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1.
IEEE Sensors Journal ; JOUR: 1-1,
Article in English | Scopus | ID: covidwho-2088063

ABSTRACT

Mask wearing has become critical for preventing the aerosolization and inhalation of virus-laden particles during the ongoing COVID-19 global pandemic. However, facial masks with effective filtration are either not readily accessible (e.g., N95) or have reduced filtration efficiency due to air gaps between the mask and wearer (e.g., cloth masks). We have developed a novel combination of a mask and shield named Mask And Shield Integrated (MASI) that provides nearly the same levels of protection as an N95 mask by addressing these issues. Magnetic latches reduce gaps between the mask and wearer, while a novel fin structure on the shield provides protection against floating particles. A series of experiments was performed to study MASI’s efficacy in both eliminating mask gaps and also providing N95-like filtration efficiency. MASI was found to solve both problems, thus providing a low-cost mask solution that can be applied to a broad range of environments to prevent inhalation of small air-borne particles. IEEE

2.
Chest ; 162(4):A1646-A1647, 2022.
Article in English | EMBASE | ID: covidwho-2060851

ABSTRACT

SESSION TITLE: Lung Cancer Assessment and Risk Calculations SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Detection of pulmonary nodules is central to early diagnosis of lung cancer. Many types of observer error have been reported in literature. During the pandemic the radiology departments were stretched, and it is possible that the radiologists were primarily looking to either confirm or rule out COVID and missed nodules due to satisfaction of search and fatigue. This study was undertaken to estimate the magnitude of such errors. METHOD: 1312 consecutive chest CT scans interpreted in two specialist radiology units during the months of May-Jun 2021 (peak of India's 2nd covid wave) were used in this study. All scans were processed by qCT-Lung, a deep learning algorithm capable of flagging nodules. The radiology reports of the cases flagged by qCT were searched for findings suggestive of lung cancer. Cases for which nodules or mass were not mentioned in the report were re-read by an independent radiologist with qCT's assistance. The radiologist was aware of the context and was asked to mark flagged lesions as Yes/no for nodules. They also rated the nodule for malignancy potential in a positive directed five-point Likert scale if the flag was correct and gave an alternative finding if incorrect. RESULTS: 381 (29.0%) scans were flagged for nodules by qCT. 52 of these were also reported in radiology reports. Of the 329 scans re-read by radiologist, 65 (19.8 %) scans were reported as having nodules. These 65 scans had a total of 134 nodules. The median size (longest diameter) of these nodules was 14 mm (range: 7 - 33) and most (95) were solid nodules. The most common reason (94.5%) of false flag by qCT was ground-glass opacity with consolidation. 53 of 65 of the correctly identified scans were given malignancy rating of 1 or 2 (non-malignant or probably non-malignant). 10 were given a rating of 3 (could be malignant or non-malignant) and 2 were rated as probably malignant. Two cases of lung cancers were flagged by both qCT and reports. CONCLUSIONS: Nodules were not reported in 65 scans. All of them can't be considered as missed by radiologists. From the ratings provided by the radiologist doing re-reads - it is possible that previous radiologists could have not reported the nodule due to perceived malignancy risk. 12 scans had ratings that would have warranted follow-up action. False flags were mainly due to ground glass with consolidation. The occurrence of ground glass opacities in COVID could in part explain the high number of false flags in this study. CLINICAL IMPLICATIONS: All scans had nodules with size > 6 mm and 26 had multiple nodules making the patients eligible for follow-up as per Fleischner guideline. Radiologist report only clinically significant findings focussing mostly on indication(s) of the scan. Taking a conservative approach and reporting all nodules irrespective of perceived risk will help clinicians plan follow-up. Algorithms like qCT-Lung can help readers in identifying all nodules. DISCLOSURES: Employee relationship with Qure.ai Please note: 15/12/2020 Added 04/04/2022 by Vikash Challa, value=Salary Removed 04/04/2022 by Vikash Challa Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Vikash Challa, value=Salary Owner/Founder relationship with bodyScans Please note: Current co-founder Added 04/05/2022 by Era Dwivedi, value=Salary Employee relationship with Aarthi Scans and Labs Please note: Current Employee Added 04/04/2022 by Arunkumar Govindarajan, value=Salary Owner/Founder relationship with bodyScans Please note: Current Director Added 04/05/2022 by Arpit Kothari, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Souvik Mandal, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/04/2022 by Ankit Modi, value=Salary Self relationship with Qure.ai Please note: Current employee Added 04/04/2022 by SAI NAREN V S, value=Salary Employee elationship with Qure AI Please note: Current Employee Added 04/04/2022 by Vanapalli Prakash, value=Salary Employee relationship with Qure.ai Please note: Current employee Added 04/07/2022 by Preetham Putha, value=Salary Employee relationship with Qure.ai Please note: 4 years Added 04/04/2022 by Bhargava Reddy, value=Salary Employee relationship with Qure.ai Please note: Current Employee Added 03/27/2022 by Saigopal Sathyamurthy, value=Salary Owner/Founder relationship with Qure.ai Please note: Current co-founder Added 04/04/2022 by Prashant Warier, value=Salary

