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1.
Applied Organometallic Chemistry ; 2022.
Article in English | Scopus | ID: covidwho-1940697

ABSTRACT

Novel Schiff base was synthesized from the condensation reaction of metformin with [4-(Diethylamino) benzaldehyde (NBM). Different metal complexes were prepared using Pd (II), Pt (II), Cu (II), and V (IV) metal ions. All complexes showed the nonelectrolytic behavior. So, the expected molecular formulas for complexes were [Pd (NBM)Cl2], [Pt (NBM)Cl2], [Cu (NBM)2Cl2] and [VO (NBM)2]. The cytotoxicity of (NBM) Schiff base and its metal complexes on human cancer cell line, MCF-7, was investigated. V (IV) and Cu (II) complexes showed potential blood glucose lowering effect higher than the commercial metformin drug. VO (II) complex has superior antioxidant activity more than the other synthesized compounds and the standard ascorbic acid. Molecular docking investigation proved the presence of interesting interactions between all synthesized compounds with the active site amino acids of EGFR tyrosine kinase (anticancer activity). The molecular docking of metal complexes has observed effective inhibition for the specific mTOR protein that is expected to aid the growth of the COVID-19 virus. © 2022 John Wiley & Sons, Ltd.

2.
Bulletin of Pharmaceutical Sciences. Assiut ; 45(1):311-325, 2022.
Article in English | EMBASE | ID: covidwho-1929000

ABSTRACT

Background: The COVID-19 pandemic is a global public health crisis that affected human beings, businesses and the economy negatively. Community pharmacies are the frontline of health care, and pharmacists are considered as the first point of care. However, the pandemic of COVID-19 has posed a great danger to the public health and pharmaceutical markets. Aim: To investigate the impact of the COVID-19 pandemic on the community pharmacies administratively and economically. Methods: An online cross-sectional survey was conducted from 1 to 30 November 2020 among pharmacy employees in independent and chain community pharmacies. The questionnaire covered the areas of changes in different pharmaceutical business functions as pharmacy administration and management, supply chain, sales and training programs. Results: A total of 1154 respondents have participated in the survey study from different Egyptian regions. The majority of responses were from independent pharmacies 916(79.4%). Most pharmacies 1119(97%) reported an increase in the demand for pharmaceutical products. During the COVID-19 outbreak, the sales of chain pharmacies were increased compared to independent pharmacies. Several community pharmacies workforce 923(80%) were shifted towards home delivery business. Most pharmacies cancelled the training programs during the COVID-19 and only a small percentage 28(2.4%) shifted to online programs. COVID-19 pandemic resulted in a negative psychological impact on the pharmacy employees with about two-third (68.1%) of participants were seeking career shifts.Conclusion: This study identified particular influences of COVID-19 on community pharmacies services from administrative and economic perspectives. The findings of this study may help decision-makers and pharmacy professionals to impart suitable preparedness for community pharmacists and handle future pandemic waves to keep business maintenance of community pharmacies and foster pharmacy employees' satisfaction.

3.
Journal of Gastroenterology and Hepatology Research ; 11(3):3725-3728, 2022.
Article in English | EMBASE | ID: covidwho-1928946

ABSTRACT

OBJECTIVES: In Morocco, in order to prepare health facilities for the upcoming influx of COVID-19 patients, it was necessary to minimize non-COVID-19 related activities, which led to a significant reduction of non-urgent procedures. The aim of the study was to describe the impact of the COVID-19 pandemic on the digestive endoscopic activity in our department by comparing it to the previous year. Study design: This was a retrospective study. METHODS: We performed a retrospective study, comparing endoscopic procedures performed (excluding emergencies) in both 2019 and 2020, especially the periods from March 20 to June 30 (lockdown period). Statistical analysis was performed by SPSS 21.0 software. RESULTS: 5018 endoscopy procedures were performed in 2019 and 2020, but only 1869 performed in 2020. For the lockdown period, a large decrease in the number of patients undergoing endoscopy was seen in 2020 compared with 2019 (179 vs 863). Gastroscopy, colonoscopy, and rectosigmoidoscopy volumes experienced a 59%, 53%, and 67% reduction, respectively. A reduction of 50% in the number of echo-endoscopy was also seen, especially during the lockdown period 11 versus 21 in 2019 (p = 0.006), whereas the number of ERCPs remained relatively unchanged, with 22 during the lockdown period versus 29 in 2019 (p < 0.001). We also compared the different endoscopy procedures performed during the post-lockdown period compared to the same period in 2019. CONCLUSION: The COVID-19 pandemic had a significant impact on endoscopy services, its staff and especially on patients following the reduction and limitation of endoscopy indications and procedures.

