Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 33
Filter
1.
Ann Am Thorac Soc ; 19(8): 1346-1354, 2022 08.
Article in English | MEDLINE | ID: covidwho-1974363

ABSTRACT

Rationale: During the first wave of the coronavirus disease (COVID-19) pandemic in New York City, the number of mechanically ventilated COVID-19 patients rapidly surpassed the capacity of traditional intensive care units (ICUs), resulting in health systems utilizing other areas as expanded ICUs to provide critical care. Objectives: To evaluate the mortality of patients admitted to expanded ICUs compared with those admitted to traditional ICUs. Methods: Multicenter, retrospective, cohort study of mechanically ventilated patients with COVID-19 admitted to the ICUs at 11 Northwell Health hospitals in the greater New York City area between March 1, 2020 and April 30, 2020. Primary outcome was in-hospital mortality up to 28 days after intubation of COVID-19 patients. Results: Among 1,966 mechanically ventilated patients with COVID-19, 1,198 (61%) died within 28 days after intubation, 46 (2%) were transferred to other hospitals outside of the Northwell Health system, 722 (37%) survived in the hospital until 28 days or were discharged after recovery. The risk of mortality of mechanically ventilated patients admitted to expanded ICUs was not different from those admitted to traditional ICUs (hazard ratio [HR], 1.07; 95% confidence interval [CI], 0.95-1.20; P = 0.28), while hospital occupancy for critically ill patients itself was associated with increased risk of mortality (HR, 1.28; 95% CI, 1.12-1.45; P < 0.001). Conclusions: Although increased hospital occupancy for critically ill patients itself was associated with increased mortality, the risk of 28-day in-hospital mortality of mechanically ventilated patients with COVID-19 who were admitted to expanded ICUs was not different from those admitted to traditional ICUs.


Subject(s)
COVID-19 , Critical Illness , COVID-19/therapy , Cohort Studies , Hospital Mortality , Humans , Intensive Care Units , New York City/epidemiology , Respiration, Artificial , Retrospective Studies
2.
Turk J Emerg Med ; 22(3): 149-155, 2022.
Article in English | MEDLINE | ID: covidwho-1954252

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) virus usually spreads through aerosol and close contact. Frontline health-care workers handle aerosol-generating procedures like endotracheal intubation. To reduce this risk, COVID-19 barrier box came into the picture. However, the COVID-19 barrier box may compromise easy and successful intubation, and their limitation must be studied. OBJECTIVES: The objective of this study was to assess the time to successful intubation with or without the COVID-19 barrier box using the Macintosh laryngoscope and King Vision video laryngoscope (KVVL). We also assessed the first-pass success rate, ease of intubation, Cormack-Lehane (CL) grade, and requirement of external laryngeal manipulation. METHODS: We conducted this manikin-based randomized crossover study to assess the time to successful intubation by anesthesiologists (22) and emergency physicians (11) having 1 year or more experience with or without COVID-19 barrier box by using the Macintosh laryngoscope and KVVL. Our study randomized the sequence of the four different intubation scenarios. RESULTS: The comparison of mean duration of intubation between KVVL (13.21 ± 4.05 s) and Macintosh laryngoscope (12.89 ± 4.28 s) with COVID-19 barrier box was not statistically significant (95% confidence interval: 1.21-0.97). The ease of intubation, number of attempts, and requirement of external laryngeal manipulation were not statistically significant. Intubations were statistically significant more difficult with barrier box in view of higher CL grade. CONCLUSION: Time to intubation was longer with COVID-19 barrier box using KVVL as compared to Macintosh laryngoscope which was statistically not significant.

