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1.
Methods of Mathematical Modelling: Infectious Diseases ; : 173-187, 2022.
Article in English | Scopus | ID: covidwho-2035637

ABSTRACT

Several techniques, including mathematical models, have been explored since the onset of COVID-19 transmission to evaluate the end outcome and implement drastic measures for this illness. Using the currently infected, noninfected, exposed, susceptible, and recovered cases in the Indian community, we created a mathematical model to describe the transmission of COVID-19. In particular, we used the semianalytical Adomian decomposition method without considering any discretization to perform the first-order differential equations related to COVID-19 cases. According to our early findings, rigorous initial isolation for 22-25days would reduce the number of exposed and newly infected people. As a result of the downstream effect, the number of suspected and recovered persons would remain stable, assuming that social distance is properly recognized. In a larger sense, the parameters established by our mathematical model may aid in the refinement of future pandemic tactics. © 2022 Elsevier Inc. All rights reserved.

2.
Annals of oncology : official journal of the European Society for Medical Oncology ; 32(9):S1052-S1052, 2021.
Article in English | EuropePMC | ID: covidwho-2010974
3.
Med J Armed Forces India ; 2022 Aug 22.
Article in English | MEDLINE | ID: covidwho-1996433

ABSTRACT

Background: India is the epicenter of diabetes mellitus (DM). The relationship between COVID and DM in age/gender-matched non-diabetics has not been studied yet. The role of DM in predicting the disease severity and outcome in COVID patients might provide new insight for effective management. Methods: We conducted a prospective comparative study at a COVID care center from 25th April-31st May 2021. Among 357 severe-COVID patients screened, all consecutive diabetes (n-113) and age/gender-matched non-diabetes (n-113) patients were recruited. All diabetics and non-diabetics at admission were subjected to high resolution computed tomography (HRCT) chest and inflammatory markers (C-reactive protein (CRP), D-dimer, ferritin, interleukin-6 (IL-6), lactate dehydrogenase (LDH), Neutrophil-Lymphocyte Ratio (NLR)) before starting anti- COVID therapy. Statistical analysis was done using JMP 15·0 ver·3·0·0. Results: The prevalence of DM among the screened population (n-357) was 38·37%. The mean age of the study population was 61y with male preponderance (57%). There was no statistical difference in the HRCT-score or inflammatory markers in the two groups except for higher NLR (p-0·0283) in diabetics. Diabetics had significantly inferior overall survival (OS) (p-0·0251) with a 15d-OS of diabetics vs. non-diabetics being 58·87%, 72·67%, and 30d-OS of diabetics vs. non-diabetics being 46·76%, 64·61%, respectively. The duration of the hospital stay was not statistically different in the two groups (p-0·2). Conclusion: The mortality is significantly higher in severe-COVID patients with DM when compared to age/gender-matched non-diabetics. There was no significant difference in most inflammatory markers/CT at admission between the two groups.

4.
International Journal of Phytocosmetics and Natural Ingredients ; 8(1), 2021.
Article in English | CAB Abstracts | ID: covidwho-1893424

ABSTRACT

Background: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected by a new strain of human coronavirus, has engulfed the whole globe with its vicious potential to eradicate humankind. The pandemic has emerged from the Wuhan provinces of China with high transmissibility. Researchers are rushing to discover vaccines and drugs for the disease, which is not known yet. In this study, we have focused on the in-silico screening of phytochemicals occurring naturally in plant extracts that could possibly interact with receptor binding motif (RBM) of spike protein and thereby inhibit virus-cell interaction. Materials and Methods: In this study, we have taken 100 phytochemicals that have been studied in various viral interactions and have shown antiviral properties. Initially, these compounds were analyzed on the basis of their physicochemical and pharmacokinetic properties, biological activities, possible target interactions, similar compounds in humans, and gene regulations using bioinformatic tools, namely Swiss-ADME, PASS (prediction of activity spectra for substances), SwissTargetPrediction, similar ensemble approach (SEA) search server, DIEGP-pred, respectively and were filtered out on the basis of immunobiological activities and expression of genes involved in cytokine storm regulation and immunostimulation. Further, they were docked with the receptor-binding domain (RBD) of spike protein in the SARS-CoV-2 using SwissDock and analyzed by UCSF Chimera.

