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2.
Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 15(7):S60-S64, 2022.
Article in English | Scopus | ID: covidwho-2024835

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in the lives of students and health care systems worldwide. Objectives: The study explored the impact of the prolonged COVID-19 pandemic among medical students in Malaysia. Methods: An online, cross-sectional survey was conducted among 397 medical students using Google forms circulated on social networking sites, like WhatsApp. Data were collected on self-reported anxiety and preventive health behaviors, challenges faced in daily activities, perception of e-learning, and changes in social and personal relationships. Results: As compared to before the advent of the pandemic, 83% of the students were more nervous and anxious, 38% washed their hands more often, and 43% bought more cleaning and hygiene supplies during the pandemic. Forty-two percent of the respondents went out less often, and 73% had lesser in-person social contact with their friends. The majority of students practiced a sedentary lifestyle;47% snacked more often, and 58% had lesser physical activity. Conclusion: This study emphasizes the role of the provision of emotional support and strategies to enhance the well-being of medical students. © Medical Journal of Dr. D.Y. Patil Vidyapeeth 2022.

3.
Medicine (Baltimore) ; 101(35), 2022.
Article in English | PMC | ID: covidwho-2008671

ABSTRACT

Coronavirus disease 2019 (COVID-19) in patients with severe impairment of kidney function is associated with high mortality. We evaluated the effect of high dependency renal unit (HDRU), with nephrologists as primary care physicians, as a quality improvement initiative for the management of these patients. This was a quasi-experimental observational study conducted at a tertiary care hospital in western India. Patients hospitalized for COVID-19 with pre-existing end-stage-renal-disease and those with severe AKI requiring dialysis (AKI-D) were included. For the first 2 months, these patients were cared for in medical wards designated for COVID-19, after which HDRU was set up for their management. With nephrologists as primary care providers, the 4 key components of care in HDRU included: care bundles focusing on key nephrology and COVID-19 related issues, checklist-based clinical monitoring, integration of multi-specialty care, and training of nurses and doctors. Primary outcome of the study was in-hospital mortality before and after institution of the HDRU care. Secondary outcomes were dialysis dependence in AKI-D and predictors of death. A total of 238 out of 4254 (5.59%) patients with COVID-19, admitted from 28th March to 30th September 2020, had severe renal impairment (116 AKI-D and 122 end-stage-renal-disease). 145 (62%) had severe COVID-19. From 28th May to 31st August 2020, these patients were managed in HDRU. Kaplan–Meier analysis showed significant improvement in survival during HDRU care [19 of 52 (36.5%) in pre-HDRU versus 35 of 160 (21.9%) in HDRU died, P ≤ .01]. 44 (67.7%) AKI-D survivors were dialysis dependent at discharge. Breathlessness and altered mental status at presentation, development of shock during hospital stay, and leukocytosis predicted mortality. HDRU managed by nephrologists is a feasible and potentially effective approach to improve the outcomes of patients with COVID-19 and severe renal impairment.

4.
Indian Journal of Critical Care Medicine ; 26:S82, 2022.
Article in English | EMBASE | ID: covidwho-2006368

ABSTRACT

Aim and objective: To demonstrate the effectiveness of lateral positioning as a salvage for deteriorating PaO2/FiO2 ratio through a case report of a morbidly obese individual managed with lateral positioning. To demonstrate that the improvement of oxygenation was due to the recruitment of previously non-ventilated lung areas as demonstrated by Electrical impedance tomography. The study noted the evolution in SpO2, variations in regional distribution of ventilation (TV), and changes in end-expiratory lung volume/ FRC. Materials and methods: The patient was ventilated using the Carescape R860 GE ventilator. As per protocol, the transpulmonary pressure was monitored using an esophageal manometer using the Nutrivent. End expiratory lung volume (EELV) or the functional residual capacity (FRC) was measured using the nitrogen washout method. The patient was ventilated with a pressurecontrolled mode at a FiO2 of 80% of ventilated with the driving pressure (pressure control-peep) maintained at 15. The PEEP was progressively increased in steps of 5 (staircase maneuver). The staircase recruitment was continued to reach an inspiratory transpulmonary pressure of 25 or a peep of 40 (whichever reached earlier). At each step of the staircase manoeuvre, the end expiratory lung volume, compliance, and the electrical impedance tomography values were noted to avoid overdistension. Lateral (both left and right, ∼ 40° with pillows) and supine positions were performed (∼ 2 h for each position). At each position, an FRC calculation (average of three) was done and an EIT measurement was done. The strain was a calculation by the formula tidal volume/functional residual capacity and found to be <0.25 at all times. Results: The positional alteration (right and left lateral) consistently showed an improvement in the end-expiratory lung volume/FRC along with a clear demonstration of improvement of air redistribution in the lung maps by electrical impedance tomography. The findings of the case suggest recruitment of previously non-ventilated/ poorly ventilated lung areas. Conclusion: The case study results provide evidence of the effectiveness of a lateral positioning in the improvement of oxygenation in COVID ARDS. This case report would encourage the use of lateral positioning in those hypoxic patients who cannot be proned or in those units who have no expertise in proning.