3.
Confl Health ; 16(1): 30, 2022 Jun 03.
Article in English | MEDLINE | ID: covidwho-1951274

ABSTRACT

BACKGROUND: The impacts of COVID-19 are unprecedented globally. The pandemic is reversing decades of progress in maternal, newborn, child health and nutrition (MNCHN), especially fragile and conflict-affected settings (FCAS) whose populations were already facing challenges in accessing basic health and nutrition services. This study aimed to investigate the collateral impact of COVID-19 on funding, services and MNCHN outcomes in FCAS, as well as adaptations used in the field to continue activities. METHODS: A scoping review of peer-reviewed and grey literature published between 1st March 2020-31st January 2021 was conducted. We analysed 103 publications using a narrative synthesis approach. 39 remote semi-structured key informant interviews with humanitarian actors and donor staff within 12 FCAS were conducted between October 2020 and February 2021. Thematic analysis was undertaken independently by two researchers on interview transcripts and supporting documents provided by key informants, and triangulated with literature review findings. RESULTS: Funding for MNCHN has been reduced or suspended with increase in cost of continuing the same activities, and diversion of MNCHN funding to COVID-19 activities. Disruption in supply and demand of interventions was reported across different settings which, despite data evidence still being missing, points towards likely increased maternal and child morbidity and mortality. Some positive adaptations including use of technology and decentralisation of services have been reported, however overall adaptation strategies have been insufficient to equitably meet additional challenges posed by the pandemic, and have not been evaluated for their effectiveness. CONCLUSIONS: COVID-19 is further exacerbating negative women's and children's health outcomes in FCAS. Increased funding is urgently required to re-establish MNCHN activities which have been deprioritised or halted. Improved planning to sustain routine health services and enable surge planning for emergencies with focus on the community/service users throughout adaptations is vital for improved MNCHN outcomes in FCAS.

4.
Regional Science Policy & Practice ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1868692

ABSTRACT

This study presented forecasting methods using Time Series Analysis for confirmed cases, the number of deaths and recovery cases, and individual vaccination status in different states of India. It aims to forecast the confirmed cases and mortality rate and develop an Artificial Intelligence method and different statistical methodologies that can help predict the future of Covid-19 cases. Various Forecasting methods in Time Series Analysis like ARIMA, Holt?s Trend, Naive, Simple Exponential Smoothing, TBATS, and MAPE are extended for the study. It also involved the Case Fatality Rate for the number of deaths and confirmed cases for respective states in India. This study includes the forecast values for the number of positive cases, cured patients, mortality rate, and case fatality rate for Covid-19 cases. Among all forecast methods involved in this study, the naive and simple exponential smoothing method shows an increased number of positive instances and cured patients.

5.
Indian J Palliat Care ; 26(Suppl 1): S86-S89, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792219

ABSTRACT

OBJECTIVE: To understand the trend of prevalence of symptoms of coronavirus disease 2019 (COVID-19) pandemic, some studies have been conducted outside India, but for Indian patients, there is no such study available. Therefore, this study was designed to analyze the trends of symptoms in Indian patients during COVID-19 pandemic. METHODS: A retrospective study was conducted on 100 patients (73 males, 24 females, and 3 transgenders) admitted under institutional isolation at a tertiary care center in India using a self-designed survey-based questionnaire. A descriptive analysis of results done based on age and sex. RESULTS: COVID incidence recorded is high in male (73%) as compared to female (24%), yet female patients have a higher prevalence of symptoms as compared to male patients. CONCLUSION: Male patients are more as far as COVID incidence is concerned, while female patients show high prevalence of symptoms as compared to male patients. Patients presenting with COVID-positive report suffer a significant burden of symptoms, and timely recognition of symptoms and their management can significantly reduce morbidity and mortality due to COVID-19.

6.
Indian J Palliat Care ; 26(Suppl 1): S90-S94, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792218

ABSTRACT

OBJECTIVE: Health-care professionals (HCPs) are the frontline warriors in the time of this uncertain and unpredictable crisis of COVID. They face many challenges while caring for these patients, yet they are expected to cope with it and deliver their duties for the betterment of humankind. Our primary aim was to identify and assess the concerns of HCPs working in COVID area in a tertiary institutional isolation center. METHODOLOGY: An online Google-based questionnaire survey was distributed through various social media platforms after approval of the institutional review board to a total of 100 HCPs who were treating and managing COVID-positive patients. RESULTS: Of 100 responses, 72% were concerned about the risk of infection to self and family, while 46% reported disruption of their daily activities at a personal level. At the institutional level, 17% were concerned about inadequate personal protective equipment-related challenges. 20% had inadequate knowledge and training about COVID. 16% of participants were anxious all the time, 11% feared all the time, and 12% had stress all the time while treating COVID patients. Connectedness and communication with family and friends, word of appreciation, music, and TV were few strategies to cope up with these challenges. CONCLUSION: There is a need to identify and address the concerns and challenges faced by HCPs and to develop a comprehensive strategy and guideline to provide a holistic care and to ensure their security in the workplace.