4.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925396

ABSTRACT

Objective: To describe a severe case of autoimmune gastrointestinal dysmotility (AGID) following SARS-CoV-2 infection responsive to intravenous immunoglobulin (IVIG). Background: Autoimmune gastrointestinal dysmotility is a limited form of dysautonomia that can be paraneoplastic or idiopathic, sometimes preceded by a viral infection. Design/Methods: We present the case of a 17-year old female with celiac disease who developed intractable nausea and early satiety after SARS-CoV-2 infection. Over ten months, she required nasogastric and nasoduodenal tube feedings and finally was advanced to total parenteral nutrition to meet her caloric needs. Her α3 nicotinic ganglionic acetylcholine and anti-striational antibodies were mildly elevated. Gastrointestinal transit scintigraphy studies showed delayed gastric emptying and slowed small bowel transit. Thermoregulatory stress test showed areas of anhidrosis consistent with autonomic sudomotor impairment. Results: Following IVIG treatment, the patient's symptoms improved and she was able to tolerate full oral diet. This was reflected by improvement of objective testing including transit studies and a repeat thermoregulatory sweat test. Conclusions: AGID should be considered as part of the differential diagnosis in patients with subacute GI dysmotility, a recent viral illness, and evidence of family or personal history of autoimmunity. SARS-CoV-2 infection may be associated with AGID. An immunotherapy trial in the appropriate clinical setting can be helpful in establishing the diagnosis and can result in meaningful recovery. This is the first report of AGID occurring after SARS-CoV-2 infection. The dramatic response to IVIG emphasizes the importance of early recognition and the reversible nature of this condition.

5.
British Journal of Haematology ; 197(SUPPL 1):180-181, 2022.
Article in English | EMBASE | ID: covidwho-1861265

ABSTRACT

Dasatinib, a second-generation BCRABL1 tyrosine kinase inhibitor (TKI), is an approved treatment for chronic myeloid leukaemia, both as first-line therapy and following imatinib intolerance or resistance. It is generally well tolerated, however, dasatinib has been associated with a higher risk for pleural effusions. Frequency, risk factors and outcomes of this significant side effect were analysed in the phase 3 DASISION and 034/Dose-optimization trials. Annual risk of 5%-15% was reported. Drug-related pleural effusion occurred in 28%-33% of patients in a minimum of 5-year follow-up period. One major risk factor was advanced age. We therefore reviewed a cohort of 34 patients treated with dasatinib between 2016 and 2021, to determine 'real-world' data of this toxicity. Case notes, pathology results and radiological reports were analysed. We identified 12 (35%) cases of pleural effusions. Eight (66%) cases were male. The median average age of patients with and without drug-related pleural effusion were 59.5 years (range: 31-91 years) and 54.5 years (range: 20-88 years) respectively. Cardiovascular and respiratory comorbidities were noted in eight patients (66.6%) with pleural effusion (ischaemic heart disease, hypertension, lung cancer, COVID, peripheral vascular disease and hyperlipidaemia) and nine patients (41%) without pleural effusion (prior non-TKI pleural effusion, hypertension, asthma, congenital heart defect, COPD and atrial fibrillation). Nine cases (75%) of those with pleural effusion were non-smokers. Lymphocytosis was not noted in any of those 12 cases of drug-related pleural effusion. Ten cases (83%) were on dasatinib 100 mg daily when pleural effusion was diagnosed, one was on 50 mg daily and the other was on 20 mg daily. Pleural effusion occurred after a median of 36 months (range: 6-108 months). Nine cases (75%) were mild to moderate in severity-Common Terminology Criteria for Adverse Events (CTCAE ) grade 1-2, two were grade 3 and one was grade 4. Two required no intervention, three required only medical intervention (steroid+/-antibiotics), three required pleural tap and three required pleural drain. One required VATS procedure with talc pleurodesis. The patient with grade 1 pleural effusion required no treatment change. One required dose reduction of dasatinib without interruption. One required temporary interruption but restarted on the same dose. Six required temporary interruption of dasatinib followed by dose reduction to 50 mg daily. Two of these subsequently recurred on lower dose dasatinib and were then switched to an alternative TKI (bosutinib and imatinib). Two required temporary TKI interruption and were restarted on a different TKI (nilotinib). One case of pleural effusion persisted and the patient was kept off TKI treatment. Although the numbers are too small for statistically robust analysis, we have observed several trends which may help to guide patient counselling and selection. Pleural effusion has an incidence of 35% in our local population. Risk factors were cardiovascular and respiratory comorbidities, advanced age and male sex. Smoking status and lymphocytosis did not appear to be risk factors in our cohort, where they have been in other reports. Most effusions were mild to moderate in severity and could usually be managed by steroid+/-pleural tap+/-drain. Most patients required temporary interruption of their dasatinib but were successfully able to restart at a lower dose without recurrence..

