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1.
Non-conventional in English | [Unspecified Source], Grey literature | ID: grc-750570
2.
Drug Discov Ther ; 15(4): 171-179, 2021 Sep 22.
Article in English | MEDLINE | ID: covidwho-1449126

ABSTRACT

In the face of the ongoing pandemic, the primary care physicians in India are dealing not only with an increased number of patients but are also facing difficulties in the management of complex critically ill patients. To guide the management plans of primary care physicians, several guidelines have been published by the central and state health bodies. In such a situation, an updated and unifying state, national and international guidelines based on critical analysis and appraisal of evolving data is the need of the hour. In this review, we critically analysed the current existing guidelines that have been formulated within India in light of recent evidence.


Subject(s)
COVID-19/drug therapy , COVID-19/classification , COVID-19/mortality , Clinical Trials as Topic , Disease Management , Humans , India , Practice Guidelines as Topic , Severity of Illness Index , Survival Analysis , Treatment Outcome
3.
J Clin Transl Hepatol ; 9(3): 436-446, 2021 Jun 28.
Article in English | MEDLINE | ID: covidwho-1296236

ABSTRACT

Corona virus disease (COVID)-19 is caused by the novel severe acute respiratory syndrome coronavirus-2 (commonly referred to as SARS-CoV-2). In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. Though the target organ for the virus is primarily the lungs, with the recent understanding of the pathobiology of this disease and the immune dysregulation associated with it, it is now clear that COVID-19 affects multiple organ systems. Several drugs and therapies have been tried or repurposed to combat the wrath posed by this disease. On October 22, 2020, the USA Food and Drug Administration approved remdesivir for use in adults and pediatric patients (12 years of age and older). Several of the drugs being tried against COVID-19 have hepatotoxicity as their potential side effect. This review aims to provide the latest insights on various drugs being used in the treatment of COVID-19 and their effects on the liver.

4.
Indian J Psychiatry ; 63(3): 294-296, 2021.
Article in English | MEDLINE | ID: covidwho-1296029

ABSTRACT

The COVID-19 pandemic in India has been reported to be associated with numerous major mental health issues globally; the most common is - stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear. This case series presents three different cases, wherein the COVID-19 pandemic resulted not only in deterioration of previous symptoms experienced by patients (obsessive-compulsive disorder and depression) but also led to the development of new symptoms specifically related to coronavirus (Psychosis). Authors highlight the need to develop preventive strategies for vulnerable groups and try to understand the etiopathogenesis of illnesses so developing, in order to identify support systems and management strategies during the pandemicrelated crisis.

5.
Diagnostics (Basel) ; 11(6)2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1270018

ABSTRACT

Real-time RT-PCR is considered the gold standard confirmatory test for coronavirus disease 2019 (COVID-19). However, many scientists disagree, and it is essential to understand that several factors and variables can cause a false-negative test. In this context, cycle threshold (Ct) values are being utilized to diagnose or predict SARS-CoV-2 infection. This practice has a significant clinical utility as Ct values can be correlated with the viral load. In addition, Ct values have a strong correlation with multiple haematological and biochemical markers. However, it is essential to consider that Ct values might be affected by pre-analytic, analytic, and post-analytical variables such as collection technique, specimen type, sampling time, viral kinetics, transport and storage conditions, nucleic acid extraction, viral RNA load, primer designing, real-time PCR efficiency, and Ct value determination method. Therefore, understanding the interpretation of Ct values and other influential factors could play a crucial role in interpreting viral load and disease severity. In several clinical studies consisting of small or large sample sizes, several discrepancies exist regarding a significant positive correlation between the Ct value and disease severity in COVID-19. In this context, a revised review of the literature has been conducted to fill the knowledge gaps regarding the correlations between Ct values and severity/fatality rates of patients with COVID-19. Various databases such as PubMed, Science Direct, Medline, Scopus, and Google Scholar were searched up to April 2021 by using keywords including "RT-PCR or viral load", "SARS-CoV-2 and RT-PCR", "Ct value and viral load", "Ct value or COVID-19". Research articles were extracted and selected independently by the authors and included in the present review based on their relevance to the study. The current narrative review explores the correlation of Ct values with mortality, disease progression, severity, and infectivity. We also discuss the factors that can affect these values, such as collection technique, type of swab, sampling method, etc.

