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1.
Communication Sciences and Disorders-Csd ; 27(1):239-250, 2022.
Article in English | Web of Science | ID: covidwho-1820504

ABSTRACT

Objectives: The Coronavirus Disease 2019 (COVID-19) led speech-language pathologists (SLPs) around the world to shift their service delivery methods from face-to-face service to telepractice.This study explored the implementation of telepractice by Malaysian SLPs and determined whether there was an association between the SLPs' perceptions of the effectiveness of telepractice and the frequency of the telepractice services provided, as well as between the use of telepractice and prior training received. Methods: Eighty-nine SLPs responded to an 18-question online survey that inquired about demographics, telepractice during the pandemic, perceptions of telepractice and prior training received. Results: Seventy-five percent of SLPs reported providing services via telepractice during the pandemic compared to 19% before the pandemic. Most SLPs who used telepractice stated that services delivered via telepractice were comparable with face-to-face services;no association was found between the frequency of providing services via telepractice and the SLPs' perceptions of its effectiveness.They had also received some training in telepractice, although no association was found between the type of training received and the provision of telepractice services. SLPs who did not provide services via telepractice reported awareness of telepractice but described a lack of knowledge, support, and training. All SLPs expressed interest to receive more training in telepractice to enable them to provide better services. Conclusion: Malaysian SLPs demonstrated great commitment towards service provision during the pandemic, similar to SLPs in other nations. It is hoped that Malaysian SLPs continue to have positive attitudes toward telepractice with increased familiarity, use, and training. Telepractice services, undoubtedly, are here to stay.

2.
PLoS Pathog ; 18(4):e1010465, 2022.
Article in English | PubMed | ID: covidwho-1817511

ABSTRACT

Although efficacious vaccines have significantly reduced the morbidity and mortality of COVID-19, there remains an unmet medical need for treatment options, which monoclonal antibodies (mAbs) can potentially fill. This unmet need is exacerbated by the emergence and spread of SARS-CoV-2 variants of concern (VOCs) that have shown some resistance to vaccine responses. Here we report the isolation of five neutralizing mAbs from an Indian convalescent donor, out of which two (THSC20.HVTR04 and THSC20.HVTR26) showed potent neutralization of SARS-CoV-2 VOCs at picomolar concentrations, including the Delta variant (B.1.617.2). One of these (THSC20.HVTR26) also retained activity against the Omicron variant. These two mAbs target non-overlapping epitopes on the receptor-binding domain (RBD) of the spike protein and prevent virus attachment to its host receptor, human angiotensin converting enzyme-2 (hACE2). Furthermore, the mAb cocktail demonstrated protection against the Delta variant at low antibody doses when passively administered in the K18 hACE2 transgenic mice model, highlighting their potential as a cocktail for prophylactic and therapeutic applications. Developing the capacity to rapidly discover and develop mAbs effective against highly transmissible pathogens like coronaviruses at a local level, especially in a low- and middle-income country (LMIC) such as India, will enable prompt responses to future pandemics as an important component of global pandemic preparedness.

3.
Journal of Medical Education and Curricular Development ; 9:238212052210963-238212052210963, 2022.
Article in English | PMC | ID: covidwho-1817154

ABSTRACT

Conflict medicine is an age-old branch of medicine which focuses on delivering healthcare services to the injured in the setting of conflicts, wars, disasters, and/or other calamities. The course in its purest form has been traditionally given only in military medical schools while civilian medical students are usually taught parts of the course in other overlapping subjects like surgery, infectious diseases, etc. However, in a crisis situation, civilian doctors are expected to double up as military doctors, which leads to emotional, mental, and physical stress for the civilian doctors along with logistical and organizational challenges. The current Covid-19 pandemic and the Russo-Ukrainian conflict have highlighted once again the emergent need for the implementation of conflict medicine courses in regular medical curricula, so as to make the medical students situation-ready. With our present discussion, we aim to provide a brief overview of the course, its core modules, challenges to its implementation, and possible solutions. We believe that the complex management skills gained by this course are not only useful in conflict scenario but are also valuable in managing day-to-day medical emergencies.