5.
Rheumatology (United Kingdom) ; 61(SUPPL 1):i64-i65, 2022.
Article in English | EMBASE | ID: covidwho-1868394

ABSTRACT

Background/Aims The COVID-19 pandemic led to an overnight shift in healthcare delivery and rapid uptake of digital technology. Such approaches risk digital exclusion for people without access to or not confident in their use of technology. We sought to examine digital access and e-health literacy in people with inflammatory conditions. Methods People (n=2,024) were identified from their electronic health record and invited to participate in a survey, using SMS and postal approaches. Data were collected on age, gender, self-reported arthritis diagnosis (RA, PsA, AS, SLE and other), access to an internet-enabled device and frequency of internet access, health literacy (single-item literacy screener) and self-perceived e-health literacy (eHEALs). Ethical approval was obtained (Ref 21/PR/0867). Results 639 people completed the survey, of whom 287 (44.9%) completed it online. Mean (sd) age was 64.5 (13.1) years and 384 (64.7%) were female. 98.3% were white. Approximately 20% of people did not have access to an internet enabled device (Table). 93 (15.3%) of patients reported never accessing the internet, this proportion was higher in people with RA. Approximately 19% had low health literacy. In those reporting internet use, eHealth literacy was moderate. The most Conclusion Low health literacy, lack of digital access and low reported internet use was common, especially in people with RA, leading to high use of telephone advice and rheumatology appointments. Digital roll-out needs to take account of people requiring extra support to enable them to access care or risks excluding many patients with inflammatory conditions.

6.
Rheumatology (United Kingdom) ; 61(SUPPL 1):i51-i52, 2022.
Article in English | EMBASE | ID: covidwho-1868375

ABSTRACT

Background/Aims Concerns about the risk of COVID-19 infection led to guidelines advocating shielding for many people with inflammatory conditions. We aimed to assess the impact of the pandemic on the self-reported physical and mental health of people with inflammatory conditions. Methods 2024 patients with inflammatory conditions (RA, PsA, AS, SLE and other) were randomly selected from electronic health records. Survey invites were sent (August 2021 to coincide with relaxation of COVID restrictions) using a combination of SMS and postal approaches. Data collected included demographics, COVID infection and shielding status, physical (MSK-HQ) and mental health (PHQ8 and GAD7) and global impact on physical or mental health (4 options: none-severe). Ethical approval was obtained (REC Ref 21/PR/0867). Results 639 people completed the survey, of whom 287 (44.9%) completed online. Mean (sd) age was 64.5 (13.1) years and 384 (64.7%) were female. The majority of people had RA although 57 (9%) reported more than one inflammatory condition. 349 (57.9%) of people were advised to shield. Rates of COVID infection were relatively low across the groups (Table 1). 254 (41.2%) reported moderate or severe impact of the pandemic on physical health, which impacted least in people with RA. 244 (39.4%) reported moderate or severe impact of the pandemic on mental health with 175 (28.7%) reporting moderate depression (PHQ8>10) and 138 (22.6%) moderate anxiety (GAD-7≥10). Conclusion Reported COVID infections were low in our cohort. The pandemic had significant effects on physical and mental health, which appeared less in people with RA than other inflammatory conditions.

7.
Lung India ; 39(SUPPL 1):S157-S158, 2022.
Article in English | EMBASE | ID: covidwho-1857496

ABSTRACT

Background: Majority of COVID 19 patients that are hospitalized are with respiratory illness including pneumonia and ARDS.The acute manifestations of COVID 19 has been well documented however long-term sequelae from acute COVID 19 remain speculative. Chronic lung disease including IPF is a risk factor for poorer prognosis in COVID 19 infection. Case Study: A 52-year-old male patient presented to emergency department with history of dyspnea on and off for past 6 months increased over last two days, cough with expectoration for past 2 months. Eight months back he was treated for COVID 19 pneumonia with dexamethasone and maximal oxygen requirement of 2L via nasal cannula. CT chest showed diffuse GGO's in bilateral upper and lower lobes with CT severity score of 20/25. Patient was discharged with no oxygen requirement with saturation of 96% on room air. On arrival to the hospital, patient was tachypneic and in type 1 respiratory failure, requiring 10L of oxygen. CT chest showed honeycombing with consolidation and traction bronchiectasis. Discussion: Advanced fibrosis and poor lung function are associated with severe disease and poorer prognosis in COVID 19 infection. CD 209L receptors has been implied in the pathogenesis of progressive ILD in COVID 19 infection. Conclusion: Early detection of potential cases of post- COVID 19 pulmonary fibrosis may give a chance to prevent or at least modify such disabling complication.

