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1.
Indian J Pediatr ; 2022 Jun 14.
Article in English | MEDLINE | ID: covidwho-1889047

ABSTRACT

OBJECTIVE: To determine the outcomes in children with MIS-C receiving different immunomodulatory treatment. METHODS: In this multicentric, retrospective cohort study, data regarding treatment and outcomes of children meeting the WHO case definition for MIS-C, were collected. The primary composite outcome was the requirement of vasoactive/inotropic support on day 2 or beyond or need of mechanical ventilation on day 2 or beyond after initiation of immunomodulatory treatment or death during hospitalization in the treatment groups. Logistic regression and propensity score matching analyses were used to compare the outcomes in different treatment arms based on the initial immunomodulation, i.e., IVIG alone, IVIG plus steroids, and steroids alone. RESULTS: The data of 368 children (diagnosed between April 2020 and June 2021) meeting the WHO case definition for MIS-C, were analyzed. Of the 368 subjects, 28 received IVIG alone, 82 received steroids alone, 237 received IVIG and steroids, and 21 did not receive any immunomodulation. One hundred fifty-six (42.39%) children had the primary outcome. On logistic regression analysis, the treatment group was not associated with the primary outcome; only the children with shock at diagnosis had higher odds for the occurrence of the outcome [OR (95% CI): 11.4 (5.19-25.0), p < 0.001]. On propensity score matching analysis, the primary outcome was comparable in steroid (n = 45), and IVIG plus steroid (n = 84) groups (p = 0.515). CONCLUSION: While no significant difference was observed in the frequency of occurrence of the primary outcome in different treatment groups, data from adequately powered RCTs are required for definitive recommendations.

2.
SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-334518

ABSTRACT

Abstract In the process of unlocking India after the COVID-19 outbreak, the Indian tourism and transport industry is resuming to revive the economy. In this scenario, it is substantial to examine the impact of Covid-19 pandemic on the travel pattern of the Indians. At the same time, making public transports safe to prevent mass transmission of the Corona-virus is equally important to ensure safe-travel. The present study investigates the impact of COVID-19 on the travel behavior of the Indians, their readiness for availing public transports, as well as their stand on the reoperation of public transport. A total of 212 responses are collected through convenience sampling method for this purpose. The study reveals that COVID-19 pandemic has deeply affected the travel pattern of the Indians. The transport sector has been considered as one of the major causes of transmission of Corona-virus whereas;railway has been identified as the riskiest mode of transport. Though many Indians are ready to avail public transport, the majority still prefer private vehicles more than anything. The Indian respondents are also found doubtful regarding the effective implementation of rules and regulations, which is no doubt crucial for safe travelling. This study will provide useful understandings to the Indian transportation authorities as well as to the Tour Operators regarding the Indian travelers’ concern for transport sector amid COVID-19.

3.
Behaviour & Information Technology ; 41(6):1286-1297, 2021.
Article in English | ProQuest Central | ID: covidwho-1830370

ABSTRACT

Social news sites have enabled news identification and its promotion through crowdsourcing and provided users with the capabilities to discuss topics. Compared to social media, social news sites are information-rich and possess their own social network. Reddit has been classified as a social news website and possesses similar characteristics to other websites in the domain. These include Slashdot, Digg, and StumbleUpon. This paper provides a broad analysis of spectators’ sentimental (or emotional) behaviour surrounding the 2020 Summer Olympics on Reddit. The study measures the impact of the COVID-19 pandemic on spectator sentiments and proposes a scheme for sensitising Redditors’ behaviour by crowdsourcing the influencers present in the Redditor pool.