4.
Geriatric Orthopaedic Surgery and Rehabilitation ; 12:76-77, 2021.
Article in English | EMBASE | ID: covidwho-1817117

ABSTRACT

Introduction: COVID-19 has led to a change in the health-seeking behaviour and the delivery of healthcare. Globally, fragility fracture admissions have reduced by 0-54% depending on location. When Malaysia implemented the third movement control order on 3 May 2021 in response to increasing COVID-19 cases, the number of orthopaedic beds in the University Malaya Medical Centre was reduced from over a hundred to twenty-eight. To date, the impact of COVID-19 on fragility fracture admission in Malaysia is unknown. This study aims to investigate the relationship between COVID-19 cases and fragility fracture admissions to a tertiary hospital in Malaysia. Methods: This retrospective study was conducted from April to June 2021 in the University Malaya Medical Centre. The patients admitted to the University Malaya Medical Centre with fragility fractures between April and June 2021 were identified and compared to the corresponding periods in 2018. Patients <50 years old and those who had fractures due to cancer were excluded. The relationship between the total number of COVID-19 cases per week and weekly fragility fractures admissions were determined. Results: A total of 406,479 COVID-19 cases were reported over 3 months (April, n = 63,213;May, n = 163,644;June, n = 179,622). Fifty-five patients [mean age (78.9±8.6), female (44/55,80%), hip fractures (36/55,65.5%)] were admitted in April-June 2021, which was a 35.3% reduction when compared to the same period in 2018 [n = 85, mean age (75.1±9.9), female (62/85,72.9%), hip fractures (53/85,62.4%)], although no significant difference was found between the baseline characteristics. However, both fragility fracture and hip fracture admissions were found to be negatively correlated (r =-0.76 and r =-0.75) with the COVID-19 cases (P < 0.01). Twelve (12/51,23.5%) patients admitted in 2021 due to post-fall fragility fractures presented to the hospital more than a day after their injury. The proportion of patients with delayed presentation (>1 day post-fall) increased over the study period (April = 5/26, 19.2%;May = 3/13, 23.1%;June = 4/12, 33.3%). Conclusion: There was a reduction in fragility fracture admissions during the COVID outbreak in Malaysia. There might be a rebound in cases after the COVID crisis is over, reorganising medical services may be warranted to ensure effective fracture care delivery.

5.
Therapeutic Apheresis & Dialysis: Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy ; 26(3):566-582, 2022.
Article in English | MEDLINE | ID: covidwho-1816498

ABSTRACT

COVID-19 has challenged the global healthcare system through rapid proliferation and lack of existing treatment resulting in over 180 million cases and 3.8 million deaths since December 2019. Although pediatric patients only comprise 1%-2% of diagnosed cases, their incidence of acute kidney injury ranges from 8.2% to 18.2% compared to 49% in adults. Severe infection, initiated by dysregulated host response, can lead to multiorgan failure. In this review, we focus on the use of various blood filters approved for use in pediatric kidney replacement therapy to mitigate adverse effects of severe illness. Therapeutic effects of these blood filters range from cytokine removal (CytoSorb, HA330, HCO/MCO), endotoxin removal (Toraymyxin, CPFA), both cytokine and endotoxin removal (oXiris), and nonspecific removal of proteins (PMMA) that have already been established and can be used to mitigate the various effects of the cytokine storm syndrome in COVID-19.

6.
Clinical Neurosurgery ; 68(SUPPL 1):141, 2022.
Article in English | EMBASE | ID: covidwho-1812787

ABSTRACT

INTRODUCTION: Second wave of covid19 affected India significantly with total numbers of cases 31,440,950 and total death 4,21,224. As India acheived stablity in fight against covid, another challenge emerged in the form of Mucormycosis. Mucormycosis is a serious angioinvasive infection caused by the order Mucorales and class of Mucormycetes. It is associated with high mortality in immunocompromised mainly diabetic patients if not treated agressively. METHODS: Our Hospital, IGIMS was declared exclusive covid facility in April 2021 and subsequently was declared dedicated hospital for Mucormycosis.During this two month period demographic, Clinical details and outcome were collected prospectively. RESULTS: During two month period, 500 cases were seen in OPD, 300 patients were admitted and 120 patients were operated. 47 patients have cerebral involvement. 11 patients with extensive involvement of brain including cavernous sinus were not offered surgery, because of poor pronosis. 4 patients of this group improved 5 patients died and 2 patients were discharged in moribund condition. Another 26 patients with only meningeal involvement and small lesion, with no mass effect and was treated conservatively. 16 of this group improved, Four (with poor coma score expired. Another 4 patients were transferred to other medical facilities and details of these patients are not available. 10 patients having large fungal lesion in non eloquent area along with mass effect were operated. six patients were operated with microscopic technique and 4 patients with endoscopic technique. eight patients were earlier, Covid RT-PCR positive and was treated with steroid and oxygen inhalation. Another two patient had fever , but Covid RT-PCR was negative and was treated at home with oxygen cylinder.All of them were treated with liposomal amphotrecin B. Sinus surgery was performed in all patients. Eight patient did well and was discharged from hospital in good condition. One patient, in which endoscopic cerebral exploration was done expired. Another patient was discharged with severe neurological sequlae. CONCLUSIONS: Patients with Rhincerebral Mucormycosis spreading outside sinonasal cavity to the base of the brain can be treated by neurosurgical intervention.