5.
Indian Journal of Critical Care Medicine ; 26:S69-S70, 2022.
Article in English | EMBASE | ID: covidwho-2006359

ABSTRACT

Aim and objective: To find out whether the COVID-19 affected ARDS lungs are recruitable with the combined use of 1. Transpulmonary pressure monitoring (to limit the stress);2. End expiratory lung volume measurement (to limit strain);3. Electrical impedance tomography;4. Compliance (to diagnose overdistension) and the increase in the SpO2 as a marker of clinical recruitment. Materials and methods: Retrospective data from charts and progress sheets were collected from 27 patients admitted to the ICU (between February 2021 and June 2021) with PaO2/FiO2 ratio <150 with a diagnosis of acute respiratory distress syndrome. Data acquisition: As a protocol, the esophageal pressure was monitored using the polyfunctional nasogastric tube (Nutrivent). The end-expiratory volume was measured using the Carescape R860 (Carescape R860;GE Healthcare) by the nitrogen multiple breath wash-out/ wash-in (EELV) at a PEEP of 5. Electrical impedance tomography measurements were performed using the PulmoVista 500. We performed a recruitment maneuver using the staircase maneuver. Statistics: Categorical variables are presented as frequency and percentage (%) and continuous variables are presented as mean and standard deviation. Comparison between pre- and post-recruitable was tested using t-test, while repeated-measures ANOVA was used to test follow-ups like 2 hours and 4 hours. Statistical significance is assumed at a value of p < 0.05. Results: As per the results of our study we found that almost 2/3rd (66.7%) of the COVID ARDS lungs were recruitable safely. The average plateau pressure (cm of H2O), mean compliance, FRC, and SPO2 were noted before the attempt at recruitment and after recruitment. After conducting the staircase manoeuvre, the plateau pressure remained at 25.56 with a standard deviation of 3.641. However, the mean compliance rose to 31.926 with a standard deviation of 10.099. Post recruitment there was a marked rise of FRC to 1581.778 with a standard deviation of 311.049 mL. Pre recruitment means SPO2 was 83.6% with a standard deviation of 3.9%. Post recruitment at 2 hours the SPO2 had reached 91.1% with a standard deviation of 5.4% and remained the same at 91.9% with a standard deviation of 7.5%. Among the 27 patients' clinical recruitment was seen in 18 patients (66.7%). As per the results of our study, we found that almost 2/3rd (66.7% or 18/27 pts) of the COVID ARDS lungs were recruitable safely (rise in SPO2 maintained at 2 and 4 hours along with the absence of overdistension as seen on EIT with an increase in FRC and compliance). Conclusion: As per the results of our study almost 2/3rd of COVID-19 patients were recruitable. This is the first Indian study to comprehensively study recruitment in COVID-19. ARDS pts with the best available techniques. This study shows that majority of COVID-19 lungs may be recruitable in the earlier stage of the illness (within the first week of ARDS) and thus warrant a trial of a safe monitored recruitment strategy.

6.
Electronic Journal of General Medicine ; 19(6):8, 2022.
Article in English | Web of Science | ID: covidwho-1979929

ABSTRACT

Introduction: Dengue-COVID-19 overlap is mixture of both diseases sharing few similarities in pulmonary and extra pulmonary involvement. Methods: Prospective, observational study, included 300 COVID-19 cases with dengue NS1 or dengue IgM positive, with lung involvement documented and categorized on HRCT thorax at entry point. All cases were subjected to dengue IgG antibody titers and dengue IgM/IgG antibody titer analysis after 12 weeks of discharge form hospital. Results: Hematological evaluation, white blood cell count & platelet count were having significant association with dengue-COVID-19 overlap (p<0.0076) & (p<0.00001), respectively. Clinical parameters as hypoxia have significant association with dengue-COVID-19 overlap (p<0.00001). Inflammatory markers as IL-6, CRP, and LDH has significant association in dengue-COVID-19 overlap (p<0.00001), respectively. Dengue-COVID-19 overlap was documented in 16.33% (49/300) cases. CT severity has documented significant correlation with dengue-COVID-19 overlap cases (p<0.00001). In study of 49 cases of 'dengue-COVID-19', post-COVID-19 lung fibrosis (p<0.004), and serological assessment in dengue IgM/IgG and COVID-19 antibody titers has significant association (p<0.00001). Conclusion: 'Dengue-COVID-19' is disease of concern in ongoing pandemic in critical care setting, and timely workup is crucial step in preventing delay in diagnosis and final adverse outcomes.