3.
Chest ; 162(4):A1506-A1507, 2022.
Article in English | EMBASE | ID: covidwho-2060835

ABSTRACT

SESSION TITLE: Respiratory Care: Oxygen, Rehabilitation, and Inhalers SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Background More than 1.5 million Americans live with supplemental oxygen that improves quality of life in adults living with chronic lung disease. After hospitalization for serious illness such as pneumonia (especially COVID), heart failure, COPD exacerbation or other lung disease, patients are discharged on supplemental oxygen. Hypoxemia often resolves after recovery from the illness and supplemental oxygen is no longer needed. As a part of “Choosing Wisely” campaign from ABIM, ATS/ACCP recommends “For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, don’t renew the prescription without assessing the patient for ongoing hypoxemia within 90 days after discharge. Objectives The primary objective of the study is to improve home oxygen reassessment after discharge from the hospital. METHODS: Study Design Subjects will be identified by electronic medical records (EMR) report and will include data from the 1st of January 2021 to 30th June 2021 (period of 6 months) Inclusion Criteria Subjects 18 years and older who were discharged from the RPH on supplemental oxygen Exclusion: Subjects 18 years and older on oxygen for palliation and hospice Study Outcomes The primary outcome measure will be assessed as percent of patients in whom oxygen requirement reassessed and percent in whom oxygen requirement was not reassessed. The secondary outcome measure will be assessed as percent of patients who had PCP follow up and percent of patients on continuous oxygen without reassessment Quality improvement PDSA: Phase I: pre-intervention data Phase II: Intervention-> education session to the providers and new epic order inclusion (BPA for reassessment and discontinuation) Phase III: post-intervention survey RESULTS: Based on chart review, 155 patients qualified for the study criteria. Among 155 patients, regarding the primary outcome-> 63 patients (40.6%) 90 days oxygen reassessment was done, 64 patients (41.2%) oxygen reassessment was not done, 10 patients (6%) died within the 90 days reassessment period and 19 patients were 90 days reassessment was not applicable (12%- 19 patients-on long term oxygen). Regarding the secondary outcomes, 113 patients (72.9%) were followed up with PCP, 16 patients (10.3%) did not have follow up, 19 patients (12.2%- no information available) had outside PCP follow up, 7 patients (4.5%- 2 died on same admission, 5 opted for hospice). Regarding patient who continued to use oxygen, 74 patients (47.7%) were continued on oxygen, 47 patients (30.3%) were discontinued of oxygen and 34 patients (22%) did not have any information available regarding oxygen use. CONCLUSIONS: From the above data, There is room for improvement regarding oxygen reassessment by educating primary care providers. Post intervention survey will be done in 6 months. CLINICAL IMPLICATIONS: Improve oxygen reassessment in patients after discharge with oxygen DISCLOSURES: No relevant relationships by Anam Aqeel No relevant relationships by Mansur Assaad No relevant relationships by Apurwa Karki No relevant relationships by Shobha Mandal No relevant relationships by Rajamurugan Meenakshisundaram