4.
Vision ; : 09722629221096055, 2022.
Article in English | Sage | ID: covidwho-1820061

ABSTRACT

The multiple phase-wise lockdowns starting 24 March 2020, imposed to control COVID-19 spread in India, put a shrieking halt to industrial activities. Such nationwide lockdowns further exacerbated the financial distress, a long-standing challenge for small and medium-sized enterprises (SMEs). In this study, we examine how corporate governance forms like promoters? ownership, financial performance and market competition affect the distress of listed SMEs, both in the pre-COVID-19 era and during the COVID-19 period. To do so, the study adopts a two-fold sampling and multi-methodology approach. First, by applying panel data analysis on the first sample of 80 listed SMEs for the financial year (FY), FY 2017?2018 to FY 2019?2020, pre-COVID-19 period results are obtained. Second, by applying cross-sectional analysis on the second sample of 155 listed SMEs for FY 2020?2021, results during the COVID-19 period are obtained. Main results indicate that previous years? distress determines distress in the current year in the pre-COVID-19 era. In addition, promoters? ownership and return on equity reduce the possibility of distress, while current period competition is insignificant. Conversely, COVID-19 can exacerbate distress and render promoters? ownership insignificant. Furthermore, the COVID-19 period is characterized by reduced asset utilization. Therefore, any marginal increase in return on assets reduces distress. Interestingly, MC becomes an active determinant of distress during the COVID-19 pandemic. In summary, episodes like COVID-19 can modify the impact behaviour of the aforementioned determinants of distress. Notably, the results highlight the fragility of internal governance forms like ownership effects, while establishing the dominance of external factors like competition during the COVID-19 period.

5.
Psychol Res Behav Manag ; 15: 913-925, 2022.
Article in English | MEDLINE | ID: covidwho-1799021

ABSTRACT

Introduction: COVID-19 pandemic has imposed nation-wide lock-downs which severely impacted day-to-day lifestyle and caused anxiety, stress and fear among patients taking medical care including dental treatments. These psychological behaviors have also been observed during the strategic relaxation of social restrictions (Unlock). However, potential effect of these psychological behavior in endodontic cases have not been probed. Here, it is of great interest to explore the magnitude and buffering effect of two important psychological resources: satisfaction-with-life, and confidence in hospital-infection-control-policy in relation with COVID-19 risk perception on psychological impact due to fear for COVID-19. Methods: Patients visiting Dental Clinic & Research Center for endodontic procedures were randomly asked to fill survey questionnaire, and were later enrolled as per the study criteria. The study carried out in two phases: from 15 Sept 2020 to 15 Dec 2020 (restrained confinement; Unlock 1.0); and from 16 Dec 2020 to 12 Feb 2021 (mild confinement; Unlock 2.0) with total sample size of 136. We used data collection tools such as fear-of-COVID-19 scale (FCV-19), perceived-stress-scale (PSS), modified-dental-anxiety-scale (MDAS), satisfaction-with-life scale (SWLS), COVID-19 risk perception, and confidence in hospital-infection-control-policy for COVID-19. Results: A double moderation and dual moderated mediation structured model were used to establish the correlation of various parameters using SPSS (version 25.0) software suite. Confidence in hospital-infection-control-policy and SWLS were negatively correlated with FCV-19, MDAS, and PSS. Risk perception of COVID-19 was found to positively associated with FCV-19, MDAS, and PSS. Discussion: Patient's confidence in hospital-infection-control-policy for COVID-19 and SWLS acted as independent moderator for FCV-19 and mental distress. FCV-19 and risk perception were found to be lower during mild confinement (Unlock 2.0), and were also the positive predictors of PSS; and negative predictors of SWLS. The higher SWLS correlated very well with lower COVID-19 risk perception, concerning PSS and MDAS.

6.
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.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-321645

ABSTRACT

We extract entities and relationships related to COVID-19 from a corpus of articles related to Corona virus by employing a novel entities and relationship model. The entity recognition and relationship discovery models are trained with a multi-task learning objective on a large annotated corpus. We employ a concept masking paradigm to prevent the evolution of neural networks functioning as an associative memory and induce right inductive bias guiding the network to make inference using only the context. We uncover several import subnetworks, highlight important terms and concepts and elucidate several treatment modalities employed in related ailments in the past.

8.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-316396

ABSTRACT

The authors have requested that this preprint be removed from Research Square.

9.
Rev. colomb. cardiol ; 28(4): 319-323, jul.-ago. 2021. tab, graf
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-1687786

ABSTRACT

Abstract Introduction: Severe acute respiratory syndrome due to coronavirus disease (COVID-19) has overwhelmingly affected the health-care systems globally. Delivering cardiovascular care has become unusually difficult both for caregivers and physicians in these unprecedented times. Methods: We briefly reviewed how cardiac care can be delivered to patients while limiting the exposure of both patients and healthcare workers through telemedicine services. We made a comparison at our institute of outpatient services through routine and telemedicine visits. Results: We found that telemedicine can be an equally effective alternative cardiac care during the times of pandemic with no significant difference in patients profile admitted through telemedicine services. Conclusions: We concluded that telemedicine can prove to be an effective tool in delivering cardiac care by limiting exposure of both patients and physicians with better triage of cardiac patients in the situation of COVID-19 pandemic and may complement to regular cardiac care in routine times.