7.
Medicine (Baltimore) ; 100(20): e25719, 2021 May 21.
Article in English | MEDLINE | ID: covidwho-1236278

ABSTRACT

BACKGROUND: Corticosteroid treatment is an effective and common therapeutic strategy for various inflammatory lung pathologies and may be an effective treatment for coronavirus disease 2019 (COVID-19). The purpose of this systematic review and meta-analysis of current literature was to investigate the clinical outcomes associated with corticosteroid treatment of COVID-19. METHODS: We systematically searched PubMed, medRxiv, Web of Science, and Scopus databases through March 10, 2021 to identify randomized controlled trials (RCTs) that evaluated the effects of corticosteroid therapies for COVID-19 treatment. Outcomes of interest were mortality, need for mechanical ventilation, serious adverse events (SAEs), and superinfection. RESULTS: A total of 7737 patients from 8 RCTs were included in the quantitative meta-analysis, of which 2795 (36.1%) patients received corticosteroids plus standard of care (SOC) while 4942 (63.9%) patients received placebo and/or SOC alone. The odds of mortality were significantly lower in patients that received corticosteroids as compared to SOC (odds ratio [OR] = 0.85 [95% CI: 0.76; 0.95], P = .003). Corticosteroid treatment reduced the odds of a need for mechanical ventilation as compared to SOC (OR = 0.76 [95% CI: 0.59; 0.97], P = .030). There was no significant difference between the corticosteroid and SOC groups with regards to SAEs and superinfections. CONCLUSION: Corticosteroid treatment can reduce the odds for mortality and the need for mechanical ventilation in severe COVID-19 patients.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , COVID-19/drug therapy , COVID-19/mortality , Humans , Odds Ratio , Randomized Controlled Trials as Topic , Respiration, Artificial/statistics & numerical data , SARS-CoV-2 , Treatment Outcome
8.
Indian J Crit Care Med ; 25(5): 535-539, 2021 May.
Article in English | MEDLINE | ID: covidwho-1229406

ABSTRACT

Introduction: Coronavirus disease-2019 (COVID-19) pandemic has overloaded the healthcare system beyond its functional capacity. Late referral to higher levels of care may be one of the factors associated with higher mortality. Therefore, we aimed to find simple demographic and laboratory parameters which predict the requirement of admission to a critical care unit. Materials and methods: A case-control study was undertaken in adult age population >18 years, admitted in a dedicated COVID hospital in South India. A total of 50 patients with severe disease (cases) were compared with 143 mild or asymptomatic cases (controls). Those demographic and laboratory parameters that were found to be significant on univariate analysis were used for multiple logistic regression analysis. Results: Univariate analysis of demographic and laboratory data showed higher age, male sex, presence of diabetes mellitus, higher values of C-reactive protein, ferritin, D-dimer, neutrophil-lymphocyte ratio (NLR), and lactate dehydrogenase to be significantly associated with cases. Multivariate logistic regression analysis of these significant variables showed NLR and ferritin to be the independent predictors of the requirement of admission to a critical care unit. The receiver-operating characteristic curve showed an NLR value of 5.2 and a ferritin value of 462 µg/L that were able to predict the requirement of admission in critical care units. Conclusion: High ferritin and NLR were independent predictors of the requirement of admission in critical care units. NLR is a simple tool that can be used in resource-limited settings for triage and early referral to higher levels of care. How to cite this article: Maddani SS, Gupta N, Umakanth S, Joylin S, Saravu K. Neutrophil-Lymphocyte Ratio in Patients with COVID-19 as a Simple Tool to Predict Requirement of Admission to a Critical Care Unit. Indian J Crit Care Med 2021;25(5):535-539.

9.
Journal of Industrial Integration and Management ; 6(2), 2021.
Article in English | ProQuest Central | ID: covidwho-1226775

ABSTRACT

The coronavirus (COVID-19) pandemic is one of the biggest challenges in the field of healthcare. Nanomedicine is a developing area that has the potential to treat various diseases and control infections. Now, its applications are open for the treatment of COVID-19. We have studied relevant papers through Scopus, Google Scholar, Science Direct and ResearchGate on nanomedicine in context of COVID-19. This paper provides detailed information about nanomedicine in the context of healthcare. It further identifies the primary challenges faced in the current situation. This study provides details about the advancements in the area of nanomedicine in healthcare for fighting the COVID-19 pandemic. Finally, we have identified and discussed various significant applications of nanomedicine in solving challenges thrown by the COVID-19 pandemic. Researchers can work on developing applications of nanoparticles with the size of the novel Coronavirus. Nanomedicine is helpful to repair the cells of an infected patient the help of repair proteins. It also plays a vital role in testing medicine and helps many clinical trials get approval from healthcare agencies. In the future, nanomedicine will be helpful for fighting against this pandemic and creating advancements in healthcare.