6.
International Research Journal of Innovations in Engineering and Technology ; 6(3):120-131, 2022.
Article in English | ProQuest Central | ID: covidwho-1836655

ABSTRACT

Throughout history, there are always descriptive moments in different generations. The rapid migration of digital technology driven by the epidemic has gripped the world by 2020. The global COVID-19 epidemic will affect all generations and especially consumers of Generation Y which is the main focus of this study. Considering the recent challenges, the role of messenger services and social media relationships becomes a life-changing issue. Companies understand that building customer relationships through a social media platform and the way these channels are managed is an important factor in product success. Therefore, the study attempts to determine how the 23-35-year-olds perceive social networking sites, by examining the combined use of popular SNS lists, including Facebook, Twitter, Myspace, Instagram, Tumblr, LinkedIn, and Google Plus. Sixty participants, ages 20 to 35, participated in an online study that used open-ended questions to ask how participants described and used different SNSs. To achieve this goal, the research uses a variety of methods that include descriptive/interpretive studies of literature and previous studies by academics and industry institutions. It also uses the quantitative survey taken from participants. The findings of this study suggest that researchers should consider how people use SNS collectively as this affects the decisions people make about which SNS accounts they use and how they present themselves on these sites.

7.
Frontiers in Environmental Science ; 10, 2022.
Article in English | Scopus | ID: covidwho-1834385

ABSTRACT

This study aims to find the nexuses among energy efficiency, renewable energy consumption, foreign direct investment, logistics industry, manufacturing industry and global trade during the COVID-19 pandemic and their impact on global supply chains in exporting nations of the world. The data for this study has been extracted from the World Development Indicators and Statista 2021 for 13 years ranging from 2007-to 2020 for nine top exporting countries. The fixed effect panel estimation technique was implied to examine and analyze the data. The results of our study revealed that highly risky diseases significantly impact supply chain operations globally. Global supply chains, logistics and manufacturing industries significantly influence global trade operations. Our results implicate that the overall international trade and logistics can be enhanced by improving the manufacturing and logistics industries by coping with the risk of pandemic diseases. Moreover, by utilizing cost-effective, renewable and efficient energy resources companies address sustainability issues of global trade and operations. By exerting further attention to the proficiency of the levies approval process, competence and quality of logistics services, and ease of assembling competitively priced shipments, the governments can significantly enhance the export from the logistics industry. Also, increasing manufacturing and agricultural value-added healthier consequences might be acquired in global supply chain operations from the manufacturing industry. Copyright © 2022 Rehman Khan, Hassan, Khan, Khan, Godil and Tanveer.

