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1.
Clinical Epidemiology and Global Health ; : 101044, 2022.
Article in English | ScienceDirect | ID: covidwho-1783224

ABSTRACT

Introduction Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method Single centred study from June 2020 to May 2021 at a tertiary centre in North India. A preformed questionnaire was used to record clinical and laboratory parameters and to identify cases which are in addition to CDC list and Indian data. Results 0.67% (46) cases out of 6832 patients were identified to have non-classical coexisting illness. It was divided into 2 groups-infections A (60.1%) and non-infections B (39.9%). Group A included-tuberculosis- pulmonary (14.3%) & extra pulmonary (32.9%), bacterial (25.0%) viral infections [dengue, hepatitis B & C] (14.3%), HIV disease (10.7%) and malaria (3.6%). Group B included- organ transplant (27.8%), autoimmune [myasthenia gravis, polymyositis, psoriasis] (22.6%), haematologic [Haemophilia, ITP, Aplastic anaemia, APML, CML] (27.8%), uncommon malignancies [disseminated sacral chordoma and GTN] (11.1%) and snakebite (11.1%). Serum Procalcitonin was not helpful for diagnosis of bacterial infection in COVID-19 disease. Group A had significantly longer duration of illness, hepatitis and elevated CRP. The mortality in group A & B were 32.1% and 43.8% respectively. Death in non-severe COVID cases was in tetanus and snakebite. 30.7% death among tuberculosis patients. More than 70% of deaths were attributable to COVID 19 in both the groups. Conclusion In Indian settings, comorbidities like tuberculosis and bacterial infections can precipitate severe COVID 19 unlike other parts of the world where tuberculosis is relatively uncommon.

2.
J Matern Fetal Neonatal Med ; 35(8): 1610-1618, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1747012

ABSTRACT

Corona virus disease 2019 started in December 2019 as an outbreak of unexplained pneumonias in Wuhan, a city in Hubei province of China. This illness emerged as an epidemic in China and later spread to almost all countries over the globe except Antarctica. This is caused by a beta Corona virus, which is genetically similar to SARS virus. The predominant mode of transmission is via droplet spread, when the infected person coughs, sneezes or talks the virus is released in the respiratory secretions. As there are only a few cases of COVID 19 in neonates, there is no convincing evidence to support the possibility of vertical transmission. Clinical presentation in neonates is nonspecific, commonly observed are temperature instability, respiratory distress, poor feeding, lethargy, vomiting and diarrhea. Laboratory examinations may be nonspecific. Definitive test for 2019-nCoV is the detection of viral nucleic acid by real-time fluorescence polymerase chain reaction (RT-PCR). Suspected and confirmed COVID positive mothers should be delivered in separate delivery rooms and operation theaters. Since there is no approved treatment or drug for this disease, prevention of infection and breaking the chain of transmission plays a crucial role.


Subject(s)
COVID-19 , SARS Virus , COVID-19/diagnosis , Disease Outbreaks , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , SARS-CoV-2
3.
IJID Reg ; 2: 1-7, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1521056

ABSTRACT

Background: COVID-19 emerged as a global pandemic in 2020, spreading rapidly to most parts of the world. The proportion of infected individuals in a population can be reliably estimated via serosurveillance, making it a valuable tool for planning control measures. Our serosurvey study aimed to investigate SARS-CoV-2 seroprevalence in the urban population of Hyderabad at the end of the first wave of infections. Methods: This cross-sectional survey, conducted in January 2021 and including males and females aged 10 years and above, used multi-stage random sampling. 9363 samples were collected from 30 wards distributed over six zones of Hyderabad, and tested for antibodies against SARS-CoV-2 nucleocapsid antigen. Results: Overall seropositivity was 54.2%, ranging from 50% to 60% in most wards. Highest exposure appeared to be among those aged 30-39 and 50-59 years, with women showing greater seropositivity. Seropositivity increased with family size, with only marginal differences among people with varying levels of education. Seroprevalence was significantly lower among smokers. Only 11% of the survey subjects reported any COVID-19 symptoms, while 17% had appeared for COVID-19 testing. Conclusion: Over half the city's population was infected within a year of onset of the pandemic. However, ∼ 46% of people remained susceptible, contributing to subsequent waves of infection.

