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1.
Cureus ; 14(8):e27816, 2022.
Article in English | MEDLINE | ID: covidwho-2030312

ABSTRACT

INTRODUCTION: Since the onset of COVID-19, physicians and scientists have been working to further understand biomarkers associated with the infection, so that patients who have contracted the virus can be treated. Although COVID-19 is a complex virus that affects patients differently, current research suggests that COVID-19 infections have been associated with increased procalcitonin, a biomarker traditionally indicative of bacterial infections. This paper aims to investigate the relationship between COVID-19 infection severity and procalcitonin levels in the hopes to aid the management of patients with COVID-19 infections. METHODS: Patient data were obtained from the Renaissance School of Medicine at Stony Brook University. The data of the patients who had tested positive for COVID-19 and had an associated procalcitonin value (n=1046) was divided into age splits of 18-59, 59-74, and 74-90. Multiple factors were analyzed to determine the severity of each patient's infection. Patients were divided into low, medium, and high severity dependent on the patient's COVID-19 severity. A one-way analysis of variance (ANOVA) was done for each age split to compare procalcitonin values of the severity groups within the respective age split. Next, post hoc analysis was done for the severity groups in each age split to further compare the groups against each other. Results: One-way ANOVA testing of the three age splits all had a resulting p<0.0001, displaying that the null hypothesis was rejected. In the post hoc analysis, however, the test failed to reject the null hypothesis when comparing the medium and high severity groups against each other in the 59-74 and 74-90 age splits. The null hypothesis was rejected in all pairwise comparisons in the 18-59 age split. We determined that a procalcitonin value of greater than 0.24 ng/mL would be characterized as a more severe COVID-19 infection when considering patient factors and comorbidities. Conclusion: The analysis of the data concluded that elevated procalcitonin levels correlated with the severity of COVID-19 infections. This finding can be used to assist medical providers in the management of COVID-19 patients.