8.
Journal of the Liaquat University of Medical and Health Sciences ; 21(1):23-26, 2022.
Article in English | EMBASE | ID: covidwho-1818981

ABSTRACT

OBJECTIVE: To determine the association of sunlight exposure and PCR positivity of SARS-COV-2 samples. METHODOLOGY: This Quasi-Experimental Study was carried out at PAQSJIMS – Gambat, District Khairpur, Sindh, Pakistan. This experiment was conducted during the summer season from April-September 2020 with consecutive sampling techniques. The average temperature of the study during the given period was 41°C. Sample Size was 8 PCR positive Covid-19 Patients (Each sample divided into 12 portions) (6 controls and 6 test samples) and re-tested by PCR. Six control samples were kept in a laboratory environment. In contrast, six were kept in sunlight (each for a differing duration, i.e., 0, 5, 15, 30, 60, and 120 minutes), and the temperature and humidity levels were recorded. The experiment samples underwent a PCR test (along with its time-matched control), and SARS-COV-2 positivity was recorded. Following the experiment, the samples were discarded as per safety regulations. Both male and female covid-19 patients (PCR positive) aged 18 years and above were included, Patients enrolled in treatment trials were excluded. RESULTS: Among the eight samples (each tested in six different batches after exposure to sunlight for varying amounts of time), most, i.e., 45 (93.75%), tested positive for SARS-COV-2. However, there may be a relationship between the length of exposure to sunlight and PCR positivity of the samples since all three samples that tested negative were exposed to sunlight for more at least 30 minutes, all controls (placed in the laboratory and not exposed to sunlight, tested positive). CONCLUSION: There is no significant association between sunlight exposure and PCR positivity of SARS-COV-2 samples.

9.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333621

ABSTRACT

BACKGROUND AND AIMS: The coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 have consistently been reported as risk factors for unfavorable prognosis. We aim at this study to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for ICU admission or decease. METHODS: Four hundreds and thirty nine adult patients who are admitted through (June and July 2020) in Assiut and Aswan University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or Probable case. Detection of SARS-CoV-2 RNA was done by (TaqMana" 2019-nCoV Control Kit v1 (Cat. No. A47532) supplied by QIAGEN, Germany on the Applied Biosystem 7500 Fast RT PCR System, USA. RESULTS: Patients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and LRT symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of CVD cases were admitted in ICU followed by DM cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 vs. 10.7%, P<0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% vs. 81%, P<0.001) and death rate was significantly higher in cases with comorbidities (P< 0.001). The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P<0.002 and 0.001 respectively). CONCLUSION: Association of cardiovascular comorbid conditions including hypertension or neurological diseases together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

10.
Emerging Science Journal ; 6(Special Issue), 2022.
Article in English | Scopus | ID: covidwho-1789897

ABSTRACT

Since the outbreak of COVID-19, several researches have been conducted in different parts of the world, including Saudi Arabia. However, there is little focus of attention on qualitative exploration of the impacts of COVID-19 in the context of Saudi Arabia. The primary objective of this study was to explore the opinions of legal, economic, and medical experts pertaining to the impacts of COVID-19. The methodology employed in this paper was a qualitative research design. The data was collected with a specific focus on the use of an in-depth interview. Fifteen (15) participants among the legal, economic, and medical experts were finally used for the interview among the targeted participants. In order to analyze the data, different themes were generated from the transcribed interviews, which were: Overview of COVID-19, legal, economic, health impacts. The finding of the study revealed that the current pandemic of Covid-19 has multidimensional impacts in Saudi Arabia. The pandemic has negative impact not only on the social and economic areas but also on the legal sphere. Social and economic impacts of the Covid-19 increase the inequality, discrimination, unemployment, deprivation of usual education, and disruption in business activities. The findings further indicated that the legal impact of COVID-19 has been mentioned in the aspect of the inability to perform contracts that have the potential to trigger default or force majeure provisions leading to litigation or reconciliation. In addition, the participants also acknowledged the health impact of COVID-19 in causing anxiety, suffering from illness, loneliness, depression, and causing death, among others. If not properly addressed through effective measures and policy, the impact of the COVID-19 on the legal, economic, and health spheres would have severe consequences. Therefore, it is recommended that all the stakeholders, especially the government of Saudi Arabia should effectively and efficiently address the legal, economic, and health impacts of COVID-19. © 2022 by the authors. Licensee ESJ, Italy.