7.
Journal of Forensic Medicine and Toxicology ; 38(1):98-101, 2021.
Article in English | Scopus | ID: covidwho-1811180

ABSTRACT

COVID-19 leads to a serious impact on health of people worldwide which not only as a direct consequence of the infection but also due to the measures taken to reduce its transmission. The present study was conducted at Government Medical College Patiala .The aim of our study was to identify and compare the characteristics of cases referred for autopsy during the lockdown period for the COVID-19 First wave 2020, Second wave 2021 and the same period in year 2019.There was fall of 34.3 % and 24.7% in no. of postmortem cases in year 2020 and 2021 respectively when compared to 2019. During all periods 21-40 age group is most vulnerable. There is substantial fall in road traffic accident causalities during lockdown period. Rise in no. of suicides is seen in lockdown period while there is not much change seen in no. of assault cases. India needs to implement evidence-based road safety interventions, promote strong policies and traffic law enforcement, have better road and vehicle design, and improve care for road injuries. The patterns for suicide are alarming. There is urgency for implementing a comprehensive response service for mental health during the pandemic. © 2021, Medico Legal Society. All rights reserved.

8.
J Adv Nurs ; 2022.
Article in English | PubMed | ID: covidwho-1807148

ABSTRACT

AIMS: To identify strategies used by registered nurses and non-registered nursing care staff in overcoming barriers when providing fundamental nursing care for non-invasively ventilated inpatients with COVID-19. DESIGN: Online survey with open-ended questions to collect qualitative data. METHODS: In August 2020, we asked UK-based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non-invasively ventilated patients with COVID-19. We analysed data using Framework Analysis. RESULTS: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non-verbal communication with patients, using information technology to enable patients' significant others to communicate with staff and patients, and establishing clear information-sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self-care and using 'runners' and interdisciplinary input. 3) Addressing patients' well-being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients' wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. CONCLUSIONS: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well-being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. IMPACT: As these strategies are unlikely to be exclusive to the COVID-19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial.

9.
J Biomol Struct Dyn ; : 1-18, 2022.
Article in English | PubMed | ID: covidwho-1805901

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused appalling conditions over the globe, which is currently faced by the entire human population. One of the primary reasons behind the uncontrollable situation is the lack of specific therapeutics. In such conditions, drug repurposing of available drugs (viz. Chloroquine, Lopinavir, etc.) has been proposed, but various clinical and preclinical investigations indicated the toxicity and adverse side effects of these drugs. This study explores the inhibition potency of phytochemicals from Tinospora cordifolia (Giloy) against SARS CoV-2 drugable targets (spike glycoprotein and M(pro) proteins) using molecular docking and MD simulation studies. ADMET, virtual screening, MD simulation, postsimulation analysis (RMSD, RMSF, Rg, SASA, PCA, FES) and MM-PBSA calculations were carried out to predict the inhibition efficacy of the phytochemicals against SARS CoV-2 targets. Tinospora compounds showed better binding affinity than the corresponding reference. Their binding affinity ranges from -9.63 to -5.68 kcal/mole with spike protein and -10.27 to -7.25 kcal/mole with main protease. Further 100 ns exhaustive simulation studies and MM-PBSA calculations supported favorable and stable binding of them. This work identifies Nine Tinospora compounds as potential inhibitors. Among those, 7-desacetoxy-6,7-dehydrogedunin was found to inhibit both spike (7NEG) and Mpro (7MGS and 6LU7) proteins, and Columbin was found to inhibit selected spike targets (7NEG and 7NX7). In all the analyses, these compounds performed well and confirms the stable binding. Hence the identified compounds, advocated as potential inhibitors can be taken for further in vitro and in vivo experimental validation to determine their anti-SARS-CoV-2 potential.Communicated by Ramaswamy H. Sarma.

