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1.
ERJ Open Res ; 8(1)2022 Jan.
Article in English | MEDLINE | ID: covidwho-1686001

ABSTRACT

Continuous positive airway pressure is an efficacious and cost-effective modality of treatment for #COVID19 ARDS, particularly in resource-poor settings with late referrals to overwhelmed intensive care units https://bit.ly/3dKwXwP.

2.
ERJ open research ; 2021.
Article in English | EuropePMC | ID: covidwho-1601700

ABSTRACT

Management of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated Acute Respiratory Distress Syndrome (Covid 19 ARDS or CARDS) has challenged the health systems of developed countries, and even more so the health systems of resource poor settings [1]. Within this context Continuous Positive Airway Pressure (CPAP) has been trialled in as an alternative less resource intensive respiratory support to early Invasive Mechanical Ventilation (IMV) [2] with promising results and now features in some major guidelines [3]. However, there are limited studies from resource poor settings massively impacted by Covid 19. We retrospectively analysed the completed survival outcomes and characteristics for the exclusive use of CPAP for moderate to severe CARDS as defined by Kigali criteria [4] in a cohort of patients admitted to Bach Christian Hospital (BCH) between April and August 2021.

3.
Journal of the American College of Cardiology ; 77(18, Supplement 1):2035, 2021.
Article in English | ScienceDirect | ID: covidwho-1212617
5.
J Racial Ethn Health Disparities ; 8(3): 732-742, 2021 06.
Article in English | MEDLINE | ID: covidwho-739703

ABSTRACT

OBJECTIVES: There is preliminary evidence of racial and social economic disparities in the population infected by and dying from COVID-19. The goal of this study is to report the associations of COVID-19 with respect to race, health, and economic inequality in the United States. METHODS: We performed an ecological study of the associations between infection and mortality rate of COVID-19 and demographic, socioeconomic, and mobility variables from 369 counties (total population, 102,178,117 [median, 73,447; IQR, 30,761-256,098]) from the seven most affected states (Michigan, New York, New Jersey, Pennsylvania, California, Louisiana, Massachusetts). RESULTS: The risk factors for infection and mortality are different. Our analysis shows that counties with more diverse demographics, higher population, education, income levels, and lower disability rates were at a higher risk of COVID-19 infection. However, counties with higher proportion with disability and poverty rates had a higher death rate. African Americans were more vulnerable to COVID-19 than other ethnic groups (1981 African American infected cases versus 658 Whites per million). Data on mobility changes corroborate the impact of social distancing. CONCLUSION: Our study provides evidence of racial, economic, and health inequality in the population infected by and dying from COVID-19. These observations might be due to the workforce of essential services, poverty, and access to care. Counties in more urban areas are probably better equipped at providing care. The lower rate of infection, but a higher death rate in counties with higher poverty and disability could be due to lower levels of mobility, but a higher rate of comorbidities and health care access.


Subject(s)
COVID-19/ethnology , Health Status Disparities , /statistics & numerical data , COVID-19/mortality , Female , Humans , Male , Risk Factors , Socioeconomic Factors , United States/epidemiology
6.
EBioMedicine ; 59: 102939, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-716658

ABSTRACT

BACKGROUND: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. METHODS: This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. FINDINGS: We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke-123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1-3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4-4.7, p = 0.006) were predictive of stroke. INTERPRETATION: The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients. FUNDING: None.


Subject(s)
Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Stroke/diagnosis , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/virology , Female , Hospitalization , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/virology , Risk Factors , SARS-CoV-2 , Stroke/complications , Tertiary Care Centers
8.
J Biomol Struct Dyn ; 39(11): 4089-4099, 2021 07.
Article in English | MEDLINE | ID: covidwho-610639

ABSTRACT

An rare pandemic of viral pneumonia occurs in December 2019 in Wuhan, China, which is now recognized internationally as Corona Virus Disease 2019 (COVID-19), the etiological agent classified as Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). According to the World Health Organization (WHO), it has so far expanded to more than 213 countries/territories worldwide. Our study aims to find the viral peptides of SARS-COV-2 by peptide mass fingerprinting (PMF) in order to predict its novel structure and find an inhibitor for each viral peptide. For this reason, we calculated the mass of amino acid sequences translated from the SARS-CoV2 whole genome and identify the peptides that may be a target for inhibition. Molecular peptide docking with Moringa oleifera, phytochemicals (aqueous and ethanolic) leaf extracts of flavonoids (3.56 ± 0.03), (3.83 ± 0.02), anthraquinone (11.68 ± 0.04), (10.86 ± 0.06) and hydroxychloroquine present therapy of COVID-19 in Pakistan for comparative study. Results indicate that 15 peptides of SARS-CoV2 have been identified from PMF, which is then used as a selective inhibitor. The maximum energy obtained from AutoDock Vina for hydroxychloroquine is -5.1 kcal/mol, kaempferol (flavonoid) is -6.2 kcal/mol, and for anthraquinone -6 kcal/mol. Visualization of docking complex, important effects are observed regarding the binding of peptides to drug compounds. In conclusion, it is proposed that these compounds are effective antiviral agents against COVID-19 and can be used in clinical trials.Communicated by Ramaswamy H. Sarma.


Subject(s)
COVID-19 , Moringa oleifera , Anthraquinones , COVID-19/drug therapy , Flavonoids/pharmacology , Humans , Hydroxychloroquine , Peptides , RNA, Viral , SARS-CoV-2
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