4.
Chest ; 162(4):A641, 2022.
Article in English | EMBASE | ID: covidwho-2060655

ABSTRACT

SESSION TITLE: Pathology Identifying Chest Infections Case Report Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Coronavirus disease 2019 (COVID-19) patients presented in a wide variety and had multiple complications. The well-known associations found are myocardial infraction, pulmonary embolism, meningitis, encephalitis. We are presenting a new diagnosis of Hairy cell leukemia in COVID 19 patients. CASE PRESENTATION: We present a 55-year-old pleasant female with no significant past medical history;non immunocompromised who presented with 7 days history of shortness of breath on exertion, fever, fatigue, and cough. Her physical exam was unremarkable, but she was desaturating on presentation hence was placed on oxygen via nasal canula. On work up she tested positive for COVID-19. Initial chest Xray revealed bilateral diffuse pulmonary infiltrates. Complete blood count (CBC) showed pancytopenia with white blood cell count (WBC) 0.8 × 103/μL (4–10 × 103/μL), absolute neutrophil count (ANC) 0.5 × 103/μL (2–7 × 103/μL), hemoglobin (Hgb) 10.4 g/dL (13.0–17.0 g/dL), and platelet count 156× 103/μL (150–400 × 103/μL). She received treatment for COVID 19 pneumonia as per the protocol. On repeat CBC check there was minimal improvement in her counts. The rest of her WBC differential showed a lymphopenia with ALC ranging from 350–500 with no other obvious immature cells or blasts to suggest a myeloid neoplasm such as acute leukemia. Work-up including vitamin B12, folate, TSH, EBV, ANA, and hepatitis were unremarkable. She also received treatment with supportive granulocyte colony-stimulating factor (G-CSF) but there was minimal improvement. As her pancytopenia persisted for 1 week the peripheral blood smear was done which showed pancytopenia (with prominent red cell agglutination, with rare, atypical lymphoid cells with multiple hairy projections. A bone marrow (BM) aspirate was hypocellular showing markedly decreased trilineage hematopoiesis with atypical lymphoid cells with oval or indented nuclear borders, unclumped chromatin, absent or inconspicuous nucleoli, and moderate to abundant pale blue cytoplasm with multiple circumferential cytoplasmic projections (hairy cells) [Figure:1]. The hairy cells showed strong positivity for CD20[Figure:2]. She was followed up by hematology and was started on treatment. DISCUSSION: Hairy cell leukemia (HCL) is a rare B cell lymphoproliferative disease with marked cytopenia and circulating leukemia cells. Multiple viruses (EBV, HTLV1) were found to be associated with multiple different malignancies. It is found that COVID19 is not associated with any malignancy so far, but our patient got diagnosed with HCL during COVID19 illness. CONCLUSIONS: The association of HCL could be an incidental finding but we need to do further studies to clarify the associations Reference #1: Kohla, Samah et al. "A Rare Case of Hairy Cell Leukemia with Unusual Loss of CD123 Associated with COVID-19 at the Time of Presentation.” Case reports in oncology vol. 13,3 1430-1440. 4 Dec. 2020, doi:10.1159/000512830 DISCLOSURES: No relevant relationships by Apurwa Karki No relevant relationships by Shobha Mandal No relevant relationships by Rajamurugan Meenakshisundaram

5.
Chest ; 162(4):A430, 2022.
Article in English | EMBASE | ID: covidwho-2060595

ABSTRACT

SESSION TITLE: Issues After COVID-19 Vaccination Case Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Since the onset of the COVID-19 pandemic, vaccines were introduced to mitigate the spread of the virus. Depending on the COVID-19 vaccine, regimens consist of one dose (ie, J&J) or two doses (ie, Pfizer and Moderna) and is followed by a third dose/booster (for immunocompromised/immunocompetent individuals). Here, we present a case of COVID-19 infection in a triple vaccinated patient with concurrent rheumatoid arthritis (RA) receiving disease modifying antirheumatic drugs (DMARDs) who was unable to mount an adequate immune response to the vaccine. CASE PRESENTATION: Patient is a 67 year old male with PMH of RA (on DMARDs) presented to the ED with complaints of shortness of breath. He was on treatment for RA with leflunomide, rituximab and prednisone. He was COVID-19 triple vaccinated. In ED, the patient was found to be hypoxic, saturating at 87% on room air with a respiratory rate of 18. Physical examination was significant for coarse breath sounds bilaterally and remaining vitals were unremarkable. Patient was initially placed on 3 L oxygen via NC but due to persistent hypoxia, was transitioned to high-flow nasal cannula. Further investigations revealed that the patient was COVID-19 positive. He was treated with remdesivir and dexamethasone. His oxygen requirements continued to escalate and he was ultimately intubated. While in the ICU, the patient's hypoxia continued to worsen despite optimal medical and ventilatory management and he subsequently died. DISCUSSION: DMARDs are a group of medications used to slow the progression of rheumatoid arthritis. They work by reducing the immune response of B cells, T cells and cytokines. Our patient was on two commonly prescribed medications for rheumatoid arthritis, leflunomide and rituximab. The former acts by inhibiting the pyrimidine synthesis pathway, thereby decreasing T lymphocyte production and the latter depletes CD-20 positive B cells. While there is limited data on COVID-19 vaccine, it has been established that patients on DMARDs have reduced antibody titres after immunization against influenza and pneumonia vaccinations [1, 2]. A study assessing the effectiveness of a third vaccine dose in patients taking rituximab vs placebo found a significant difference in seroconversion (78.8% vs 18.2%, p=<0.0001) and neutralizing activity (80.0% vs 21.9%, p=<0.0001) [3]. In our case, the patient was on two immunosuppressive drugs which suppressed both the humoral and cell mediated immunity, resulting in an inadequate immune response and subsequently developing COVID. CONCLUSIONS: This case highlights patients on immunosuppressant therapy failing to mount an adequate immune response to the COVID-19 vaccine, warranting more booster doses in patients on DMARDs. Reference #1: Adler S, Krivine A, Weix J et al. Protective effect of A/ H1N1 vaccination in immune-mediated disease–a prospectively controlled vaccination study. Rheumatology 2012;51:695–700. Reference #2: Franca ILA, Ribeiro ACM, Aikawa NE et al. TNF blockers show distinct patterns of immune response to the pandemic influenza A H1N1 vaccine in inflammatory arthritis patients. Rheumatology 2012;51:2091–8. Reference #3: David S, Koray T, Filippo F et al. Efficacy and safety of SARS-CoV-2 revaccination in non-responders with immune-mediated inflammatory disease. http://dx.doi.org/10.1136/annrheumdis-2021-221554 DISCLOSURES: No relevant relationships by Gursharan Kaur No relevant relationships by Aishwarya Krishnaiah No relevant relationships by sandeep mandal