11.
Genetics in Medicine ; 24(3):S242, 2022.
Article in English | EMBASE | ID: covidwho-1768096

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, has resulted in an ongoing vicious pandemic. COVID-19 has a wide range of clinical outcomes ranging from no clinical symptoms to severe respiratory disease and death. Disease severity has been linked to old age and other co-morbidities. In children and infants, the infection has typically a milder and often asymptomatic course. However, Multisystem Inflammatory Syndrome in Children (MIS-C) has been recognized as a pediatric complication of severe acute respiratory syndrome coronavirus-2 infections. It is a state of hyperinflammation that typically presents 4-6 weeks after SARS-CoV-2 acute infection with high fever, organ dysfunction, and raised inflammatory markers leading to multiorgan failure and shock. Family clusters of MIS-C have been reported suggesting heritable traits predisposing to severe infection. The underlying cause of phenotypic heterogeneity, susceptibility, and disease severity among affected individuals is still unclear. It has been thought that both viral and host genetic variations could be probable factors influencing the disease severity and susceptibility. To this end, we have studied the clinical and genetic characteristics of children with MIS-C in Kuwait. Utilizing 28 large kindreds with familial MIS-C clustering, we report, here, the preliminary results obtained from three families. Methods: Children aged ≤ 12 years who met the World Health Organization (WHO) MIS-C diagnostic criteria were identified from the national Pediatric COVID-19 Registry in Kuwait (PCR-Q8). Detailed demographic and clinical phenotype data were obtained from medical charts. All subjects and their families were invited for blood molecular genetic testing. Genetic analysis using genome sequencing at 30x depth has been performed on the affected individuals and their parents. In this , we present preliminary results from three families. Results: Sixty-seven children with MIS-C were identified in the period between April 2020 and October 2021. So far, molecular genetic testing was performed on 28 subjects and their biological parents. Genetic analysis (genome sequencing) of 3 families was completed. All of the three children were previously healthy, non-obese, with no known co-morbidities, and no family history of MIS-C. They all had evidence of recent SARS-CoV-2 infection (positive RT-PCR result and positive IgG antibody detection). One child aged 9 years developed myocarditis as a complication of MIS-C. He presented with hypotension, hemodynamic instability, and required inotropic support. All three kids have fully recovered after receiving respiratory support in the Pediatric Intensive Care Unit (PICU). Consanguinity was observed in two families. Probands harbored various homozygous variants in the BTNL8, IL17RA, and IRS4 genes will be presented and discussed. Conclusion: This is the first study to review the demographic, clinical, epidemiological, and genetic characteristics of children with MIS-C in Kuwait. Although familial clustering of severe COVID-19 infection has not been observed in our cohort, our data shows that utilizing a family-based study allows for significant enrichment for homozygous genetic variants that may impact our understanding of MIS-C.

12.
Clinical Infection in Practice ; 13, 2022.
Article in English | EMBASE | ID: covidwho-1757218

ABSTRACT

The aim of this study was to describe the patient's characteristics and clinical course of CAPA and to investigate possible association of Dexamethasone with CAPA incidence. This is a retrospective descriptive study. All adult patients in GGC NHS with laboratory proven SARS-CoV-2 infection who subsequently had Aspergillus species isolated from their respiratory samples between 01/02/20 and 31/01/21were included. A total of 24 patients fulfilled the inclusion criteria.79% of the cases were between October/2020-January/2021 coinciding with the second wave of COVID-19 and the increased use of steroids after the RECOVERY trial results. Based on the proposed screening and diagnostic algorithm for CAPA and Modified AspITU classification, 6 patients had likely/putative, and 2 patients had highly likely/probable CAPA, respectively. Based on the CAPA algorithm, for 11 patients CAPA was not excluded and 5 considered colonization. Based on Modified AspITU, 10 considered query Putative CAPA and 6 colonization. 13 patients were males. The median age was 62. 46% of patients had underlying lung disease, 20% had previous exposure to inhaled steroids, 8% to Methotrexate, 4% to each of systemic steroids and Rituximab. 79% of patients received Dexamethasone and 12.5% received Tocilizumab for COVID-19. 75% of patients were in ITU at time of first Aspergillus isolation. 67% of patients received antifungal for CAPA. CAPA remains an area of research. From our limited data, we observed an association between Dexamethasone use and incidence of CAPA. We also noticed a correlation between the number of samples with positive Aspergillus species culture from the same patient and the likelihood of CAPA diagnosis.

