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1.
Aids ; 37(1):105-112, 2023.
Article in English | PubMed | ID: covidwho-2152273

ABSTRACT

OBJECTIVES: This study aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific T-cell responses 14 days after single-dose ChAdOx1 nCoV-19 (AZD1222) vaccination in black Africans with and without HIV in South Africa, as well as determine the effect of AZD1222 vaccination on cell-mediated immune responses in people with HIV (PWH) with prior SARS-CoV-2 infection. METHODS: A total of 70 HIV-uninfected people and 104 PWH were prospectively enrolled in the multicentre, randomized, double-blinded, placebo-controlled, phase Ib/IIa trial (COV005). Peripheral blood mononuclear cells (PBMCs) were collected from trial participants 14 days after receipt of first dose of study treatment (placebo or AZD1222 vaccine). T-cell responses against the full-length spike (FLS) glycoprotein of wild-type SARS-CoV-2 and mutated S-protein regions found in the Alpha, Beta and Delta variants were assessed using an ex-vivo ELISpot assay. RESULTS: Among AZD1222 recipients without preceding SARS-CoV-2 infection, T-cell responses to FLS of wild-type SARS-CoV-2 were similarly common in PWH and HIV-uninfected people (30/33, 90.9% vs. 16/21, 76.2%;P = 0.138);and magnitude of response was similar among responders (78 vs. 56 SFCs/106 PBMCs;P = 0.255). Among PWH, AZD1222 vaccinees with prior SARS-CoV-2 infection, displayed a heightened T-cell response magnitude compared with those without prior infection (186 vs. 78 SFCs/106 PBMCs;P = 0.001);and similar response rate (14/14, 100% vs. 30/33, 90.9%;P = 0.244). CONCLUSION: Our results indicate comparable T-cell responses following AZD1222 vaccination in HIV-uninfected people and PWH on stable antiretroviral therapy. Our results additionally show that hybrid immunity acquired through SARS-CoV-2 infection and AZD1222 vaccination, induce a heightened T-cell response.

2.
Chest ; 162(4):A2478, 2022.
Article in English | EMBASE | ID: covidwho-2060950

ABSTRACT

SESSION TITLE: COVID-19 Case Report Posters 2 SESSION TYPE: Case Report Posters PRESENTED ON: 10/19/2022 12:45 pm - 01:45 pm INTRODUCTION: Pneumomediastinum is the presence of air or other gas in the mediastinum which can be due to trauma related to mechanical ventilation or spontaneous in preexisting lung diseases. Here, we present the case of Covid-19 pneumonia, who developed pneumomediastinum without any trauma or other risk factors. CASE PRESENTATION: A 56-year-old male COVID unvaccinated with a history of essential hypertension presented to the ED with shortness of breath and worsening cough for one week. He was living with his father, who was admitted to the ICU and receiving treatment for COVID pneumonia. The patient appeared to be in respiratory distress. His initial vital signs were temperature of 99.6 F, respiratory rate of 26 breaths per minute, blood pressure 125/71 mm Hg, heart rate 109 beats per minute with a regular rhythm, and oxygen saturation of 50% while he was breathing ambient air. Pulmonary examination revealed use of respiratory accessory muscle and widespread bilateral coarse rhonchi on auscultation. The rest of the physical examination was within normal limits. RT- PCR COVID -19 test was positive. The blood gas analysis reported respiratory alkalosis. Inflammatory markers were elevated: erythrocyte sedimentation rate (35.2 mg/L), C-Reactive Protein (17.70 mg/dL), Ferritin (1108.1 ng/mL), Lactate Dehydrogenase (813 U/L), Lactate (2.4 mg/dL), D-Dimer (35.20 mg/L) and Troponin High Sensitivity-236.6 ng/L. His CBC, electrolytes, and kidney function were normal. Chest X-ray showed Pneumomediastinum with dense basilar predominant consolidation. CT Angio Chest with contrast reported Pneumomediastinum likely from the left central airway source and bilateral dense ground glass consolidation. An echocardiogram showed an ejection fraction of 60-65%, no valvular abnormalities. He was placed on vapotherm(Oxygen 40L/min) with 100% FiO2. He was given Dexamethasone 6mg for ten days, Remdesivir, Barcitinib, and a 7-day course of Azithromycin and Ceftriaxone for community-acquired pneumonia. He was advised to practice prone positioning for 12 hours or more per day. Pulmonology, Infectious Disease, and Cardiology were consulted. Gradually, his oxygen requirement was weaned down and Pneumomediastinum resolved on serial chest x rays. He was discharged on home oxygen in a clinically stable condition. DISCUSSION: Pneumomediastinum in viral pneumonia is rare. The exact mechanism is unknown. Covid-19 pneumonia causes diffuse alveolar wall damage, which might cause air leakage into the mediastinum. The development of pneumomediastinum is an ominous sign in these patients. Fortunately, our patient did not worsen and was weaned off high flow oxygenation requirement. CONCLUSIONS: Few isolated reported cases of pneumomediastinum in a COVID-19 patient have been associated with life-threatening complications. It should be used as a prognostic marker, and close monitoring of these patients is advisable. Reference #1: Damous, S.H.B., dos Santos Junior, J.P., Pezzano, Á.V.A. et al. Pneumomediastinum complicating COVID-19: a case series. Eur J Med Res 26, 114 (2021) DISCLOSURES: No relevant relationships by Saad Ansari No relevant relationships by Akshit Chitkara No relevant relationships by Sudeshna Ghosh No relevant relationships by Femina Patel