2.
Tegally, H.; San, J. E.; Cotten, M.; Moir, M.; Tegomoh, B.; Mboowa, G.; Martin, D. P.; Baxter, C.; Lambisia, A. W.; Diallo, A.; Amoako, D. G.; Diagne, M. M.; Sisay, A.; Zekri, A. N.; Gueye, A. S.; Sangare, A. K.; Ouedraogo, A. S.; Sow, A.; Musa, A. O.; Sesay, A. K.; Abias, A. G.; Elzagheid, A. I.; Lagare, A.; Kemi, A. S.; Abar, A. E.; Johnson, A. A.; Fowotade, A.; Oluwapelumi, A. O.; Amuri, A. A.; Juru, A.; Kandeil, A.; Mostafa, A.; Rebai, A.; Sayed, A.; Kazeem, A.; Balde, A.; Christoffels, A.; Trotter, A. J.; Campbell, A.; Keita, A. K.; Kone, A.; Bouzid, A.; Souissi, A.; Agweyu, A.; Naguib, A.; Gutierrez, A. V.; Nkeshimana, A.; Page, A. J.; Yadouleton, A.; Vinze, A.; Happi, A. N.; Chouikha, A.; Iranzadeh, A.; Maharaj, A.; Batchi-Bouyou, A. L.; Ismail, A.; Sylverken, A. A.; Goba, A.; Femi, A.; Sijuwola, A. E.; Marycelin, B.; Salako, B. L.; Oderinde, B. S.; Bolajoko, B.; Diarra, B.; Herring, B. L.; Tsofa, B.; Lekana-Douki, B.; Mvula, B.; Njanpop-Lafourcade, B. M.; Marondera, B. T.; Khaireh, B. A.; Kouriba, B.; Adu, B.; Pool, B.; McInnis, B.; Brook, C.; Williamson, C.; Nduwimana, C.; Anscombe, C.; Pratt, C. B.; Scheepers, C.; Akoua-Koffi, C. G.; Agoti, C. N.; Mapanguy, C. M.; Loucoubar, C.; Onwuamah, C. K.; Ihekweazu, C.; Malaka, C. N.; Peyrefitte, C.; Grace, C.; Omoruyi, C. E.; Rafaï, C. D.; Morang'a, C. M.; Erameh, C.; Lule, D. B.; Bridges, D. J.; Mukadi-Bamuleka, D.; Park, D.; Rasmussen, D. A.; Baker, D.; Nokes, D. J.; Ssemwanga, D.; Tshiabuila, D.; Amuzu, D. S. Y.; Goedhals, D.; Grant, D. S.; Omuoyo, D. O.; Maruapula, D.; Wanjohi, D. W.; Foster-Nyarko, E.; Lusamaki, E. K.; Simulundu, E.; Ong'era, E. M.; Ngabana, E. N.; Abworo, E. O.; Otieno, E.; Shumba, E.; Barasa, E.; Ahmed, E. B.; Ahmed, E. A.; Lokilo, E.; Mukantwari, E.; Philomena, E.; Belarbi, E.; Simon-Loriere, E.; Anoh, E. A.; Manuel, E.; Leendertz, F.; Taweh, F. M.; Wasfi, F.; Abdelmoula, F.; Takawira, F. T.; Derrar, F.; Ajogbasile, F. V.; Treurnicht, F.; Onikepe, F.; Ntoumi, F.; Muyembe, F. M.; Ragomzingba, F. E. Z.; Dratibi, F. A.; Iyanu, F. A.; Mbunsu, G. K.; Thilliez, G.; Kay, G. L.; Akpede, G. O.; van Zyl, G. U.; Awandare, G. A.; Kpeli, G. S.; Schubert, G.; Maphalala, G. P.; Ranaivoson, H. C.; Omunakwe, H. E.; Onywera, H.; Abe, H.; Karray, H.; Nansumba, H.; Triki, H.; Kadjo, H. A. A.; Elgahzaly, H.; Gumbo, H.; Mathieu, H.; Kavunga-Membo, H.; Smeti, I.; Olawoye, I. B.; Adetifa, I. M. O.; Odia, I.; Ben Boubaker, I. B.; Mohammad, I. A.; Ssewanyana, I.; Wurie, I.; Konstantinus, I. S.; Halatoko, J. W. A.; Ayei, J.; Sonoo, J.; Makangara, J. C.; Tamfum, J. M.; Heraud, J. M.; Shaffer, J. G.; Giandhari, J.; Musyoki, J.; Nkurunziza, J.; Uwanibe, J. N.; Bhiman, J. N.; Yasuda, J.; Morais, J.; Kiconco, J.; Sandi, J. D.; Huddleston, J.; Odoom, J. K.; Morobe, J. M.; Gyapong, J. O.; Kayiwa, J. T.; Okolie, J. C.; Xavier, J. S.; Gyamfi, J.; Wamala, J. F.; Bonney, J. H. K.; Nyandwi, J.; Everatt, J.; Nakaseegu, J.; Ngoi, J. M.; Namulondo, J.; Oguzie, J. U.; Andeko, J. C.; Lutwama, J. J.; Mogga, J. J. H.; O'Grady, J.; Siddle, K. J.; Victoir, K.; Adeyemi, K. T.; Tumedi, K. A.; Carvalho, K. S.; Mohammed, K. S.; Dellagi, K.; Musonda, K. G.; Duedu, K. O.; Fki-Berrajah, L.; Singh, L.; Kepler, L. M.; Biscornet, L.; de Oliveira Martins, L.; Chabuka, L.; Olubayo, L.; Ojok, L. D.; Deng, L. L.; Ochola-Oyier, L. I.; Tyers, L.; Mine, M.; Ramuth, M.; Mastouri, M.; ElHefnawi, M.; Mbanne, M.; Matsheka, M. I.; Kebabonye, M.; Diop, M.; Momoh, M.; Lima Mendonça, M. D. L.; Venter, M.; Paye, M. F.; Faye, M.; Nyaga, M. M.; Mareka, M.; Damaris, M. M.; Mburu, M. W.; Mpina, M. G.; Owusu, M.; Wiley, M. R.; Tatfeng, M. Y.; Ayekaba, M. O.; Abouelhoda, M.; Beloufa, M. A.; Seadawy, M. G.; Khalifa, M. K.; Matobo, M. M.; Kane, M.; Salou, M.; Mbulawa, M. B.; Mwenda, M.; Allam, M.; Phan, M. V. T.; Abid, N.; Rujeni, N.; Abuzaid, N.; Ismael, N.; Elguindy, N.; Top, N. M.; Dia, N.; Mabunda, N.; Hsiao, N. Y.; Silochi, N. B.; Francisco, N. M.; Saasa, N.; Bbosa, N.; Murunga, N.; Gumede, N.; Wolter, N.; Sitharam, N.; Ndodo, N.; Ajayi, N. A.; Tordo, N.; Mbhele, N.; Razanajatovo, N. H.; Iguosadolo, N.; Mba, N.; Kingsley, O. C.; Sylvanus, O.; Femi, O.; Adewumi, O. M.; Testimony, O.; Ogunsanya, O. A.; Fakayode, O.; Ogah, O. E.; Oludayo, O. E.; Faye, O.; Smith-Lawrence, P.; Ondoa, P.; Combe, P.; Nabisubi, P.; Semanda, P.; Oluniyi, P. E.; Arnaldo, P.; Quashie, P. K.; Okokhere, P. O.; Bejon, P.; Dussart, P.; Bester, P. A.; Mbala, P. K.; Kaleebu, P.; Abechi, P.; El-Shesheny, R.; Joseph, R.; Aziz, R. K.; Essomba, R. G.; Ayivor-Djanie, R.; Njouom, R.; Phillips, R. O.; Gorman, R.; Kingsley, R. A.; Neto Rodrigues, Rmdesa, Audu, R. A.; Carr, R. A. A.; Gargouri, S.; Masmoudi, S.; Bootsma, S.; Sankhe, S.; Mohamed, S. I.; Femi, S.; Mhalla, S.; Hosch, S.; Kassim, S. K.; Metha, S.; Trabelsi, S.; Agwa, S. H.; Mwangi, S. W.; Doumbia, S.; Makiala-Mandanda, S.; Aryeetey, S.; Ahmed, S. S.; Ahmed, S. M.; Elhamoumi, S.; Moyo, S.; Lutucuta, S.; Gaseitsiwe, S.; Jalloh, S.; Andriamandimby, S. F.; Oguntope, S.; Grayo, S.; Lekana-Douki, S.; Prosolek, S.; Ouangraoua, S.; van Wyk, S.; Schaffner, S. F.; Kanyerezi, S.; Ahuka-Mundeke, S.; Rudder, S.; Pillay, S.; Nabadda, S.; Behillil, S.; Budiaki, S. L.; van der Werf, S.; Mashe, T.; Mohale, T.; Le-Viet, T.; Velavan, T. P.; Schindler, T.; Maponga, T. G.; Bedford, T.; Anyaneji, U. J.; Chinedu, U.; Ramphal, U.; George, U. E.; Enouf, V.; Nene, V.; Gorova, V.; Roshdy, W. H.; Karim, W. A.; Ampofo, W. K.; Preiser, W.; Choga, W. T.; Ahmed, Y. A.; Ramphal, Y.; Bediako, Y.; Naidoo, Y.; Butera, Y.; de Laurent, Z. R.; Ouma, A. E. O.; von Gottberg, A.; Githinji, G.; Moeti, M.; Tomori, O.; Sabeti, P. C.; Sall, A. A.; Oyola, S. O.; Tebeje, Y. K.; Tessema, S. K.; de Oliveira, T.; Happi, C.; Lessells, R.; Nkengasong, J.; Wilkinson, E..
Science ; : eabq5358, 2022.
Article in English | PubMed | ID: covidwho-2029459