6.
Economic and Political Weekly ; 57(35):53-61, 2022.
Article in English | Scopus | ID: covidwho-2046792

ABSTRACT

The Indian stock market witnessed a sharp recovery in the post-COVID-19 period owing to the sweeping investor enthusiasm. The event studies show that the 2020 lockdown and announcement of the first fiscal package had a significant impact on the stock returns. The impact of other events like the first COVID-19 case, second fiscal package, beginning of the vaccination drive, and the second wave was insignificant. Our estimates also show a significant impact of investor sentiment on stock returns, except during periods of extreme volatility. Further, the stock returns are positively related to oil price and negatively related to the exchange rate. © 2022 Economic and Political Weekly. All rights reserved.

7.
ACS Sustainable Chemistry and Engineering ; 10(30):9811-9819, 2022.
Article in English | Scopus | ID: covidwho-2016557

ABSTRACT

For the past two years, doxycycline has been employed hugely for the treatment of COVID 19 over the globe. Excessive use of doxycycline can result in bacteria and gene resistance, which affects the future treatment of infectious diseases. Furthermore, unused doxycycline left from the hospital and pharmaceutical industries may have an adverse effect on the environment, posing a significant menace to modern society. As a result, doxycycline detection is required. Herein, we developed blue luminous nitrogen-doped carbon quantum dots (N-CQDs) using ascorbic acid and diethylenetriamine (DETA) as carbon and nitrogen sources via a microwave-assisted technique for the differential detection of doxycycline (DC) via a fluorescence quenching mechanism, even when other tetracycline derivatives interfere. The quenching mechanism has been elaborately explained by using a Stern-Volmer plot, UV-vis and fluorescence spectroscopy, and TCSPC to attribute the static quenching and inner filter effect. In addition, the limit of detection of our suggested sensor is 0.25 μM. To confirm the structural properties and the size of the N-CQDs, FT-IR, Raman spectroscopy, HRTEM, DLS, and EDX have been performed. Moreover, this approach was used to identify doxycycline in pharmaceutical waste and bacterial cells. Because of its great sensitivity and selectivity, N-CQDs are ideal for measuring DC in environmental applications. © 2022 American Chemical Society. All rights reserved.

8.
Journal of Health and Translational Medicine ; 25(1):145-153, 2022.
Article in English | EMBASE | ID: covidwho-1979857

ABSTRACT

Viral diseases are the most devastating health concern worldwide. Outbreaks of coronavirus (CoVs)-related acute respiratory diseases are responsible for the massive health/socio-economic breakdown in the last two decades including the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), the third reported spillover SARS-CoV-2 from an animal coronavirus to humans. After the H1N1 pandemic influenza (2009), SARS-CoV-2 (novel-beta coronavirus) causing COVID-19 has stretched across 215 countries in 5 major continents with 200,523,190 confirmed cases (4 August 2021;https://www.worldometers.info/coronavirus/). COVID-19 patients had cough, fever, dyspnea, headache, and respiratory failure, as well as shock, acute respiratory distress syndrome, and sepsis in severe instances. Independent of two preceding epidemics, SARS (2002) and MERS (2012), a knowledge gap about the emerging medical manifestations as well as complications of SARS-CoV-2 (2019-2020) infections in humans must be filled, with a focus on immunological complications and computational genomics for forecasting/preparedness for a similar outbreak in the future. This paper aims to address aspects of this gap.

9.
Journal of Scientometric Research ; 11(1):47-54, 2022.
Article in English | Web of Science | ID: covidwho-1897066

ABSTRACT

This study aims to analyze the dynamics of the published articles and preprints of Covid-19 related literature from different scientific databases and sharing platforms. The PubMed, ScienceDirect, and ResearchGate (RG) databases were under consideration in this study over a specific time. Analyses were carried out on the number of publications as (a) function of time (day), (b) journals and (c) authors. Doubling time of the number of publications was analyzed for PubMed "all articles" and ScienceDirect published articles. Analyzed databases were (1A) PubMed (01/12/2019-12/06/2020) "all_articles" (16) PubMed Review articles) and (1C) PubMed Clinical Trials (2) ScienceDirect all publications (01/12/2019- 25/05/2020) (3) RG (Article, Pre Print, Technical Report) (15/04/2020 - 30/4/2020). Total publications in the observation period for PubMed, ScienceDirect, and RG were 23000, 5898 and 5393 respectively. The average number of publications/day for PubMed, ScienceDirect and RG were 70.0 +/- 128.6, 77.6 +/- 125.3 and 255.6 +/- 205.8 respectively. PubMed shows an avalanche in the number of publications around May 10, the number of publications jumped from 6.0 +/- 8.4/day to 282.5 +/- 110.3/ day. The average doubling time for PubMed, ScienceDirect, and RG was 10.3 +/- 4 days, 20.6 days, and 2.3 +/- 2.0 days respectively. The average number of publications per author for PubMed, ScienceDirect, and RG was 1.2 +/- 1.4, 1.3 +/- 0.9, and 1.1 +/- 0.4 respectively. Subgroup analysis, PubMed review articles mean review <0 vertical bar 17 +/- 17 vertical bar 77> days: and reducing at a rate of -0.21 days (count)/day. The number of publications related to the COVID-19 until now is huge and growing very fast with time. It is essential to rationalize and limit the publications.