13.
International Series in Operations Research and Management Science ; 320:287-303, 2022.
Article in English | Scopus | ID: covidwho-1756690

ABSTRACT

This chapter is devoted to present a generalized model for scheduling multiple ambulance vehicles from multiple ambulance centers assigned to evacuate COVID-19 patients. The proposed formulation is a multi-objective multiple 0–1 mathematical model as a new application of the multi-objective multiple 0/1 knapsack problem. The scheduling aims at achieving the best utilization of the time shift as a planning time window. The best utilization of time is evaluated by a compromise between maximizing the number of evacuated people who might be infected with the virus to the isolation hospitals and maximizing the evacuated patients having higher relative priorities measured according to their health status. The complete mathematical model for the problem is formulated including the representation of binary decision variables, the problem constraints, and the multi-objective functions. The proposed multi-objective multiple ambulances model is applied to an illustrated case study in Great Cairo, Egypt, the case study aims at improving the scheduling of ambulance vehicles in the back-and-forth shuttle movements between patient locations and the available multiple isolation hospitals with multiple ambulance vehicles. The solution procedure is illustrated while two efficient solutions for the case study with different numbers of evacuated patients are obtained. The proposed mathematical model is so general that it can be applied to cases covering the whole Governorates and even the whole country all over the world. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

15.
Arthritis & Rheumatology ; 73:3247-3249, 2021.
Article in English | Web of Science | ID: covidwho-1728193
16.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329157

ABSTRACT

Background: Timely identification of deteriorating COVID-19 patients is needed to guide changes in clinical management and admission to intensive care units (ICUs). There is significant concern that widely used early warning scores (EWSs) underestimate illness severity in COVID-19 patients and therefore, we developed an early warning model specifically for COVID-19 patients. Methods: We collected electronic medical record data to extract predictors and used these to fit a random forest model. To simulate the situation in which the model would have been developed after the first COVID-19 ‘wave’ in the Netherlands and implemented during the second wave, we performed a temporal validation by splitting all included patients into groups admitted before and after August 1, 2020. Furthermore, we propose a method for dynamic model updating to retain the model’s predictive performance over time. We evaluated model discrimination and calibration, performed a decision curve analysis, and quantified the importance of predictors using SHapley Additive exPlanations values. Findings: We included 3 514 COVID-19 patient admissions from six Dutch hospitals between February 2020 until May 2021, and included a total of 18 predictors for model fitting. The model showed a higher discriminative performance in terms of partial area under the receiver operating characteristic curve (0.82 [0.80 to 0.84]) compared to the National Early Warning Score (0.72 [0.69 to 0.74]) and the Modified Early Warning Score (0.67 [0.65 to 0.69]), a greater net benefit over a range of clinically relevant model thresholds, and good calibration (intercept=0.03 [-0.09 to 0.14], slope=0.79 [0.73 to 0.86]). Interpretation Thisstudyshowsthepotentialbenefitofmovingfromearlywarningmodelsforthegeneralinpatientpopulationtomodelsforspecificpatientgroups. The COVID-19-specific early warning model is available online at https://github.com/jimmsmit/COVID-19_EWSandweencourageotherstofurther validate this model independently.

