severe COVID-19 among the Indian population during the period of dominance of highly transmissible Delta variant in second wave of pandemic. An escalation of two-dose coverage with COVID-19 vaccines is critical to control the pandemic in the country.<br><br>Funding Information: Indian Council of Medical Research<br><br>Declaration of Interests: None to declare. <br><br>Ethics Approval Statement: We obtained written informed consent from all the participants or their legally authorized representatives. Study procedures were approved by the Institutional Human Ethics Committees of all participating institutions.<br><br>

10.
J Family Med Prim Care ; 10(6): 2400-2404, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1328187

ABSTRACT

AIMS: The indigenously developed Indian Council of Medical Research (ICMR)-NIV COVID Kavach IgG enzyme linked immunosorbent assay (ELISA) has been recommended for seroprevalence among vulnerable populations in India, which provided essential services throughout the lockdown. The staff working in the High Court was one such group. We compared anti-SARS-CoV-2 IgG seropositivity among the staff of Jodhpur and Jaipur High Courts, Rajasthan, India. METHODS: Asymptomatic judiciary staff of Jodhpur and Jaipur benches of High Courts were enrolled after informed written consent. A questionnaire was filled and 3-5 ml venous blood was collected from participants. The ICMR-NIV COVID Kavach IgG ELISA and EUROIMMUN IgG ELISA were used for detection of Anti-SARS-CoV-2 IgG antibodies. RESULTS: A total of 63 samples (41 from Jodhpur and 22 from Jaipur) were collected between 28th July to 4th August 2020. The overall anti-SARS-CoV-2 IgG seroprevalence was found to be 6.35%. Seropositivity was higher among the staff from Jaipur (13.64%) as compared to Jodhpur (2.44%). The Kavach ELISA results were in complete agreement with EUROIMMUN ELISA. The infection control measures were deemed effective. CONCLUSION: Seroprevalence among the staff of Jodhpur High Court was found to be lower than Jaipur, reflecting higher susceptibility to COVID-19 in the former. Many offices worldwide are closed till mid 2020 but need to come up with pre-emptive policies eventually. This study may help to anticipate the possible challenges when other government/private offices start functioning. The infection control practices of one workplace may help formulate guidelines for other offices.

11.
Acta Biomed ; 92(3): e2021024, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1296329

ABSTRACT

BACKGROUND: The outbreak ofsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted inexponential rise in the number of patients getting hospitalised with corona virus disease 2019 (COVID-19). There is a paucity of data from South East Asian Region related to the predictors of clinical outcomes in these patients. This formed the basis of conducting our study. METHODS: This was an analytical cross-sectional study. Demographic, clinical, radiological and laboratory data of 125 patients was collected on admission. The study outcome was death or discharge after recovery. For univariate analysis, unpaired t-test, Chi-square and Fisher's Exact test were used. Receiver operating characteristic (ROC) curves were plotted for Sequential Organ Failure Assessment (SOFA) score and few laboratory parameters. Logistic regression was applied for multivariate analysis. RESULTS: Elderly age, ischemic heart disease and smoking were significantly associated with mortality. Elevated levels of D-dimer and lactate dehydrogenase (LDH) and reduced lymphocyte counts were the predictors of mortality. The ROCs for SOFA score curve showed a cut-off value ≥ 3.5 (sensitivity- 91.7% and specificity- 87.5%), for IL-6 the cut-off value was ≥ 37.9 (sensitivity- 96% and specificity- 78%) and for lymphocyte counts, a cut off was calculated to be less than and equal to 1.46 x 109per litre (sensitivity-75.2%and specificity- 83.3%). CONCLUSION: Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised LDH and low lymphocyte counts at baseline are associated with COVID-19 mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19 patients.


Subject(s)
COVID-19 , Adult , Aged , Cross-Sectional Studies , Humans , India/epidemiology , Prognosis , ROC Curve , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers
12.
Infect Drug Resist ; 14: 2233-2239, 2021.
Article in English | MEDLINE | ID: covidwho-1282358