11.
Benchmarking-an International Journal ; : 28, 2022.
Article in English | Web of Science | ID: covidwho-1853324

ABSTRACT

Purpose With the emergence of COVID-19 and increased infections, organizations urged their employees to work from home. Furthermore, with the on-going pandemic, employees take measures to ensure individual safety and their families. Hence, work from home culture can result in long-term employee satisfaction. However, no study addresses the development of work from the home culture in an integrated framework. Therefore, the current research explores the role of safety during the pandemic, organizational commitment and employee motivation on work from home culture, which may influence employee satisfaction. Furthermore, job demands and home demands were also evaluated for employee satisfaction. Design/methodology/approach The study used existing scales of the factors to develop the measures and collect perceptual responses from employees working from home, supported with a pre-test. The study executed a survey with effective responses from 132 individuals spread across different sectors to validate the hypotheses. The responses were analysed using partial least squares in ADANCO 2.2. Findings Findings suggest safety concerns along with organization commitment enhances work from home culture. Such work from home culture enhances employee motivation and employee satisfaction. Furthermore, job demands and home demands also influence employee satisfaction. Originality/value To the best of the authors knowledge, the study is the foremost to develop an integrated empirical framework for work from home culture and its antecedents and consequences. The study has several important implications for managers.

12.
European Respiratory Journal ; 58:2, 2021.
Article in English | Web of Science | ID: covidwho-1703873
13.
Journal of the Indian Chemical Society ; 99(1), 2022.
Article in English | Scopus | ID: covidwho-1596717

ABSTRACT

Background: The recent pandemic by COVID-19 is a global threat to human health. The disease is caused by SARS-CoV-2 and the infection rate is increased more quickly than MERS and SARS as their rapid adaptation to varied climatic conditions through rapid mutations. It becomes more severe due to the lack of proper therapeutic drugs, insufficient diagnostic tool, scarcity of appropriate drug, life supporting medical facility and mostly lack of awareness. Therefore, preventive measure is one of the important strategies to control. In this context, herbal medicinal plants received a noticeable attention to treat COVID-19 in Indian subcontinent. Here, 44 Indian traditional plants have been discussed with their novel phytochemicals that prevent the novel corona virus. The basic of SARS-CoV-2, their common way of transmission including their effect on immune and nervous system have been discussed. We have analysed their mechanism of action against COVID-19 following in-silico analysis. Their probable mechanism and therapeutic approaches behind the activity of phytochemicals to stimulate immune response as well as inhibition of viral multiplication discussed rationally. Thus, mixtures of active secondary metabolites/phytochemicals are the only choice to prevent the disease in countries where vaccination will take long time due to overcrowded population density. © 2021 Indian Chemical Society

14.
IEEE Sensors Journal ; 2021.
Article in English | Scopus | ID: covidwho-1574574

ABSTRACT

This paper describes a wearable, open-source wrist temperature monitoring system that enables the reliable identification of slowly-varying skin temperature patterns that may be indicative of infections. The hardware platform uses a Bluetooth Low Energy (BLE) wireless interface and includes three skin temperature sensors, a thermally-isolated ambient temperature sensor, an inertial measurement unit (IMU), and a Galvanic skin response (GSR) sensor. A template-matching algorithm is used to detect weak but long-lived anomalous temperature patterns that deviate from the normal circadian rhythm are thus may be driven by infections. Experimental and simulation results confirm that small temperature anomalies (peak value <0.4°C) extending over 2-3 weeks can be detected with a total error rate <10%. IEEE