7.
Indian J Palliat Care ; 26(Suppl 1): S99-S105, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1792216

ABSTRACT

INTRODUCTION: The World Health Organization has declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a pandemic. The interventions employed by various health authorities in combating the infection may help in eliminating the threat; however, they have long-term cognitive and mental health effects on the population. AIMS: The primary objective was to assess the prevalent concerns and coping strategies and perspectives in persons suspected of SARS-CoV-2 infection under institutional quarantine in India during the period from April 2020 to May 2020. SETTING AND DESIGN: Its a cross-sectional observational study conducted in the National Cancer Institute, Jhajjar, India. METHODOLOGY: After ethical clearance, convenience sampling was done. Relevant demographic details were obtained. Health-care professionally administered questionnaire to assess psychological concerns and coping mechanisms. All statistics are deemed to be descriptive only. RESULTS: The most common physical concern was fever seen in 37% of respondents, followed by cough in 31% and sore throat in 29%. In terms of emotional concerns, 55.3% of respondents were worried and 43% were anxious and 33% were sad. About 80.6% of participants selected support from family and friends helped them cope during the institutional quarantine. 57% maintained a daily routine, 70% selected praying, and 45% used music as a coping strategy. Only 2% felt that they were unable to cope. CONCLUSION: It highlights that the psychological impact of illness on affected individuals should not be overlooked as it may have the potential to cause major psychiatric morbidity. It also provides a crucial assessment of their coping mechanisms.

8.
Journal of Microbiology & Infectious Diseases ; 12(1):1-5, 2022.
Article in English | Academic Search Complete | ID: covidwho-1753888

ABSTRACT

Objectives: The coronavirus disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. However, little is known about the association between pregnant women with COVID-19 and its transmission to neonates. This investigation aimed to see if COVID-19 infection could be transmitted vertically into the uterus. Methods: We conducted a prospective observational study. 48 COVID-19 infected mothers were enrolled during their third trimester. A qRT-PCR assay of the nasal and oropharyngeal swab samples was performed to confirm positive for COVID-19 infection as per WHO protocol. In addition, characteristics of pregnant women with confirmed SARS -CoV-2 infection and newborns were documented. Results: Forty-eight expectant mothers, 10 (20.8%) were found symptomatic, and 38 (79.2%) were asymptomatic, with COVID-19 infection were delivered (33 cesarean section & 15 vaginal deliveries). One female child (4.1%) out of 48 newborns was initially diagnosed with COVID-19 infection based on a nucleic acid qRT-PCR. The female child showed no or negligible signs and recovered completely, whereas 47 neonates (95.9%) confirmed negative. None of the mothers or neonates died from COVID-19 related pulmonary problems. Conclusion: There is insufficient evidence on vertical virologic transmission of COVID-19 infection during the third trimester of pregnancy. Additionally, research and surveillance involving adequate testing of samples of placental tissue, breast milk, vaginal swab, amniotic fluid, and cord blood will be needed to establish the possibility of vertical transmission of infection. [ FROM AUTHOR] Copyright of Journal of Microbiology & Infectious Diseases is the property of Journal of Microbiology & Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