9.
Critical Care Medicine ; 50(1 SUPPL):556, 2022.
Article in English | EMBASE | ID: covidwho-1691822

ABSTRACT

INTRODUCTION: The diagnosis of methemoglobinemia is infrequently thought of in cases of hypoxia, given its rarity. The most common inciting factor is an exposure to oxidizing agents, such as various antibiotics (sulfonamides, trimethoprim, and dapsone), local anesthetics, nitrites, and aniline dyes. This is a case of methemoglobinemia in a patient who was initially treated for COVID 19 with outpatient vitamin infusions. DESCRIPTION: A 76-year-old man was brought to the emergency department after collapsing at home. He was treated for COVID-19 the week prior with ivermectin and vitamin infusions, however developed high fevers, up to 102 F, with worsening cough and fatigue. On arrival his oxygen saturation was 50%, which improved with non-rebreather. Chest CT revealed multifocal ground glass opacities, consistent with COVID pneumonia. Shortly after admission, a rapid response was initiated as the patient was becoming more hypoxic with worsening altered mental status. Pulse oximetry revealed oxygen saturation of 60%;the patient was quickly intubated and transferred to the intensive care unit - oxygen saturation continued to read 70% despite a FiO2 100%. An arterial blood gas appeared brown in color and revealed a normal paO2 and pCO2. The patient was found to have a methemoglobin level of 21%. The patient underwent exchange transfusion of 7 units, with subsequent resolution of his hypoxia. DISCUSSION: Methemoglobinemia is a life threatening disorder, and diagnosis is dependent on a high degree of clinical suspicion. Patients typically present with shortness of breath, fatigue, cyanosis, and can ultimately develop loss of consciousness. An arterial blood gas, with its classic chocolate-brown appearance, a normal Po2, and CO-oximetry panel confirms diagnosis. Methemoglobinemia is routinely treated with methylene blue and, in severe cases, requires red cell exchange. There are reports that have shown benefits of high-dose vitamin C for safe and effective treatment of methemoglobinemia in centers with no access to methylene blue, through its anti-oxidant effect. Interestingly, this patient developed this condition after being treated for COVID 19 with vitamin infusions. This case highlights the importance of careful history taking, as certain medications can have unknown and fatal side effects.

10.
5th International Conference on Information and Communication Technology for Intelligent Systems, ICTIS 2021 ; 251:145-155, 2022.
Article in English | Scopus | ID: covidwho-1653368

ABSTRACT

The spread of COVID-19 contagion has to lead the world on a pause, because of its alarming rate. The only immediate solution was to practice social distancing and enforce lockdown. COVID-19 has declared an international emergency because it has been labeled pandemic, and different countries are still developing their vaccine. As far as now various countries with various governments have undertaken active plans and emergency measures to protect the public. The government and various health organizations are in charge of the survey. In fear of being affected, people tend to avoid hospital visits and circumvent the COVID-19 test. As of now, many Web applications are developed to avoid social interaction and community gathering. The COVID-19 test booking Web app provides the user to choose what, when, and where to take the COVID-19 test, it also helps the government health officials to maintain a safe database. This ensures the increase of COVID-19 test being taken and provides the individual proper safety and assurance. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

11.
Journal of Pharmaceutical Research International ; 33(57B):178-188, 2021.
Article in English | Web of Science | ID: covidwho-1614276

ABSTRACT

COVID-19 patients have lower immunosuppressive CD4+ T and CD8+ T cells and henceforth patients in intensive care units (ICU) need mechanical ventilation, henceforward they stay in hospitals. These patients have been exposed to advances in fungal co-infections. COVID-19 patients progress towards mucormycosis a black fungal infection that is deadly leading to loss of sight and hearing and eventually death. This article discusses the clinical manifestations, risk factors and emphases on virulence traits and management of black fungus.