ABSTRACT

PURPOSE: Jodhpur administration directed its efforts to control and mitigate COVID 19 infection by implementing and monitoring facility isolation (FI) and home isolation (HI) measures. This study is conducted with a hypothesis that there is no difference in the quality of life and cost-effectiveness of mildly symptomatic or asymptomatic patients in HI and FI. PATIENTS AND METHODS: A mixed-method study was conducted in Jodhpur in September 2020. The purposive sampling technique was used and data from 120 individuals admitted in HI and FI were collected. The information about the status and functioning of isolation facilities was collected from various sources. Multi-stakeholder interactions with 15 personnel engaged in managing isolation facilities were done. EQ-5D version (EQ-5D-5L) which consists of the EQ-5D descriptive system and the EQ visual analog scale (EQ-VAS) was used to assess health-related quality of life. RESULTS: The strength of HI strategy is demonstrated by its ability to provide psychological and social support with minimal logistic requirements but the issue of sufficient household infrastructure, adequate family and societal support for implementing this strategy is of concern. The strength of FI strategy includes its ability to provide support to patients who have issues of sufficient household infrastructure, adequate family and societal support, but this strategy poses a threat of increasing human resource constraints and financial load on the health system. The respondents from HI obtained a mean EQ-5D index score of 0.90 and a mean VAS score of 85, whereas it was 0.80 and 78.5, respectively, for FI. The cost estimated for home isolation was Rs 549 (7.43 US $) per person, whereas it was Rs 2440 (33.02 US $) for facility Isolation. CONCLUSION: Though HI seems advantageous in terms of a better quality of life and cost-saving over FI, both the strategies are context-specific having their own trade-offs.

13.
J Family Med Prim Care ; 10(5): 1818-1822, 2021 May.
Article in English | MEDLINE | ID: covidwho-1280845

ABSTRACT

The COVID-19 pandemic gave an opportunity to adopt many appropriate changes in the behavior of the people in India. The major gears of those behavior changes were the enforcement by the government, fear, motivation (self and induced), and self-experiences or realizations with time. If those changes are fitted in the Trans-Theoretical Model, Indian people have passed through the "Pre-Contemplation" to "Action" stage of behavior changes during different phases of this pandemic. Frequent hand hygiene, maintaining physical distancing, use of face mask, cough etiquettes, avoid greetings through physical contacts, fear in spitting and urination at public places, refrain from gatherings and avoiding outside food are some of the examples of those appropriate behaviors which were enforced or learnt during the COVID pandemic. The continuous lockdown made people understand the difference between "want" and "need," the importance of local production, and the significance of social media and technology in routine life. The work-from-home strategy gave a chance to appreciate the work--life balance in a more applied way. The first-ever lifetime experience of unbelievable rejuvenating nature because of lack of human play taught people to appreciate nature. Although the current focus is on responding to the pandemic and on coping with its immediate effects, yet this is the time when there is an urgent need to create an enabling environment to support and sustain these COVID-19 appropriate behaviors (maintenance stage) to reap the maximum benefits out of them. Sustaining these appropriate behaviors is also important considering the bimodal distribution of the COVID-19 and possibility of advent of the second wave of COVID-19 in near future.

14.
J Infect Dev Ctries ; 15(5): 618-624, 2021 05 31.
Article in English | MEDLINE | ID: covidwho-1262625

ABSTRACT

INTRODUCTION: This study was planned to assess the trends of epidemiological indicators and demographic determinants related to the COVID-19 in India. METHODOLOGY: This was a descriptive analysis of the COVID-19 cases and their outcomes between 1st March to 31st May 2020 in India. Unpaired t-test and ANOVA were used to determine the statistical differences. Linear regression models were prepared to estimate the effect of testing on the fatalities. The Infection Fatality Rate (IFR)/Case Fatality Rate (CFR), doubling time, and Basic Reproduction Number (R0) per week were calculated. RESULTS: Two-thirds of the cases were between 21-50 years of age, while three-fourth of deaths were among people above 50-years of age. The mean age of people infected with COVID-19 was declining throughout the study period. The mean age of infected males and females was significantly different. The male-female ratio of both infection and deaths due to COVID-19 was near about 2:1. IFR/CFR was 3.31 (95% CI = 3.13-3.50) in April, which reduced to 2.84 (95% CI = 2.77-2.92) in May. An incremental trend was observed in the recovery rates (9.42% to 48.18%), tests conducted / million population (12 / million to 2708 / million) and doubling time (3.59 to 17.71 days). The number of tests was significantly influencing the fatalities (ß = 0.016, 95% CI = 0.012-0.020). The overall R0 was found to be 1.72. CONCLUSIONS: Public health interventions were likely effective in containing the spread of COVID-19. There is a need to further improve the testing capacity. The high-risk category of individuals being prioritized for hospital admission should be redefined to include individuals older than 50 years.


