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1.
Journal of Infectious Diseases ; 10:10, 2023.
Article in English | MEDLINE | ID: covidwho-2189175

ABSTRACT

BACKGROUND: SARS-CoV-2 immunity has declined with subsequent waves and accrual of viral mutations. In vitro studies raise concern for immune escape by BA.4/BA.5, and a study in Qatar showed moderate protection, but these findings have yet to be reproduced.

2.
Journal of Nepal Health Research Council ; 20(2):475-481, 2022.
Article in English | MEDLINE | ID: covidwho-2206057

ABSTRACT

BACKGROUND: The second wave of COVID-19 pandemic hit all age groups with different presentations and outcomes. This study aimed to explore the clinical characteristics, investigational findings, hospital outcomes along with a ninety days telephonic follow-up of COVID-19 infection in children.

3.
Journal of the Nepal Medical Association ; 61(257):39-42, 2023.
Article in English | EMBASE | ID: covidwho-2205809

ABSTRACT

Introduction: Coronavirus disease can affect the renal system in various forms ranging from mild proteinuria to acute kidney injury, some even needing renal replacement therapy. This study aimed to find out the prevalence of acute kidney injury in patients admitted with COVID-19 at a tertiary care centre. Method(s): This descriptive cross-sectional study was done in patients admitted in COVID-19 ward in our hospital from July 2021 to June 2022. Ethical approval was obtained from the Institutional Review Committee (Reference number: 066-077/078). The serum creatinine level was used for the diagnosis of acute kidney injury. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Result(s): Out of 80 patients with COVID-19, the prevalence of acute kidney injury was 25 (31.25%) (21.09-41.41, 95% Confidence Interval). Conclusion(s): The prevalence of acute kidney injury in COVID-19 patients was similar to other studies done in similar settings. Copyright © 2023, Nepal Medical Association. All rights reserved.

4.
American Journal of Transplantation ; 22(Supplement 3):420, 2022.
Article in English | EMBASE | ID: covidwho-2063366

ABSTRACT

Purpose: Extra-pulmonary organs from donors with SARS-CoV-2 detection during donor evaluation are not accepted by many centers due to theoretical concerns for productive infection and organ injury from COVID-related sequelae. We aimed to compare outcomes for kidney transplantation (KT) from donors with and without SAR-CoV-2 RNA detection, CoVD+ and CoVDneg, respectively. Method(s): We retrospectively reviewed donor data, recipient data and key outcomes for all adult CoVD+ KTs performed at our center between 2/1/2021 and 10/31/2021 and compared such data to all consecutive adult CoVDneg KTs during the same period. Organ selection was by protocol and excluded donors within the 1st 14 days of diagnosed symptomatic infection. No COVID-directed therapies were provided to CoVD+ KT recipients (KTRs). Vaccination was not required in early 2021. Result(s): There were 159 KTs, including 71 (44%) from 41 CoVD+'s with mean follow up 151d (range 35-291d). Of the 41 CoV+ donors, 16 (40%) died of COVID complications, mostly hypoxic respiratory failure, with 4 on VV ECMO. For those dying of COVID, the median time from first SARS-CoV2 RNA detection to donation was 28d (range 16-65). Compared to CoVneg donors, CoV+D's had lower KDPI (mean 31 v 43, mean difference -10.8, 95% CI -18.41 to -3.17, p=0.006), and were more likely DCD (OR 2.41, 95% CI 1.28-0.463, p=0.007). Having a CoV+ donor was not associated with delayed graft function (DGF). On multivariable analysis, CoVD+ was not associated with a higher serum creatinine (Cr) at 1, 3 or 6 months, but DCD was. There was 1 death (from pre-existing interstitial lung disease without SARS-CoV-2 detection from the lower airway) at 4 mo and 1 graft loss at 6 wk post-KT, both in the CoVD+ group. Neither of these KTR's donors had died of a COVID-related cause. Rejection occurred in 3 CoVD+ and 4 CoVneg KTRs. Six (3.7%) KTRs were diagnosed with COVID, all >3 mo post-KT, with 5/6 occurring >6 mo post-KT during peak periods of circulating virus. Conclusion(s): In a large series, kidney transplant outcomes from CoVD+s were similar to CoVDnegs up to 6 months post-transplant. CoVD+ KT recipients likely benefited from lower KDPI organs. We demonstrate safe and successful transplantation of CoVD+ kidneys outside of the peak period of symptomatic SARS-CoV-2 infection. (Figure Presented).