10.
Journal of Indian Association for Child & Adolescent Mental Health ; 17(2):219-229, 2021.
Article in English | Academic Search Complete | ID: covidwho-1178700

ABSTRACT

Digitalization has changed the way children learn and grow in the contemporary society. Also, COVID-19 has ushered in a 'new normal' as a means of prevention and safety, necessitating children and adolescents to stay at home for educational and recreational purposes. This 'Position Statement' addresses the issue of conceiving a balance with respect to exposure to digital media and the 'new normal' in mind. Individualized evidence-based family plans remain the cornerstone of ensuring effective management. [ABSTRACT FROM AUTHOR] Copyright of Journal of Indian Association for Child & Adolescent Mental Health is the property of Indian Association for Child & Adolescent Mental Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

11.
Drug Discov Ther ; 15(1): 1-8, 2021 Mar 10.
Article in English | MEDLINE | ID: covidwho-1110629

ABSTRACT

Despite the high number of coronavirus disease-19 (COVID-19) cases from India, there are few reports from India describing the clinical epidemiology of COVID-19. This study aimed to describe the clinical/epidemiological characteristics and outcomes of asymptomatic vs. symptomatic COVID-19 patients. This was a retrospective chart review of all admitted patients with COVID-19 above 18 years with a history of travel within one month of the admission. The patients were categorized into asymptomatic and symptomatic. The symptomatic patients were further classified into mild, moderate and severe. The demographic profile, risk factors, clinical features, laboratory parameters, treatment details and outcome of all patients were recorded. The clinical and laboratory parameters were compared between symptomatic patients and asymptomatic patients. Of the 127 recruited patients, 75 were asymptomatic. Of the 52 symptomatic patients, 41 patients were classified as a mild illness. The mean age of the patients was 44.5 ± 15 years. A total of 73 patients had one or more risk factors. The male patients were more commonly found to be symptomatic compared to female patients. Neutrophil-lymphocyte ratio, C-reactive protein and lactate dehydrogenase were significantly elevated in symptomatic patients. A total of five individuals required supplemental oxygen therapy, and one of them required mechanical ventilation. All the patients had favourable outcomes. Asymptomatic and mild illness form a significant proportion of positive patients and have excellent outcomes without therapeutic interventions.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/epidemiology , COVID-19/therapy , Communicable Diseases, Imported/epidemiology , Communicable Diseases, Imported/therapy , Adult , C-Reactive Protein/metabolism , COVID-19/blood , Communicable Diseases, Imported/blood , Communicable Diseases, Imported/virology , Female , Hospitalization/statistics & numerical data , Humans , India/epidemiology , L-Lactate Dehydrogenase/blood , Lymphocyte Count , Male , Middle Aged , Neutrophils/metabolism , Oxygen Inhalation Therapy , Prognosis , Respiration, Artificial , Retrospective Studies , Travel-Related Illness , Young Adult
12.
Internet of Things ; : 100377, 2021.
Article in English | ScienceDirect | ID: covidwho-1101309

ABSTRACT

The ongoing pandemic of COVID-19 has shown the limitations of our current medical institutions. There is a need for research in automated diagnosis for speeding up the process while maintaining accuracy and reducing the computational requirements. This work proposes an automated diagnosis of COVID-19 infection from CT scans of the patients using deep learning technique. The proposed model, ReCOV-101, uses full chest CT scans to detect varying degrees of COVID-19 infection. To improve the detection accuracy, the CT-scans were preprocessed by employing segmentation and interpolation. The proposed scheme is based on the residual network that takes advantage of skip connection, allowing the model to go deeper. The model was trained on a single enterprise-level GPU. It can easily be provided on a network’s edge, reducing communication with the cloud, often required for larger neural networks. This work aims to demonstrate a less hardware-intensive approach for COVID-19 detection with excellent performance that can be combined with medical equipment and help ease the examination procedure. With the proposed model, an accuracy of 94.9% was achieved.

13.
J Clin Apher ; 36(3): 470-482, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1064370

ABSTRACT

The purpose of this systematic review and meta-analysis was to examine clinical outcomes associated with convalescent plasma therapy in COVID-19 patients. We performed a literature search on PubMed, medRxiv, Web of Science, and Scopus to identify studies published up to December 10th, 2020 that examined the efficacy of convalescent plasma treatment for COVID-19. The primary endpoints were mortality, clinical improvement, and hospital length of stay. We screened 859 studies that met the search criteria, performed full-text reviews of 56 articles, and identified 15 articles that fulfilled inclusion criteria for meta-analysis. The odds of mortality were significantly lower in the convalescent plasma group compared to the control group (OR = 0.59 [95% CI = 0.44; 0.78], P < .001), although results from two key randomized controlled trials did not support the mortality benefit. The odds of clinical improvement were significantly higher in the convalescent plasma group compared to the control group (OR = 2.02 [95% CI = 1.54; 2.65], P < .001). There was no difference in hospital length of stay between the convalescent plasma group and the control group (MD = -0.49 days [95% CI = -3.11; 2.12], P = .713). In all, these data indicate that a mortality benefit with convalescent plasma is unclear, although there remain benefits with convalescent plasma therapy for COVID-19.


