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1.
BJOG: An International Journal of Obstetrics and Gynaecology ; 129:182, 2022.
Article in English | EMBASE | ID: covidwho-1956667

ABSTRACT

Objective: To compare the role of intra-ovarian Platelet-Rich Plasma (PRP) versus marrow derived Stem-Cells (SC) instillation for improvement in ovarian-reserve (AFC,AMH, FSH). Design: A prospective comparative study. Method: 72 infertile females (20-39 years) with poor ovarian reserve (AMH <1.2 ng/ml;AFC < 5) (POSEIDON criterion) were enrolled for study between January 2020 -December 2021. The two comparative groups underwent either intra-ovarian PRP instillation (n = 42) or autologous SC transplantation (n = 30). After the two groups were matched (PRP vs. SC) for baseline characteristics (Age, AMH, AFC, FSH, Estradiol), 30 subjects in each group were compared for change in serum FSH/AMH/Estradiol levels and AFC at 1st month and 3rd month post intervention from the baseline. This was also compared between the two groups using Student t-test. The cost and procedural pain measured using Visual analog scale (VAS) were also compared. Results: After matching for baseline characteristics, significant ∼ 1.8/2 and ∼1.5/1.6fold increase in AFC at 1st/3rd month post intervention (p < 0.001) was observed after PRP instillation and SC transplantation respectively. However, PRP group fared better than SC group at 3rd month post intervention (7.07 vs. 5.60, p = 0.02), while no significant difference existed amongst the two at 1st month of follow up. Levels of Serum FSH, AMH and Estradiol (p > 0.05) did not differ significantly from the baseline at 1st and 3rd month post intervention in both the groups. Similarly, there was no significant difference between the two groups in serum FSH level (7.98 IU/ml vs. 9.62 IU/ml, p = 0.062;8.26 IU/ml vs. 9.50 IU/ml, p = 0.15), AMH level (1.62 ng/ml vs. 1.02 ng/ ml, p = 0.27;1.35 ng/ml vs. 0.95 ng/ml, p = 0.24), Estradiol level (49.12 pg/ml vs. 56.48 pg/ml p = 0.443;54.7 pg/ml vs. 61.12 pg/ml, p = 0.44) at 1st and 3rd month post intervention respectively. PRP is comparatively more cost effective and is associated with lesser pain (32.5 mm vs. 28.13 mm, p = 0.02) then SC group thus showing better compliance and acceptability. Conclusion: Both PRP and SC therapies improves the ovarian reserve markers however, response to PRP is superior to SC. Also, further to note that PRP is minimally invasive and has better compliance and acceptability. The main limitation of this study is small sample size and due to Covid pandemic inability to perform the IVF cycles to show improvement in clinical pregnancies and live births. Therefore, a large randomized trial is required to validate these results.

2.
BJOG: An International Journal of Obstetrics and Gynaecology ; 129:114-115, 2022.
Article in English | EMBASE | ID: covidwho-1956652

ABSTRACT

Objective: To study the impact of national recommendations on the method of screening used for GDM during the COVID-19 pandemic, and evaluate differences in maternal and fetal outcomes among women with first-time GDM (ftGDM). Design: A retrospective observational study in a single Tertiary London Hospital. During the pandemic, the RCOG recommended an amended GDM screening protocol to reduce hospital attendance and risk of virus transmission (fasting blood glucose level ≥5.3 and/or HbA1c ≥39 at 28 weeks of gestation). Our Trust did not adopt this due to concerns regarding its sensitivity. We adopt a 2-step approach to universal GDM screening using a 50g glucose challenge test, and refer those screening positive for a full oral glucose tolerance test. Method: Outcomes were reviewed for women with ftGDM delivering a singleton at ≥24 weeks gestation between 01/04/20 -28/ 5/21. Our primary aim was to determine the impact of the change in COVID-19 GDM screening policy, had it been implemented. Our secondary outcomes included GDM management method, maternal and perinatal complications. We excluded women with a booking HbA1c ≥42 (indicative of pre-diabetes) and those who had bariatric surgery. Demographic and outcome data were obtained from electronic databases. Results: 247 women were diagnosed with ftGDM using local screening methods. Only 23 of these women had a HbA1c ≥39 at time of diagnosis and a further 12 had FBG ≥5.3. There was no significant difference in age or ethnicity between the two groups. The locally diagnosed group had a statistically significantly lower booking BMI (P<0.001) and were less likely to require pharmacological management of GDM (P<0.001). There were no significant differences in rates of induction of labour, gestation at delivery, birth weight or any perinatal adverse outcome. However, the women in the Covid-19 GDM screening group were significantly more likely to be delivered by Emergency Caesarean Section (p = 0.03) and have gestational hypertensive disease (p = 0.025). Conclusions: If we had implemented RCOG HbA1c screening, we would have not diagnosed 207 women with GDM, 41% of whom required pharmacological treatment. It is not surprising that women with higher HbA1c values had higher rates of maternal complications, due to the well-established association between maternal hyperglycaemia and adverse obstetric outcomes. As such, it is imperative that more sensitive screening protocols such as the 50g screen are considered in any future pandemics, such that women with GDM can be identified and maternal hyperglycaemia treated to benefit in-utero fetal programming.