ABSTRACT

Investment in SARS-CoV-2 sequencing in Africa over the past year has led to a major increase in the number of sequences generated, now exceeding 100,000 genomes, used to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence domestically, and highlight that local sequencing enables faster turnaround time and more regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and shed light on the distinct dispersal dynamics of Variants of Concern, particularly Alpha, Beta, Delta, and Omicron, on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve, while the continent faces many emerging and re-emerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century.

3.
Journal of Medical Education Development ; 14(44):12-18, 2022.
Article in English | Scopus | ID: covidwho-1980926

ABSTRACT

Background & Objective:) The present study was undertaken to determine the perception of medical students towards the Online Assessment in North Indian medical university amidst COVID-19 Pandemic. Materials & Methods: An online questionnaire was validated and distributed among 500 medical students of a tertiary care hospital in North India. The consent was taken and the responses were analysed anonymously. It consisted of standard Likert scale questions, close-ended and open-ended questions comprising a total of 22 questions. The questionnaire was grouped into 4 categories such as demographics, Comparison between traditional and online assessment, Advantages and limitations, and Acceptance of online assessment. The responses were analysed by using descriptive analyses. Results: Out of the 500 students, 430 responded out of which 57.8 % were females and within 20-25yrs (86.8%). 54.6 % students found online exams less stressful, comfortable (58.13%) & within the COVID norms (75.11 %). Limitations included no interaction with patients (64.88%),social isolation (36.04%) & bad internet connection (80.9%). 50 % of undergraduate students preferred traditional assessment while 30% prefer blended method and least number of students preferred online assessment (20%). Conclusion: The results show that undergraduate students prefer traditional than online assessment. The online assessment provides several limitations such as technical issues, no interaction with patients, etc. The student's responses provided the educators an insight into the online assessment and will help in improving the assessment method. © 2022, Zanjan University of Medical Sciences and Health Services. All rights reserved.