10.
Acs Applied Bio Materials ; 5(2):483-491, 2022.
Article in English | Web of Science | ID: covidwho-1805546

ABSTRACT

Interleukin-mediated deep cytokine storm, an aggressive inflammatory response to SARS-CoV-2 virus infection in COVID-19 patients, is correlated directly with lung injury, multi-organ failure, and poor prognosis of severe COVID-19 patients. Curcumin (CUR), a phenolic antioxidant compound obtained from turmeric (Curcuma longa L.), is well-known for its strong anti-inflammatory activity. However, its in vivo efficacy is constrained due to poor bioavailability. Herein, we report that CUR-encapsulated polysaccharide nanoparticles (CUR-PS-NPs) potently inhibit the release of cytokines, chemokines, and growth factors associated with damage of SARS-CoV-2 spike protein (CoV2-SP)-stimulated liver Huh7.5 and lung A549 epithelial cells. Treatment with CUR-PS-NPs effectively attenuated the interaction of ACE2 and CoV2-SP. The effects of CUR-PS-NPs were linked to reduced NF-kappa B/MAPK signaling which in turn decreased CoV2-SP-mediated phosphorylation of p38 MAPK, p42/44 MAPK, and p65/NF-kappa B as well as nuclear p65/NF-kappa B expression. The findings of the study strongly indicate that organic NPs of CUR can be used to control hyper-inflammatory responses and prevent lung and liver injuries associated with CoV2-SP-mediated cytokine storm.

11.
JAMA Netw Open ; 5(4):e228855, 2022.
Article in English | PubMed | ID: covidwho-1801991

ABSTRACT

IMPORTANCE: The COVID-19 pandemic has impacted cancer systems worldwide. Quantifying the changes is critical to informing the delivery of care while the pandemic continues, as well as for system recovery and future pandemic planning. OBJECTIVE: To quantify change in the delivery of cancer services across the continuum of care during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study assessed cancer screening, imaging, diagnostic, treatment, and psychosocial oncological care services delivered in pediatric and adult populations in Ontario, Canada (population 14.7 million), from April 1, 2019, to March 1, 2021. Data were analyzed from May 1 to July 31, 2021. EXPOSURES: COVID-19 pandemic. MAIN OUTCOMES AND MEASURES: Cancer service volumes from the first year of the COVID-19 pandemic, defined as April 1, 2020, to March 31, 2021, were compared with volumes during a prepandemic period of April 1, 2019, to March 31, 2020. RESULTS: During the first year of the pandemic, there were a total of 4 476 693 cancer care services, compared with 5 644 105 services in the year prior, a difference of 20.7% fewer services of cancer care, representing a potential backlog of 1 167 412 cancer services. While there were less pronounced changes in systemic treatments, emergency and urgent imaging examinations (eg, 1.9% more parenteral systemic treatments) and surgical procedures (eg, 65% more urgent surgical procedures), major reductions were observed for most services beginning in March 2020. Compared with the year prior, during the first pandemic year, cancer screenings were reduced by 42.4% (-1 016 181 screening tests), cancer treatment surgical procedures by 14.1% (-8020 procedures), and radiation treatment visits by 21.0% (-141 629 visits). Biopsies to confirm cancer decreased by up to 41.2% and surgical cancer resections by up to 27.8% during the first pandemic wave. New consultation volumes also decreased, such as for systemic treatment (-8.2%) and radiation treatment (-9.3%). The use of virtual cancer care increased for systemic treatment and radiation treatment and psychosocial oncological care visits, increasing from 0% to 20% of total new or follow-up visits prior to the pandemic up to 78% of total visits in the first pandemic year. CONCLUSIONS AND RELEVANCE: In this population-based cohort study in Ontario, Canada, large reductions in cancer service volumes were observed. While most services recovered to prepandemic levels at the end of the first pandemic year, a substantial care deficit likely accrued. The anticipated downstream morbidity and mortality associated with this deficit underscore the urgent need to address the backlog and recover cancer care and warrant further study.

12.
Economic and Political Weekly ; 57(14):43-50, 2022.
Article in English | Scopus | ID: covidwho-1801684

ABSTRACT

The information technology and information technology-enabled services sector in India have largely been opaque, with little known about its social profile, work conditions, and office culture. The sector hides its everyday workings behind massive revenue figures and the number of jobs in the organised sector it has created. What slips through the cracks is the precarious nature of these permanent jobs and the shocking ineffectiveness of employee protections. These vulnerabilities, built into the employment and work culture of the sector, acquired a nightmarish quality during the COVID-19 pandemic. With most IT companies being forced to shift their employees to work-from-home formats, it is crucial to study how these vulnerabilities have affected the latter. This paper draws upon media reports, a short online survey, and telephonic interviews to highlight the working conditions in the IT and ITeS sector, the experience of working from home, and the overall state of its permanent employment. © 2022 Economic and Political Weekly. All rights reserved.