Resumen Introducción: El síndrome respiratorio agudo grave dado por el COVID-19 ha afectado de manera abrumadora a los sistemas de salud a nivel mundial. La prestación de servicios de atención cardiovascular se ha tornado inusualmente difícil tanto para los cuidadores como para los médicos en estos tiempos inéditos. Métodos: Realizamos una revisión breve de cómo se puede brindar atención cardíaca a los pacientes a la vez que se limita la exposición tanto de pacientes como del personal de la salud a través de los servicios de telemedicina. Comparamos los servicios ambulatorios habituales con las visitas de telemedicina en nuestro instituto. Resultados: Encontramos que la tele medicina puede ser una alternativa igualmente efectiva de atención cardíaca durante tiempos de pandemia, sin ninguna diferencia significativa en el perfil de los pacientes ingresados a través de los servicios de telemedicina. Conclusiones: Concluimos que la telemedicina puede convertirse en una herramienta efectiva para proporcionar atención en salud cardíaca al limitar la exposición tanto de pacientes como de médicos con un mejor triage de pacientes cardíacos en el contexto de la pandemia por COVID-19, y puede llegar a ser un complemento de la atención cardíaca habitual en tiempos normales.


Subject(s)
Humans , Telemedicine , COVID-19 , Pandemics , Ambulatory Care
10.
J Trop Pediatr ; 68(2)2022 02 03.
Article in English | MEDLINE | ID: covidwho-1684807

ABSTRACT

INTRODUCTION: The coronavirus disease-2019 (COVID-19) pandemic has had an unprecedented impact on the lives and lifestyles of people of all ages worldwide. Lifestyle has an essential role in the management of diabetes mellitus in children. METHODS: The study was carried out at a tertiary care centre in India. A telehealth survey was conducted among the parents/guardians of children with diabetes to study the impact of the COVID-19 pandemic. The survey evaluated the effects on lifestyle, diabetes management and challenges in connecting to a new telemedicine programme. RESULTS: The survey was completed by guardians of 91 patients. The mean age of the patients was 13.0 ± 3.8 years in boys and 11.9 ± 4.5 years in girls. Fifty-seven per cent of them were boys, and 63.7% stayed in rural areas. The pandemic has resulted in a significant increase in screen time and sleep duration. The median non-educational screen time has gone up from 1.00 (0.5-2.0) to 2.50 (1.0-4.0) h. The mean sleep duration in children increased from 9.1 ± 1.4 to 9.7 ± 1.4 h. Telemedicine services have been established with minimum resources, but they have limitations, and awareness about them is also limited. CONCLUSION: The COVID-19 pandemic has made the lifestyle of children with diabetes more sedentary. Some of them have also faced challenges with regard to diabetes-related supplies and management. It would be fair to anticipate more complications related to this sedentary lifestyle in the future and work towards identifying and treating them.


Subject(s)
COVID-19 , Diabetes Mellitus , Telemedicine , Adolescent , COVID-19/epidemiology , Child , Female , Humans , Life Style , Male , Pandemics , SARS-CoV-2
11.
Biol Trace Elem Res ; 2022 Jan 22.
Article in English | MEDLINE | ID: covidwho-1641008

ABSTRACT

The deficiencies of trace elements and infectious diseases often coexist and exhibit complex interactions. Several trace elements such as zinc (Zn), copper (Cu) and magnesium (Mg) have immunomodulatory functions and thus influence the susceptibility to the course and outcome of a variety of viral infections. So, this present study was aimed to study relations of trace metals in association with severity and mortality in SARS-CoV-2 patients. A total of 150 individuals infected with COVID-19 and 50 healthy individuals were recruited. Cases were divided based on severity (mild, moderate and severe) and outcome (discharged or deceased). Serum Zn, Mg and Cu levels were analysed by direct colourimetric method. Both serum Cu and Zn levels were significantly decreased in cases when compared to those in controls (p < 0.005 and p < 0.0001). Serum magnesium levels although not significant were found to be slightly decreased in controls. On comparing the trace elements between the deceased and discharged cases, a significant difference was found between serum copper and zinc levels, but for magnesium, both groups have similar levels. The receiver operating characteristic (ROC) curve results indicate that a serum Cu/Zn ratio along with the age of patient provides some reliable information on COVID-19 course and survival odds by yielding an AUC of 95.1% with a sensitivity of 93.8% and specificity of 89.8%. Therefore, we would like to emphasize that measuring the serum copper and zinc along with their ratio can be used as routine investigations for COVID-19 patients in proper identification and management of severe cases in upcoming new waves of COVID-19.