3.
Journal of Neurology, Neurosurgery and Psychiatry ; 93(6):115, 2022.
Article in English | EMBASE | ID: covidwho-1916434

ABSTRACT

Introduction In 2019 the ABN delivered the first Acute Neurology Boot Camp. This addressed an unmet need in postgraduate training. We designed a one-day series of seminars covering common or critical presentations for neurology registrars on-call. In 2020, face-to-face events weren't feasible, and while having to adapt to a new model of working including tele-neurology, virtual radiology meetings, we adapted the boot camp to this model. Methods We designed an online version of the boot camp over two weeks. Videos were recorded for repeat viewing. All delegates were encouraged to complete surveys on confidence levels, before and after each session, and with reference to the course as a whole. Results 77 participants provided feedback. 289 logged-in live and YYY have viewed the videos on-demand. This compares to XYZ in the 2019 iteration. 30% of respondents were confident or very confident at being the neurology registrar oncall prior to the course, compared to 88% at the end of the course (p< 0.00001). Participants were very happy with the delivery, content and format of the talks, with 'very good' ratings for 60%, 56% and 57% respectively. Conclusion The Covid-19 pandemic brought tumultuous shifts in practice that were uncharted waters for the entire neurological community. As we all tried to stay afloat, we also provided a necessary life-raft to trainees who were negotiating the challenge of the transition to being a neurology registrar.

4.
American Journal of Respiratory and Critical Care Medicine ; 203(9):1, 2021.
Article in English | Web of Science | ID: covidwho-1407400
5.
Journal of Mental Health and Human Behaviour ; 26(1):20-27, 2021.
Article in English | Web of Science | ID: covidwho-1365758

