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1.
Natl Acad Sci Lett ; : 1-7, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1943494

ABSTRACT

Aim: To characterize Th1/Th2/Th17 cytokine profile (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ, and IL-17A) among different stages of COVID-19 infection. Methods: This was a cross-sectional study which included six healthy individuals and 68 patients who were admitted with COVID-19 in the Department of Medicine, at All India Institute of Medical Sciences, New Delhi, from July 2020 to September 2020. Patients were categorized into mild, moderate, and severe COVID-19 groups, and serum samples were drawn for the measurement of Th1/Th2/Th17 cytokines (IL-4, IL-6, IL-10, TNF-α, IFN-γ, and IL-17A) which was done by BD™ Cytometric Bead Array. Results: All the cytokines showed dynamic expression in the COVID-19 group, of which only IL-6 was statistically significant. Among the three severity groups of COVID-19, increased severity did not transform into increased cytokine level, with the exception for IL-6, which was statistically significant. Conclusions: In our small sample study, six cytokines expressions were evaluated however most of them were elevated in COVID-19 patients but were not statistically significant except IL-6.

2.
QJM ; 2021 Jul 15.
Article in English | MEDLINE | ID: covidwho-1878816
3.
J Infect ; 84(3): 383-390, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1629925

ABSTRACT

BACKGROUND: The epidemiology of the Coronavirus-disease associated mucormycosis (CAM) syndemic is poorly elucidated. We aimed to identify risk factors that may explain the burden of cases and help develop preventive strategies. METHODS: We performed a case-control study comparing cases diagnosed with CAM and taking controls as recovered COVID 19 patients who did not develop mucormycosis. Information on comorbidities, glycemic control, and practices related to COVID-19 prevention and treatment was recorded. Multivariate regression analysis was used to identify independent predictors. RESULTS: A total of 352 patients (152 cases and 200 controls) diagnosed with COVID-19 during April-May 2021 were included. In the CAM group, symptoms of mucormycosis began a mean of 18.9 (SD 9.1) days after onset of COVID-19, and predominantly rhino-sinus and orbital involvement was present. All, but one, CAM cases had conventional risk factors of diabetes and steroid use. On multivariable regression, increased odds of CAM were associated with the presence of diabetes (adjusted OR 3.5, 95% CI 1.1-11), use of systemic steroids (aOR 7.7, 95% CI 2.4-24.7), prolonged use of cloth and surgical masks (vs. no mask, aOR 6.9, 95%CI 1.5-33.1), and repeated nasopharyngeal swab testing during the COVID-19 illness (aOR 1.6, 95% CI 1.2-2.2). Zinc therapy was found to be protective (aOR 0.05, 95%CI 0.01-0.19). Notably, the requirement of oxygen supplementation or hospitalization did not affect the risk of CAM. CONCLUSION: Judicious use of steroids and stringent glycemic control are vital to preventing mucormycosis. Use of clean masks, preference for N95 masks if available, and minimizing swab testing after the diagnosis of COVID-19 may further reduce the incidence of CAM.


Subject(s)
COVID-19 , Mucormycosis , Case-Control Studies , Humans , Mucormycosis/epidemiology , Risk Factors , SARS-CoV-2
4.
Mycoses ; 65(1): 57-64, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1570935

ABSTRACT

BACKGROUND: Though invasive pulmonary aspergillosis is a well known complication of COVID-19 pneumonia, indolent forms of aspergillosis have been rarely described. METHODS: We prospectively collected the clinico-radio-microbiological data of 10 patients of subacute invasive pulmonary aspergillosis (SAIA), who presented to our hospital with recent history of COVID-19 pneumonia along with cavitary lung disease, positive IgG (against Aspergillus) with or without positive respiratory samples for Aspergillus spp. RESULT: The mean age of presentation of SAIA was 50.7 ± 11.8 years. All the patients had recently recovered from severe COVID-19 illness with a mean duration of 29.2 ± 12 days from COVID-19 positivity. Cough was the predominant symptom seen in 8/10 (80%) patients followed by haemoptysis. 7/10 (70%) patients were known diabetic. While serum galactomannan was positive in 5/9 patients (55.5%), fungal culture was positive in 2/7 patients (28.5%) and polymerase chain reaction (PCR) for Aspergillus was positive in three patients. Eight (80%) patients presented with a single cavitary lesion; pseudoaneurysm of pulmonary artery was seen in two patients and post-COVID-19 changes were seen in all patients. All patients were treated with voriconazole, out of which four (40%) patients died during the follow-up period. CONCLUSION: SAIA should be considered in the differential diagnosis of cavitating lung lesions in patients with recent history of COVID-19 in the background of steroid use with or without pre-existing diabetes.