17.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326679

ABSTRACT

Development of lab-on-a-chip (LOC) system based on integration of reverse transcription loop-mediated isothermal amplification (RT-LAMP) and microfluidic technology is expected to speed up SARS-CoV-2 diagnostics allowing early intervention. In the current work, reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) and RT-LAMP assays were performed on extracted RNA of 7 wastewater samples from COVID-19 hotspots. RT□LAMP assay was also performed on wastewater samples without RNA extraction. Current detection of SARS-CoV-2 is mainly by RT-qPCR of ORF (ORF1ab) and N genes so we targeted both to find the best surrogate marker for SARS-CoV-2 detection. We also performed RT-LAMP with/without RNA extraction inside microfluidic device to target both genes. Positivity rates of RT-qPCR and RT-LAMP performed on extracted RNA were 100.0% (7/7) and 85.7% (6/7), respectively. RT-qPCR results revealed that all 7 wastewater samples were positive for N gene (Ct range 37-39), and negative for ORF1ab, suggesting that N gene could be used as a surrogate marker for detection of SARS-CoV-2. RT-LAMP of N and ORF (ORF1a) genes performed on wastewater samples without RNA extraction indicated that all 7 samples remains pink (negative). The color remains pink in all microchannels except microchannels which subjected to RT-LAMP for targeting N region after RNA extraction (yellow color) in 6 out of 7 samples. This study shows that SARS-CoV-2 was successfully detected from wastewater samples using RT-LAMP in microfluidic chips.

19.
Journal of Pakistan Association of Dermatologists ; 31(3):420-428, 2021.
Article in English | EMBASE | ID: covidwho-1610181

ABSTRACT

Background Frontline doctors performing duties during Covid-19 pandemic have to use the personal protective equipment to avoid exposure and decrease the risk of Covid-19 infection. These protective measures can lead to various cutaneous manifestations and problems which affect their working. Objective To assess dermatological morbidity due to use of personal protective equipment (PPE). Methods This descriptive observational study was conducted on 220 doctors performing duties on frontline in Covid-19 pandemic. Data was collected through e- questionnaire regarding demography, daily duty, daily PPE wearing time, cutaneous manifestation, their type and site. Participants voluntarily allowed and submitted the questionnaire through cell phones. Results 52% of frontline doctors using PPEs while performing duties in Covid-19 pandemic showed dermatological morbidity. Most of them belonged to the age group >35 years, males, married, having postgraduate qualification. Most of the frontline doctors having dermatological manifestation were performing regular OPD duties for > 4 hours. Presence of comorbidities and hand washing for more than 10 times were also associated factors. Conclusion There is 52% dermatological morbidity in frontline doctors using PPEs while performing duties in Covid-19 pandemic and it was statistically significantly associated with male gender, postgraduate qualification, >4 hours/ day OPD duty, presence of comorbidities and hand washing >10 times per day.