13.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333839

ABSTRACT

SARS-CoV-2 infections elicit both humoral and cellular immune responses. For the prevention and treatment of COVID19, the disease caused by SARS-CoV-2, T cell responses are important in mediating recovery and immune-protection. The identification of immunogenic epitopes that can elicit a meaningful T cell response can be elusive. Traditionally, this has been achieved using sophisticated in silico methods to predict putative epitopes;however, our previous studies find that 'immunodominant' SARS-CoV-2 peptides defined by such in silico methods often fail to elicit T cell responses recognizing SARS-CoV-2. We postulated that immunogenic epitopes for SARS-CoV-2 are best defined by directly analyzing peptides eluted from the peptide-MHC complex and then validating immunogenicity empirically by determining if such peptides can elicit T cells recognizing SARS-CoV-2 antigen-expressing cells. Using a tandem mass spectrometry approach, we identified epitopes of SARS-CoV-2 derived not only from structural but also non-structural genes in regions highly conserved among SARS-CoV-2 strains including recently recognized variants. We report here, for the first time, several novel SARS-CoV-2 epitopes from membrane glycol-protein (MGP) and non-structure protein-13 (NSP13) defined by mass-spectrometric analysis of MHC-eluted peptides, provide empiric evidence for their immunogenicity to induce T cell response. SIGNIFICANCE STATEMENT: Current state of the art uses putative epitope peptides based on in silico prediction algorithms to evaluate the T cell response among COVID-19 patients. However, none of these peptides have been tested for immunogenicity, i.e. the ability to elicit a T cell response capable of recognizing endogenously presented peptide. In this study, we used MHC immune-precipitation, acid elution and tandem mass spectrometry to define the SARS-CoV-2 immunopeptidome for membrane glycol-protein and the non-structural protein. Furthermore, taking advantage of a highly robust endogenous T cell (ETC) workflow, we verify the immunogenicity of these MS-defined peptides by in vitro generation of MGP and NSP13 peptide-specific T cells and confirm T cell recognition of MGP or NSP13 endogenously expressing cell lines.

14.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333637

ABSTRACT

Coronaviruses have caused multiple epidemics in the past two decades, in addition to the current COVID-19 pandemic that is severely damaging global health and the economy. Coronaviruses employ between twenty and thirty proteins to carry out their viral replication cycle including infection, immune evasion, and replication. Among these, nonstructural protein 16 (Nsp16), a 2'-O-methyltransferase, plays an essential role in immune evasion. Nsp16 achieves this by mimicking its human homolog, CMTr1, which methylates mRNA to enhance translation efficiency and distinguish self from other. Unlike human CMTr1, Nsp16 requires a binding partner, Nsp10, to activate its enzymatic activity. The requirement of this binding partner presents two questions that we investigate in this manuscript. First, how does Nsp10 activate Nsp16? While experimentally-derived structures of the active Nsp16/Nsp10 complex exist, structures of inactive, monomeric Nsp16 have yet to be solved. Therefore, it is unclear how Nsp10 activates Nsp16. Using over one millisecond of molecular dynamics simulations of both Nsp16 and its complex with Nsp10, we investigate how the presence of Nsp10 shifts Nsp16's conformational ensemble in order to activate it. Second, guided by this activation mechanism and Markov state models (MSMs), we investigate if Nsp16 adopts inactive structures with cryptic pockets that, if targeted with a small molecule, could inhibit Nsp16 by stabilizing its inactive state. After identifying such a pocket in SARS-CoV-2 Nsp16, we show that this cryptic pocket also opens in SARS-CoV-1 and MERS, but not in human CMTr1. Therefore, it may be possible to develop pan-coronavirus antivirals that target this cryptic pocket. STATEMENT OF SIGNIFICANCE: Coronaviruses are a major threat to human health. These viruses employ molecular machines, called proteins, to infect host cells and replicate. Characterizing the structure and dynamics of these proteins could provide a basis for designing small molecule antivirals. In this work, we use computer simulations to understand the moving parts of an essential SARS-CoV-2 protein, understand how a binding partner turns it on and off, and identify a novel pocket that antivirals could target to shut this protein off. The pocket is also present in other coronaviruses but not in the related human protein, so it could be a valuable target for pan-coronavirus antivirals.