7.
8.
Journal of Medicine (Bangladesh) ; 23(2):112-120, 2022.
Article in English | EMBASE | ID: covidwho-1968985

ABSTRACT

Introduction: Robust data of CRP is available in bacterial infection, and now it can be utilized in Covid-19 pneumonia pandemic initial assessment of severity and planning of treatment. Materials and methods: Multicentric, prospective, observational and interventional study conducted during July 2020 to May 2021 included 1000 Covid-19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker as CRP at entry point and follow up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi square test. Observations and analysis ysis: Age (<50 and >50 years) and gender (male versus female) has significant association with CRP in predicting severity [p<0.00001] & [p<0.010] respectively. CT severity score at entry point with CRP level has significant correlation [p<0.00001] CRP level has significant association with duration of illness (Doi) [p<0.00001] Comorbidities has significant association with CRP level. [p<0.00001] CRP level has significant association with oxygen saturation [p<0.00001] BIPAP/NIV requirement during hospitalization has significant association with CRP level. [p<0.00001] Timing of BIPAP/NIV requirement has significant association with CRP level. [p<0.00001] Follow-up CRP titer during hospitalization as compared to entry point normal and abnormal CRP has significant association in post-covid lung fibrosis [p<0.00001] Conclusion: CRP is easily available and universally acceptable inflammatory marker in Covid-19 pandemic and ‘serial titer’ documented very crucial role in predicting severity of illness, need of ventilatory support and help in predicting post-covid lung fibrosis.

9.
Journal of Contemporary Dental Practice ; 23(4):379-382, 2022.
Article in English | Scopus | ID: covidwho-1964329

ABSTRACT

Saline nasal irrigation (SNI) is a clinically established treatment that has been used to manage upper respiratory infections and allergies;there is also some indication that it may be effective in the setting of coronavirus disease-2019 (COVID-19). The possible advantages of SNI include the following benefits due to the well-known antiviral impact of sodium chloride (NaCl) and the mechanical cleansing effect arising from the irrigation method. First, there will most likely be a decrease in COVID-19 infection rates;second, illness severity will be lowered;and third, community transmission will be mitigated. Despite the need for more concentrated research into these aspects, public health organizations should emphasize alternate infection mitigation measures such as SNI in light of the ongoing COVID-19 problem, low global vaccine supply, and the rapid introduction of SARS-CoV-2 variants. © The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

10.
Global Perspectives ; 1(1), 2022.
Article in English | Scopus | ID: covidwho-1951645

ABSTRACT

COVID-19 and its associated lockdowns and restrictions on movement may be impacting women and men’s access to and use of health care services including contraceptive, prenatal, and postnatal care. Yet we know little of its impact to date, especially in low- and middle-income countries, including India. Understanding how COVID-19 impacts the use of these services now, and as it persists, is essential for improving access and use today. Additionally, these data are necessary to understand fertility and other health-related outcomes we may see in the future. The objectives of this study are to understand a Facebook sample of respondent’s perceived barriers to contraceptive, prenatal, and postnatal care in India and how these changed over 4 months of the COVID-19 pandemic. To meet this need, we conducted four rounds of monthly online surveys with men and women (N = 9,140) recruited using Facebook ads in India between April and July 2020, a period when the national lockdown was tapered from the strictest to restricted. While about 75% of respondents reported no barriers to contraception due to COVID-19, about half of those pregnant or postpartum reported barriers to pre- and postnatal care. Barriers to care for contraception, prenatal, and postnatal care increased significantly over time. Most respondents reported some change on fertility preferences, with more respondents reporting desire to delay, rather than to have a child sooner, due to COVID-19. Overall, as the early COVID-19 pandemic persisted, barriers to reproductive and maternal health care increased in India, suggesting that as the pandemic continued there have likely been additional challenges for people seeking these services. It is essential that health care providers begin to address these barriers to ensure access to care throughout these important time periods. © 2022 The Author(s).