Subject(s)
COVID-19/therapy , COVID-19/mortality , Humans , Immunization, Passive/methods , Length of Stay , Plasma , Quality Assurance, Health Care , Risk , Treatment Outcome
14.
Clinical Epidemiology and Global Health ; : 100703, 2021.
Article in English | ScienceDirect | ID: covidwho-1062269

ABSTRACT

Objective To assess the effect of nationwide lockdown and its associated repercussion on the self-care management of Type 2 Diabetes Mellitus (T2D). Methods Response from 1406 diabetic patients was collected against a 16 item questionnaire. Data was collected on diabetic self-management practices, behavioral aspects, psychological implications, drug availability and awareness towards the pandemic. Emphasis was on choices made by patients in the absence of guidance from physicians and impact of stress and blood sugar levels on other variables. The data was analyzed using Chi-square tests at P < 0.05. Results About 27% were under stress, 14.7% and 30.8% reported a change in dietary and sleep pattern. About 83% could not consult a doctor and as a result 13% stopped taking medications. Patients with stress slept less, observed a change in dietary patterns and had uncontrolled blood sugar levels (P = 0.0001). On the contrary those without stress spent time with family and were occupied with a hobby (P = 0.0001). Those with controlled blood sugar levels exercised more and had normal sleep patterns. Fluctuation with doses was observed among those with uncontrolled blood sugar levels in the absence of physicians consultation (P = 0.001). Conclusion Even though majority of study participants were not able to consult their physicians yet nearly 2/3rd were practicing Self-Monitoring of Blood Glucose (SMBG), more than half were exercising regularly, more than 2/3rds continued taking their medications and majority were following appropriate diet pattern. Stress management is a key factor during these times due to its association with other variables.

15.
Ann Med Surg (Lond) ; 62: 43-48, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1009287

ABSTRACT

Purpose: To perform a systematic review and meta-analysis of randomized controlled trials that examined remdesivir treatment for COVID-19. Materials and methods: A systematic literature search was performed using Pubmed, Embase, and ClinicalTrials.gov to identify studies published up to October 25, 2020 that examined COVID-19 treatment with remdesivir. A total of 3 randomized controlled trials that consisted of 1691 patients were included in the meta-analysis. Results: The odds for mechanical ventilation (MV) or extracorporeal membrane oxygenation (ECMO) following treatment was significantly lower in the remdesivir group compared to the control group (OR = 0.48 [95% CI: 0.34; 0.69], p < 0.001). The odds of early (at day 14/15; OR = 1.42 [95% CI: 1.16; 1.74], p < 0.001) and late (at day 28/29; OR = 1.44 [95% CI: 1.16; 1.79], p = 0.001) hospital discharge were significantly higher in the remdesivir group compared to the control group. There was no difference in the odds for mortality in patients treated with remdesivir (OR = 0.77 [95% CI: 0.56; 1.06], p = 0.108). Conclusions: Remdesivir attenuates disease progression, leading to lower odds of MV/ECMO and greater odds of hospital discharge for COVID-19 patients. However, remdesivir does not affect odds of mortality.

16.
Drug Discov Ther ; 15(1): 42-43, 2021 Mar 10.
Article in English | MEDLINE | ID: covidwho-1005610

ABSTRACT

Most studies have described worse outcomes with coronavirus disease 2019 (COVID-19) in patients with human immunodeficiency virus (HIV). This has been attributed to COVID-19 associated lymphopenia (resulting in lower CD4 count), higher prevalence of comorbidities (established risk factors for severity in COVID-19) and pre-existing lung damage. The problem has been further aggravated by the lack in the access to routine care in HIV patients due to diversion of resources. In this article, we discuss the impact of COVID-19 on patients with HIV infection.