15.
International Journal of Infectious Diseases ; 116:S61-S61, 2022.
Article in English | Web of Science | ID: covidwho-1799941
16.
Evans, R. A.; Leavy, O. C.; Richardson, M.; Elneima, O.; McCauley, H. J. C.; Shikotra, A.; Singapuri, A.; Sereno, M.; Saunders, R. M.; Harris, V. C.; Houchen-Wolloff, L.; Aul, R.; Beirne, P.; Bolton, C. E.; Brown, J. S.; Choudhury, G.; Diar-Bakerly, N.; Easom, N.; Echevarria, C.; Fuld, J.; Hart, N.; Hurst, J.; Jones, M. G.; Parekh, D.; Pfeffer, P.; Rahman, N. M.; Rowland-Jones, S. L.; Shah, A. M.; Wootton, D. G.; Chalder, T.; Davies, M. J.; De Soyza, A.; Geddes, J. R.; Greenhalf, W.; Greening, N. J.; Heaney, L. G.; Heller, S.; Howard, L. S.; Jacob, J.; Jenkins, R. G.; Lord, J. M.; Man, W. D. C.; McCann, G. P.; Neubauer, S.; Openshaw, P. J. M.; Porter, J. C.; Rowland, M. J.; Scott, J. T.; Semple, M. G.; Singh, S. J.; Thomas, D. C.; Toshner, M.; Lewis, K. E.; Thwaites, R. S.; Briggs, A.; Docherty, A. B.; Kerr, S.; Lone, N. I.; Quint, J.; Sheikh, A.; Thorpe, M.; Zheng, B.; Chalmers, J. D.; Ho, L. P.; Horsley, A.; Marks, M.; Poinasamy, K.; Raman, B.; Harrison, E. M.; Wain, L. V.; Brightling, C. E.; Abel, K.; Adamali, H.; Adeloye, D.; Adeyemi, O.; Adrego, R.; Aguilar Jimenez, L. A.; Ahmad, S.; Ahmad Haider, N.; Ahmed, R.; Ahwireng, N.; Ainsworth, M.; Al-Sheklly, B.; Alamoudi, A.; Ali, M.; Aljaroof, M.; All, A. M.; Allan, L.; Allen, R. J.; Allerton, L.; Allsop, L.; Almeida, P.; Altmann, D.; Alvarez Corral, M.; Amoils, S.; Anderson, D.; Antoniades, C.; Arbane, G.; Arias, A.; Armour, C.; Armstrong, L.; Armstrong, N.; Arnold, D.; Arnold, H.; Ashish, A.; Ashworth, A.; Ashworth, M.; Aslani, S.; Assefa-Kebede, H.; Atkin, C.; Atkin, P.; Aung, H.; Austin, L.; Avram, C.; Ayoub, A.; Babores, M.; Baggott, R.; Bagshaw, J.; Baguley, D.; Bailey, L.; Baillie, J. K.; Bain, S.; Bakali, M.; Bakau, M.; Baldry, E.; Baldwin, D.; Ballard, C.; Banerjee, A.; Bang, B.; Barker, R. E.; Barman, L.; Barratt, S.; Barrett, F.; Basire, D.; Basu, N.; Bates, M.; Bates, A.; Batterham, R.; Baxendale, H.; Bayes, H.; Beadsworth, M.; Beckett, P.; Beggs, M.; Begum, M.; Bell, D.; Bell, R.; Bennett, K.; Beranova, E.; Bermperi, A.; Berridge, A.; Berry, C.; Betts, S.; Bevan, E.; Bhui, K.; Bingham, M.; Birchall, K.; Bishop, L.; Bisnauthsing, K.; Blaikely, J.; Bloss, A.; Bolger, A.; Bonnington, J.; Botkai, A.; Bourne, C.; Bourne, M.; Bramham, K.; Brear, L.; Breen, G.; Breeze, J.; Bright, E.; Brill, S.; Brindle, K.; Broad, L.; Broadley, A.; Brookes, C.; Broome, M.; Brown, A.; Brown, A.; Brown, J.; Brown, J.; Brown, M.; Brown, M.; Brown, V.; Brugha, T.; Brunskill, N.; Buch, M.; Buckley, P.; Bularga, A.; Bullmore, E.; Burden, L.; Burdett, T.; Burn, D.; Burns, G.; Burns, A.; Busby, J.; Butcher, R.; Butt, A.; Byrne, S.; Cairns, P.; Calder, P. C.; Calvelo, E.; Carborn, H.; Card, B.; Carr, C.; Carr, L.; Carson, G.; Carter, P.; Casey, A.; Cassar, M.; Cavanagh, J.; Chablani, M.; Chambers, R. C.; Chan, F.; Channon, K. M.; Chapman, K.; Charalambou, A.; Chaudhuri, N.; Checkley, A.; Chen, J.; Cheng, Y.; Chetham, L.; Childs, C.; Chilvers, E. R.; Chinoy, H.; Chiribiri, A.; Chong-James, K.; Choudhury, N.; Chowienczyk, P.; Christie, C.; Chrystal, M.; Clark, D.; Clark, C.; Clarke, J.; Clohisey, S.; Coakley, G.; Coburn, Z.; Coetzee, S.; Cole, J.; Coleman, C.; Conneh, F.; Connell, D.; Connolly, B.; Connor, L.; Cook, A.; Cooper, B.; Cooper, J.; Cooper, S.; Copeland, D.; Cosier, T.; Coulding, M.; Coupland, C.; Cox, E.; Craig, T.; Crisp, P.; Cristiano, D.; Crooks, M. G.; Cross, A.; Cruz, I.; Cullinan, P.; Cuthbertson, D.; Daines, L.; Dalton, M.; Daly, P.; Daniels, A.; Dark, P.; Dasgin, J.; David, A.; David, C.; Davies, E.; Davies, F.; Davies, G.; Davies, G. A.; Davies, K.; Dawson, J.; Daynes, E.; Deakin, B.; Deans, A.; Deas, C.; Deery, J.; Defres, S.; Dell, A.; Dempsey, K.; Denneny, E.; Dennis, J.; Dewar, A.; Dharmagunawardena, R.; Dickens, C.; Dipper, A.; Diver, S.; Diwanji, S. N.; Dixon, M.; Djukanovic, R.; Dobson, H.; Dobson, S. L.; Donaldson, A.; Dong, T.; Dormand, N.; Dougherty, A.; Dowling, R.; Drain, S.; Draxlbauer, K.; Drury, K.; Dulawan, P.; Dunleavy, A.; Dunn, S.; Earley, J.; Edwards, S.; Edwardson, C.; El-Taweel, H.; Elliott, A.; Elliott, K.; Ellis, Y.; Elmer, A.; Evans, D.; Evans, H.; Evans, J.; Evans, R.; Evans, R. I.; Evans, T.; Evenden, C.; Evison, L.; Fabbri, L.; Fairbairn, S.; Fairman, A.; Fallon, K.; Faluyi, D.; Favager, C.; Fayzan, T.; Featherstone, J.; Felton, T.; Finch, J.; Finney, S.; Finnigan, J.; Finnigan, L.; Fisher, H.; Fletcher, S.; Flockton, R.; Flynn, M.; Foot, H.; Foote, D.; Ford, A.; Forton, D.; Fraile, E.; Francis, C.; Francis, R.; Francis, S.; Frankel, A.; Fraser, E.; Free, R.; French, N.; Fu, X.; Furniss, J.; Garner, L.; Gautam, N.; George, J.; George, P.; Gibbons, M.; Gill, M.; Gilmour, L.; Gleeson, F.; Glossop, J.; Glover, S.; Goodman, N.; Goodwin, C.; Gooptu, B.; Gordon, H.; Gorsuch, T.; Greatorex, M.; Greenhaff, P. L.; Greenhalgh, A.; Greenwood, J.; Gregory, H.; Gregory, R.; Grieve, D.; Griffin, D.; Griffiths, L.; Guerdette, A. M.; Guillen Guio, B.; Gummadi, M.; Gupta, A.; Gurram, S.; Guthrie, E.; Guy, Z.; H Henson, H.; Hadley, K.; Haggar, A.; Hainey, K.; Hairsine, B.; Haldar, P.; Hall, I.; Hall, L.; Halling-Brown, M.; Hamil, R.; Hancock, A.; Hancock, K.; Hanley, N. 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The Lancet Respiratory Medicine ; 2022.
Article in English | ScienceDirect | ID: covidwho-1799635