11.
CLINICAL DIABETOLOGY ; 11(2):107-118, 2022.
Article in English | Web of Science | ID: covidwho-1939336

ABSTRACT

Background: Laboratory parameters play a key role in triaging, predicting disease course, severity and may determine prognosis COVID-19 patients. Material and methods: Aim and Objectives: To study the relation of clinical and laboratory parameters (total WBC count, neutrophil: lymphocyte ratio, serum ferritin, serum D-dimer, serum LDH, CRP, ESR) with severity and outcome of Corona Virus Disease (COVID-19) confirmed by real-time RT-PCR. Sample size: It was a time-bound study conducted over 3 months (1st April to 30th June, 2020). A total of 206 patients will be included in this study satisfying the inclusion criteria. Study design: This was a prospective, observational and non-interventional study conducted on patients with laboratory-confirmed COVID-19 admitted in a tertiary care teaching hospital. Statistical Analysis: Data will be analyzed for mean, percentage, standard deviation, and chi-square test for quantitative data by using appropriate statistical tests using INSTAT software version 8.0 (trial version) and p-value < 0.05 will be considered statistically significant. Results: Total of 206 patients of both genders were included in the present study. Total 141 (68.44%) patients were males and 65 (31.55%) patients were females (Chi Sq. 56.07;DF:1;p < 0.001). Among all the groups according to the severity of illness, 'D' group was the most common group (n = 99;45.06%). Age > 60 years (17.48%), obesity (13.11%), hypertension (10.19%), COPD (5.83%), and diabetes mellitus (5.83%) were the most frequent risk factors or comorbidities associated with COVID-19 disease. Many patients had multiple risk factors in the present study. The majority (3/4th) of the patients were in C and D group (moderate) with co-morbidities and about 1/4th were in the severe group. Total 5 (2.43%) patients with COVID-19 patients succumbed to death with an overall case fatality rate of 2.43%. The case fatality rate was significantly higher among the patients with risk factors or comorbidities (p = 0.0124). Late presentation, associated comorbidity, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia. Conclusions: Late presentation, associated comorbidity like diabetes mellitus, advancing age, High level of ferritin, D-dimer, CRP, PaO2/FiO(2) ratio less than 100 at the time of admission were associated with mortality. The terminal event in patients who have succumbed was bradycardia followed by cardiorespiratory arrest. The cause of death was ARDS with bilateral extensive pneumonia.

12.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927838

ABSTRACT

Introduction: Mucormycosis is a rare invasive opportunistic fungal infection caused by Zygomycetes. [1,2] It is associated with worse outcomes in immunocompromised patients.[3,4] Invasive pulmonary infections can lead to bronchial necrosis from angioinvasion.[1,3] Here, we present a case of invasive pulmonary mucormycosis (IPM) caused by Rhizopus spp, resulting in tracheo-esophageal fistula. Case : An 18-year-old male with uncontrolled type 1 diabetes was admitted to the intensive care unit for diabetic ketoacidosis (DKA) and acute hypoxia due to COVID 19 pneumonia requiring ventilatory support. Chest imaging showed bilateral opacities. He was treated with dexamethasone for COVID 19 and broad-spectrum antibiotics for superimposed bacterial pneumonia. Clinical course was complicated by acute respiratory distress syndrome and pneumomediastinum. Computed tomography of the chest showed large pneumomediastinum with air leak within the distal thoracic trachea. Bronchoscopy revealed a disfigured main carina with erosions (figure 1), a tracheo-esophageal fistula, necrotic blood-tinged left mainstem bronchus tissue, and a necrotic pus-filled superior segment of the right lower lobe. Left mainstem bronchial tissue specimen culture grew Rhizopus and Klebsiella spp. Liposomal amphotericin was initiated. Given his poor prognosis, the patient's family refused aggressive thoracic surgical intervention and pursued palliative care. Discussion: Rhizopus spp is the most common cause of mucormycosis in immunocompromised populations.[6] IPM is the second most common clinical form reported after the central nervous system.[3,6] Typically, IPM lesions are localized, and invasive presentations are infrequent. Rarely, IPM can cause invasive disease by angioinvasion, obstructing blood flow, and ischemic tissue necrosis.[6] Airway tissue necrosis can lead to fistulas between the airway and adjacent structures, including pleura, pericardium, and mediastinum.[2,3,4,5] Published clinical literature review revealed only a few cases due to IPM. Common predisposing factors include diabetes, DKA, and immunosuppressive medications, as observed in our patient.[3] Lobar bronchi are the usual locations of endobronchial erosions, with a predilection for the upper lobes.[3] In contrast, the left mainstem bronchus and right lower lobe were involved in the case presented here. In addition to antifungal treatment, surgical debridement is the mainstay of therapy due to necrosis.[7] The survival rate is between 35-46% in medically managed compared to 51-90% in surgically treated patients.[3]Conclusion: IPM is a life-threatening invasive disease associated with high mortality rates. Clinicians should suspect it in immunocompromised patients, including diabetes. The clinical history may include uncontrolled diabetes, recent DKA, and infections predisposing patients to develop superimposed fungal infections. The concurrent use of systemic steroids may also contribute to worse outcomes. (Figure Presented).