6.
J Med Virol ; 93(10): 6045-6049, 2021 10.
Article in English | MEDLINE | ID: covidwho-1432431

ABSTRACT

Coronavirus disease 2019 (COVID-19) has been shown to be associated with a lot of neurological complications, of whom Guillain-Barre syndrome (GBS) is an important post-infectious consequentiality. More than 220 patients with GBS have been reported thus far. We intend to share our experience with five patients of GBS where one of them had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF). This is the first-ever report demonstrating the presence of SARS-CoV-2 in the CSF of an adult patient; a similar occurrence has recently been described in a pediatric patient. We wish to emphasize the fact that commonly GBS occurs as a result of a post-infectious process but in a few cases where the symptoms of COVID-19 and GBS occur concurrently, corresponding to the viremic phase, separate pathogenesis needs to be thought of. This para-infectious nature is exemplified by the presence of virus in the cerebrospinal fluid of one of our patients. We review the neuroinvasive potential of SARS-Cov-2 in this regard and draw parallels with Cytomegalovirus, Zika virus, and Human Immunodeficiency virus-associated occurrences of GBS.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/etiology , Adult , COVID-19/cerebrospinal fluid , COVID-19/therapy , Cerebrospinal Fluid/virology , Female , Guillain-Barre Syndrome/cerebrospinal fluid , Humans , Immunoglobulins, Intravenous/administration & dosage , Male , Middle Aged , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Treatment Outcome
7.
Comb Chem High Throughput Screen ; 25(5): 768-770, 2022.
Article in English | MEDLINE | ID: covidwho-1354798

ABSTRACT

As most of the countries have already passed the peaks of the second or third wave of infections, COVID-19 is (finally) on the wane and will soon touch the baseline persistence with a reduced death rate. The Case Fatality Ratio (CFR) or lethality is presently only ~2.0%, which is relatively low in comparison to the high of 14% in April 2020. More importantly, the lethality in healthy people is 20 times lower. In addition, successful vaccination programs are currently underway in several countries. Thus, although new pathogenic variants as well as a few isolated cases of resurgence, will continue to emerge, the worst seems to be over and we will surely win this battle soon.


Subject(s)
COVID-19 , Humans , SARS-CoV-2
8.
Diabetes Metab Syndr ; 15(4): 102196, 2021.
Article in English | MEDLINE | ID: covidwho-1293738

ABSTRACT

AIMS: Diabetes Mellitus predisposes patients to invasive fungal infections. There has been a recent surge of Mucormycosis with COVID 19 infection particularly in patients with diabetes. This study aims to study the clinical spectrum of CAM (COVID -associated Mucormycosis) with diabetes and subsequent outcomes. MATERIAL AND METHODS: This was a descriptive study conducted at a single COVID Care Centre in India in patients with COVID Associated Mucormycosis from April 12, 2021 to May 31, 2021. RESULTS: Among 953 hospitalized patients with COVID 19 infection, 32 patients had CAM with an incidence of 3.36%. In patients with CAM, 87.5% had Diabetes Mellitus as the most common co-morbidity. The majority of the patients had poor glycemic control with a mean HbA1c of 9.06%. Out of the total study population, 93% had prior exposure to high dose corticosteroids. During the study period, 12.5% patients of CAM did not survive. CONCLUSION: Mucormycosis is an angioinvasive fungal infection with high mortality. The disease has surged in COVID 19 pandemic due to uncontrolled diabetes and improper corticosteroid use.


Subject(s)
COVID-19/complications , Diabetes Mellitus/physiopathology , Hospitalization/statistics & numerical data , Mucormycosis/mortality , SARS-CoV-2/isolation & purification , COVID-19/transmission , COVID-19/virology , Diabetes Mellitus/virology , Female , Humans , India/epidemiology , Male , Middle Aged , Mucormycosis/epidemiology , Mucormycosis/pathology , Mucormycosis/virology , Prognosis , Risk Factors , Survival Rate
9.
J Med Virol ; 93(10): 6045-6049, 2021 10.
Article in English | MEDLINE | ID: covidwho-1281226