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/mortality , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Analysis of Variance , COVID-19/diagnosis , Child , Female , Humans , India/epidemiology , Male , Middle Aged , Pandemics , Risk Factors , SARS-CoV-2 , Sex Distribution , Young Adult
15.
Epidemiol Infect ; 149: e132, 2021 05 20.
Article in English | MEDLINE | ID: covidwho-1236044

ABSTRACT

The coronavirus disease 2019 (COVID-19) vaccine was launched in India on 16 January 2021, prioritising health care workers which included medical students. We aimed to assess vaccine hesitancy and factors related to it among medical students in India. An online questionnaire was filled by 1068 medical students across 22 states and union territories of India from 2 February to 7 March 2021. Vaccine hesitancy was found among 10.6%. Concern regarding vaccine safety and efficacy, lack of awareness regarding their eligibility for vaccination and lack of trust in government agencies predicted COVID-19 vaccine hesitancy among medical students. On the other hand, the presence of risk perception regarding themselves being affected with COVID-19 reduced vaccine hesitancy as well as hesitancy in participating in COVID-19 vaccine trials. Vaccine-hesitant students were more likely to derive information from social media and less likely from teachers at their medical colleges. Choosing between the two available vaccines (Covishield and Covaxin) was considered important by medical students both for themselves and for their future patients. Covishield was preferred to Covaxin by students. Majority of those willing to take the COVID-19 vaccine felt that it was important for them to resume their clinical posting, face-to-face classes and get their personal life back on track. Around three-fourths medical students viewed that COVID-19 vaccine should be made mandatory for both health care workers and international travellers. Prior adult vaccination did not have an effect on COVID-19 vaccine hesitancy. Targeted awareness campaigns, regulatory oversight of vaccine trials and public release of safety and efficacy data and trust building activities could further reduce COVID-19 vaccine hesitancy among medical students.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Decision Making , Students, Medical/psychology , COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Humans , India/epidemiology , Risk Factors , SARS-CoV-2/immunology , Surveys and Questionnaires , Vaccination/psychology , Vaccination/statistics & numerical data
16.
Trans R Soc Trop Med Hyg ; 115(7): 820-831, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1029982

ABSTRACT

BACKGROUND: Understanding risk factors of symptomatic coronavirus disease 2019 (COVID-19) vis-à-vis asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, severe disease and death is important. METHODS: An unmatched case-control study was conducted through telephonic interviews among individuals who tested positive for SARS-CoV-2 in Jodhpur, India from 23 March to 20 July 2020. Contact history, comorbidities and tobacco and alcohol use were elicited using standard tools. RESULTS: Among 911 SARS-CoV-2-infected individuals, 47.5% were symptomatic, 14.1% had severe COVID-19 and 41 (4.5%) died. Older age, working outside the home, cardiac and respiratory comorbidity and alcohol use were found to increase the risk of symptomatic disease as compared with asymptomatic infection. Current tobacco smoking (odds ratio [OR] 0.46 [95% confidence interval {CI} 0.26 to 0.78]) but not smokeless tobacco use (OR 0.81 [95% CI 0.55 to 1.19]) appeared to reduce the risk of symptomatic disease. Age ≥60 y and renal comorbidity were significantly associated with severe COVID-19. Age ≥60 y and respiratory and cardiac comorbidity were found to predispose to mortality. CONCLUSIONS: The apparent reduced risk of symptomatic COVID-19 among tobacco smokers could be due to residual confounding owing to unknown factors, while acknowledging the limitation of recall bias. Cross-protection afforded by frequent upper respiratory tract infection among tobacco smokers could explain why a similar association was not found for smokeless tobacco use, thereby being more plausible than the 'nicotinic hypothesis'. Those with comorbidities and age ≥60 y should be prioritized for hospital admission.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Case-Control Studies , Humans , India/epidemiology , Risk Factors , Tobacco
17.
JMIR Public Health Surveill ; 6(4): e22678, 2020 10 15.
Article in English | MEDLINE | ID: covidwho-862994