3.
LANCET ; 399(10342):2212-2225, 2022.
Article in English | Web of Science | ID: covidwho-1935221

ABSTRACT

Background Vaccination of children and young people against SARS-CoV-2 is recommended in some countries. Scarce data have been published on immune responses induced by COVID-19 vaccines in people younger than 18 years compared with the same data that are available in adults. Methods COV006 is a phase 2, single-blind, randomised, controlled trial of ChAdOx1 nCoV-19 (AZD1222) in children and adolescents at four trial sites in the UK. Healthy participants aged 6-17 years, who did not have a history of chronic respiratory conditions, laboratory-confirmed COVID-19, or previously received capsular group B meningococcal vaccine (the control), were randomly assigned to four groups (4:1:4:1) to receive two intramuscular doses of 5 x 10(1)degrees viral particles of ChAdOx1 nCoV-19 or control, 28 days or 84 days apart. Participants, clinical investigators, and the laboratory team were masked to treatment allocation. Study groups were stratified by age, and participants aged 12-17 years were enrolled before those aged 6-11 years. Due to the restrictions in the use of ChAdOx1 nCoV-19 in people younger than 30 years that were introduced during the study, only participants aged 12-17 years who were randomly assigned to the 28-day interval group had received their vaccinations at the intended interval (day 28). The remaining participants received their second dose at day 112. The primary outcome was assessment of safety and tolerability in the safety population, which included all participants who received at least one dose of the study drug. The secondary outcome was immunogenicity, which was assessed in participants who were seronegative to the nucleocapsid protein at baseline and received both prime and boost vaccine. This study is registered with ISRCTN (15638344). Findings Between Feb 15 and April 2, 2021, 262 participants (150 [57%] participants aged 12-17 years and 112 [43%] aged 6-11 years;due to the change in the UK vaccination policy, the study terminated recruitment of the younger age group before the planned number of participants had been enrolled) were randomly assigned to receive vaccination with two doses of either ChAdOx1 nCoV-19 (n=211 [n=105 at day 28 and n=106 at day 84]) or control (n=51 [n=26 at day 28 and n=25 at day 84]). One participant in the ChAdOx1 nCoV-19 day 28 group in the younger age bracket withdrew their consent before receiving a first dose. Of the participants who received ChAdOx1 nCoV-19, 169 (80%) of 210 participants reported at least one solicited local or systemic adverse event up to 7 days following the first dose, and 146 (76%) of 193 participants following the second dose. No serious adverse events related to ChAdOx1 nCoV-19 administration were recorded by the data cutoff date on Oct 28, 2021. Of the participants who received at least one dose of ChAdOx1 nCoV-19, there were 128 unsolicited adverse events up to 28 days after vaccination reported by 83 (40%) of 210 participants. One participant aged 6-11 years receiving ChAdOx1 nCoV-19 reported a grade 4 fever of 40.2 degrees C on day 1 following first vaccination, which resolved within 24 h. Pain and tenderness were the most common local solicited adverse events for all the ChAdOx1 nCoV-19 and capsular group B meningococcal groups following both doses. Of the 242 participants with available serostatus data, 14 (6%) were seropositive at baseline. Serostatus data were not available for 20 (8%) of 262 participants. Among seronegative participants who received ChAdOx1 nCoV-19, anti-SARS-CoV-2 IgG and pseudoneutralising antibody titres at day 28 after the second dose were higher in participants aged 12-17 years with a longer interval between doses (geometric means of 73 371 arbitrary units [AU]/mL [95% CI 58 685-91 733] and 299 half-maximal inhibitory concentration [IC 50;95% CI 230-390]) compared with those aged 12-17 years who received their vaccines 28 days apart (43 280 AU/mL [95% CI 35 852-52 246] and 150 IC 50 [95% CI 116-194]). Humoral responses were higher in those aged 6-11 years than in those aged 12-17 years receiving their second dose at the same 112-day interval (geometric mean ratios 1.48 [95% CI 1.07-2.07] for anti-SARS-CoV-2 IgG and 2.96 [1.89-4.62] for pseudoneutralising antibody titres). Cellular responses peaked after a first dose of ChAdOx1 nCoV-19 across all age and interval groups and remained above baseline after a second vaccination. Interpretation ChAdOx1 nCoV-19 is well tolerated and immunogenic in children aged 6-17 years, inducing concentrations of antibody that are similar to those associated with high efficacy in phase 3 studies in adults. No safety concerns were raised in this trial. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.