ABSTRACT

Coronavirus disease 2019 (COVID-19) has been shown to be associated with a lot of neurological complications, of whom Guillain-Barre syndrome (GBS) is an important post-infectious consequentiality. More than 220 patients with GBS have been reported thus far. We intend to share our experience with five patients of GBS where one of them had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the cerebrospinal fluid (CSF). This is the first-ever report demonstrating the presence of SARS-CoV-2 in the CSF of an adult patient; a similar occurrence has recently been described in a pediatric patient. We wish to emphasize the fact that commonly GBS occurs as a result of a post-infectious process but in a few cases where the symptoms of COVID-19 and GBS occur concurrently, corresponding to the viremic phase, separate pathogenesis needs to be thought of. This para-infectious nature is exemplified by the presence of virus in the cerebrospinal fluid of one of our patients. We review the neuroinvasive potential of SARS-Cov-2 in this regard and draw parallels with Cytomegalovirus, Zika virus, and Human Immunodeficiency virus-associated occurrences of GBS.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/etiology , Adult , COVID-19/cerebrospinal fluid , COVID-19/therapy , Cerebrospinal Fluid/virology , Female , Guillain-Barre Syndrome/cerebrospinal fluid , Humans , Immunoglobulins, Intravenous/administration & dosage , Male , Middle Aged , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Treatment Outcome
10.
Internet of Things ; : 100377, 2021.
Article in English | ScienceDirect | ID: covidwho-1101309

ABSTRACT

The ongoing pandemic of COVID-19 has shown the limitations of our current medical institutions. There is a need for research in automated diagnosis for speeding up the process while maintaining accuracy and reducing the computational requirements. This work proposes an automated diagnosis of COVID-19 infection from CT scans of the patients using deep learning technique. The proposed model, ReCOV-101, uses full chest CT scans to detect varying degrees of COVID-19 infection. To improve the detection accuracy, the CT-scans were preprocessed by employing segmentation and interpolation. The proposed scheme is based on the residual network that takes advantage of skip connection, allowing the model to go deeper. The model was trained on a single enterprise-level GPU. It can easily be provided on a network’s edge, reducing communication with the cloud, often required for larger neural networks. This work aims to demonstrate a less hardware-intensive approach for COVID-19 detection with excellent performance that can be combined with medical equipment and help ease the examination procedure. With the proposed model, an accuracy of 94.9% was achieved.

11.
J Neurosurg Anesthesiol ; 33(1): 7-9, 2021 01.
Article in English | MEDLINE | ID: covidwho-1044104
12.
J Biomol Struct Dyn ; : 1-16, 2020 Nov 30.
Article in English | MEDLINE | ID: covidwho-949568

ABSTRACT

Since the emergence of novel Coronavirus (SARS-CoV-2) infection in Wuhan, China in December 2019, it has now spread to over 205 countries. The ever-growing list of globally spread corona virus-19 disease (COVID-19) patients has demonstrated the high transmission rate among the human population. Currently, there are no FDA approved drugs or vaccines to prevent and treat the infection of the SARS-CoV-2. Considering the current state of affairs, there is an urgent unmet medical need to identify novel and effective approaches for the prevention and treatment of COVID-19 by re-evaluating the knowledge of traditional medicines and repurposing of drugs. Here, we used molecular docking and molecular dynamics simulation approach to explore the beneficial roles of phytochemicals and active pharmacological agents present in the Indian herbs which are widely used in the preparation of Ayurvedic medicines in the form of Kadha to control various respiratory disorders such as cough, cold and flu. Our study has identified an array of phytochemicals present in these herbs which have significant docking scores and potential to inhibit different stages of SARS-CoV-2 infection as well as other Coronavirus target proteins. The phytochemicals present in these herbs possess significant anti-inflammatory property. Apart from this, based on their pharmaceutical characteristics, we have also performed in-silico drug-likeness and predicted pharmacokinetics of the selected phytochemicals found in the Kadha. Overall our study provides scientific justification in terms of binding of active ingredients present in different plants used in Kadha preparation with viral proteins and target proteins for prevention and treatment of the COVID-19.Communicated by Ramaswamy H. Sarma.