Subject(s)
COVID-19/epidemiology , Coinfection/immunology , HIV Infections/epidemiology , CD4 Lymphocyte Count , COVID-19/immunology , HIV Infections/immunology , Health Services Accessibility , Humans , Prognosis , Socioeconomic Factors
17.
Drug Discov Ther ; 14(6): 282-286, 2021 Jan 23.
Article in English | MEDLINE | ID: covidwho-1005609

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a febrile respiratory illness that has spread rampantly across the globe and has emerged as one of the biggest pandemics of all time. Besides the direct effects of COVID-19 on mortality, collateral impacts on diagnosis and management of acute febrile illnesses (AFI) is a matter of great concern. The overlap in presentation, shunting of available resources and infection control precautions in patients with suspected COVID-19 result in a significant delay in diagnoses and management of AFI. This review highlights the challenges in the management of acute febrile illness during COVID pandemic and possible solutions for the same.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , Fever/diagnosis , Antiparasitic Agents/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , COVID-19/epidemiology , Diagnosis, Differential , Fever/drug therapy , Fever/epidemiology , Humans , Predictive Value of Tests , Prognosis , Risk Assessment , Risk Factors
18.
J Trop Pediatr ; 67(1)2021 01 29.
Article in English | MEDLINE | ID: covidwho-960586

ABSTRACT

The susceptibility of children to coronavirus disease-19 (COVID-19) and transmission of COVID-19 from children to others is a relatively unexplored area. The aim of this study was to understand the transmission dynamics of Severe Acute Respiratory Syndrome Coronavirus 2 in children. This was a retrospective observational study where a total of 19 paediatric index cases (including a set of twins) with COVID-19 and 42 primary contacts (adults-36, paediatric-6) from the immediate family members were included. All the index cases and four of the five positive contacts were asymptomatic. Despite adults staying with positive children in the same vehicle, same room in the quarantine centre and the same ward, only four of the parents became positive.


Subject(s)
Asymptomatic Infections , COVID-19/transmission , Adult , Carrier State , Child , Family , Humans , India/epidemiology , Retrospective Studies
19.
Expert Rev Anti Infect Ther ; 19(6): 679-687, 2021 06.
Article in English | MEDLINE | ID: covidwho-927085

ABSTRACT

Objectives: To systematically review the clinical literature reporting the use of Lopinavir/ritonavir (LPV/r) for the treatment of patients with Cornonavirus disease 19 (COVID-19) to assess the efficacy of LPV/r for the treatment of COVID-19.Methods: The authors systematically searched PubMed and MedRxiv databases for studies describing treatment of COVID-19 patients using LPV/r compared to other therapies. Articles were excluded if they were case reports, opinion editorials, preclinical studies, single-armed studies, not written in English, not relevant to the topic, or published before May 2020. The included outcomes were viral clearance as measured by reverse-transcription polymerase chain reaction (RT-PCR) negativity and/or improvement on chest computed tomography (CT), mortality, and adverse events.Results: Among 858 total studies, 16 studies met the inclusion criteria and were included in the qualitative review. These studies consisted of 3 randomized control trials, 3 open-label trials, and 10 observational studies. Most of these studies did not report positive clinical outcomes with LPV/r treatment.Conclusion: The systematic review revealed insufficient evidence of effectiveness and clinical benefit of LPV/r in the treatment of COVID-19 patients. Specifically, LPV/r does not appear to improve clinical outcome, mortality, time to RT-PCR negativity, or chest CT clearance in patients with COVID-19.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Lopinavir/therapeutic use , Ritonavir/therapeutic use , SARS-CoV-2/drug effects , Antiviral Agents/administration & dosage , Drug Combinations , Humans , Lopinavir/administration & dosage , Lopinavir/adverse effects , Ritonavir/administration & dosage , Ritonavir/adverse effects , Treatment Outcome
20.
Drug Discov Ther ; 14(4): 171-176, 2020.
Article in English | MEDLINE | ID: covidwho-745657

ABSTRACT

The healthcare sector has been overwhelmed by the global rise in the number of COVID-19 cases. The primary care physicians at the forefront of this pandemic are being provided with multiple guidelines (state, national, international). The aim of this review was to examine the existing guidelines for congruence and critically analyze them in light of current evidence. A discordance was noted between the national and state guidelines with respect to indication, duration and dosage of antivirals, steroids/immunomodulators, anticoagulation and convalescent plasma. The lack of concordance between various guidelines mandates the need for a unified national guideline that is regularly updated.


Subject(s)
Antiviral Agents/therapeutic use , Betacoronavirus/drug effects , Coronavirus Infections/therapy , Pneumonia, Viral/therapy , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/standards , Anticoagulants/therapeutic use , Antiviral Agents/adverse effects , Betacoronavirus/pathogenicity , COVID-19 , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Host Microbial Interactions , Humans , Immunization, Passive , Immunologic Factors/therapeutic use , India/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , SARS-CoV-2 , Steroids/therapeutic use
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