12.
Mini Rev Med Chem ; 2021 Nov 16.
Article in English | MEDLINE | ID: covidwho-1523579

ABSTRACT

BACKGROUND: Coumarin is an oxygen-containing compound in medicinal chemistry. Coumarin plays an important role in both natural systems like plants and also in synthetic medicinal applications as drug molecules. Many structurally different coumarin compounds were found to show a big range of similarity with the vital molecular targets for their pharmacological action and small modifications in their structures resulted insignificant changes in their biological activities. OBJECTIVE: This review gives detailed information about the studies of the recent advances in various pharmacological aspects of coumarins. METHOD: Various oxygen-containing heterocyclic compounds represented remarkable biological significances. The fused aromatic oxygen-heterocyclic nucleus is able to change its electron density; thus changing the chemical, physical and biological properties respectively due to its multiple binding modes with the receptors, which play crucial role in pharmacological screening of drugs. A number of heterocyclic compounds have been synthesized which have their nucleus derived from various plants and animals. In coumarins, benzene ring is fused with pyrone nucleus which provides stability to the nucleus. Coumarins have shown a wide range of pharmacological activities such as anti-tumour, anti-coagulant, anti-inflammatory, anti-oxidant, antiviral, anti-malarial, anti-HIV and antimicrobial activity etc. Results: Reactive oxygen species like superoxide anion, hydroxyl radical and hydrogen peroxide are a type of unstable molecule that contains oxygen, which reacts with other molecules in the cell during the metabolism process but it may produce cytotoxicity when reactive oxygen species increase in number, by the damage of biological macromolecules. Hydroxyl radical (˙OH), is a strong oxidizing agent and it is responsible for the cytotoxicity by oxygen in different plants, animals and other microbes. coumarin is the oldest and effective compound having antimicrobial activity, anti-inflammatory, antioxidant, antidepressant activity, analgesic, anticonvulsant activity, etc. Naturally existing coumarin compounds act against SARS-CoV-2 by preventing viral replication through the targeting on active site against the Mpro target protein. CONCLUSION: This review highlights the different biological activities of coumarin derivatives. In this review we provide an updated summary of the researches which are related to recent advances in biological activities of coumarins analogue and their most recent activities against COVID -19. Natural compounds act as a rich resource for novel drug development against various SARS-CoV-2 viral strains including viruses like herpes simplex virus, influenza virus, human immunodeficiency virus, hepatitis B and C viruses, middle east respiratory syndrome and severe acute respiratory syndrome.

15.
Infect Drug Resist ; 14: 2233-2239, 2021.
Article in English | MEDLINE | ID: covidwho-1282358

ABSTRACT

PURPOSE: Jodhpur administration directed its efforts to control and mitigate COVID 19 infection by implementing and monitoring facility isolation (FI) and home isolation (HI) measures. This study is conducted with a hypothesis that there is no difference in the quality of life and cost-effectiveness of mildly symptomatic or asymptomatic patients in HI and FI. PATIENTS AND METHODS: A mixed-method study was conducted in Jodhpur in September 2020. The purposive sampling technique was used and data from 120 individuals admitted in HI and FI were collected. The information about the status and functioning of isolation facilities was collected from various sources. Multi-stakeholder interactions with 15 personnel engaged in managing isolation facilities were done. EQ-5D version (EQ-5D-5L) which consists of the EQ-5D descriptive system and the EQ visual analog scale (EQ-VAS) was used to assess health-related quality of life. RESULTS: The strength of HI strategy is demonstrated by its ability to provide psychological and social support with minimal logistic requirements but the issue of sufficient household infrastructure, adequate family and societal support for implementing this strategy is of concern. The strength of FI strategy includes its ability to provide support to patients who have issues of sufficient household infrastructure, adequate family and societal support, but this strategy poses a threat of increasing human resource constraints and financial load on the health system. The respondents from HI obtained a mean EQ-5D index score of 0.90 and a mean VAS score of 85, whereas it was 0.80 and 78.5, respectively, for FI. The cost estimated for home isolation was Rs 549 (7.43 US $) per person, whereas it was Rs 2440 (33.02 US $) for facility Isolation. CONCLUSION: Though HI seems advantageous in terms of a better quality of life and cost-saving over FI, both the strategies are context-specific having their own trade-offs.

