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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-337683

ABSTRACT

Background COVID-19 has tormented the global health and economy like no other event in the recent past. Researchers and policymakers have been working strenuously to end the pandemic completely. Methodology/Principal Findings Infectious disease dynamics could be well-explained at an individual level with established contact networks and disease models that represent the behaviour of the infection. Hence, an Agent-Based Model, SHIVIR (Susceptible, Infected, Admitted, ICU, Ventilator, Recovered, Immune) that can assess the transmission dynamics of COVID-19 and the effects of Non-Pharmaceutical Interventions (NPI) was developed. Two models were developed using to test the synthetic populations of Rangareddy, a district in Telangana state, and the state itself respectively. NPI such as lockdowns, masks, and social distancing along with the effect of post-recovery immunity were tested across scenarios. The actual and forecast curves were plotted till the unlock phase began in India. The Mean Absolute Percentage Error of scenario MD100I180 was 6.41 percent while those of 3 other scenarios were around 10 percent each. Since the model anticipated lifting of lockdowns that would increase the contact rate proportionately, the forecasts exceeded the actual estimates. Some possible reasons for the difference are discussed. Conclusions Models like SHIVIR that employ a bottom-up Agent-Based Modelling are more suitable to investigate various aspects of infectious diseases owing to their ability to hold details of each individual in the population. Also, the scalability and reproducibility of the model allow modifications to variables, disease model, agent attributes, etc. to provide localized estimates across different places. Author Summary The world has witnessed several infectious disease outbreaks from time to time. COVID-19 is one such event that tormented the life of mankind. Healthcare practitioners, policymakers, and governments struggled enormously to handle the influx of infections and devise suitable interventions. Agent-Based Models that use the population data could cater to these requirements better. Hence, we developed a disease model that represents various states acquired by COVID-19 infected individuals. The contact network among the individuals in the population was defined based on which the simulation progresses. The effect of various Non-Pharmaceutical Interventions such as lockdowns, the use of masks and social distancing along with post-recovery immunity were enacted considering two case studies viz. population of Rangareddy district and Telangana state. The capability of these models to adapt to different input data fields and types make them handy to be tailored based on available inputs and desired outputs. Simulating them using local population data would fetch useful estimates for policymakers.

2.
Indian J Ophthalmol ; 70(5): 1780-1786, 2022 05.
Article in English | MEDLINE | ID: covidwho-1835158

ABSTRACT

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID-19 during the second wave of the pandemic in North India. Methods: In this observational cross-sectional study, 70 eyes of 35 patients who recovered from severe COVID-19 during the second wave underwent detailed ophthalmic evaluation 4-6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell-inner plexiform layer (GC-IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID-19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature.


Subject(s)
COVID-19 , Macula Lutea , Adult , COVID-19/complications , COVID-19/epidemiology , Female , Fluorescein Angiography/methods , Humans , Male , Middle Aged , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence/methods
3.
Clin Ophthalmol ; 15: 3505-3514, 2021.
Article in English | MEDLINE | ID: covidwho-1379902

ABSTRACT

PURPOSE: To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during the second wave of COVID-19 in India. PATIENTS AND METHODS: A cross-sectional, single-center study was done on 60 cases of probable CA-ROCM based on clinical features and supportive diagnostic nasal endoscopic findings and/or radiologic findings. Patients with recent or active COVID-19 were included. The demographic profile, clinical features, possible risk factors and diagnostic workup (microbiological, pathological and radiological) were analysed to identify the triggering factors for CA-ROCM. RESULTS: The age of patients ranged from 29 to 75 years and male-female ratio was 3:1. The duration between the first positive COVID report and onset of CA-ROCM was 0 to 47 days. Forty-nine (81.66%) patients had a recent COVID infection and 11 (18.33%) had active COVID infection at presentation. Thirty-five patients (58%) had ocular/orbital involvement at presentation. In the affected eye, 10 had no perception of light and in the rest visual acuity ranged from log MAR 0 to +1.5. Ocular manifestations were ptosis (29), ophthalmoplegia (23), periocular tenderness and edema (33), proptosis (14), black discoloration of eyelids (3), facial palsy (3), endophthalmitis (4), retinal artery occlusion (8), disc edema (4) and disc pallor (5). Twenty-two (25%) patients had neither received steroids nor oxygen. Thirty patients (50%) were managed with oxygen while 38 patients (63.3%) with systemic steroids. The most common risk factor was diabetes in 59 patients. The average glycosylated hemoglobin (HbA1c) was 10.31 ± 2.59%. Systemic Amphotericin B was started in all the patients. Radical surgical debridement was performed in 12 patients and the remaining were planned. CONCLUSION: SARS-CoV-2 variant with accompanying glycaemic dysregulation was found to be the triggering factor for the epidemic of CA-ROCM.

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