4.
INDIAN JOURNAL OF CRITICAL CARE MEDICINE ; 26(7):833-835, 2022.
Article in English | Web of Science | ID: covidwho-1939280

ABSTRACT

Background: The major brunt of coronavirus disease-2019 (COVID-2019) is borne by the lungs. The major cause of morbidity and mortality in COVID-19 patients is a compromise of the respiratory system. Pneumothorax is noted as an insignificant proportion of patients suffering from COVID-19, but it jeopardizes the clinical recovery significantly. We, in the case series of 10 patients, will be summarizing the epidemiological, demographic, and clinical characteristics of COVID-19 patients who also developed pneumothorax. Patients and methods: All the confirmed cases of COVID-19 pneumonia diagnosed between May 1, 2020 and August 30, 2020, admitted at our center meeting the inclusion criteria and whose clinical course was complicated by pneumothorax were made part of our study. Their clinical records were studied, and epidemiological, demographic, and clinical data of these patients were collected and compiled in this case series. Results: All the patients in our study required ICU care, and 60% received non-invasive mechanical ventilation, while 40% of the patients progressed to intubation and invasive mechanical ventilation. A total of 70% of the patients in our study had a successful outcome, while 30% succumbed to the disease and expired. Conclusion: Epidemiological, demographic, and clinical characteristics of COVID-19 patients complicated with pneumothorax were evaluated. Our study showed that pneumothorax also developed in some patients who had not received mechanical ventilation, indicating that pneumothorax could be a secondary complication of SARS-CoV-2 infection. Our study also emphasizes the fact that even the majority of patients whose clinical course was complicated by pneumothorax had a successful outcome emphasizing the need for timely and adequate intervention in such cases.

5.
Urban Book Series ; : 17-37, 2022.
Article in English | Scopus | ID: covidwho-1930266

ABSTRACT

Cities around the world have traditionally dealt with a wide array of natural and human-made risks and hazards. Annually, this results in significant human and economic losses in urban areas. As climate change is expected to further increase the frequency and intensity of adverse events, and other adverse events such as the recent COVID-19 pandemic may also hit cities again in the future, cities around the world increasingly recognize the importance of building on urban resilience to minimize vulnerabilities and enhance resistance, absorption, recovery and adaptation capacities. The rapid advances in smart city solutions enabled by information and communication technologies have also provided cities with more tools and opportunities to deal with adverse events. There is a vast body of literature on both smart city and urban resilience. However, the concept of smart city resilience has received limited attention in the literature. To fill this gap, in this chapter, we first provide overviews of the underlying principles of the smart city and urban resilience concepts. Next, we explain how adopting integrated approaches that simultaneously consider both smartness and resilience can help cities take more effective and efficient efforts toward dealing with adverse events, enhancing quality of life and ensuring transition toward sustainable development. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

