ABSTRACT
Coronavirus disease 2019 (COVID-19) is a highly infectious disease characterized by higher leukocyte numbers, acute respiratory distress, and elevated levels of plasma proinflammatory cytokines. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, begins its pathogenesis by the binding of the virus to the host's angiotensin-converting enzyme 2 (ACE-2) receptor and then replication. The various replicated viruses then reinfect other cells and organs with ACE-2 receptor and further wreak havoc and could later result in multisystem organ failure. Presently, efforts are on the way to develop vaccines and drugs for this virus. But the current spike in COVID-19 cases linked to mutation in the virus genome and those of its enzymes is a cause of concern. Studies conducted by some authors have identified 6 major clads (basal, D614G, L84S, L3606F, D448del, and G392D), out of which D614G (a G-to-A base change at position 23403 in the Wuhan reference strain) was found to be the most reoccurring clad. This chapter examines all of these. © 2022 Elsevier Inc. All rights reserved.
ABSTRACT
Objectives: Worldwide reduction in emergency procedures has been observed during the current COVID-19 pandemic. The effects of the pandemic and its associated lockdown on arrhythmia related emergency procedures is not known. This study was done to see the effects of the COVID-19 pandemic lockdown on provision of emergency arrhythmia procedures and to identify vulnerable patient groups that may be disproportionately affected during lockdown. Methodology: Data for patients requiring emergency intracardiac devices including temporary and permanent pacemakers was collected from three public sector hospitals of Sindh, Pakistan, for the COVID-19 lockdown period of March to May 2020. This was compared to the data for the same period for 2019. Results: Patients presenting during lockdown decreased by 32.8% (from 250 to 168) compared to the same period without lockdown. The decline was across all emergency procedures considered. There was a more than fivefold reduction in the number of patients in patients from outside the metropolitan area of the hospital (64.3%) compared to those residing within the city (12.5%) (p=0.001). There was a trend showing women to be more effected, with the percentage decline in women being statistically significant in the rural setting (-93.8% vs. -52.9%, p=0.043). All age groups were equally affected (p=0.152). Conclusion: A marked reduction in the number of patients who presented for emergency intra cardiac devices and TPM procedures was seen during COVID-19 lockdown. The patients who presented from outside the city of the hospital and women in rural setting were significantly more effected.
ABSTRACT
IntroductionIn these unprecedented times, the medical workers particularly at the frontlines of the pandemic are vulnerable to psychological trauma rooted in the new demands of their work, as well as the prevailing sense of insecurity and safety concerns for themselves and their loved ones.ObjectivesTo explore the mental health impact of the covid-19 pandemic on the front-line health care workers in a tertiary care hospital in Rawalpindi, PakistanMethodsFrontline healthcare workers will include all doctors, nurses and paramedical staff performing duties that involve dealing directly with known or suspected cases of COVID-19 at triage clinics, ICUs and isolation wards. Depression Anxiety and Stress Scale (DASS) and Impact of events scale-revised (IES-R) were administered to them to assess the mental health of these frontlines.ResultsA total of 94 frontlines were included in the study. 76(80.9%) had no significant depression while 18 (19.1%) had presence of significant depression. 62 (66%) had no significant anxiety while 32 (34%) had significant anxiety. Female gender and degree of contact with high clinical suspicion cases were significantly related with presence of anxiety and depression among the study participants. Being female, single, a nurse or a paramedic and degree of contact with high clinical suspicion cases was significantly related with presence of stress among the frontlines. People working in ICU or corona isolation unit had more chances of having trauma as compared to other frontlines.ConclusionsDepression, anxiety, stress and trauma were common among the front liners fighting in this pandemic
ABSTRACT
Coronavirus disease 2019 (COVID-19) is associated with an increased risk of venous and arterial thrombosis in patients. Numerous studies have been conducted on COVID-19 and its association with thromboembolism is well known. We conducted a meta-analysis to find out the incidence of thromboembolism in hospitalised patients with COVID-19 to provide more generalized results. A systematic literature search was conducted in PubMed and SCOPUS to find observational studies reporting outcomes of interest. Amongst the studied thromboembolic events, the meta-analysis showed the prevalence of pulmonary embolism (PP: 12.4% [7.2%, 18.6%];12 = 97.23%) to be the highest. It was followed by deep vein thrombosis (PP: 8.6% [4.2%, 14.3%];12 = 97.52%), myocardial infarction (PP: 2.3% [0.2%, 11.2%];12 = 99.3%), and stroke (PP: 1.2% [0.8%, 1.6%];12 = 65.09%). The results of this analysis further warrant the timely and appropriate use of pharmacological thromboprophylaxis and identification of risk factors in hospitalized COVID-19 patients.
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Objective: To explore the emic perspective of survivors and their family members with regards to their lived experience with COVID-19 Study Design: Cross sectional qualitative research using phenomenological approach with a constructivist paradigm. Telephonic interviews of patients from Punjab and KP for 2 weeks during May 2020, as approved by the ethical review committee of Fauji Foundation Hospital, Rawalpindi Methods: Non-probability maximum variation purposive sampling technique was employed to conduct semi structured interviews with 22 individuals;including those who had tested positive for COVID-19 on PCR test and recovered after minimum 2 weeks of isolation, along with their family members. Braun and Clarke's thematic analysis was done concurrently with data collection and management. Results: 5 data-driven themes with 21 subthemes were;"Perceived Susceptibility": symptoms, risk factors, causes/origin, modes of transmission, "Knowledge and Experience with Precautionary Behaviors": use of masks, hygiene practices, social distancing, religiosity, "Treatment seeking behavior: Perceived costs and benefits": experience with test, complementary home remedies, medical treatment, mistrust for quarantine facilities, interaction with health care practitioners, less priority to other diseases, "Psycho-social dimensions of COVID-19": guilt and fear, caregiver burden, family quarantined, renewed spiritual connections, "Barriers to Care": health care workers: dichotomy of praise and stigma, media: dramatic and traumatic, stigma-behavior of others. Conclusion: This study revealed the lived experiences of COVID-19 survivors and their family members, detailing their conceptualization with regards to disease vulnerability and associated precautionary behaviors. It mainly showed how survivors and family members navigate through biomedical systems, complementary healing practices, resilience and stigma.
ABSTRACT
SARS-CoV-2 causing COVID-19 has appeared as an ongoing global public crisis, growing with geometric progression and has caused huge devastation till date majorly because of lack of targeted therapeutic agents like vaccines. SARS-Cov-2 entrance into the host cells is reliant on acidic pH. Thus, in the current clinical emergency there is a pressing need to look forward for adjunct therapies which could counter the acidic pH, so as to restrain the viral entry and its subsequent reproduction in the host cells. Therefore, the current review attempted to explore the possibility to use sodium bicarbonate as an alternative lysosomotropic agent based on the reported literature owing to its anti-flu properties and widespread use during 1918 Spanish flu pandemic. The suggestions put forward in the current review article based on the careful use of sodium bicarbonate could probably help to restrain SARS-CoV-2 infection. © 2020, Romanian Society for Pharmaceutical Sciences. All rights reserved.