15.
Thorax ; 76(Suppl 2):A119-A120, 2021.
Article in English | ProQuest Central | ID: covidwho-1506750

ABSTRACT

P97 Table 1Demographics and clinical characteristics of participants at hospital admission and follow up for wave 1 and 2 admissions Wave 1 Wave 2 p-value N = 400 N = 400 Demographics and Lifestyle Age (years) (Median, IQR) 61 (50 -74) 61 (51 - 74) 0.59 Male gender (N,%) 247 (61.8%) 237 (59.3%) 0.47 Ethnicity (White) (N,%) 200 (50.0%) 195 (48.8%) 0.001* Smoking status – Never smoker (N,%) 215 (53.8%) 219 (54.8%) 0.58 BMI (kg/m2) (Median, IQR) 26.8 (24.1 - 29.4) 27.7 (24.3 - 31.6) 0.015 Underlying clinical status Clinical Frailty Score (Median, IQR) 2 (2, 4) N = 332 3 (2, 3) N = 384 0.001 Shielding Status (N,%) Extremely vulnerable HCP issued letter 32 (10.1%) 23 (7.2%) 39 (11.2%) 5 (1.4%) 0.001 Covid Admission Severity Parameters Total number of symptoms (Median, IQR) 4 (3 - 6) 3 (2 - 3) <0.0001 NEWS2 score (Median, IQR) 5 (2 - 7) N = 372 4 (3 - 6) N = 379 0.60 TEP status – For full escalation (N,%) 284/365 (77.8%) 361/400 (90.3%) <0.0001 Maximum respiratory support (N,%) CPAP NIV N= 377 10 (2.7%) 2 (0.5%) N = 400 32 (8.0%) 5 (1.3%) <0.0001 Received anti-viral or immunosuppressive drugs (N,%) 23/374 (6.2%) 127/400 (31.8%) <0.0001 ITU admission (N,%) 62/377 (16.5%) 43/400 (10.8%) 0.02 Intubation (N,%) 49/364 (13.5%) 19/400 (4.8%) <0.0001 Pulmonary Embolus (N,%) 22/360 (6.1%) 24/395 (6.1%) 0.98 Follow-up Outcomes N = 322 N = 365 Mental Health Outcomes PHQ2 score ≥ 3 (N,%) 47 (15.4%) 34 (9.9%) 0.04 TSQ score ≥ 5 (N,%) 44 (14.9%) 12 (3.3%) <0.0001 Physical Recovery and Symptoms Not returned to work (N,%) 76 (24.8%) 114 (33.6%) 0.03 Improved Sleep quality (N,%) 168 (61.5%) 265 (78.4%) <0.0001 Improved Fatigue (N,%) 241 (87.6%) 307 (88.7%) 0.91 Improved Cough (N,%) 194 (69.5%) 291 (84.8%) <0.0001 Improved Breathlessness (N,%) 213 (76.1%) 311 (89.6%) <0.0001 Total Number of Symptoms (Median, IQR) 1 (0 - 2) N=314 0 (0 – 1) N=364 Radiology outcomes (N,%) Normalised Significantly Improved Not significantly improved Worsened N=309 211 (68.3%) 55 (17.8%) 2 (0.7%) 30 (9.7%) N=279 187 (67.0%) 65 (23.3%) 13 (4.7%) 14 (5.0%) <0.0001 *p value likely attributable to differences in unknown ethnicityConclusionThese data suggest second wave pa ients, although frailer, presented with fewer symptoms and experienced improved hospital admission trajectory. They demonstrated improved self-reported mental health and physical recovery outcomes despite earlier follow-up, possibly attributed to improved in-hospital treatment. Supporting recovery remains a clinical priority given many patients had not returned to work.ReferenceSaito S, et al. First and second COVID-19 waves in Japan: comparison of disease severity and characteristics. J Infect. 2021;82(4):84-123.