ABSTRACT

Summary Background No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge. Methods The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing. Findings 2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7–9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46–0·99]), obesity (0·50 [0·34–0·74]) and invasive mechanical ventilation (0·42 [0·23–0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment;0·88 [IQR 0·74–1·00]), at 5 months (0·74 [0·64–0·88]) to 1 year (0·75 [0·62–0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters. Interpretation The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials. Funding

17.
Medical Journal Armed Forces India ; 2022.
Article in English | ScienceDirect | ID: covidwho-1796301

ABSTRACT

Background Despite having an effective COVID-19 vaccine, the COVID-19 pandemic is far from over and the delta variant continues to cause havoc across several continents. The present study was conducted to analyze and describe the occurrence of COVID-19 cases among completely vaccinated individuals. Methods In an educational institute in Western Maharashtra, we analyzed a cluster of RTPCR positive COVID-19 cases among fully vaccinated students which occurred in 12 days. The cases were linked to a series of curricular and co-curricular events in the institute. A detailed epidemiological investigation and genome sequencing of cases were conducted. IgG antibodies against S1 protein of novel SARS-CoV-2 were estimated for cases and age, sex, and vaccination status matched controls. Results All 37 identified cases were mild COVID. 188 high risk (HR) contacts of the cases were identified. The overall secondary attack was 9.5%. Out of 31 cases and 50 controls, 09 (29%) cases and 08 (16%) controls were found to have IgG antibodies against S1 protein of novel SARS-CoV-2 titer of more than 60 U/ml. Whole-genome sequencing of 15 samples of the cluster showed the presence of the Delta variant of SARS-CoV-2. No correlation was observed between Ct value and IgG S1 antibody titers. Conclusion The study provides significant evidence that only vaccination alone does not completely protect against SARS-CoV-2 B.1.617.2 (Delta) variant infection. An all-encompassing multicomponent strategy involving implementation of NPIs, robust contact tracing, early identification and isolation of cases, and high vaccination coverage is the way forward for the prevention of COVID-19.

19.
Cureus Journal of Medical Science ; 14(3):16, 2022.
Article in English | Web of Science | ID: covidwho-1791843

ABSTRACT

Background and objective Ever since its emergence in December 2019, coronavirus disease 2019 (COVID-19) has affected more than 220 million people worldwide, resulting in more than 45 million deaths. The present autopsy-based study was undertaken to understand the pathophysiology of the disease and correlate the histopathological and virological findings with the antemortem clinical and biochemical determinants. Methods In this prospective observational study, autopsies were carried out on 21 reverse transcription-polymerase chain reaction (RT-PCR)-proven COVID-19 patients who had died of the disease. The histopathological findings of tissue samples from lungs, liver, and kidneys collected during the autopsy were graded based on their presence or absence;if present, they were graded as either focal or diffuse. The findings were correlated with antemortem clinical and biochemical findings. Postmortem tissue RT-PCR analysis was conducted, and findings were compared with postmortem histopathological findings. Results There was multisystem involvement with the COVID-19 cases. The involvement of lungs was observed in most of the cases (90.4%). The presence of viral RNA was observed in all the organs including the liver (57.1%) and kidney (66.6%). An association was observed between antemortem biochemical parameters [aspartate aminotransferase (AST), alanine aminotransferase (ALT)] and the histopathological features in the liver. No correlation between the Sequential Organ Failure Assessment (SOFA) score recorded clinically and lung histopathology was observed;nor was there any correlation between blood urea-creatinine levels and kidney histopathology. Conclusions Our study shows that COVID-19 is a multisystemic disease and the mortality associated with it is likely to be multifactorial. Despite the presence of amplifiable severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in various organs, no association could be established between the clinical and histopathology findings. Neither the duration of hospitalization nor the duration of mechanical ventilation showed any correlation with the severity of histopathological findings in the lungs at autopsy.

20.
19th Orissa Information Technology Society International Conference on Information Technology, OCIT 2021 ; : 319-324, 2021.
Article in English | Scopus | ID: covidwho-1788763

ABSTRACT

The outbreak of COVID-19 pandemic has resulted in a devastating impact all around the world. The social distancing protocol has become the compulsory preventive measures in many countries for the purpose of avoiding physical contacts with other persons. This paper presents a drone based surveillance approach that uses Computer Vision and Deep Learning based techniques to check if two persons are violating social distancing norms. The implementation has been done using a Raspberry Pi based Drone where the camera captures the video from a height and detects the persons who are in near proximity with the help of an object detection algorithm and computes the distance between two persons in order to check whether they lie near to each other. The Euclidean distance between the two persons is calculated which is then compared with the given margin distance. If the distance is found to be below the margin., local authorities or law enforcement agencies can be notified through an automatically generated email alert. © 2021 IEEE.

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