20.
Blood ; 138:4120, 2021.
Article in English | EMBASE | ID: covidwho-1582391

ABSTRACT

Introduction: Daratumumab in combination with bortezomib and dexamethasone (DVd) demonstrated a superior overall response rates (ORR) and progression free survival (PFS) compared to Vd in the CASTOR phase 3 trial for patients with RRMM. On this basis, DVd was recommended in March 2019 for UK patients with RRMM that had 1 prior line (PL). Discrepancies in outcomes between patients treated in clinical trials compared to routine practice is well recognised due to a combination of patient, disease and treatment-related factors. In addition, bortezomib is often administered once-weekly in routine practice to minimise neuropathy, while CASTOR used bi-weekly bortezomib dosing. As a result, the real-world outcomes of patients treated with DVd are yet to be determined. The primary aims of this analysis was to assess the ORR and PFS for patients with RRMM with 1PL treated with DVd in routine practice. Secondary aims were to assess OS, time to next treatment (TTNT), and efficacy in different sub-groups (high risk cytogenetics, previous proteasome inhibitor (PI) exposure, refractoriness of prior therapies, bi-weekly vs weekly bortezomib schedule, and previous treatment free interval (TFI)). Methods: This was a retrospective analysis from 14 centres (academic and community hospitals;7 within the West Midlands Research Consortium (WMRC)) treated with DVd between March 2019 and June 2021. Patients received daratumumab (IV and then SC from June 2020) weekly in cycles 1-3, on day 1 of a 3-week cycle during cycles 4-8, and then monthly from cycle 9 to progression. SC Bortezomib was predominantly given weekly for cycles 1-8 although 5 centres used bi-weekly dosing for selected patients with aggressive disease. Adverse events were graded as per CTCAE criteria. Results: 288 patients were included, with a median age of 69 years (range 20-88) (Table 1). Patients received a median of 1 PL (range 1-2) with 93% (269) 1PL, 7% (18) 2 PL (due to COVID-19 measures). The majority had an ECOG performance status of 0-2 (98%) and most received weekly bortezomib (n=201). This population differed from those with 1PL treated on CASTOR in being older, more were ISS 3 (31% vs 19%, p=0.0145), and more had prior bortezomib exposure (71% vs 51%, p=0.0003), 4% were PI refractory, 9% had a GFR of <30ml/min (<20ml/min was an exclusion from CASTOR), and 2% had an ECOG performance status of ≥3. The ORR was 76%, with >VGPR in 54% (Table 2), with no significant difference in response between patients receiving biweekly vs weekly bortezomib (85% vs 83%;p=0.71). The median time to response was 1.6m. With a median follow up of 15m, the median PFS was 14m (95% CI 11.6-16). High cytogenetic risk patients had inferior outcomes: median PFS 10m (95% CI 6-14) for high risk vs not reached for standard risk (p=0.043);as did those with advanced ISS: median PFS was not reached, 15 and 12m for stage I, II and III respectively (p=0.05). For 15 patients with extramedullary disease (EMD), the median PFS was 3m (95% CI 1-5). Median PFS for patients who were PI refractory was shorter (10m vs 15m for PI sensitive patients (p=0.006)). There was no difference in median PFS for patients with prior PI exposure vs no prior PI (15 vs 13m;p=0.75), or according to weekly or bi-weekly bortezomib schedule (11 vs 15m;p=0.14). The median TTNT was 21m (95% CI 17-25). Overall, the median duration of treatment was 8m and 25 patients (9%) stopped treatment to receive a second autologous stem cell transplant. Those that had a prior TFI of >12m had a longer median PFS of 21m vs 10m (p=0.0004). The median OS has not been reached, with an estimated 2-year OS of 74%. For patients with high risk cytogenetics the median OS was 16m (95% CI 9-23;vs not reached for standard risk;p=0.0006), with estimated 2-year OS in the high risk group of 36%. There was no difference in OS for patients treated with biweekly vs weekly bortezomib (not reached for either;p=0.38). DVd was generally well tolerated with 6% stopping due to adverse events (CASTOR 9.5%). Grade 3 or 4 toxicity occurred in 62 (22%) most comm nly neutropenia and thrombocytopenia, with any grade infusion reactions reported in 27 (9%). Conclusions: These real-world data of DVd at 1 st relapse demonstrated good tolerability and high response rates with a weekly bortezomib schedule despite a more heterogenous population. However, high risk patients by cytogenetics, ISS or EMD had inferior outcomes as did those treated within 12 months from first line treatment. [Formula presented] Disclosures: Cook: Karyopharm: Consultancy, Honoraria;Pfizer: Consultancy, Honoraria;Sanofi: Consultancy, Honoraria;Takeda: Consultancy, Honoraria, Research Funding;Amgen: Consultancy, Honoraria, Research Funding;BMS: Consultancy, Honoraria, Research Funding;Oncopeptides: Consultancy, Honoraria;Roche: Consultancy, Honoraria;Janssen: Consultancy, Honoraria, Research Funding. Pratt: Binding Site: Consultancy;BMS/Celgene: Consultancy;Gilead: Consultancy;Janssen: Consultancy;Takeda: Consultancy;Amgen: Consultancy. Kishore: Celgene: Other: Attending fees;Jannsen: Other: Attending fees;Sanofi: Other: Attending fees;Takeda: Other: Attending fees. Yong: Amgen: Honoraria;Autolus: Research Funding;BMS: Research Funding;Janssen: Honoraria, Research Funding;Sanofi: Honoraria, Research Funding;GSK: Honoraria;Takeda: Honoraria. Popat: Abbvie, Takeda, Janssen, and Celgene: Consultancy;Takeda: Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES;GlaxoSmithKline: Consultancy, Honoraria, Research Funding;AbbVie, BMS, Janssen, Oncopeptides, and Amgen: Honoraria;Janssen and BMS: Other: travel expenses.

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