16.
J Trop Pediatr ; 67(3)2021 07 02.
Article in English | MEDLINE | ID: covidwho-1276236

ABSTRACT

INTRODUCTION: There is a lack of large multicentric studies in children with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in children hospitalized with COVID-19 from India. METHODS: In this multicentric retrospective study, we retrieved data related to demographic details, clinical features, including the severity of disease, laboratory investigations and outcome. RESULTS: We included 402 children with a median (IQR) age of 7 (2-11) years. Fever was the most common symptom, present in 38.2% of children. About 44% had underlying comorbidity. The majority were asymptomatic (144, 35.8%) or mildly symptomatic (219, 54.5%). There were 39 (9.7%) moderate-severe cases and 13 (3.2%) deaths. The laboratory abnormalities included lymphopenia 25.4%, thrombocytopenia 22.1%, transaminitis 26.4%, low total serum protein 34.7%, low serum albumin 37.9% and low alkaline phosphatase 40%. Out of those who were tested, raised inflammatory markers were ferritin 58.9% (56/95), c-reactive protein 33.3% (41/123), procalcitonin 53.5% (46/86) and interleukin-6 (IL-6) 76%. The presence of fever, rash, vomiting, underlying comorbidity, increased total leucocyte count, thrombocytopenia, high urea, low total serum protein and raised c-reactive protein was factors associated with moderate to severe disease. CONCLUSION: Fever was the commonest symptom. We identified additional laboratory abnormalities, namely lymphopenia, low total serum protein and albumin and low alkaline phosphatase. The majority of the children were asymptomatic or mildly symptomatic. We found high urea and low total serum protein as risk factors for moderate to severe disease for the first time.


Subject(s)
COVID-19 , SARS-CoV-2 , Child , Humans , India/epidemiology , Retrospective Studies , Risk Factors
17.
PLoS One ; 16(5): e0251891, 2021.
Article in English | MEDLINE | ID: covidwho-1232466

ABSTRACT

Quick identification and isolation of SARS-CoV-2 infected individuals is central to managing the COVID-19 pandemic. Real time reverse transcriptase PCR (rRT-PCR) is the gold standard for COVID-19 diagnosis. However, this resource-intensive and relatively lengthy technique is not ideally suited for mass testing. While pooled testing offers substantial savings in cost and time, the size of the optimum pool that offers complete concordance with results of individualized testing remains elusive. To determine the optimum pool size, we first evaluated the utility of pool testing using simulated 5-sample pools with varying proportions of positive and negative samples. We observed that 5-sample pool testing resulted in false negativity rate of 5% when the pools contained one positive sample. We then examined the diagnostic performance of 4-sample pools in the operational setting of a diagnostic laboratory using 500 consecutive samples in 125 pools. With background prevalence of 2.4%, this 4-sample pool testing showed 100% concordance with individualized testing and resulted in 66% and 59% reduction in resource and turnaround time, respectively. Since the negative predictive value of a diagnostic test varies inversely with prevalence, we re-tested the 4-sample pooling strategy using a fresh batch of 500 samples in 125 pools when the prevalence rose to 12.7% and recorded 100% concordance and reduction in cost and turnaround time by 36% and 30%, respectively. These observations led us to conclude that 4-sample pool testing offers the optimal blend of resource optimization and diagnostic performance across difference disease prevalence settings.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , SARS-CoV-2/genetics , Specimen Handling , COVID-19/virology , Humans , RNA, Viral/analysis , Real-Time Polymerase Chain Reaction , SARS-CoV-2/isolation & purification
18.
Pediatr Infect Dis J ; 40(6): e236-e239, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1203763

ABSTRACT

Neurologic manifestation of coronavirus disease 2019 (COVID-19) in children is evolving with time. We are reporting a young girl who presented to us with acute febrile illness followed by acute onset severe flaccid paralysis requiring prolonged intensive care unit stay and ventilator support. She was evaluated extensively and found to be positive for COVID serology, and neuroimaging revealed features of longitudinally extensive transverse myelitis (LETM) with enhancing cauda equina nerve roots, suggesting Guillain-Barré Syndrome (GBS). She failed to respond to immune suppressive therapy and needed plasma exchange for recovery. Like other common viral illnesses, COVID-19 can also act as a trigger for GBS-like illness and LETM, and we need to suspect these diagnoses in the cases with COVID-19 infection in compatible cases. This is probably the first pediatric case with concurrent GBS and LETM secondary to COVID-19 infection.