16.
Thorax ; 76(Suppl 2):A141, 2021.
Article in English | ProQuest Central | ID: covidwho-1506492

ABSTRACT

P137 Table 1Demographics, admission severity and follow-up symptomsVariable White N = 603 Asian N = 252 Black N = 130 Other N = 122 p-value Age 65 ± 16.5 59 ± 15.4 59 ± 13.9 59 ± 14.7 <0.001 Male (%) 372 (62) 148 (59) 72 (55) 81 (66) 0.28 Index of deprivation* 6 (3–7) 6 (4–8) 5 (3–7) 5 (3–7) 0.03 Body mass index 27.1 (23.5–30.5) 26.0 (23.7 – 29.2) 28.9 (25.9 – 34.7) 26.7 (25.1 – 30.9) <0.001 Hypertension (%) 244/583 (42) 113/247 (46) 72/125 (58) 40/119 (34) 0.001 Cardiovascular disease (%) 133/415 (32) 45/166 (27) 15/86 (17) 16/73 (22) 0.02 Diabetes (%) 122/583 (21) 80/247 (32) 45/125 (36) 40/119 (34) <0.001 Respiratory disease (%) 124/416 (30) 39/167 (23) 21/91 (23) 16/70 (23) 0.25 Chronic kidney disease (%) 61/583 (11) 29/247 (12) 27/125 (22) 9/119 (8) 0.002 Any mental health (%) 77/583 (13) 23/247 (9) 8/125 (6) 17/119 (14) 0.08 Smoking history (%) 250/587 (43) 43/244 (18) 44/127 (35) 44/118 (37) <0.001 Clinical frailty score 3 (2–4) 2 (2–4) 3 (2–4) 3 (2–3) 0.11 NEWS2 4 (2–6) 4.5 (3–6) 5 (3–6) 5 (3–7) 0.3 Respiratory support 80/564 (14) 47/236 (20) 23/116 (20) 21/118 (18) 0.15 Follow-up symptoms MRC score* 2 (1–3) 2 (1–3) 2 (1–3) 2 (1–2) 0.61 Cough improved (%) 414/553 (75) 177/232 (76) 85/118 (72) 87/113 (77) 0.8 Fatigue improved (%) 451/552 (82) 193/228 (85) 109/122 (89) 88/115 (77) 0.05 Sleep improved (%) 342/536 (64) 155/228 (68) 76/117 (65) 68/112 (61) 0.57 Burden of symptoms* 1 (0–2) 1 (0–2) 1 (0–2) 1 (0–2) 0.78 Returned to work (%) 142/256 (56) 77/139 (55) 29/64 (45) 41/71 (58) 0.45 Felt back to normal (%) 256/439 (55) 112/186 (60) 62/103 (60) 43/78 (55) 0.87 Positive PHQ-2 (depression screening) 65/580 (11) 40/242 (17) 12/126 (10) 11/116 (10) 0.09 Positive TSQ (post-traumatic stress screening) 42/601 (7) 16/248 (7) 13/130 (10) 8/122 (7) 0.6 *Non-parametric data presented as median ± interquartile range, all other data presented as mean ± standard deviation.DiscussionOur data demonstrate that despite having more co-morbidities associated with worse outcomes, adults from BAME backgrounds who are discharged from hospital following COVID-19 are no more likely to experience symptoms consistent with ‘Long CO ID’. However, given the increased risk of infection among BAME communities, we must ensure that reducing health inequalities remain central to the UK health agenda.ReferenceSze, et al. EClinicalMedicine 2020. doi:10.1016/j.eclinm.2020.100630

17.
Library Philosophy and Practice ; 2021:1-11, 2021.
Article in English | Scopus | ID: covidwho-1472960

ABSTRACT

Purpose Course reserve module in ILS OPAC and web-scale library discovery services are interconnected to data management and educational resource management systems. Every department and course instructor are designed the course based on the user's requirements. The goal of this article is to analyze the instructional reserves component integrating open source tools Koha and VuFind in order to provide advanced level CMS and LCMS services that satisfy users. It is also feasible with metadata searching from other repositories, e.g., OCLC WorldCat and Amazon, to increase the web-scale discovery services among the users and library professionals. Methodology Popular level software has been selected based on course reserve requirements such as Koha and VuFind. It needs proper installation and configuration with the help of multiple files and scripts. Design the template and layout based on Koha and VuFind for course-specific reserve and add the barcode to display the items and link in Koha library OPAC easily. This course module will be integrated with the VuFind to provide web-enabled discovery services based on departments, instructors, and course URLs. Findings The whole integrated domain-specific interface is beneficial to the users because they could easily access the course reserve materials developed by different subject experts. As a consequence, both Koha and VuFind just provide capability of delivering the appropriate course module to the correct participants at the perfect time.Library users have access and download their course from this integrated interface to continue their online learning process. This framework will fully enable web-based services for CMS and LCMS regarding the fulfillment of tags clouds, metadata searching, and OCLC WorldCat Local searching. Originality This innovative integrated framework is providing full-text resources using MARC21 tags for the users. The librarians at any academic institution will benefit much from these instructions, stages, and methods. VuFind, which uses a single-window search technique, can also get a course reservation for library users. It is one of the advanced-level web-scale library discovery services for students and instructors to continue their educational activities during the COVID-19 pandemic using the course reserve module of Koha and VuFind. © 2021, Library Philosophy and Practice. All rights reserved.