12.
Science Immunology ; 6(64):12, 2021.
Article in English | Web of Science | ID: covidwho-1535511

ABSTRACT

The introduction of vaccines has inspired hope in the battle against SARS-CoV-2. However, the emergence of viral variants, in the absence of potent antivirals, has left the world struggling with the uncertain nature of this disease. Antibodies currently represent the strongest correlate of immunity against SARS-CoV-2, thus we profiled the earliest humoral signatures in a large cohort of acutely ill (survivors and nonsurvivors) and mild or asymptomatic individuals with COVID-19. Although a SARS-CoV-2-specific immune response evolved rapidly in survivors of COVID-19, nonsurvivors exhibited blunted and delayed humoral immune evolution, particularly with respect to S2-specific antibodies. Given the conservation of S2 across 0-coronaviruses, we found that the early development of SARS-CoV-2-specific immunity occurred in tandem with preexisting common I3-coronavirus OC43 humoral immunity in survivors, which was also selectively expanded in individuals that develop a paucisymptomatic infection. These data point to the importance of cross-coronavirus immunity as a correlate of protection against COVID-19.

13.
Annals of Oncology ; 32:S1052, 2021.
Article in English | EMBASE | ID: covidwho-1432850

ABSTRACT

Background: In locally advanced gastroesophageal and gastric cancers, which constitute the majority of the presentation, the postoperative 5 year survival rate remains only 30-40%. It is in these patients that perioperative chemotherapy has helped improve radical resection rates control preoperative micrometastases and improve survival. Since 2017,FLOT based chemotherapy has largely replaced ECF/ECX in this setting. We did a retrospective analysis on our patients treated with FLOT regimen during the COVID-19 pandemic to assess its efficacy, tolerance and pathological response (TRG). Methods: Patients with resectable gastric and GOJ cancers who presented to us from August 2019 – March 2020 and treated with FLOT based perioperative chemotherapy were analyzed with SPSS (version 26, IBM, Armonk, NY). Pathologic assessment of tumour regression was done by Mandard's TRG scoring. A total of 36 patients were analysed, out of which 91% were males, median age 68 years,cT3/T4 86%, cN1/2 72.2%,GOJ 77.8%,Gastric 22%,Grade 2/3 94%.Total of 80.6% patients completed all 4 cycles of neoadjuvant FLOT and 88.9% patients underwent surgery(all R0).Median interval between last dose of chemo and surgery was 7 weeks.A total of 52.8% patients completed all 4 cycles of adjuvant FLOT. Treatment was delayed due to COVID-19 in 11%. Results: Median followup was 16.3 mths.1 year DFS was 66.3% and OS was 91.4%.Pathological CR(TRG 1) was seen in 2.8% patients.3 patients died due to postop complications. Most common grd-3 toxicities were oral mucositis(6%), diarrhea (6%),neutropenia(8.3%).5FU cardiotoxicity noted in 5.6%. [Formula presented] Conclusions: In our subset of patients,treatment delivery,surgery rates and toxicity profile were comparable to the seminal FLOT4 trial.Our histological responses are lower with pathCR in only 2.8% (vs 16%)patients,with most having TRG 3.The survival rates are better but a longer followup is required. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

14.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407320
15.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407243
16.
Med J Armed Forces India ; 77: S250-S253, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1336746
17.
Journal of Investigative Medicine ; 69(5):1087-1088, 2021.
Article in English | Web of Science | ID: covidwho-1307935
18.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277709

ABSTRACT

Introduction: COVID-19 was declared a global pandemic by the WHO in March 2020. The gold standard for diagnosis relies heavily on clinical suspicion along with PCR based assays of respiratory swabs. This nucleic acid study is highly sensitive and specific, however, there are faults, especially during the incubation period, during which the virus is hard to detect. Here we present a case of a patient, presenting with signs and symptoms of pneumonia, with serial negative viral swabs spaced out over time, who was ultimately diagnosed with COVID-19 infection via more invasive means. Case: A 49-year-old female with no significant past medical history presented to the emergency department with cough and shortness of breath for 2 days which developed when she returned to New York from Florida. Her personal history was significant for her occupation as an ER nurse and a history of vaping for 5-6 years.After arrival to the emergency department, the patient was febrile to 103.3 F, tachycardic, and hypoxic, saturating 89% on room air. Her laboratory work was significant for a mildly elevated D-dimer level, elevated CRP (11.23), normal procalcitonin level, and two negative COVID-19 swabs over 2 days. Her initial chest X ray showed multifocal pneumonia and a CT chest showed ground glass opacities amid dense consolidation. The patient was empirically treated for community-acquired bacterial pneumonia with antibiotics. The patient's respiratory and hemodynamic status started to decline, despite treatment. Ultimately, the patient required further investigation - a bronchoalveolar lavage was ultimately found to be positive for the COVID-19 virus, and the patient was immediately started on Remdesivir. Discussion: In this day and age, countries are increasingly utilizing the COVID-19 reverse-transcriptase PCR and are pushing for widespread testing for case detection, but how sensitive and specific is this test, really? Serial testing with swabs performed at intervals should be the answer as the viral load of the COVID RNA steadily rises and peaks over 0-9 days after onset of symptoms. However, this may not be the case in a majority of patients and more invasive testing using bronchoscopy and bronchoalveolar lavage may be the only way to truly diagnose COVID-19 pneumonia. The delay in confirmation, however, could prove to be truly fatal, subjecting patients to painful measures like intubation. This case brings to light the realization that nasopharyngeal/oropharyngeal swabs may not be sufficient to detect the virus with full certainty.