13.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927830

ABSTRACT

COVID-19 can lead to persistent hypoxia due to persistent inflammatory responses to SARS-CoV- 2 in the respiratory system. Post-COVID syndrome, may involve multiple organ systems leading to physical and medical sequelae following COVID-19, including chronic hypoxemia. Long-term oxygen therapy (LTOT) is an established treatment for patients with chronic hypoxemia, generally used in chronic airway diseases. Aims and objectives 1.To evaluate COVID-19 patients advised LTOT in post-COVID period 2. To determine if the need for oxygen support continues 3. To ascertain as to if these post covid patients actually need oxygen concentratorsMethodology500 post COVID-19 patients on oxygen therapy at home were questioned about LTOT at follow-up visit. Patients' demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively from hospital database. Inclusion criteria1.patients aged 30 yrs and above2.Post covid patients patients with ARDS3.Patients consenting for the study Exclusion criteria Patients with active tuberculosis Patients with recent history of myocardial infarction in last 3 monthsResults1.There were 300 men (60%) and 200 women (40%) 2.The mean age of 68.6±12.6. 3.Average visit time for evaluation was 3.03±1.43 months. 4.18% of the patients died during the post-COVID process, which was related with high age (p=0.003), usage of mechanical ventilation (p=0.019) 5.The need for oxygen support continued in 32.9% of the patients. 6.Admission to intensive care unit and having a high serum D-dimer level (> 1000μg/L) were significant risk factors for the ongoing need of home oxygen support (p= 0.026 and 0.010, respectively). 7.The oxygen saturation level at hospital admission was found to be significantly lower in patients who continued to require oxygen therapy (p<0.001).Conclusion1.Most COVID-19 patients do not need LTOT in the post-COVID period meaning that the clinicians should be more selective when planning home oxygen therapy. Chest physiotheray and breathing exercises in post hospitalisation and pulmonary rehabilitation helped to exclude the need for LTOT in follow-up visits 2.Oxygen cylinders can be a more affordable option for most out covid patients discharged on LTOT. Oxygen concentrators should only be prescribed if home oxygen requirement persist on followup visits.

14.
Engineering, Construction and Architectural Management ; 2022.
Article in English | Scopus | ID: covidwho-1922467

ABSTRACT

Purpose: Construction industry is one of the worst affected sectors due to the impact of the current coronavirus disease 2019 (COVID-19) outbreak. Therefore, the purpose of this study was to identify the key competencies that should be demonstrated by the contractors in the post-COVID-19 scenario to make them resilient to the adverse impact of pandemic outbreaks. Design/methodology/approach: A survey instrument was developed using an extensive literature review and was tested using a pilot study. It was then administered online using survey monkey to 900 respondents, out of which 324 complete responses were obtained. The data analysis was performed using exploratory factor analysis and second-order confirmatory factor analysis. Findings: After analyzing the data, it was identified that the most critical competence was managing site safety (standard factor loading (SFL) = 0.91), followed by leadership skills (SFL = 0.88), technical competence (SFL = 0.81), managing supply chain disruption (SFL = 0.73) and financial stability (SFL = 0.48) that were found to be less essential from the respondents’ point of view. Originality/value: The study is first of its kind to identify the core competencies that should be demonstrated by the contractors to cope with COVID-19-induced disruptions. The findings of this article can be used by the practitioners to develop policies and procedures for selection of contractors. © 2022, Emerald Publishing Limited.