6.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927900

ABSTRACT

Introduction: Activity monitoring is important in the ICU where delirium, sedation, and critical illness are associated with both inactivity and agitation. Staff monitoring of motion and sleep is intermittent and resource intense. Wearable actigraphic devices are poorly tolerated and limited to limb motion. Here we demonstrate continuous AI video monitoring in the ICU to provide alwayson, unobtrusive patient activity monitoring. Methods: We conducted a pilot study of AI video monitoring in the Duke University Hospital Medical Intensive Care Unit. Video carts continuously recorded data on encrypted hard drives. Second-by-second AI analysis generated binary motion “counts” that were summed to generate our patient motion metric: counts per minute (CPM). Scene intelligence from AI object and people detectors provided room environment information. These data streams along with de-identified (blurred) video data were used to generate prototype graphical and visual summaries of patient activity patterns and the hospital room environment. Results: We enrolled 22 patients and collected 2155 hours (116 days) of video. Representative time-series data streams are shown in the Figure (top left). These data were acquired from a 76-year-old with liver failure and an escalating nasal cannula oxygen requirement who was endotracheally intubated on the subsequent day. Note 1) the declining patient activity as the patient deteriorates and 2) the significant bedside activity (high acuity) throughout the day. We developed a prototype “overnight report” that summarizes patient activity and room environment. The Figure (bottom left) shows the overnight report for a 54-year-old post-COVID-19 patient admitted to the MICU for respiratory failure with hypoactive delirium that resolved per CAM-ICU on day 5 of data collection. Notably, our report demonstrates significant overnight movement, possibly consistent with a mixed or hyperactive delirium. To visually summarize patient motion, we generated activity “heat maps” over 10-minute intervals. As a control, we showed that the intubated and sedated liver failure patient generated a still heat map (Figure upper right). Further, we visualized daytime hypoactivity/sleep in the delirious post-COVID patient (Figure lower right), suggesting disrupted circadian rhythm, giving additional context to the negative CAM assessment. Conclusions: We demonstrated the feasibility of AI to monitor patient activity in a quaternary-care MICU. Our method has advantages compared to wearable actigraphic methods for monitoring patient activity, including being unobtrusive and being able to visualize and summarize wholebody motion. The data presented here suggest that such monitoring may be able to provide clinically actionable insights in delirium care and sedation weaning.

7.
Journal of Pain and Symptom Management ; 63(5):919-920, 2022.
Article in English | Web of Science | ID: covidwho-1925513
8.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925140

ABSTRACT

Objective: To characterize the incidence and spectrum of neurological adverse events (AE) after COVID-19 vaccination. Background: The devastating COVID-19 pandemic has led to 230 million people diagnosed and greater than 4.8 million deaths worldwide. Widespread vaccination efforts have resulted in administration of over 6 million vaccine doses to curb the significant health and socioeconomic impacts of the disease. While there are numerous reports of adverse events following COVID-19 vaccine, there is limited characterization of the spectrum of neurological AEs post-vaccination. Design/Methods: Data was gathered from the publicly available Vaccine Adverse Event Reporting System (VAERS), a passive reporting system not implying causality. Among individuals who received the J&J, Moderna, and Pfizer vaccines from 1/1/2021-6/14/2021, 314,610 adverse events were reported and these were reviewed by Neurology trained clinicians to determine the presence of various neurological AEs (40 conditions coded). Results: 306,473,169 COVID vaccine dose were administered in the USA during the study period with 314,610 total AEs (0.10%) and 105,930 neurological AEs (0.03%) reported. J&J vaccine was associated with the most AEs (17,670, 0.15%), followed by Moderna (42656, 0.03%) and Pfizer (42267, 0.03%). On average more events were reported in women (71%) and a majority occurred after the first dose (54%). < 1 events were reported per million vaccine doses for serious neurological conditions such as Bell's palsy (0.0007%), Guillain-Barre syndrome (0.00009%), cerebral venous thrombosis (0.00005%), transverse myelitis (0.00003%), and acute disseminated encephalomyelitis (0.00006%). Overall neurological complications following vaccine were drastically lower than complications post-COVID infection (14-80%). Conclusions: Adverse neurological events following COVID-19 vaccination are extremely rare and significantly less common than adverse neurological effects following SARS-CoV-2 infection. Current evidence suggests that along with being up to 100,000 times more likely to experience a major complication from COVID infection vs. vaccine, the risk of neurological complication is up to 5000 times more likely from infection itself.