9.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329959

ABSTRACT

Background: The impacts of COVID-19 are unprecedented globally. The pandemic is reversing decades of progress in maternal, newborn, child health and nutrition (MNCHN), including fragile and conflict-affected settings (FCAS) whose populations were already facing challenges in accessing basic health and nutrition services. This study aimed to investigate the collateral impact of COVID-19 on funding, services and MNCHN outcomes in FCAS, as well as adaptations used in the field to continue activities. Methods: : A scoping review of peer-reviewed and grey literature published between1 st March 2020 - 31 st January 2021 was conducted and analysed using a narrative synthesis approach. 39 remote semi-structured key informant interviews with humanitarian actors and donor staff within 12 FCAS were conducted between October 2020 and February 2021. Thematic analysis was undertaken independently by two researchers on interview transcripts and supporting documents provided by key informants, and triangulated with literature review findings. Results: : Funding for MNCHN has been reduced or suspended with increase in cost of continuing the same activities, and diversion of MNCHN funding to COVID-19 activities. Disruption in supply and demand of interventions was reported across different settings which, despite data evidence still being missing, points towards likely increased maternal and child morbidity and mortality. Some positive adaptations including use of technology and decentralisation of services have been reported, however overall adaptation strategies have been insufficient to equitably meet additional challenges posed by the pandemic, and have not been evaluated for their effectiveness. Conclusions: : COVID-19 is further exacerbating negative women’s and children’s health outcomes in FCAS. Increased funding is urgently required to re-establish MNCHN activities which have been deprioritised or halted. Improved planning to sustain routine health services and enable surge planning for emergencies with focus on the community/service users throughout adaptations is vital for improved MNCHN outcomes in FCAS.

10.
Glob Public Health ; 17(5): 794-799, 2022 05.
Article in English | MEDLINE | ID: covidwho-1700753

ABSTRACT

The COVID-19 pandemic has placed strain on healthcare systems across the world; however, countries experiencing overlapping crises such as economic or political unrest face immense pressure in ensuring routine healthcare services can continue to operate. Despite being less likely suffer severe disease or die from COVID-19, data suggest women have experienced poorer mental health, higher rates of unemployment, and more social isolation during the pandemic. In general, we know women and girls experience multiple forms of disadvantage in disaster contexts including being more likely to become homeless, work as an unpaid carer, and to experience poverty. Research from previous disaster contexts has demonstrated that women's healthcare services tend to be deprioritised in the emergency response, and reports suggest this has been the case during the COVID-19 pandemic. This paper highlights key priorities for safeguarding women's and girls' health in disaster contexts, especially during the COVID-19 pandemic, by drawing on learning from the multiple crises facing Beirut, including responding to the pandemic, economic collapse, and the Beirut Port Explosion in 2020.


Subject(s)
COVID-19 , Disasters , COVID-19/epidemiology , Delivery of Health Care , Female , Humans , Lebanon/epidemiology , Pandemics
11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-320188

ABSTRACT

Background: Highly infectious diseases like COVID-19, which are rapidly disseminating and exceedingly contagious, require vital safety skills to be followed by all health professionals. These safety skills need to be taught to all individuals working in the health care sector, by qualified trainers. The present study describes the experiences of COVID-19 trainers who were involved in providing this intensive training to health workers, in a tertiary level institution. The hospital was providing services to COVID positive patients, as well as emergency and tertiary care services during the COVID-19 pandemic. Most of the participants in the study were high risk groups who were in direct interaction with COVID positive patients. Methods: : The COVID-19 training program was conducted for more than three months, with the aim of training all the health care workers at a tertiary care institute, during the Corona virus pandemic. Twenty trainers, who had completed at least 30 or more sessions of training more than 2700 health workers, were included in this study. These trainers were interviewed for an average of thirty minutes per participant and were asked 30 open ended questions each. Results: : The mean age of the trainers was 28.9 years, and 75% of them were females. The interview of the COVID-19 trainers highlighted four important factors, which according to them were the pillars of this successful and effective training program. These factors included: The use of video demonstration and simulation for the training;Regular updating of the skill of the trainers in this program;Ease of communication to address the challenges faced by the trainers;and strong administrative support for the training. Conclusion: The results of this study reveal that if health workers are provided a conducive environment for training, as well as full support for updating their knowledge and skills, they can provide optimal health care services to their patients and fellow healthcare workers, even during a challenging time like the COVID-19 pandemic. The trainers in this study provided training to all the health care workers of the hospital, who were posted in COVID wards, even at a time when everyone had the fear of contracting the infection.