Subject(s)
COVID-19/complications , Guillain-Barre Syndrome/virology , COVID-19/diagnosis , COVID-19/immunology , COVID-19 Serological Testing , Child , Female , Guillain-Barre Syndrome/immunology , Humans , Myelitis, Transverse/immunology , SARS-CoV-2/isolation & purification
19.
Int J Gynaecol Obstet ; 152(2): 231-235, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1125309

ABSTRACT

OBJECTIVE: To assess the effects of the COVID-19 pandemic on obstetric care and outcomes. METHODS: A prospective observational single-center study was performed, including all antenatal and parturient women admitted from April to August, 2020. Data were collected regarding number of admissions, deliveries, antenatal visits, reason for inaccessibility of health care, and complications during pregnancy, and compared with data from the pre-COVID period of October 2019 to February 2020. RESULTS: There was a reduction of 45.1% in institutional deliveries (P < 0.001), a percentage point increase of 7.2 in high-risk pregnancy, and 2.5-fold rise in admission to the intensive care unit of pregnant women during the pandemic. One-third of women had inadequate antenatal visits. The main reason for delayed health-seeking was lockdown and fear of contracting infection, resulting in 44.7% of pregnancies with complications. Thirty-two symptomatic women who tested positive for COVID-19 were managed at the center with good maternal and fetal outcomes. CONCLUSION: Although COVID-19 does not directly affect pregnancy outcomes, it has indirect adverse effects on maternal and child health. Emergency obstetric and antenatal care are essential services to be continued with awareness of people while maintaining social distancing and personal hygiene.


Subject(s)
COVID-19 , Maternal Health , Pandemics , Patient Acceptance of Health Care , Prenatal Care , Time-to-Treatment , Communicable Disease Control , Female , Hospitalization , Humans , India , Infant, Newborn , Intensive Care Units , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , Pregnancy Outcome , Pregnancy, High-Risk , Prospective Studies , Tertiary Care Centers
20.
Trans R Soc Trop Med Hyg ; 115(7): 820-831, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1029982

ABSTRACT

BACKGROUND: Understanding risk factors of symptomatic coronavirus disease 2019 (COVID-19) vis-à-vis asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, severe disease and death is important. METHODS: An unmatched case-control study was conducted through telephonic interviews among individuals who tested positive for SARS-CoV-2 in Jodhpur, India from 23 March to 20 July 2020. Contact history, comorbidities and tobacco and alcohol use were elicited using standard tools. RESULTS: Among 911 SARS-CoV-2-infected individuals, 47.5% were symptomatic, 14.1% had severe COVID-19 and 41 (4.5%) died. Older age, working outside the home, cardiac and respiratory comorbidity and alcohol use were found to increase the risk of symptomatic disease as compared with asymptomatic infection. Current tobacco smoking (odds ratio [OR] 0.46 [95% confidence interval {CI} 0.26 to 0.78]) but not smokeless tobacco use (OR 0.81 [95% CI 0.55 to 1.19]) appeared to reduce the risk of symptomatic disease. Age ≥60 y and renal comorbidity were significantly associated with severe COVID-19. Age ≥60 y and respiratory and cardiac comorbidity were found to predispose to mortality. CONCLUSIONS: The apparent reduced risk of symptomatic COVID-19 among tobacco smokers could be due to residual confounding owing to unknown factors, while acknowledging the limitation of recall bias. Cross-protection afforded by frequent upper respiratory tract infection among tobacco smokers could explain why a similar association was not found for smokeless tobacco use, thereby being more plausible than the 'nicotinic hypothesis'. Those with comorbidities and age ≥60 y should be prioritized for hospital admission.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Case-Control Studies , Humans , India/epidemiology , Risk Factors , Tobacco
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