9.
International Journal of Interdisciplinary Telecommunications and Networking ; 14(1):11, 2022.
Article in English | Web of Science | ID: covidwho-1917935

ABSTRACT

The number of the elderly experiencing cognitive disorders or dementia including Alzheimer's has been increasing worldwide. During COVID-19 pandemic, they are vulnerable not only to the coronavirus, but also to the social isolation with no family visits. The elderly are increasingly depressed, resisting care, refusing medications, and showing signs of agitation. These behavioral disturbances are leading to an increased use of psychotropic medications and/or increased hospitalizations to the already overloaded healthcare systems. To address this, the authors focus on a mobile intervention, named AlzhaTV, as a suite of mobile apps. The intervention, not requiring any technical interaction from the elderly, is available on both Android and iOS platforms. The mobile intervention has the potential to improve the quality of life and reduction in medications for the elderly. The results show that multiple personalized and non-personalized videos can be transmitted over existing wireless networks. During the current and future pandemics and disasters, AlzhaTV can actively support the elderly.

10.
Journal of Neurology, Neurosurgery and Psychiatry ; 93(6):103, 2022.
Article in English | EMBASE | ID: covidwho-1916427

ABSTRACT

Since the advent of the COVID-19 pandemic, anecdotal reports have indicated a possible relationship between COVID-19 infections and novel seizures. This study explores the relationship between COVID-19 infections and novel or breakthrough seizures in a single New York-based hospital system with the largest patient sample to date. We analyzed 426 patients admitted with COVID-19 infections and administered antiepileptic medications between 1 February and 30 June 2020. Patients were divided into those with and those without a known history of epilepsy. The incidences of new-onset seizures and the mortality rates were compared between these groups by employing Pearson's chi-squared test, and their statisti-cal significance was measured by Fisher's exact test. Novel seizures were more likely to occur in patients without a known history of epilepsy than in patients with one (p=0.0004). There was no difference between the mortality rates of patients who had novel seizures and those who did not (p=0.1253). There was also no difference in mortality rates between patients who had a history of epilepsy and those who did not (p=0.9048). These results indicate that COVID-19 infections may cause novel seizures in patients without epilepsy, and would warrant further exploration into this pathophysiology.

11.
HEALTHCARE IN LOW-RESOURCE SETTINGS ; 10(1), 2022.
Article in English | Web of Science | ID: covidwho-1911842

ABSTRACT

Experts in the field are predicting a third COVID-19 peak very soon in coming times, it is important to assess recent knowledge, attitude in view of prolonged exhaustion and adherence to preventive practices of HCWs. This cross-sectional study involved 168 HCWs (42 doctors, 42 nurses, 42 paramedical staff and 42 ANMs). Data was collected through online survey tool Google forms in July and August 2021. First section included sociodemographic information and infection with SARS-CoV-2, section 2 assessed recent knowledge, section 3 practices of COVID-19 appropriate behavior and section 4 assessed attitude of HCWs. Shapiro Wilk test was used to determine normality of distribution of variables. Kruskal-Wallis and Mann-Whitney U tests were used to determine the association between two variables. Pairwise comparison was done following a significant Kruskal-Wallis test using Bonferroni's correction. 42.9% of the HCWs and family members of 44.6% HCWs were infected with SARS-CoV-2. 54.1% of infected HCWs were infected during the March-May 2021 peak. 85.1% HCWs had taken COVID-19 vaccine. Mean knowledge, attitude, practice scores were 7.88 +/- 3.03(maximum score: 12), 20.35 +/- 3.2 (maximum score: 25), 69.89 +/- 9.39 (maximum score: 85) respectively. Only 48.8% HCWs had good knowledge about more recent COVID-19 information. A significant association was observed between profession and knowledge scores (p<0.001). Over 85% HCWs had good scores for attitude towards COVID-19 and 88.7% HCWs scored good in COVID-19 appropriate behavior practices. Our HCWs need to be better equipped with the more recently available knowledge about COVID-19 to improve our preparedness for the next anticipated peak.