12.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-318222

ABSTRACT

Background: For humanitarian organisations to respond effectively to complex crises, they require access to up-to-date evidence-based guidance. In addition, the COVID-19 crisis has highlighted the importance of adapting and updating global guidance to context-specific and evolving needs in fragile and humanitarian settings. Our study aimed to understand the use of evidence in humanitarian responses during COVID-19. Methods: : We collected and analysed COVID-19 guidance documents, and conducted semi-structured interviews remotely with a variety of humanitarian organisations responding and adapting to the COVID-19 pandemic. We used the COVID-19 Humanitarian platform, a website established by three universities in March 2020, to solicit, collate and document these experiences and knowledge. Results: : We collected 180 guidance documents, and after excluding those that did not meet our inclusion criteria, analysed 131. We conducted 80 interviews with humanitarian organisations in the field, generating 61 published field experiences. Although COVID-19 guidance was quickly developed and disseminated in the initial phases of the crisis (from January to May 2020), updates or ongoing revision of the guidance has been limited. Interviews conducted between April and September 2020 showed that humanitarian organisations have responded to COVID-19 in innovative and context-specific ways, but have often had to adapt existing guidance to inform their operations in complex humanitarian settings. Conclusion: Experiences from the field indicate that adopting guidance to respond and adapt to COVID-19 is a complex process requiring innovation and collaboration based on the local context and resource availability. Global guidance aimed at humanitarian actors could be improved through responsive incorporation of contextualised field experiences in a timely manner using real-time feedback loops through online platforms like the COVID-19 Humanitarian platform.

13.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308673

ABSTRACT

To predict if developing human embryos are permissive to coronaviruses, we analyzed publicly available single cell RNA-seq datasets of zygotes, 4-cell, 8-cell, morula, inner cell mass, epiblast, primitive endoderm and trophectoderm for the coronavirus receptors (ACE2, BSG, DPP4 and ANPEP), the Spike protein cleavage enzymes (TMPRSS2, CTSL). We also analyzed the presence of host genes involved in viral replication, the endosomal sorting complexes required for transport (ESCRT) and SARS-Cov-2 interactions. The results reveal that ACE2, BSG, DPP4 and ANPEP are expressed in the cells of the zygote, to blastocyst including the trophectodermal lineage. ACE2, TMPRSS, BSG and CTSL are co-transcribed in a proportion of epiblast cells and most cells of the trophectoderm. The embryonic and trophectodermal cells also express genes for proteins ESCRT, viral replication and those that interact with SARS-CoV-2. We identified 1985 genes in epiblast and 1452 genes in the trophectoderm that are enriched in the ACE2 and TMPRSS2 co-expressing cells;216 genes of these are common in both the cell types. These genes are associated with lipid metabolism, lysosome, peroxisome and oxidative phosphorylation pathways. Together our results suggest that developing human embryos could be permissive to coronavirus entry by both canonical and non-canonical mechanisms and they also express the genes for proteins involved in viral endocytosis and replication. This knowledge will be useful for evidence-based patient management for IVF during the COVID-19 pandemic.

14.
Confl Health ; 15(1): 83, 2021 Nov 19.
Article in English | MEDLINE | ID: covidwho-1526651

ABSTRACT

BACKGROUND: For humanitarian organisations to respond effectively to complex crises, they require access to up-to-date evidence-based guidance. The COVID-19 crisis has highlighted the importance of updating global guidance to context-specific and evolving needs in humanitarian settings. Our study aimed to understand the use of evidence-based guidance in humanitarian responses during COVID-19. Primary data collected during the rapidly evolving pandemic sheds new light on evidence-use processes in humanitarian response. METHODS: We collected and analysed COVID-19 guidance documents, and conducted semi-structured interviews remotely with a variety of humanitarian organisations responding and adapting to the COVID-19 pandemic. We used the COVID-19 Humanitarian platform, a website established by three universities in March 2020, to solicit, collate and document these experiences and knowledge. RESULTS: We analysed 131 guidance documents and conducted 80 interviews with humanitarian organisations, generating 61 published field experiences. Although COVID-19 guidance was quickly developed and disseminated in the initial phases of the crisis (from January to May 2020), updates or ongoing revision of the guidance has been limited. Interviews conducted between April and September 2020 showed that humanitarian organisations have responded to COVID-19 in innovative and context-specific ways, but have often had to adapt existing guidance to inform their operations in complex humanitarian settings. CONCLUSIONS: Experiences from the field indicate that humanitarian organisations consulted guidance to respond and adapt to COVID-19, but whether referring to available guidance indicates evidence use depends on its accessibility, coherence, contextual relevance and trustworthiness. Feedback loops through online platforms like the COVID-19 Humanitarian platform that relay details of these evidence-use processes to global guidance setters could improve future humanitarian response.