5.
Vox Sanguinis ; 117(SUPPL 1):25-26, 2022.
Article in English | EMBASE | ID: covidwho-1916360

ABSTRACT

Background: ABO hemolytic disease of the fetus and newborn (ABOHFDN) is a frequent event, and usually a problem of the neonate rather than the fetus, however, it is difficult to predict the disease severity. Thus, there is a need to increase awareness towards ABOHFDN for optimizing care in terms of early diagnosis and adequate monitoring. Aims: To determine the frequency of ABO-incompatibility in neonates born to group O mothers and to assess the severity of ABO-HDFN in neonates and determine the neonatal outcomes. Methods: This prospective observational study was carried out from February 2020 to May 2021 after obtaining a written informed consent from the mothers. A total of 260 neonates born to blood group O mothers were recruited. The maternal red cell antibody screen (ABS) using a 3-cell panel (Diacell, Bio-Rad, Switzerland) and the neonatal direct antiglobulin test (DAT) were done by column agglutination technique (CAT). For DAT positive samples, the IgG subclass of anti-A/anti-B was determined using DAT IgG1/IgG3 screening cards (Bio-Rad, Switzerland) and a heat elution at 56°C was also performed. The maternal anti-A/anti-B IgG titers was determined by tube technique after treating the serum sample with 0.01 M di-thiothreitol (DTT). The neonatal total serum bilirubin (TSB) and other relevant parameters were also recorded. The requirement for treatment in terms of phototherapy and/or exchange transfusion (ET) and the neonatal outcome were also recorded. Due to travel restrictions during the ongoing COVID-19 pandemic, the follow-up was performed telephonically with parents 6-8 weeks after discharge. Results: Of the 260 group O mothers, none had positive ABS. Of the 260 neonates born to them as an outcome of singleton pregnancies, 84 with blood group O were excluded from the study. The overall frequency of ABO-incompatibility between mother and neonates was 67.69% (176/260). Out of 176 neonates, 77 (43.8%) were group A and 99 (56.2%) were group B, and 15 (8.5%) of them had a positive DAT. Overall, 26.7% (47/176) neonates received phototherapy and 172 (97.7%) neonates survived. The mean (±SD) duration of phototherapy (hours) was 34.17 (±25.67) hours and it ranged from 12- 120 h. Only 1 neonate required ET. None of the neonates required readmission. The median maternal IgG anti-A titre was 16 (8-64) (range: 2-512), while the IgG anti-B titre was 32 (32-64) (range: 4- 512) (p = <0.001). The maximal TSB in neonates had a significant positive association with neonatal birth weight (p = 0.045), maturity at birth (p = 0.037), positive DAT (p = 0.006) and requirement of phototherapy (p = <0.001). Neonatal DAT positivity was significantly associated with maternal IgG titers (p = <0.001), neonatal PCV (p = 0.017), maximal TSB (p = 0.006), requirement (p = <0.001) and duration of phototherapy (p = 0.024). At a cut-off of maternal IgG titre ≥64, it predicted the requirement of phototherapy with a sensitivity of 72.3% and a specificity of 72%. The relative risk (95% CI) of a DAT positive neonate requiring phototherapy was calculated to be 4.55 (3.12-6.33). Summary/Conclusions: The frequency of ABO-incompatibility in neonates born to group O mothers was 67.69% (176/260). The maternal IgG titre of anti-A/anti-B of 64 or more could be a good predictor for identifying the neonates at-risk for developing hyperbilirubinemia requiring further management and combining it with neonatal DAT further enhances the sensitivity to identify such at-risk neonates.