ABSTRACT

Context: COVID-19 outbreak has had a huge impact on health-care facilities, and challenges of health-care providers would compromise their physical and mental well-being during this epidemic. Aims: This study aimed to find out stress, anxiety, insomnia, and depression among the health-care workers during COVID-19 outbreak. Settings and Design: This was a 3-month, cross-sectional, observational, single-center study of health-care workers of designated COVID-19 hospital. Subjects and Methods: Study objectives were explained to health-care workers, and written consent was obtained. Participants were approached in their department as per their convenience and requested to fill the pro forma. Depression, Anxiety, and Stress Scale-21 and Insomnia Severity Index were used to detect psychological issues in the form of stress, anxiety, insomnia, and depression. Statistical Analysis: Descriptive statistics and Chi-square test were used for analysis of variables in the study. Results: Overall 27.41% and 29.18% of the health-care workers reported stress and anxiety symptoms, respectively, while 18.78% reported clinically significant insomnia and depression. Among them, being female, married, elderly, presence of medical illness, frontline workers, frequently watching COVID news, and excessive fear of COVID emerged as statistically significant variables associated with stress, anxiety, insomnia, and depression. Conclusions: Health-care workers experienced many mental health issues while performing duties during COVID-19 outbreak. Such issues are alarming and need to be addressed with appropriate health-care policy.

6.
2nd International Conference on Intelligent Engineering and Management, ICIEM 2021 ; : 271-276, 2021.
Article in English | Scopus | ID: covidwho-1280228

ABSTRACT

In this article, the authors propose a scheme, BloCoV6, that integrates sixth-generation (6G)-assisted unmanned aerial vehicles (UAVs) and blockchain (BC) to monitor mass surveillance of persons in dense areas, and implement a trust-based contact-tracing ecosystem in BC. The scheme operates in two phases. In the first phase, based on the area density, and the number of users, UAVs swarms are mounted with thermal imaging sensors that monitor the body temperature of persons. The collected data are sent to ground stations in real-time, through 6G network services. Once, the images are analyzed, the details of potential COVID-19 patients are identified, and their travel and contact records are fetched and stored in BC. Then, in the second phase, the contact-tracing information is validated in BC. The proposed scheme is simulated for smart contracts (SC) functionalities, UAV observations, latency, spectral efficiency, and transaction and signing costs. The obtained results indicate the scheme viability. For example, 6G has a low latency of 330.8 milliseconds (ms), which outperforms 1200.1 ms in fifth-generation (5G) channels. The observed spectral efficiency of 6G channels is 5-10× higher than 5G, and the average signing and transaction cost is 3.473 seconds (s), and 6.873 s respectively, which outperforms the conventional schemes. © 2021 IEEE.

7.
American Journal of Respiratory and Critical Care Medicine ; 203(9), 2021.
Article in English | EMBASE | ID: covidwho-1277711

ABSTRACT

A 20-year-old asymptomatic Caucasian female has been screened to the clinic for COVID-19 testing due to the recent pandemic. She works in the primary care clinic where covid-19 patients are not seen. She has a past medical history of diabetes Mellitus and thyroid nodule. Her vitals are Temp 96.2 F, BP 123/89, RR 18, spo2 99% on air. On physical examination, her nasal turbinates were pale bilaterally, with no throat congestion. She denies any cough, congestion, fever, muscle aches, shortness of breath, sore throat, loss of taste, or smell sensation. On Investigation: Early march IgG antibody positive for covid-19 and in late May, she was tested positive for RT-PCR covid-19 without symptoms both times. On both occasions, she was working with healthcare workers without strict preventive protocols, who came negative for tests. Her family and close contacts tested negative for COVID-19. Diagnosis: Asymptomatic covid 19 carriers. Treatment: Close monitoring for symptoms. Discussion: Over the last year, the COVID-19 pandemic has caused significant concern worldwide due to its rapid spread. There are few notable symptomatic cases that are hospitalized and two months after discharge, they still tested positive on the RT-PCR COVID-19 test. It means they are a dormant carrier for COVID-19. But, in our case, the patient was asymptomatic and positive for COVID-19 antibody and RT-PCR test. Surprisingly, all healthcare workers in the clinic came negative on repeated testing. We presumed that she encountered some covid-19 strain, which remains dormant in the body and non-contagious. We need further studies to evaluate the COVID-19 dormant stage like hepatitis-B and tuberculosis.

