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Journal of Neuroanaesthesiology and Critical Care ; 7(3):115-117, 2020.
Article in English | EMBASE | ID: covidwho-1260980
Journal of Neuroanaesthesiology and Critical Care ; 7(3):140-147, 2020.
Article in English | EMBASE | ID: covidwho-1260975


The ongoing pandemic of coronavirus disease 2019 (COVID-19) has triggered a global health crisis probably due to a lack of a reliable cure till date. Several clinical trials are ongoing, but initial results have not been overly promising. Convalescent plasma (CP), which refers to plasma collected from individuals recovered from an illness and developed antibodies against the pathogen, is also being proposed as a therapeutic option for COVID-19 treatment in severe cases to achieve short-term immunity against the virus. Use of CP is not new, and it has been used in various outbreaks over the past century, ranging from the Spanish influenza outbreak in 1918 to the recent Middle East respiratory syndrome (MERS). However, data available on its use in COVID-19 patients is limited. Use of CP so far is restricted to a rescue therapy and needs further trials to assess its possible use in other situations (prevention, postexposure prophylaxis) and patient populations (considering age and comorbid illnesses). In this review, we will try to summarize the current status of use of CP for COVID-19 and ongoing trials in India and elsewhere and will discuss the possible avenues for its use in future.

Journal of Neuroanaesthesiology and Critical Care ; 7(3):170-171, 2020.
Article in English | EMBASE | ID: covidwho-1260972
Journal of Neuroanaesthesiology and Critical Care ; 7(3):128-139, 2020.
Article in English | EMBASE | ID: covidwho-1260970


The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) has rapidly spread across the world including India. Management of patients complicated with neurological illness requiring neurocritical care is challenging during this time. Patients with neurological disease may develop COVID-19 infection or there could be independent neurological manifestations of COVID-19. Critically ill neurological patients are more vulnerable to contracting SARS-CoV-2 infection. Also, neurological patients with comorbidities and multisystem involvement are at increased risk of adverse outcomes. Though SARS-CoV-2 predominantly affects the pulmonary system, it can complicate the assessment and management of neurological patients. With increasing COVID-19 numbers, the hospitalizations of both non-COVID and COVID-19 neurological patients will bring significant strain on the hospital and neurocritical care facilities. Streamlining work pattern, understanding the pathophysiology of COVID-19 and its impact on neurological function, establishing general and specific neurocritical care management strategies, ensuring protection and well-being of health care providers, and implementing effective infection control policies are key elements of efficient neurocritical care management during this pandemic. This joint position statement and advisory on the practice of neurocritical care during the COVID-19 pandemic by the Neurocritical Care Society of India and the Indian Society of Neuroanaesthesiology and Critical Care has been developed to guide clinicians providing care to the critically ill neurological patients in the neurocritical care unit during the current pandemic. As the situation from this novel disease is rapidly evolving, readers must constantly update themselves with newly emerging evidence to provide the best possible care to the critically ill neurological patients.

Journal of Neuroanaesthesiology and Critical Care ; 7(3):118-127, 2020.
Article in English | EMBASE | ID: covidwho-1260968


The coronavirus disease 2019 (COVID-19) is a major health emergency in today's time. In December 2019, a cluster of pneumonia cases in Wuhan, China was attributed to a novel coronavirus. The World Health Organization declared it as a pandemic. As the majority of the cases suffering from COVID-19 are mildly symptomatic or asymptomatic, it becomes a great challenge to identify the infected persons in the absence of extensive testing. In the hospital environment, it can infect several other vulnerable patients and healthcare providers, significantly impacting the hospital services. Anesthesiologists are at an increased risk of COVID-19 transmission from the patients, as they are frequently involved in several aerosol-generating procedures. It is not possible to identify asymptomatic COVID-19 patients solely based on history-taking during their first point of contact with the anesthesiologists at the preanesthetic checkup clinic. Most of the neurosurgical conditions are of urgent in nature and cannot be postponed for a longer duration. In view of this, the position statement and practice advisory from the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) provides guidance to the practice of neuroanesthesia in the present scenario. The advisory has been prepared considering the current disease status of the COVID-19 pandemic, available literature, and consensus from experts in the field of neuroanesthesiology. Since the pandemic is still progressing and the nature of the disease is dynamic, readers are advised to constantly look for updated literature from ISNACC and other neurology and neurosurgical societies.