13.
14.
J Neurosurg Anesthesiol ; 33(1): 44-50, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-851905

ABSTRACT

BACKGROUND: According to early reports, patients affected by coronavirus disease 2019 (COVID-19) are at an increased risk of developing cerebrovascular events, including acute ischemic stroke (AIS). The COVID-19 pandemic may also impose difficulties in managing AIS patients undergoing endovascular thrombectomy (EVT), as well as concerns for the safety of health care providers. This international global survey aims to gather and summarize information from tertiary care stroke centers on periprocedural pathways and endovascular management of AIS patients during the COVID-19 pandemic. METHODS: A cross-sectional survey-based research questionnaire was sent to 259 tertiary care stroke centers with neurointerventional facilities worldwide. RESULTS: We received 114 responses (response rate: 44%) from 25 different countries across all 5 continents. The number of AIS patients and EVT cases were reported to have decreased during the pandemic. Most participants reported conducting COVID-19 testing before (49%) or after the procedure (31%); 20% of centers did not test at all. Only 16% of participating centers reported using a negative pressure room for the thrombectomy procedure. Strikingly, 50% of participating centers reported no changes in the anesthetic management of AIS patients undergoing EVT during the pandemic. CONCLUSIONS: This global survey provides information on the challenges in managing AIS patients undergoing EVT during the COVID-19 pandemic. Its findings can be used to improve patient outcomes and the safety of the health care team worldwide.


Subject(s)
COVID-19 , Ischemic Stroke/diagnostic imaging , Ischemic Stroke/therapy , Pandemics , Anesthesia , COVID-19 Testing , Cross-Sectional Studies , Endovascular Procedures , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Patient Safety , Surveys and Questionnaires , Tertiary Care Centers , Thrombectomy , Treatment Outcome
15.
BMJ Case Rep ; 13(9)2020 Sep 13.
Article in English | MEDLINE | ID: covidwho-767823

ABSTRACT

COVID-19 is the infectious disease caused by a recently discovered SARS-CoV-2. Following an initial outbreak in December 2019 in Wuhan, China, the virus has spread globally culminating in the WHO declaring a pandemic on 11 March 2020. We present the case of a patient with an initial presentation of COVID-19 pneumonitis requiring mechanical ventilation for nearly 2 weeks and total admission time of 3 weeks. She was given prophylactic dose anticoagulation according to hospital protocol during this time. Following a week at home, she was readmitted with acute massive pulmonary embolism with severe respiratory and cardiac failure, representing the first such case in the literature.


Subject(s)
Anticoagulants/therapeutic use , Coronavirus Infections/complications , Inflammation/virology , Pneumonia, Viral/complications , Pulmonary Embolism/virology , Thrombosis/drug therapy , Thrombosis/virology , COVID-19 , Female , Humans , Middle Aged , Pandemics , Severity of Illness Index
19.
J Neurosurg Anesthesiol ; 32(3): 193-201, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-548377

ABSTRACT

The pandemic of coronavirus disease 2019 (COVID-19) has unique implications for the anesthetic management of endovascular therapy for acute ischemic stroke. The Society for Neuroscience in Anesthesiology and Critical Care appointed a task force to provide timely, consensus-based expert recommendations using available evidence for the safe and effective anesthetic management of endovascular therapy for acute ischemic stroke during the COVID-19 pandemic. The goal of this consensus statement is to provide recommendations for anesthetic management considering the following (and they are): (1) optimal neurological outcomes for patients; (2) minimizing the risk for health care professionals, and (3) facilitating judicious use of resources while accounting for existing variability in care. It provides a framework for selecting the optimal anesthetic technique (general anesthesia or monitored anesthesia care) for a given patient and offers suggestions for best practices for anesthesia care during the pandemic. Institutions and health care providers are encouraged to adapt these recommendations to best suit local needs, considering existing practice standards and resource availability to ensure safety of patients and providers.


Subject(s)
Anesthesiology/methods , Brain Ischemia/surgery , Coronavirus Infections/prevention & control , Endovascular Procedures/methods , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Stroke/surgery , Betacoronavirus , Brain Ischemia/complications , COVID-19 , Consensus , Critical Care , Europe , Humans , Minimally Invasive Surgical Procedures , Neurosciences , Neurosurgery , SARS-CoV-2 , Societies, Medical , Stroke/complications , United States
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