8.
Archives of Psychiatry and Psychotherapy ; 23(1):29-35, 2021.
Article in English | Scopus | ID: covidwho-1210144

ABSTRACT

Aims: Study aimed to find out the prevalence and risk factors of depression among the health care workers during COVID-19 outbreak. Methods and Material: This was a four month, cross-sectional, observational, single center study of heath care workers of a notified COVID-19 hospital. Study objectives were explained to health care workers, and written consent was obtained. Patient health questionnaire-9 (PHQ-9), DSM-5 criterion of major depressive disorder and Structured Clinical Interview for DSM-5 were used to diagnose the depression. Descriptive statistics, chi-square test, and Binary logistic regression were used for analysis of variables Results: Overall 18.78% health workers reported major depressive disorder. Nearly three fourth of the old age participants had moderate to severe depression. 20.69% of married subjects had major depression. Medical health workers reported more depression. One third of the front line workers had major depression. 51% of the participants with medical co-morbidities reported major depression as compared to only 12% in those without any medical co-morbidity.33% of subjects watching COVID-19 news very frequently in a day had major depression Discussion: The prevalence of depression ranges from 9 to 35% in various studies. Among them living in joint family, married, elderly, presence of medical illness, frontline work, frequently watching COVID-19 news, excessive fear of COVID-19, and medical health worker emerged as statistically significant variables associated with major depression Conclusions: The prevalence of depression is high among health care workers while performing duties during COVID-19 outbreak. Early diagnosis and treatment of depression would be crucial during this difficult time. © 2021 Polish Psychiatric Association. All rights reserved.

9.
The European Journal of Psychiatry ; 2021.
Article in English | ScienceDirect | ID: covidwho-1101204

ABSTRACT

Background & objectives The Covid-19 pandemic has revolutionised how we receive services, with a huge shift to online delivery. Online health promotion tools could be a cost-effective and safe way to improve population health. We used mixed methods to explore user responses to an online cognitive health tool. Methods 15–28 months after completing an online tool, comprising a cognitive test, lifestyle questionnaire;and dietary and lifestyle behaviour feedback, 4826 participants completed an online survey about their perceptions of it;and questions about their capability, opportunity and motivation for behavioural change developed using the COM-B behaviour change model. We reported how responses to the behaviour change questionnaire predicted decisions to make lifestyle and dietary changes. 24 participants attended focus groups to further explore their responses. Results Most users reported that the tool was useful (88%), with 37% reporting they made lifestyle or dietary changes after using it. More positive responses to questions regarding capability and motivation predicted making changes. Over a third (36%) felt more fearful after completing the tool. In qualitative findings, we identified barriers to engagement across the three COM-B domains: a sense that information was “nothing new” (so did not enhance capability);that “experts don’t agree” and that the tool may not be credible (influencing motivation), and a lack of support from peers and lower availability of healthy food (reducing opportunities for change). Conclusions Future e-health tools will be most effective if they have high credibility, demonstrate advice is evidence-based and provide opportunities for support and follow up.

10.
Int. Conf. Comput. Intell., ICCI ; : 137-141, 2020.
Article in English | Scopus | ID: covidwho-991079

ABSTRACT

The rapid development in digital infrastructure such as computing power and less expensive mobile devices and explosive growth of the internet has made an impact on digital processing. This revolution has bought many new applications and new technologies, now aiming at replacement with improving effectiveness and efficiency of manual contact tracing with new approaches with maintaining user privacy. The successful containment of the Coronavirus pandemic (COVID-19) depends on the ability to identify quickly and reliably those who have been in close proximity to a contagious positive-tested individual. This can be made possible with contact tracing method. The information about interaction which happens between two users should be revealed only to themselves to maintain privacy of individuals. Users which are detected positive should not share any of their contact details or personal information or history with the authority or any other party but pass the anonymous IDs and help in tracing out the contacted people. This paper presents the most popular contact tracing data privacy techniques. © 2020 IEEE.

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