5.
Chest ; 162(4):A2351-A2352, 2022.
Article in English | EMBASE | ID: covidwho-2060938

ABSTRACT

SESSION TITLE: Expanding Considerations in Management of Pulmonary Embolism SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/19/2022 11:15 am - 12:15 pm PURPOSE: Patients with COVID have an increased risk of thrombotic events including pulmonary embolism (PE). The primary objective of this study was to understand the differences in risk factors, clinical presentation, treatment modalities, and outcomes in patients with PE who were COVID positive at time of admission compared to those who were not. METHODS: Patients diagnosed with PE and activated by the Pulmonary Embolism Response Team (PERT) at Spectrum Health hospital system between November 2019 through January 2022 were included. Clinical, demographic, laboratory, and therapeutic characteristics were compared between patients with COVID and without COVID. Continuous variables were evaluated by t-test and categorical variables by Chi square. Survival after PE was evaluated using Kaplan Meier survival analysis. RESULTS: Of the 479 PERT-activated patients at our institution, 84 (17.5%) were diagnosed with COVID upon admission. Demographics such as age, gender, BMI, and race were similar between patients with and without COVID (all p>0.05). Patients with COVID were less likely to have PE risk factors such as recent surgery (4.8% vs 16.2%, p=0.011), recent trauma (0% vs 8.1%, p=0.014), and reduced mobility (10.7% vs 26.6%, p=0.003) although they were more likely to be recently hospitalized (19.1% vs 8.9%, p<0.001). Patients with COVID were more likely to have a fever (7.1% vs 2.5%, p=0.045), hypoxia (60.7% vs 29.9%, p<0.001), tachypnea (high respiratory rate/min of 28.2 vs 24.8, p<0.001), and lower O2 saturation (low O2 mean of 87.3 vs 90.5, p<0.001) upon presentation. Compared to non-COVID patients, mean troponin (116.5 vs 83.6 ng/ml, p=0.033) was higher in patients with COVID. There was DVT in 36.9% of COVID patients and 30.63% of non-COVID patients (p=0.321). Severity of PE was similar between COVID and non-COVID patients (massive: 18% vs. 15%;sub-massive: 70% vs. 75%, p=0.661). COVID and non-COVID patients had similar rates of thrombolysis (4.7% vs 2.3%) and catheter-based interventions (56% vs 59%). Patients with COVID had longer ICU (10 vs 5.2 days, p=0.001) and hospital stays (10 vs 6.1 days, p=0.006) compared to non-COVID patients. Major bleeding in the follow-up period was higher in the COVID group (10.7% vs 3.5%, p=0.01). There was no difference in mortality between COVID and non-COVID patients at 30 days, (11.9% vs 7.6%), 90 days (15.5% vs 10.4%), or 1 year (16.7% vs 13.7%). CONCLUSIONS: Patients who presented with PE and COVID had less traditional risk factors for PE and were more hypoxemic and tachypneic at the time of PERT activation. They received similar treatment to non-COVID patients but had increased risk for major bleeding. There were no differences in short or intermediate term survival between COVID and non-COVID patients. CLINICAL IMPLICATIONS: Similar severity, treatment, and mortality show promise for PE patients with COVID but bleeding complications require further investigation. DISCLOSURES: no disclosure submitted for Wael Berjaoui;Speaker/Speaker's Bureau relationship with Bristol Myers Squibb Please note: 2015 to present Added 04/17/2022 by Trevor Cummings, value=Honoraria Speaker/Speaker's Bureau relationship with Pfizer Please note: 2015 to present Added 04/17/2022 by Trevor Cummings, value=Honoraria Speaker/Speaker's Bureau relationship with Inari Medical Please note: 2020 to Present Added 04/16/2022 by Trevor Cummings, value=Honoraria No relevant relationships by Catherine Kelty Consultant relationship with Inari Medical Please note: July 2020 - present Added 04/02/2022 by Michael Knox, value=Consulting fee No relevant relationships by marzia leacche no disclosure submitted for Renzo Loyaga-Rendon;No relevant relationships by James Morrison No relevant relationships by Joseph Pitcher No relevant relationships by Nabin Shrestha Consultant relationship with Inari Medical Please note: 1/2021 to current Added 04/08/2022 by Erin VanDyke, value=Consulting fee No relevant relationships by Glenn VanOtteren