6.
Vox Sanguinis ; 117(SUPPL 1):266, 2022.
Article in English | EMBASE | ID: covidwho-1916355

ABSTRACT

Background: Covid-19 like other viruses, can change the immunohematological profile of the infected patients and timely identification of these changes can help in the management of these patients. There are various reports which have shown decline in haemoglobin in covid patients due to autoimmune red cell hemolysis. One recent study has shown that patients admitted in ICU have higher chances of DAT positivity as compared to non-covid patients. Aims: • To assess the Immunohematological profile of COVID-19 positive patients. • To find any correlation between the immunohematological profile and clinical spectrum of COVID-19 disease. Methods: It was a prospective observational study. Blood grouping, Direct antiglobulin test (DAT) and antibody screening (ABS) were performed on RT-PCR confirmed COVID-19 positive and COVID-19 negative patients admitted in Intensive care units and General wards of our institute. The immunohematological findings were also correlated with the patient clinical laboratory profiles. Results: A total of 205 patients were recruited. Out of which 102 were RT-PCR Covid-19 positive and 103 were negative. There was difference in blood group distribution with significantly less O group individuals in RT-PCR negative group. The overall DAT positivity was seen in 24.4% of the total 203 patients enrolled in the study. The DAT positivity was significantly higher (p value 0.01) in COVID-19 positive patients (32%) than COVID-19 negative patients (16.7%). However, there was no significant difference in the percentage of DAT positivity among patients admitted in ICU or general ward patients. Among COVID-19 positive patients, the mean haemoglobin was statistically significantly (p value 0.02) lower in DAT positive (Mean Hb: 8.5gm/dl) as compared to DAT negative patients (Mean Hb 9.6gm/dl). Also, DAT positive patients among COVID-19 positive patients were found to have significantly higher C-Reactive protein levels (p value: 0.05). There was no significant difference in other biochemical parameters between COVID-19 positive and COVID-19 negative individuals. DAT positivity was not associated with any drug intake or co-morbid state. Summary/Conclusions: Like other bacterial and viral infections, COVID-19 is also associated with DAT positivity indicating some autoimmune phenomenon due to exposure of the crypt antigens. The specificity of antibodies involved in DAT are mainly IgG and hence it may present as autoimmune hemolytic anaemia. And its association with increased inflammatory makers can help us in decision making by blood transfusion services and better management of COVID-19 patients requiring blood transfusion. .

7.
Human and Ecological Risk Assessment ; 28(5-6):29, 2022.
Article in English | Web of Science | ID: covidwho-1886317

ABSTRACT

The polycyclic aromatic hydrocarbons' (PAHs) exposure through day to day cooking activities has been a serious concern for human health due to their carcinogenic nature. Given the Covid-19 conditions, where people are spending extended time indoors, the likely exposure to these compounds will increase for the members involved/not involved in cooking. In this context, this review summarizes different studies undertaken worldwide on PAHs from cooking activities, the sources of exposure (fumes/emissions, dust/depositions), effect of scale (households/restaurants/neighborhoods) of cooking, monitoring process, risk assessment (air sampling and urinary metabolites), global distribution pattern. Proportionately higher number of studies was focused on cooking fumes and emissions while very limited studies aimed at kitchen depositions and dust. Most of the studies have not reported the size of particulate matter considered for determining PAHs exposure from cooking fumes and emissions. The evaluation of reported data becomes more complicated due to difference in sampling and expression units, the number and types of PAHs (parent, oxygenated-PAHs, i.e., o-PAHs, nitro-PAHs, i.e., n-PAHs) studied/found, lack of other intrinsic information (site and control parameters), lack of specific regulations etc. Therefore, such studies require method standardization for future policy development. This review also highlights the gaps and challenges in existing knowledge and future prospects.

8.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-330706

ABSTRACT

With the emergence of SARS-CoV-2 variants that may increase transmissibility and/or cause escape from immune responses 1-3 , there is an urgent need for the targeted surveillance of circulating lineages. It was found that the B.1.1.7 (also 501Y.V1) variant first detected in the UK 4,5 could be serendipitously detected by the ThermoFisher TaqPath COVID-19 PCR assay because a key deletion in these viruses, spike DELTA69-70, would cause a "spike gene target failure" (SGTF) result. However, a SGTF result is not definitive for B.1.1.7, and this assay cannot detect other variants of concern that lack spike DELTA69-70, such as B.1.351 (also 501Y.V2) detected in South Africa 6 and P.1 (also 501Y.V3) recently detected in Brazil 7 . We identified a deletion in the ORF1a gene (ORF1a DELTA3675-3677) in all three variants, which has not yet been widely detected in other SARS-CoV-2 lineages. Using ORF1a DELTA3675-3677 as the primary target and spike DELTA69-70 to differentiate, we designed and validated an open source PCR assay to detect SARS-CoV-2 variants of concern 8 . Our assay can be rapidly deployed in laboratories around the world to enhance surveillance for the local emergence spread of B.1.1.7, B.1.351, and P.1.