12.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:116-117, 2022.
Article in English | Web of Science | ID: covidwho-1905378
13.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:177-177, 2022.
Article in English | Web of Science | ID: covidwho-1904895
14.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY ; 129:152-152, 2022.
Article in English | Web of Science | ID: covidwho-1904441
15.
Journal of Management Development ; 41(4):18, 2022.
Article in English | Web of Science | ID: covidwho-1886568

ABSTRACT

Purpose The business sector plays a major role in achieving comprehensive economic development goals in emerging economies. Consequently, the effects of business responses to the COVID-19 pandemic are receiving increasing research attention from an organizational management development perspective. This article aims to examine the role of leadership in charting the course in an extraordinary crisis context. Design/methodology/approach Using institutional leadership theory, leadership contingency theory and dynamic leadership capability theory, the authors present a research framework that defines macrochallenges and organizational level responses and outcomes. The article adopts a case study approach, which includes the identification of four target companies and conducting in-depth interviews with senior management professionals within those companies at different time periods. Findings Based on the interviews, the steps that Indian companies adopted to respond to the COVID-19 challenge are identified. Expanding the insight from the case study, the findings suggest that although feeling overwhelmed at first, organizational leaders combine prudent (i.e. timely and speedy actions for survival first) and bold (i.e. future envisioning for expansion and growth) actions enabling these firms to weather two waves of the COVID-19 pandemic in India. Originality/value These multiple case studies are unique in exploring MNEs from different industries. This study also highlights the dynamic relationships between leadership practices, risk management strategies and performance outcomes based on a sound theoretical model and rigorous study methods.

16.
Journal International Medical Sciences Academy ; 35(1):62-66, 2022.
Article in English | EMBASE | ID: covidwho-1880921

ABSTRACT

Introduction: In order to halt the progression of COVID-19, governments of many countries including India implemented national lockdown. In view of the sudden closure of educational institutions, remote teaching was implemented with the help of online learning or E-learning. Thus, the aim of the study was assessing the attitudes and perceptions of MBBS students regarding the effectiveness of e-learning and the impact of COVID-19 on the student’s mental wellbeing and learning. Methods: The survey instrument was a self-administered questionnaire consisting of 17 close ended questions and 3 open ended question. It has 3 sociodemographic questions, 13 questions assessing their attitudes and perceptions regarding the effectiveness of e-learning and 4 questions investigating the impact of COVID-19 on the student’s mental wellbeing and learning. The data obtained was analyzed using SPSS (version 20). Results: A total of 404 undergraduate students studying in FMHS, SGT University, Gurugram participated in the survey. A major part of the students (57.1%) was using their Mobile phones for e-learning followed by 24.6% using their Personal computer or Laptop, 12% were using combination of these devices and 6.3% using tablets. Due to inconsistent internet connection, most of the students (71.5%) were facing challenges. 64.9% of the respondents faced distraction during the class such as lack of audio clarity, internet connection problems, lack of environment, concentration issues, notifications and social media, student teacher interactions, practical aspect not covered and lack of physical interaction with the teacher. The continuous screen time posed a major problem for students who suffered from strain in the eyes (58.3%), headache (18.7%), neck pain (8.8%), back pain (6.3%) or all of the above problems (7.7%). Thus, 84.1% of the undergraduate students preferred conventional Classroom learning to e-learning. Conclusions: Implementation of strict social distancing and lockdown in COVID-19 era, has mandated the pedagogy of remote learning which remains the only viable option for teaching and learning in these difficult times. The students should be advised to follow good ergonomic practices to maintain their ocular health and should be motivated to enhance their mental well-being and learning amid COVID-19 pandemic.

17.
Journal International Medical Sciences Academy ; 35(1):9-12, 2022.
Article in English | EMBASE | ID: covidwho-1880306
18.
Journal International Medical Sciences Academy ; 35(1):13-22, 2022.
Article in English | EMBASE | ID: covidwho-1880047