15.
J Pharm Bioallied Sci ; 13(Suppl 2): S1000-S1002, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1515584

ABSTRACT

BACKGROUND: COVID-19 pandemic resulted in lockdown affecting all businesses globally. Everyone was forced to work from home (WFH) leading to challenges in productivity and motivation. METHODOLOGY: One thousand working professionals who worked from home participated in the online survey with semi-structured questionnaire using nonprobability Snowball sampling technique. Descriptive statistics was used to analyze the findings and to collect data method. RESULTS: Participants were asked about their biggest worries during lockdown COVID-19 situation and their biggest worry was infection to COVID-19/death. Professionals were asked whether they were affected or not affected due to "WFH" in COVID situation. The questionnaire items were clubbed into six major categories of job role overload, lifestyle choices, family distraction, occupational discomfort, job performance, and distress, and majority categories were affected. CONCLUSION: Thus, it is observed that the increase in work commitments leads to distress among employees while distractions from family members disrupt the quality of work. While good job performance contributes to life satisfaction, distress significantly diminished it. This paves the way for more studies to be done on work-life balance under WFH arrangements for as long as the pandemic of COVID-19 is prevalent.

16.
Int J Crit Illn Inj Sci ; 11(3): 151-155, 2021.
Article in English | MEDLINE | ID: covidwho-1471090

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) barrier box is being used by health-care workers for protection against aerosol-transmitted infection. Usually, a Macintosh laryngoscope (MC) or a video laryngoscope (VL) is used for endotracheal intubation (ETI). We aimed to determine the most suitable laryngoscope blade in terms of time to ETI, ease of ETI, and the first-pass success rate. METHODS: American Society of Anesthesiologists Grade I and II patients undergoing surgery under general anesthesia were randomized into the MC and the King Vision VL groups in a 1:1 ratio. ETI was performed using either the MC (the MC group) or the King Vision VL (the VL group) with a COVID-19 barrier box. The first-pass intubation success rate, intubation time, and ease of ETI were analyzed. RESULTS: The first-pass success rate was higher in the MC group (P = 0.43). The mean duration of ETI was 33 s and 47 s in the MC group and VL group, respectively. The difference was statistically significant between the groups (P = 0.002). The ease of ETI was comparable between the groups (P = 0.57), and the Cormack-Lehane grade was significantly different between the groups (P = 0.0025). CONCLUSION: ETI duration was shorter in the MC group than in the VL group. Hence, a MC can be used along with a COVID-19 barrier box by experienced operators for the prevention of aerosol spread.

17.
BMJ Open ; 11(10): e050571, 2021 10 04.
Article in English | MEDLINE | ID: covidwho-1450604

ABSTRACT

OBJECTIVE: Large data on the clinical characteristics and outcome of COVID-19 in the Indian population are scarce. We analysed the factors associated with mortality in a cohort of moderately and severely ill patients with COVID-19 enrolled in a randomised trial on convalescent plasma. DESIGN: Secondary analysis of data from a Phase II, Open Label, Randomized Controlled Trial to Assess the Safety and Efficacy of Convalescent Plasma to Limit COVID-19 Associated Complications in Moderate Disease. SETTING: 39 public and private hospitals across India during the study period from 22 April to 14 July 2020. PARTICIPANTS: Of the 464 patients recruited, two were lost to follow-up, nine withdrew consent and two patients did not receive the intervention after randomisation. The cohort of 451 participants with known outcome at 28 days was analysed. PRIMARY OUTCOME MEASURE: Factors associated with all-cause mortality at 28 days after enrolment. RESULTS: The mean (SD) age was 51±12.4 years; 76.7% were males. Admission Sequential Organ Failure Assessment score was 2.4±1.1. Non-invasive ventilation, invasive ventilation and vasopressor therapy were required in 98.9%, 8.4% and 4.0%, respectively. The 28-day mortality was 14.4%. Median time from symptom onset to hospital admission was similar in survivors (4 days; IQR 3-7) and non-survivors (4 days; IQR 3-6). Patients with two or more comorbidities had 2.25 (95% CI 1.18 to 4.29, p=0.014) times risk of death. When compared with survivors, admission interleukin-6 levels were higher (p<0.001) in non-survivors and increased further on day 3. On multivariable Fine and Gray model, severity of illness (subdistribution HR 1.22, 95% CI 1.11 to 1.35, p<0.001), PaO2/FiO2 ratio <100 (3.47, 1.64-7.37, p=0.001), neutrophil lymphocyte ratio >10 (9.97, 3.65-27.13, p<0.001), D-dimer >1.0 mg/L (2.50, 1.14-5.48, p=0.022), ferritin ≥500 ng/mL (2.67, 1.44-4.96, p=0.002) and lactate dehydrogenase ≥450 IU/L (2.96, 1.60-5.45, p=0.001) were significantly associated with death. CONCLUSION: In this cohort of moderately and severely ill patients with COVID-19, severity of illness, underlying comorbidities and elevated levels of inflammatory markers were significantly associated with death. TRIAL REGISTRATION NUMBER: CTRI/2020/04/024775.