6.
Eval Health Prof ; 44(4): 327-332, 2021 12.
Article in English | MEDLINE | ID: covidwho-1443725

ABSTRACT

We systematically reviewed studies to estimate the risk of SARS-CoV-2 reinfection among those previously infected with SARS-CoV-2. For this systematic review, we searched scientific publications on PubMed and MedRxiv, a pre-print server, through August 18, 2021. Eligible studies were retrieved on August 18, 2021. The following search term was used on PubMed: ((("Cohort Studies"[Majr]) AND ("COVID-19"[Mesh] OR "SARS-CoV-2"[Mesh])) OR "Reinfection"[Majr]) OR "Reinfection"[Mesh]. The following search term was used on MedRxiv: "Cohort Studies" AND "COVID-19" OR "SARS-CoV-2" AND "Reinfection". The search terms were broad to encompass all applicable studies. There were no restrictions on the date of publication. Studies that did not describe cohorts with estimates of the risk of SARS-CoV-2 reinfection among those with previous infection were excluded. Studies that included vaccinated participants were either excluded or limited to sub-groups of non-vaccinated individuals. To identify relevant studies with appropriate control groups, we developed the following criteria for studies to be included in the systematic analysis: (1) baseline polymerase chain reaction (PCR) testing, (2) a uninfected comparison group, (3) longitudinal follow-up, (4) a cohort of human participants, i.e. not a case report or case series, and (5) outcome determined by PCR. The review was conducted following PRISMA guidelines. We assessed for selection, information, and analysis bias, per PRISMA guidelines. We identified 1,392 reports. Of those, 10 studies were eligible for our systematic review. The weighted average risk reduction against reinfection was 90.4% with a standard deviation of 7.7% (p-value: <0.01). Protection against SARS-CoV-2 reinfection was observed for up to 10 months. Studies had potential information, selection, and analysis biases. The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination. More research is needed to characterize the duration of protection and the impact of different SARS-CoV-2 variants.


Subject(s)
COVID-19 , Reinfection/virology , COVID-19/pathology , Humans , SARS-CoV-2
7.
Kathmandu Univ Med J (KUMJ) ; 18(70): 48-52, 2020.
Article in English | MEDLINE | ID: covidwho-1089410

ABSTRACT

Background The frequent lockdown in Nepal during COVID-19 pandemic had brought various kinds of complexities such as stress among college students. This situation had created uncertainty of future academic career of undergraduate students in medical colleges. Some previously published literature showed gaming as a coping mechanism against stress. Objective To assess the gaming behavior of Medical college students during lockdown in COVID-19 pandemic. Method A cross-sectional study was conducted during lockdown period of July to August 2020. A total of 412 college students were enrolled. Online Google forms were shared to all the eligible students through email, viber and messenger with the help of class representative. Collected data were analyzed in SPSS version 20.0. Result The prevalence of gaming disorder was 8.5% among 260 internet gaming users. About 69.2% of the participants reported that their gaming behavior had increased due to stress of COVID-19 pandemic. Gender and spending more time online per day showed significant associations with greater scores on the internet gaming disorder. Conclusion During lockdown period of COVID-19 pandemic, the gaming behavior of medical college students has increased.


Subject(s)
Behavior, Addictive , COVID-19 , Communicable Disease Control , Cross-Sectional Studies , Humans , Nepal/epidemiology , Pandemics , SARS-CoV-2
8.
Kathmandu University Medical Journal ; 18(2):62-67, 2020.
Article in English | CAB Abstracts | ID: covidwho-942035

ABSTRACT

Novel coronavirus (SARS-CoV-2) is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China towards the end of 2019. At present, there is no evidence that pregnant women are more likely to be severely ill, need ICU care, or die from the illness in comparison to non-pregnant adults. Evidences suggest that vertical transmission, might be possible. We searched and retrieved the published literature from PubMed and Google Scholar using various keywords. We further searched the official webpages of various organizations for the updated information. Pregnant individuals in particular are encouraged to take all available precautions to optimize health and avoid exposure to COVID-19. Adequate Testing should be prioritized in pregnant women admitted with suspected COVID-19. When a pregnancy is complicated by critical illness, the pregnant patient should ideally be cared for at a Level III or IV hospital. In the face of COVID-19, antenatal fetal surveillance and ultrasonography should continue as medically indicated when possible and elective ultrasound examinations should not be performed. Maternal immunizations continue to be an essential component of prenatal care and Obgyns should screen all pregnant individuals for mental health issues. Although the most commonly reported sign in COVID-19 is fever, nevertheless, other causes of intrapartum fever should not be overlooked. Cesarean delivery should be based on obstetric indications and not COVID-19 status alone. Infants born to patients with known COVID-19 should be considered infants with suspected COVID-19. The suspected or confirmed COVID-19 mother and infant can be allowed to remain together with enhanced precautions and suspected or confirmed maternal COVID-19 is not a contraindication to breastfeeding. If both the mother and the infant are healthy, it may be prudent to expedite discharge, so as to limit the risk of inadvertent exposure and infection. The Ob-gyns should commit to providing necessary care, although modifications to health care delivery approaches may be necessary.