Subject(s)
COVID-19 , Invasive Pulmonary Aspergillosis , Adult , Antibodies, Fungal/blood , Aspergillus , COVID-19/complications , Humans , Immunoglobulin G/blood , Invasive Pulmonary Aspergillosis/diagnosis , Invasive Pulmonary Aspergillosis/drug therapy , Middle Aged , Voriconazole
5.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-292634

ABSTRACT

Background: The Impact of COVID-19 pandemic over non-essential health services has been massive. We initiated Influenza Like Illness (ILI) screening for resumption of out-patient services at a tertiary care centre and this study attempted to gauge its efficacy in effectively pruning out COVID-19.Methods: We included all the patients who had visited for an OPD appointment during the study period. Patient details and ILI symptoms were noted. Patients were then followed up telephonically after 2 weeks. The telephonic follow up was to ensure RT-PCR status and complaints of any newly developed ILI post OPD visit (within the last 14 days).Results:: Out of the 957 patients who were enrolled, 929 patients were successfully followed up telephonically after 14 days. Only 13 who were screened out as ‘possible ILI’, were either RT-PCR negative or did not follow up with a confirmatory test. The telephonic follow up to ensure RT-PCR status and complaints of any newly developed ILI post OPD visit (within the last 14 days) was noted in the rest of the patients. Only 1 participant out of 957 screened, tested positive for COVID-19.Conclusion: The period in which the study was held the national positivity rate was low (around 3%). Therefore, in a resource limited country such as India it is astute to restart the OPD services in the pre-existing setup using basic precautions and a verbal questionnaire during the slope of the pandemic.

6.
Diabetes Metab Syndr ; 15(6): 102308, 2021.
Article in English | MEDLINE | ID: covidwho-1517128

ABSTRACT

BACKGROUND AND AIMS: This meta-analysis aims to highlight the impact of cardio-metabolic comorbidities on COVID-19 severity and mortality. METHODS: A thorough search on major online databases was done for studies describing the clinical outcomes of COVID-19 patients. We used random-effects model to compute pooled estimates for critical or fatal disease. RESULTS: A total of 20,475 patients from 33 eligible studies were included. Maximum risk of development of critical or fatal COVID-19 disease was seen in patients with underlying cardiovascular disease [OR: 3.44, 95% CI: 2.65-4.48] followed by chronic lung disease, hypertension and diabetes mellitus. Of the total cases, 64% had one of the four comorbidities with the most prevalent being hypertension with a pooled prevalence of 27%. CONCLUSIONS: Presence of comorbidities like cardiovascular disease, chronic lung disease, hypertension and diabetes mellitus led to a higher risk of development of critical or fatal COVID-19 disease, with maximum risk seen with underlying cardiovascular disease.


Subject(s)
COVID-19/mortality , Cardiovascular Diseases/physiopathology , Diabetes Mellitus/physiopathology , Hypertension/physiopathology , Lung Diseases/physiopathology , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/pathology , COVID-19/virology , Humans
7.
J Family Med Prim Care ; 10(8): 3047-3050, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1456417

ABSTRACT

BACKGROUND: Currently, there is no data on the impact of COVID-19 on patients' income and work in India. METHODS: We conducted a cross-sectional study at a tertiary hospital in New Delhi. We included all the patients who were ≥18 years of age and consecutively diagnosed with COVID-19 between the 1st of May 2020 to 31st July 2020. Patients were interviewed by a physician using a semi-structure questionnaire. Data were collected on socio-economic status, occupation, income loss, leaves taken, decrease in work efficiency (self-perceived) and about-facing any stigma/discrimination at the workplace. RESULTS: Out of 245 patients, 190 patients were employed. A total of 126 patients (66.3%) self-reported their work was affected due to COVID-19 disease. A total of 30.5% of patients (n = 58/190) reported deduction in their salary. The median amount of salary loss was INR 10,000 (IQR 9000-25000). Decrease in income and work efficiency (self-perceived) was found to be 37.3% (n = 71) and 12.1% (n = 23), respectively. A total of 47 patients (37.3%) took personal leaves (median number - 17 days (IQR 14-25), and discrimination/stigma related to the COVID-19 at the workplace was faced by 22.6% of patients. CONCLUSION: Income and work of a substantial number of patients was affected due to COVID-19, as there was a decrease in income and work efficiency. Patients also had to take personal leaves and face stigma in the workplace. This will inform the policymakers to formulate strategies to mitigate the impact of COVID-19.

8.
QJM ; 2021 Jul 15.
Article in English | MEDLINE | ID: covidwho-1310938
9.
Int J Health Plann Manage ; 36(6): 2011-2019, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1310483

ABSTRACT

Healthcare services have been severely strained and stressed coping with the rising burden of COVID-19 patients. With the situation gradually worsening and the growing need to cater to Non-COVID patients, we ventured to reopen the OPDs. This was to be implemented in a staggered manner. The backbone to this endeavour was the specialised screening and sampling OPD for healthcare workers which had been earlier established. We would like to share our two-pronged approach in this unprecedented situation: establishment of a specialised screening and sampling clinic for healthcare workers and a high-volume "Influenza-like screening clinic" for the resumption of outpatient services.


Subject(s)
COVID-19 , Ambulatory Care , Ambulatory Care Facilities , Humans , India , SARS-CoV-2
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