15.
Global Advances in Health and Medicine ; 11:20-21, 2022.
Article in English | EMBASE | ID: covidwho-1916545

ABSTRACT

Methods: We describe our novel shared medical appointment (SMA) program developed to provide lifestyle education, mindfulness training, and group peer support for patients with long COVID symptoms. Patients virtually attended two-hour weekly visits for six weeks. The SMAs are co-led by a medical provider and a holistic psychotherapist. Every session includes mindfulness practice and peer support with daily homework consisting of lifestyle goals and mindfulness practices. Our objective was to provide patients education and support to recuperate from Long COVID symptoms. For quantitative outcomes, we assessed pre-and post-intervention change in symptoms using Medical Questionnaire Symptom Score (MSQ) and Patient-Reported Outcomes Measurement Information System (PROMIS) Global -10 measures. We used a two-tailed paired t-test. Thematic analysis of patients' feedback of the program is reported. Results: Since May 2021, nine SMA cohorts have been conducted, and 64 patients have completed the program. We have analyzed 40 MSQ's to date, which shows significant improvement in symptoms (mean difference -16.4, P = 0.001). PROMIS-10 scores for 38 patients have been analyzed. Most patients show improvements in PROMIS-10 scores, but the findings were not statistically significant (p = 0.12). Patients felt educated, connected, and supported (“I amnot alone, I amnot crazy.” “This class gives me tools to help myself”). Background: Long COVID is a new rising health concern where patients have multiple distressing symptoms with no clear treatment guidelines. Early evidence indicates the role of cytokines and chronic inflammatory processes in developing long COVID. Healthy lifestyle behaviors and modifying stress responses reduce chronic systemic inflammation. Conclusion: Shared medical appointments with lifestyle education, mindfulness practices, and peer support can effectively support patients with Long COVID symptoms. We anticipate additional data from the current ongoing cohorts will demonstrate continued improvement in patient symptoms and possible significant improvement in PROMIS 10 scores.

16.
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH ; 16(6):TC11-TC17, 2022.
Article in English | Web of Science | ID: covidwho-1912142

ABSTRACT

Introduction: The novel Coronavirus disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is seen to primarily affect the human respiratory system. Chest CT Severity Score (CTSS) provides a semi quantitative assessment of pulmonary involvement in COVID19 patients. COVID-19 pandemic mitigation measures such as SARS-CoV-2 vaccination are being deployed worldwide. However, with the emerging variants of concern of SARS-CoV-2, a high prevalence of post vaccination breakthrough infections is seen. Aim: To assess the association of CTSS with the vaccination status in a cohort of COVID-19 patients referred to a tertiary diagnostic centre and to evaluate the association of CTSS with other clinical parameters including co-morbidities in these patients. Materials and Methods: This cross-sectional observational study was conducted at a tertiary care diagnostic imaging centre in the city of Pune, Maharashtra, India. Data of 1002 symptomatic, adult patients who underwent chest CT and SARSCoV-2 Reverse Transcription Polymerase Chain Reaction (RTPCR)/Rapid Antigen Test (RAT) laboratory test between March 13, 2021 and June 22, 2021, were collected. COVID-19 reportingand Data System (CO-RADS) categories and the corresponding semi quantitative CTSS were calculated for each patient. Based on their vaccination status, patients were categorised into three groups: unvaccinated, partially vaccinated and fully vaccinated. The association of CTSS with various categories of vaccination status, demographics, co-morbidities and stages of the disease of the patients, was evaluated. Results: Of the 1002 COVID-19 patients, 768 (76.6%) were unvaccinated, 190 (19.0%) were partially vaccinated and 44 (4.4%) were fully vaccinated. Mean CTSS in the fully vaccinated cohort was significantly lower (3.75 +/- 4.7) than that in the partially vaccinated (6.05 +/- 5.7) and unvaccinated (8.29 +/- 4.9) patients (mean 3.75 vs. 6.05 vs. 8.29, respectively;(p<0.05). Mean CTSS in patients with no co-morbidities was significantly lower than that in patients with hypertension and diabetes (7.12 vs. 8.75 vs. 10.39, respectively;(p<0.05). Conclusion: Significant association was noted between the Chest CTSS and the vaccination status, age, gender, co-morbidities and stage of disease in this large cohort of COVID-19 patients. The study reiterates that full vaccination aids in reducing the severity of lung involvement in COVID-19 infection.

19.
American Journal of Respiratory and Critical Care Medicine ; 205:1, 2022.
Article in English | English Web of Science | ID: covidwho-1880702
20.
American Journal of Respiratory and Critical Care Medicine ; 205:2, 2022.
Article in English | English Web of Science | ID: covidwho-1880357
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