9.
Kathmandu University Medical Journal ; 18(2):40-47, 2020.
Article in English | CAB Abstracts | ID: covidwho-942032

ABSTRACT

Background:: Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners' satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted.

10.
Kathmandu University Medical Journal ; 18(2 70COVID-19 Special Issue):46-51, 2020.
Article in English | Scopus | ID: covidwho-847638

ABSTRACT

Novel coronavirus (SARS-CoV-2) is a new strain of coronavirus causing COVID-19, first identified in Wuhan City, China towards the end of 2019. At present, there is no evidence that pregnant women are more likely to be severely ill, need ICU care, or die from the illness in comparison to non-pregnant adults. Evidences suggest that vertical transmission, might be possible. We searched and retrieved the published literature from PubMed and Google Scholar using various keywords. We further searched the official webpages of various organizations for the updated information. Pregnant individuals in particular are encouraged to take all available precautions to optimize health and avoid exposure to COVID-19. Adequate Testing should be prioritized in pregnant women admitted with suspected COVID-19. When a pregnancy is complicated by critical illness, the pregnant patient should ideally be cared for at a Level III or IV hospital. In the face of COVID-19, antenatal fetal surveillance and ultrasonography should continue as medically indicated when possible and elective ultrasound examinations should not be performed. Maternal immunizations continue to be an essential component of prenatal care and Ob-gyns should screen all pregnant individuals for mental health issues. Although the most commonly reported sign in COVID-19 is fever, nevertheless, other causes of intrapartum fever should not be overlooked. Cesarean delivery should be based on obstetric indications and not COVID-19 status alone. Infants born to patients with known COVID-19 should be considered infants with suspected COVID-19. The suspected or confirmed COVID-19 mother and infant can be allowed to remain together with enhanced precautions and suspected or confirmed maternal COVID-19 is not a contraindication to breastfeeding. If both the mother and the infant are healthy, it may be prudent to expedite discharge, so as to limit the risk of inadvertent exposure and infection. The Ob-gyns should commit to providing necessary care, although modifications to health care delivery approaches may be necessary. © 2020, Kathmandu University. All rights reserved.

11.
Kathmandu University Medical Journal ; 18(19 70COVID-Special Issue):38-45, 2020.
Article in English | EMBASE | ID: covidwho-833777

ABSTRACT

Background Online learning can play a vital role in the process of teaching and learning during Corona Virus Disease 2019 (COVID-19) pandemic. However, learners’ satisfaction is extremely important in effective implementation of the online learning, especially at institutions where it is newly adopted. Objective To assess satisfaction towards online learning and its predictors among students at Chitwan Medical College, Bharatpur. Method A web-based cross-sectional survey was undertaken among 434 undergraduate and postgraduate students from various academic programs who had participated in the online classes started during this COVID-19 pandemic. A structured questionnaire consisting of 31 items (5-point Likert scale) covering four major student satisfaction domains (learners’ dimensions, technological characteristics, instructors’ characteristics and course management and coordination) was distributed to the students using Google Form. Result More than half (53.5%) of the students were satisfied with the online learning, while 29.7% gave neutral views. Bivariate analyses found that all four domains scores were positively correlated with each other as well as with the students’ overall satisfaction towards learning. In multivariate analysis, female gender [aOR: 2.72, p = 0.013], WiFi as internet modality for learning [aOR: 3.36, p = 0.001) and learners’ dimension score [aOR: 1.27, p<0.001] were the significant predictors of students’ satisfaction. Conclusion Although recently adopted, the satisfaction of the students towards online classes appears good, and prioritizing the identified predictors and working on the weak links could assist in enhancing students’ satisfaction and better outcomes.

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