ABSTRACT

Background: Long-COVID syndrome is now a real and pressing public health concern. We cannot reliably predict who will recover quickly or suffer with mild debilitating long COVID-19 symptoms or battle life-threatening complications. In order to address some of these questions, we studied the presence of (post covid) symptoms and various correlates in COVID-19 patients who were discharged from hospital, 3 months and up to 12 months after acute COVID-19 illness. Methods: This is an observational follow-up study of RT-PCR confirmed COVID-19 patients admitted at 3 hospitals in north India between April – August 2020. Patients were interviewed telephonically using a questionnaire regarding the post-COVID symptoms. The first tele-calling was done in the month of September 2020, which corresponded to 4- 16 weeks after disease onset. All those who reported presence of long COVID symptoms, were followed-up with a second call, in the month of March 2021, corresponding to around 9-12 months after the onset of disease. Results: Of 990 patients who responded to the first call, 615 (62.2%) had mild illness, 227 (22.9%) had moderate and 148 (15.0%) had severe COVID-19 illness at the time of admission. Nearly 40% (399) of these 990 patients reported at least one symptom at that time. Of these 399 long-COVID patients, 311 (almost 78%) responded to the second follow-up. Nearly 8% reported ongoing symptomatic COVID, lasting 1-3 months and 32% patients having post-COVID phase with symptoms lasting 3-12 months. Nearly 11% patients continued to have at least one symptom even at the time of the second interview (9-12 months after the disease onset). Overall, we observed Long-COVID in almost 40% of our study group. Incidence of the symptoms in both the follow-ups remained almost same across age-groups, gender, severity of illness at admission and presence of comorbidity, with no significant association with any of them. Most common symptoms experienced in long COVID phase in our cohort were fatigue, myalgia, neuro-psychiatric symptoms like depression, anxiety, “brain fog” and sleep disorder, and breathlessness. Fatigue was found to be significantly more often reported in the elderly population and in those patients who had a severe COVID-19 illness at the time of admission. Persistence of breathlessness was also reported significantly more often in those who had severe disease at the onset. The overall median duration of long COVID symptoms was 16.9 weeks with inter-quartile range of 12.4 to 35.6 weeks. The duration of symptom resolution was not associated with age, gender or comorbidity but was significantly associated with severity of illness at the time of admission (P=0.006). Conclusions: Long-COVID was seen in almost 40% of our study group with no correlation to age, gender, comorbidities or to the disease severity. The duration of symptom resolution was significantly associated with severity of illness at the time of admission (P = 0.006). In our study, all patients reported minor symptoms such as fatigue, myalgia, neuro-psychiatric symptoms like depression, anxiety, “brain fog” and sleep disorder and persistence of breathlessness.

19.
Journal International Medical Sciences Academy ; 34(3):145-149, 2021.
Article in English | Scopus | ID: covidwho-1876972
20.
Journal of Clinical and Diagnostic Research ; 16(5):OC12-OC16, 2022.
Article in English | EMBASE | ID: covidwho-1863301

ABSTRACT

Introduction: Coronavirus Disease-19 (COVID-19) has been creating havoc worldwide since the first report in December, 2019. Vaccination against the disease was thought to bring respite, reducing the severity of disease, morbidity and mortality. However, considering the fact that no vaccine is fully efficient, people may get COVID-19 even after full vaccination. Aim: To determine the clinical, laboratory, radiological features of COVID-19 including the outcome and compare these between vaccinated and unvaccinated patients. Materials and Methods: The prospective observational study was conducted in a dedicated COVID-19 hospital in Odisha, India, from May 2021 to June 2021. Detailed history including symptoms and vaccination status, laboratory parameters, and radiological investigations were collected from 200 patients. The cases were classified as mild, moderate and severe as per the Ministry of Health and Family Welfare (MoHFW) guidelines. All the patients were followed till the end of hospital stay. The results were expressed as the mean±standard deviation and percentages. Chi-square test was used to compare the categorical variables, and unpaired t-test was used to compare two discrete variables. A p-value of less than 0.05 was considered significant. Results: Majority of the patients were unvaccinated (65%) and belonged to the age group of 39-59 years (58.5%). Among the non vaccinated patients, 32.3% had moderate disease, while 35.4% had severe disease. In the vaccinated group, 51.4% had moderate disease, whereas only 28.6% patients developed severe disease. Increased Neutrophil to Lymphocyte Ratio (NLR), D-dimer levels, and radiological evidence of pneumonia in chest radiology were witnessed in both groups. Inflammatory markers between the vaccinated and unvaccinated groups did not show any statistical significance (p>0.05). A total of 12 (6%) patients died, out of which five were vaccinated (p=0.6). Conclusion: Vaccination is found to be protective in terms of disease severity and mortality. Vaccination of all individuals is recommended to curb the wrath of the virus.

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