ABSTRACT

BACKGROUND: On March 9, 2020, the first COVID-19 case was reported in Jodhpur, Rajasthan, in the northwestern part of India. Understanding the epidemiology of COVID-19 at a local level is becoming increasingly important to guide measures to control the pandemic. OBJECTIVE: The aim of this study was to estimate the serial interval and basic reproduction number (R0) to understand the transmission dynamics of the COVID-19 outbreak at a district level. We used standard mathematical modeling approaches to assess the utility of these factors in determining the effectiveness of COVID-19 responses and projecting the size of the epidemic. METHODS: Contact tracing of individuals infected with SARS-CoV-2 was performed to obtain the serial intervals. The median and 95th percentile values of the SARS-CoV-2 serial interval were obtained from the best fits with the weibull, log-normal, log-logistic, gamma, and generalized gamma distributions. Aggregate and instantaneous R0 values were derived with different methods using the EarlyR and EpiEstim packages in R software. RESULTS: The median and 95th percentile values of the serial interval were 5.23 days (95% CI 4.72-5.79) and 13.20 days (95% CI 10.90-18.18), respectively. R0 during the first 30 days of the outbreak was 1.62 (95% CI 1.07-2.17), which subsequently decreased to 1.15 (95% CI 1.09-1.21). The peak instantaneous R0 values obtained using a Poisson process developed by Jombert et al were 6.53 (95% CI 2.12-13.38) and 3.43 (95% CI 1.71-5.74) for sliding time windows of 7 and 14 days, respectively. The peak R0 values obtained using the method by Wallinga and Teunis were 2.96 (95% CI 2.52-3.36) and 2.92 (95% CI 2.65-3.22) for sliding time windows of 7 and 14 days, respectively. R0 values of 1.21 (95% CI 1.09-1.34) and 1.12 (95% CI 1.03-1.21) for the 7- and 14-day sliding time windows, respectively, were obtained on July 6, 2020, using method by Jombert et al. Using the method by Wallinga and Teunis, values of 0.32 (95% CI 0.27-0.36) and 0.61 (95% CI 0.58-0.63) were obtained for the 7- and 14-day sliding time windows, respectively. The projection of cases over the next month was 2131 (95% CI 1799-2462). Reductions of transmission by 25% and 50% corresponding to reasonable and aggressive control measures could lead to 58.7% and 84.0% reductions in epidemic size, respectively. CONCLUSIONS: The projected transmission reductions indicate that strengthening control measures could lead to proportionate reductions of the size of the COVID-19 epidemic. Time-dependent instantaneous R0 estimation based on the process by Jombart et al was found to be better suited for guiding COVID-19 response at the district level than overall R0 or instantaneous R0 estimation by the Wallinga and Teunis method. A data-driven approach at the local level is proposed to be useful in guiding public health strategy and surge capacity planning.


Subject(s)
Coronavirus Infections/transmission , Epidemics , Pneumonia, Viral/transmission , COVID-19 , Coronavirus Infections/epidemiology , Humans , India/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Prospective Studies
18.
J Biomol Struct Dyn ; 39(7): 2617-2627, 2021 04.
Article in English | MEDLINE | ID: covidwho-27258

ABSTRACT

Recent outbreak of Coronavirus disease (COVID-19) pandemic around the world is associated with 'severe acute respiratory syndrome' (SARS-CoV2) in humans. SARS-CoV2 is an enveloped virus and E proteins present in them are reported to form ion channels, which is mainly associated with pathogenesis. Thus, there is always a quest to inhibit these ion channels, which in turn may help in controlling diseases caused by SARS-CoV2 in humans. Considering this, in the present study, authors employed computational approaches for studying the structure as well as function of the human 'SARS-CoV2 E' protein as well as its interaction with various phytochemicals. Result obtained revealed that α-helix and loops present in this protein experience random movement under optimal condition, which in turn modulate ion channel activity; thereby aiding the pathogenesis caused via SARS-CoV2 in human and other vertebrates. However, after binding with Belachinal, Macaflavanone E, and Vibsanol B, the random motion of the human 'SARS-CoV2 E' protein gets reduced, this, in turn, inhibits the function of the 'SARS-CoV2 E' protein. It is pertinent to note that two amino acids, namely VAL25 and PHE26, play a key role while interacting with these three phytochemicals. As these three phytochemicals, namely, Belachinal, Macaflavanone E & Vibsanol B, have passed the ADMET (Absorption, Distribution, Metabolism, Excretion and Toxicity) property as well as 'Lipinski's Rule of 5s', they may be utilized as drugs in controlling disease caused via SARS-COV2, after further investigation.Communicated by Ramaswamy H. Sarma.


Subject(s)
COVID-19 , Coronavirus Envelope Proteins , Animals , Humans , Ion Channels , RNA, Viral , SARS-CoV-2
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