19.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277431

ABSTRACT

Rationale: Defining a reliable prognostication method in patients with COVID-19 has remained a challenge. Various combinations of inflammatory markers, including CRP, LDH, and D-dimer, have been predictive of increased severity in this group of patients. None of the markers mentioned, however, have had a significant association with increased mortality. Machine learning has been utilized for predictions related to COVID-19. Prior COVID-19 machine learning models used the original features as the input, but we hypothesize that the model can be improved via synthesis of new features by utilizing feature engineering. We aim to explore the predictive capacities of generated features and evaluate for improvements in COVID-19 mortality prediction. Methods: With the approval of the hospital Institutional Review Board, medical records of two hundred sixty-nine patients with a positive COVID-19 PCR study in two 350-bed medical centers were analyzed retrospectively from March 22nd through May 10th, 2020. One hundred sixty-six variables, including laboratory studies, vital signs, demographics, and comorbidities, were collected in total. Features with greater than 50 percent missing values were dropped. Missing data was imputed with SKlearn Multiple Imputation. Feature selection was performed using sequential feature selection via the machine learning extensions library (MLxtend), which led to a final feature space of seven. Feature engineering was performed using the seven features and four additional features generated. LightGBM was chosen as our classification model. The results were compared between the feature engineering and base datasets. Feature ranking was performed using SHapley Additive exPlanations (SHAP). Partial dependence plots were generated to determine feature value cutoffs that predict increased mortality. Results: LightGBM demonstrated good classification performance with an Area Under the Curve (AUC) of .9 in the base model. The feature engineering group had an increase in AUC to .94. The feature most predictive of COVID-19 mortality based upon the SHAP plot was the product of Maximum Blood Urea Nitrogen and Maximum Respiratory Rate (MaxBUN∗MaxRR). The partial dependence plot demonstrates that at a MaxBUN∗MaxRR value > 1000 there is a rise in SHAP values which denotes a rise in predicted mortality. Conclusion: The use of feature engineering improved predictive performance for mortality related to COVID-19. The strongest feature for the prediction of mortality was MaxBUN∗MaxRR. A sharp rise in predicted mortality was observed when the product of these values exceeded 1000. Feature engineering can be used to improve existing mortality prediction models.

20.
4th International Conference on Computing and Network Communications, CoCoNet 2020 ; 735 LNEE:3-13, 2021.
Article in English | Scopus | ID: covidwho-1245595

ABSTRACT

As the number of COVID-19 cases keeps growing exponentially in the world, the use of the combination of wearable technology and IoT technologies opens up a wide variety of possibilities. An IoT-enabled healthcare device is useful for proper monitoring of COVID-19 patients to increase safety and reduce spreading. The healthcare device is connected to a large cloud network to obtain desirable solutions for predicting diseases at an early stage. This paper presents the design of a healthcare system that makes use of these technologies in a cost-effective and intuitive way which highlights the application of these technologies in the battle against the pandemic. The wearable can give real-time analysis reports of body vitals so that necessary precautions can be taken in case of infection. The wearable is designed in such a way that it can be used as a precautionary measure for people who are not infected with the virus and as a monitoring device for affected patients during the curse of their treatment. This low-cost design can not only be used to prevent the community spread of the virus but also for the early prediction of the disease. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

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