18.
Chest ; 160(4):A343, 2021.
Article in English | EMBASE | ID: covidwho-1458028

ABSTRACT

TOPIC: Chest Infections TYPE: Medical Student/Resident Case Reports INTRODUCTION: Coronavirus disease (COVID-19) is a global health crisis. It is associated with increased activation of the clotting system leading to thrombotic complications in 5 to 23% of cases[1]. It is known to cause significant venous thromboembolism and few cases with arterial thrombosis with increased risk of life-threatening complications like myocardial infarction, ischemic stroke, splenic infarct, and left ventricular clot have been reported[2]. CASE PRESENTATION: A 70-year-old female with a past medical history of coronary artery disease, Hypertension, COPD, recent COVID-19 (3 weeks ago) not requiring admission to hospital presented to the hospital with bilateral leg and forearm pain. Leg pain was worse with activity. She had feeble peripheral pulses on palpation.She underwent Computed Tomography angiography which showed extensive arterial thrombosis involving the distal abdominal aorta, left common iliac artery, superior mesenteric artery, and also showed an area of wedge-shaped infarction in the spleen. She had a thrombus at the apex of the left ventricle, with incidental 1.3 cm spiculated mass in the left lung. There was no evidence of venous thromboembolism in imaging.She was started on therapeutic anticoagulation with heparin. After multidisciplinary discussion with Hematology, Vascular surgery, and Cardiology, her anticoagulation was changed to Enoxaparin. She was managed medically. Workup including JAK2, beta-2 glycoprotein antibodies, lupus anticoagulant, and anticardiolipin antibodies was negative. DISCUSSION: The exact mechanisms that activate coagulation cascade in SARS-CoV-2 infection are still unknown, but they are found to be associated with increased thrombogenesis. SARS-CoV-2 viral infection can activate the plasmatic clotting system by activating multiple procoagulant pathways. Angiotensin-converting enzymes 2 are normally found on various cells such as lymphocytes, alveolar cells, monocytes/macrophages, and platelets. In SARS-CoV-2 infection, Surface S protein of SARS-CoV-2 binds to its target transmembrane receptor( ACE2 protein) and down-regulates the expression of ACE2 protein. It leads to the accumulation of angiotensin II in the body which interacts with platelets and endothelial cells leading to further promotion of clot formation[3]. This was the likely cause of hypercoagulable state in our patient leading to thrombosis. CONCLUSIONS: An extensive arterial clot can be the initial presentation in COVID-19 patients and can be treated promptly with anticoagulation. Early introduction of prophylactic anticoagulation is necessary to prevent clot formation. REFERENCE #1:.Thromboinflammation and the hypercoagulability of COVID-19. Connors JM, Levy JH J Thromb Haemost.2020 Jul;18(7):1559-1561. REFERENCE #2: Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV, and lessonsfrom the past.Giannis D, Ziogas IA, Gianni P J Clin Virol. 2020 Jun;127():104362. REFERENCE #3: Smith S A, Mutch N J, Baskar D, Rohloff P, Docampo R, Morrissey J H. Polyphosphate modulates bloodcoagulation and fibrinolysis. Proc Natl Acad Sci U S A. 2006;103(04):903–908. DISCLOSURES: No relevant relationships by Sumit Gami, source=Web Response No relevant relationships by Subash Ghimire, source=Web Response No relevant relationships by Sushmita Khadka, source=Web Response No relevant relationships by Shobha Mandal, source=Web Response

19.
2021 IEEE International Conference on Health, Instrumentation and Measurement, and Natural Sciences, InHeNce 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1455456

ABSTRACT

The world is facing a huge loss of both humans and the economy due to COVID-19. Utilizing limited health care facilities properly might help reduce this burden. We provide a pipeline that focuses to develop a scheduler to optimally allocate medical staff based on the predicted number of cases. First, we detect the flow of initial cases in terms of network transmission using networkx (Python package). We develop a model based on Bidirectional Long Short-Term Memory (Bi-LSTM), a deep learning technique to predict future cases using recurrent neural networks with average MSE (mean squared error) of 7.2174e-04 and a novel scheduling technique is proposed by genetic and constraint algorithm-based approach. Our tool can prepare an efficient work schedule for the medical staff at the care centers based on the predicted total COVID cases for next week(s). This is the first attempt to study the pandemic situation in a region from the above-mentioned major perspectives in an integrated way. Several graphical representations and simulation results are presented to validate the obtained results. We demonstrate our method using the data for the region of New Delhi, India. However, it is a general approach and can be applied to any region in the world. © 2021 IEEE.

20.
Asian Journal of Pharmaceutical and Clinical Research ; 14(8):108-113, 2021.
Article in English | EMBASE | ID: covidwho-1369977

ABSTRACT

Objectives: According to the recent studies, it is seen that coronavirus disease 2019 (COVID-19) infection is associated with many bacterial and fungal infections. In case of COVID-19 patients, diabetes mellitus (DM) and hypertension (HTN) are the prime risk factors and during the course of treatment, patients develop secondary fungal infections like mucormycosis. We conducted a systemic review of the present scenario and tried to evaluate the association of mucormycosis with COVID-19. Methods: We searched articles related to the COVID-19 associated mucormycosis, in PubMed, IndMed, and Cochrane Library. We conducted a meta-analysis on the basis of systemically reviewed all articles which reported COVID-19 associated with mucormycosis. We analyzed comorbidity, treatment, and outcome of patients in association with COVID-19 and mucormycosis. Results: We found a total of 196 articles based on mucormycosis, out of which only 25 were selected on the basis of our inclusion and exclusion criteria. 71 cases were found and most of the cases were from India and USA. We also found that it was more prevalent among male patients and patients with DM, and in association with HTN. Conclusion: It is seen from the studies that patients already suffering from DM and HTN when infected with coronavirus are most likely to develop mucormycosis. Treatment of latent DM, prediabetic patients, conversely, that efforts to diagnose, detect, and treat DM may have a beneficial influence in the treatment of secondary fungal infections like mucormycosis. Finding out all the cases of DM and treatment of DM can carry out an advantageous effect in all patients suffering from COVID-19.

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