Subject(s)
COVID-19 , Adult , COVID-19/therapy , Humans , Immunization, Passive , India/epidemiology , Middle Aged , SARS-CoV-2
19.
World J Mens Health ; 39(4): 804-817, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1282705

ABSTRACT

PURPOSE: In response to the COVID-19 pandemic, the American Center for Reproductive Medicine (ACRM) transitioned its annual training in assisted reproductive technology (ART) from a hands-on, laboratory-based training course to a fully online training endorsed by the American College of Embryology. Here we describe our experience and assess the quality of an online training format based on participant outcomes for the first three modules of a planned series of online ART training. MATERIALS AND METHODS: These modules included manual semen analysis, sperm morphology and ancillary semen tests (testing for leukocytospermia, sperm vitality, and anti-sperm antibody screening). The virtual format consisted of lecture presentations featuring laboratory protocols with corresponding video demonstrations of routine techniques and best practices. Practical scenarios, troubleshooting, and clinical interpretation of laboratory results were also discussed. At the end of each module, an optional multiple choice question test was held as a prerequisite to obtain certification on the topics presented. Course quality was assessed using participant responses collected via online surveys. RESULTS: The digital delivery methods used were found to have largely or completely met the participants' expectations for all questions (>85%). The majority (>87%) of the participants either strongly agreed or agreed that the course content was well-structured with appropriate depth, and that their overall expectations of the course had been met. CONCLUSIONS: This training format appears to be a realistic teaching option to freely share highly specialized expertise and technical knowledge with participants from anywhere in the world with varying levels of competency or experience.

20.
J Pharm Bioallied Sci ; 13(Suppl 1): S696-S698, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1266822

ABSTRACT

BACKGROUND: Student psychological health has been an increasing concern. The COVID-19 pandemic situation has brought this vulnerable population into renewed focus. OBJECTIVE: Our study aims to conduct a timely assessment of the effects of the COVID-19 pandemic on the mental health of college graduates and postgraduates. METHODOLOGY: We conducted online survey with 550 students to understand the effects of the pandemic on their psychology and well-being. The data were analyzed through quantitative and qualitative methods. RESULTS: Of the 550 students, 138 (71%) indicated increased stress and anxiety due to the COVID-19 outbreak. When asked about how the lockdown in COVID-19 situation affecting them, 97% said that it is severely affecting them. When asked about what the problems do you faced during online class, 5% said the Internet, 83.8% said noninteractive, and 11.2% said lack of explanatory mediums. When asked about number of hours spent on the Internet, 100% said more than 10 h. When asked about the activities to keep yourself busy during lockdown in COVID-19 situation, 37% said social media followed by 23% who mentioned cooking. CONCLUSION: Due to the long-lasting pandemic situation and onerous measures such as lockdown and stay-at-home orders, the COVID-19 pandemic brings negative impacts on education. The findings of our study highlight the urgent need to develop interventions and preventive strategies to address the psychological health of college students.

SELECTION OF CITATIONS
SEARCH DETAIL