9.
International Journal of Pharmaceutical and Clinical Research ; 14(1):516-523, 2022.
Article in English | EMBASE | ID: covidwho-1688327

ABSTRACT

Background: With increasing popularity of surgical interventions in the past few decades in the field of Orthopaedics, conservative treatment methods were challenged by surgical techniques of fracture fixation with various implants. However, due to the COVID-19 pandemic, the need for pragmatic management that balances optimum treatment of patients against clinically safe practice has brought conservative treatment methods back into focus. Methods: The functional outcome of displaced mid-shaft clavicle fracture in 20 patients (6 females, 14 males) managed conservatively with figure of eight bandage was studied prospectively over a period of 9 months from March-November 2020. The demographic and the clinical data including the Constant Murley Score, length of shortening of the fractured clavicle, non-union and cosmetic outcome of the patients were recorded over 3 follow up visits at 2 weeks, 6 weeks and 3 months. The correlation between the study variables and the functional and clinical outcome was then calculated. Results: The mean shortening of fractured clavicle was 15.65±2.94 mm and the mean Constant Murley Score was 76.90±3.27. On an average, the union was achieved at 3 months and there were no non-union cases. Out of the 20 patients, 18 patients were satisfied with the treatment and 2 were dissatisfied with the outcome. Dissatisfaction was more among the males as compared to the females. 2 out of14 males were not satisfied. There was no significant association between the satisfaction of treatment and shortening of the bone (P value >0.05). There was a linear correlation between the Constant Murley Score and bone shortening with the functional outcome being better with lesser bone shortening. Conclusion: During the treatment of displaced mid shaft clavicle fractures in adults, the conservative management with figure of eight bandage yielded a good functional outcome with fewer follow-up visits to the hospital. The conservative treatment still had a significant place in the armamentarium of fracture management during the COVID 19 pandemic.

10.
Embase;
Preprint in English | EMBASE | ID: ppcovidwho-326897

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in southern Africa has been characterised by three distinct waves. The first was associated with a mix of SARS-CoV-2 lineages, whilst the second and third waves were driven by the Beta and Delta variants respectively1–3. In November 2021, genomic surveillance teams in South Africa and Botswana detected a new SARS-CoV-2 variant associated with a rapid resurgence of infections in Gauteng Province, South Africa. Within three days of the first genome being uploaded, it was designated a variant of concern (Omicron) by the World Health Organization and, within three weeks, had been identified in 87 countries. The Omicron variant is exceptional for carrying over 30 mutations in the spike glycoprotein, predicted to influence antibody neutralization and spike function4. Here, we describe the genomic profile and early transmission dynamics of Omicron, highlighting the rapid spread in regions with high levels of population immunity.

11.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-296585

ABSTRACT

Characterizing SARS-CoV-2 evolution in specific geographies may help predict the properties of variants coming from these regions. We mapped neutralization of a SARS-CoV-2 strain that evolved over 6 months from the ancestral virus in a person with advanced HIV disease. Infection was before the emergence of the Beta variant first identified in South Africa, and the Delta variant. We compared early and late evolved virus to the ancestral, Beta, Alpha, and Delta viruses and tested against convalescent plasma from ancestral, Beta, and Delta infections. Early virus was similar to ancestral, whereas late virus was similar to Beta, exhibiting vaccine escape and, despite pre-dating Delta, strong escape of Delta-elicited neutralization. This example is consistent with the notion that variants arising in immune-compromised hosts, including those with advanced HIV disease, may evolve immune escape of vaccines and enhanced escape of Delta immunity, with implications for vaccine breakthrough and reinfections. Highlights: A prolonged ancestral SARS-CoV-2 infection pre-dating the emergence of Beta and Delta resulted in evolution of a Beta-like serological phenotypeSerological phenotype includes strong escape from Delta infection elicited immunity, intermediate escape from ancestral virus immunity, and weak escape from Beta immunityEvolved virus showed substantial but incomplete escape from antibodies elicited by BNT162b2 vaccination. Graphical abstract:

12.
American Journal of Gastroenterology ; 116(SUPPL):S160, 2021.
Article in English | EMBASE | ID: covidwho-1534642

ABSTRACT

Introduction: Despite advances in treatment and vaccination, COVID-19 continues to have a significant toll on healthcare services. Identifying more modifiable risk factors for severe infection is of utmost importance to guide effective health care delivery. Recent studies show conflicting results regarding the association of gastric acid suppression with the risk of developing severe COVID-19 infection. Considering that acid-suppressive medications are among the most commonly consumed drugs in the United States, an understanding of the impact of these agents on COVID-19 outcomes is of significant importance and inconclusive. We aimed to investigate if pre-admission exposure to proton pump inhibitors (PPIs) is associated with worse outcomes among patients hospitalized with COVID-19. Methods: We retrospectively identified COVID-19 patients admitted to Ochsner LSU Health, Shreveport, from July 2020 to November 2020. Information on baseline demographics, comorbidities, presenting symptoms, PPI use and clinical course was abstracted. We compared outcomes for PPI users and non-users using univariate and multivariate logistic regression. Results: 1370 patients were included in this study, with 14 (22.9%) PPI users, and 1056 (77.1%) non-users. Baseline characteristics are shown in Table 1. PPI users were older (66.00 vs 61.24, p< .0001) and had a lower BMI (31.54 vs 32.39, p< .0085) compared to non-users. Both groups received similar treatment: steroids, antibiotics, remdesivir, convalescent plasma, and supplemental oxygen. There was no significant difference in the length of stay between these 2 groups. On univariate analysis, PPI users were significantly associated with developing secondary infection (OR 1.45, P=0.049) and acute kidney injury (AKI) (OR 1.45, P=0.015). The rate of developing other complications like deep venous thrombosis, pulmonary embolism, stroke, encephalopathy, shock, need for renal replacement therapy was similar in both groups. After adjusting for age, gender, race, BMI, comorbidities, PPI use was not associated with worse outcomes like ICU admission, ventilation requirement, mortality, or more complications (Figure 1). Conclusion: An interesting finding in this study was that PPI users were significantly associated with developing secondary infection but not with worse clinical outcomes or mortality. We recommend continuing PPI use when clinically indicated and educating users regarding their safety.

13.
1st International Conference on Future Technologies in Manufacturing, Automation, Design and Energy, ICoFT 2020 ; : 599-606, 2022.
Article in English | Scopus | ID: covidwho-1499397

ABSTRACT

Ventilators are one of the most important and complex devices in the intensive care unit (ICU). These devices are used to handle the patients in critical conditions like lungs collapse, comma, transplant surgeries, etc. But due to COVID-19 pandemic, there is a very large need of the ventilators. This paper focuses on the development of a prototype of portable ventilators with remote control. These ventilators are based on the slider-crank mechanism operated remotely as well as manually. The slider-crank mechanism compresses resuscitator (AMBU bag) and delivers the compressed air to lungs through a pipe and face mask. These ventilators are capable of controlling breath per minute (BPM) and Tidal volume (volume of the oxygen compulsory in the lungs). The range of BPM can be controlled 10-45 BPM where deliverable tidal volume is 250–750 mL. To deliver the contactless treatment to a patient and save the doctor from the disease transmission, we have developed the android application to operate ventilator remotely. Arduino-based Wi-Fi controller is used to create control over BPM. Wi-Fi controller integrates the mobile application with ventilators to establish remote and contactless control. There is the provision of emergency cut-off in antagonistic condition. The overall cost of the prototyping is only 4000 INR and can be assembled within minutes on an assembly line. Because of the ventilator’s compact size and light weight it can be used in remote locations and ambulances. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

14.
Transfusion ; 61:47A-47A, 2021.
Article in English | Web of Science | ID: covidwho-1441716
15.
JMIR Public Health and Surveillance ; 7(4):e25728, 2021.
Article in English | MEDLINE | ID: covidwho-1209460

ABSTRACT

BACKGROUND: The COVID-19 pandemic has placed unprecedented stress on economies, food systems, and health care resources in Latin America and the Caribbean (LAC). Existing surveillance provides a proxy of the COVID-19 caseload and mortalities;however, these measures make it difficult to identify the dynamics of the pandemic and places where outbreaks are likely to occur. Moreover, existing surveillance techniques have failed to measure the dynamics of the pandemic. OBJECTIVE: This study aimed to provide additional surveillance metrics for COVID-19 transmission to track changes in the speed, acceleration, jerk, and persistence in the transmission of the pandemic more accurately than existing metrics. METHODS: Through a longitudinal trend analysis, we extracted COVID-19 data over 45 days from public health registries. We used an empirical difference equation to monitor the daily number of cases in the LAC as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. COVID-19 transmission rates were tracked for the LAC between September 30 and October 6, 2020, and between October 7 and 13, 2020. RESULTS: The LAC saw a reduction in the speed, acceleration, and jerk for the week of October 13, 2020, compared to the week of October 6, 2020, accompanied by reductions in new cases and the 7-day moving average. For the week of October 6, 2020, Belize reported the highest acceleration and jerk, at 1.7 and 1.8, respectively, which is particularly concerning, given its high mortality rate. The Bahamas also had a high acceleration at 1.5. In total, 11 countries had a positive acceleration during the week of October 6, 2020, whereas only 6 countries had a positive acceleration for the week of October 13, 2020. The TAC displayed an overall positive trend, with a speed of 10.40, acceleration of 0.27, and jerk of -0.31, all of which decreased in the subsequent week to 9.04, -0.81, and -0.03, respectively. CONCLUSIONS: Metrics such as new cases, cumulative cases, deaths, and 7-day moving averages provide a static view of the pandemic but fail to identify where and the speed at which SARS-CoV-2 infects new individuals, the rate of acceleration or deceleration of the pandemic, and weekly comparison of the rate of acceleration of the pandemic indicate impending explosive growth or control of the pandemic. Enhanced surveillance will inform policymakers and leaders in the LAC about COVID-19 outbreaks.

16.
Journal of Medical Pharmaceutical and Allied Sciences ; 10(1):2653-2657, 2021.
Article in English | Scopus | ID: covidwho-1190727

ABSTRACT

To assess the impact of single chamber right ventricular pacing on the clinical profiles, QRS morphology and QRS duration on electrocardiogram. This prospective study was conducted to evaluate clinical profile, QRS morphology and QRS duration of patients are having a atrioventricular disease, undergoing single chamber pacemaker implantation between November 2017 to January 2019 at UNMICRC, Ahmedabad, Gujarat. All patients were followed up biannually. At each follow-up visit clinical features were assessed, and pacemaker interrogation, electrocardiography was done. Results: Out of 135 patients, 98 patients completed 12 months follow -up and were included in final analysis. Mean age was 65.92 ± 9.64 years with 60.2% male. Most common comorbidity was hypertension (49.5%) followed by diabetes mellitus type II (24.5%), coronary artery disease (9.2%), hypothyroidism (4.1%) and cerebro vascular accident (2.0%). The Commonest indication for pacemaker was complete heart block (85.7%) followed by high degree Atrioventricular (AV) block (14.3%). 35.7% and 40.8% patients had presyncope and syncope. About 16.3% and 7.1% patients had New York Heart Failure Association (NYHA 2) and (NYHA 3) grade dyspnea. In the present study, baseline QRS was 155.63 ± 15.70 ms which increased to 164.79 ± 10.69 ms at 12 month follow- up (p = 0.0001). All except 4 patients had Left Bundle Branch Block (LBBB) on baseline of electrocardiogram ECG. The QRS duration increases over one year followup. The patients remain asymptomatic for heart failure and arrhythmias on follow-up. © 2021 Journal of Medical Pharmaceutical and Allied Sciences. All rights reserved.

17.
Advances in Plant Sciences ; 33(1/2):175-179, 2020.
Article in English | CAB Abstracts | ID: covidwho-1115716

ABSTRACT

This research paper knuckles down the holistic therapeutic approaches helpful in mitigating the pandemic novel coronavirus (nCoV) through the national combination of Allopathic, Ayurvedic, and Naturopathic therapies, which may become a boon in fighting against this fatal disease. The present overview is aimed at bringing an innovative and indicative account of the efforts, which have been made so far and should be undertaken, which are based on holistic health conservation practices of different systems of healing. The Allopathic system is based on symptomatic treatments and critical care of the patients. The Ayurvedic and Naturopathic system is based on Vatta, Pitta, Kapha, and detoxification of the body. These practices are being followed since ancient times and having preventive, curative, antiaging and immunity modulating potential. The exact molecular biology, mechanism of action, receptor-antigen combinations, genes, and protein functioning, and secondary messaging requires further explorations. The medicinal plants have now emerged as a solution due to its cost-effectiveness, higher therapeutic index (TI) and immunity promoting capabilities. However, the Pharmacognostic identification (PI) of medicinal plants species, mode of administration, dosage form and doses are very significant and should be taken under medical supervision.

18.
American Journal of Gastroenterology ; 115:S1372-S1373, 2020.
Article in English | Web of Science | ID: covidwho-1070405
19.
Alternative Therapies in Health and Medicine ; 26:90-91, 2020.
Article in English | Web of Science | ID: covidwho-1070354
20.
Millennial Asia ; 11(3):265-267, 2020.
Article in English | Scopus | ID: covidwho-1011112
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