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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-310071

ABSTRACT

Background: Ibuprofen disappeared off the pharmacy shelves during the COVID-19 pandemic. However, a while later circulating information was that ibuprofen should be avoided as it could worsen COVID-19 symptoms. The aim of our study was to assess the association of NSAID acute and chronic use with worse COVID-19 outcomes. Methods: : We did a prospective cohort study between April 12 and June 1, 2020. Adults consecutively diagnosed with COVID-19 were included. Information on NSAID use was collected through a telephone questionnaire and patients were followed up for COVID-19 infection outcomes, including death, admission, severity, time to clinical improvement, oxygen requirement, and length of stay. Findings: Ibuprofen acute use was not associated with a greater risk of mortality relative to nonusers (adjusted hazard ratio (HR) 0·632 [95% CI, 0·073- 5·441;P=0·6758]). NSIAD chronic use was also not associated with greater risk of mortality (adjusted HR, 0·492 [95% CI, 0·178 - 1·362;P= 0·1721]). Ibuprofen acute use was not associated with a higher risk of admission compared to non-NSAID users (adjusted odds ratio OR, 1·271;95% CI, 0·548 - 2·953). NSAID users did not have a significantly longer time to clinical improvement, or length of stay. Interpretation: Ibuprofen and other NSAID acute or chronic use were not associated with worse COVID-19 disease outcomes.

2.
Indian J Crit Care Med ; 25(6): 691-698, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1270198

ABSTRACT

OBJECTIVES: This systematic review aims to provide insight into the outcome of extracorporeal membrane oxygenation (ECMO) and invasive mechanical ventilation use in critically ill COVID-19 patients. DATA SOURCES: Electronic databases PubMed Central and PubMed were searched from January 2020 to June 2020 for published studies about ECMO and/or invasive mechanical ventilation use in COVID-19 patients. Data Extraction and Study Selection: The search strategy retrieved 766 articles, of which 19 studies consisting of 204 patients fulfilled the inclusion criteria and were included in the analysis. DATA SYNTHESIS: Primary outcomes evaluated were discharge and/or clinical improvement and mortality rate. Secondary outcomes evaluated included reported complications and the mean number of days of hospitalization for survivors. Weighted averages of included studies were calculated, and data were pooled in forest plots. Nearly, 68.1% of the patients received invasive mechanical ventilation without ECMO support, and 31.9% were placed on ECMO. Also, 22.5% of the patients were discharged and/or clinically improved and 51.5% died. Twenty-six percent of the study population deteriorated but remained alive or experienced no improvement in clinical condition. And 75.2% of those who died belonged to the non-ECMO group and 24.8% to the ECMO group. The mortality rate in the non-ECMO group was 56.8% compared to 40% in the ECMO group. CONCLUSION: The utility of ECMO during a pandemic is uncertain as it is a resource-intensive modality, especially when the mortality rate in severely ill patients infected with COVID-19 virus is already known to be high. HOW TO CITE THIS ARTICLE: Nagraj S, Karia R, Hassanain S, Ghosh P, Shah VR, Thomas A. Role of Invasive Mechanical Ventilation and ECMO in the Management of COVID-19: A Systematic Review. Indian J Crit Care Med 2021;25(6):691-698.

3.
Science of The Total Environment ; : 146918, 2021.
Article in English | ScienceDirect | ID: covidwho-1164461

ABSTRACT

The Indo Gangetic Plain (IGP), one of the most densely populated regions of the world, is a global hotspot of anthropogenic aerosol emissions. In the pre-monsoon season (March-May), the strong westerlies carry transported dust aerosols along with anthropogenic aerosols onto the Bay of Bengal (BoB). The outflow from IGP modulates the aerosol loading and the aerosol direct radiative forcing (ADRF) over the BoB. The quantification of the anthropogenic aerosol impact on the radiative forcing over the outflow region remains inadequate. The enforced shutdown amid the COVID-19 pandemic eased the anthropogenic activities across the country, which helped to examine the magnitude and variability of aerosol loading and subsequent changes in ADRF over IGP and the outflow region of the BoB. Wind trajectory analysis illustrates that the ADRF over the BoB is greater during the days when the winds originated from the IGP region (at the surface -54.2±6.4 W m-2, at the top of the atmosphere, -26.9±3.4 W m-2 and on the atmosphere, 27.0±3.1 W m-2 ) compared to the seasonal average (-46.3±7.1 W m-2, -24.9±4.0 W m-2 and 20.6±3.2 W m-2, respectively). This indicates that anthropogenic aerosols emission in IGP can contribute an additional 31% of the atmospheric ADRF over the IGP outflow region of the BoB. The reduced aerosol loading during the shutdown period resulted in a reduction of ADRF at the surface, at the top of the atmosphere, and on the atmosphere over the IGP outflow region of the BoB by 22.0±3.1%, 20.9±3.4% and 23.2±3.3%, respectively. This resultant 20-25% reduction in ADRF over the IGP outflow region of BOB matches well with 10-25% reduction in aerosol optical depth (AOD) over the IGP during the shutdown period showing a robust coupling between IGP aerosol emissions and ADRF over the BoB.

4.
Urban Clim ; 36: 100791, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1062626

ABSTRACT

The enforced lockdown amid COVID-19 pandemic eased anthropogenic activities across India. The satellite-derived aerosol optical depth (AOD) and absorption AOD showed a significant reduction of ~30% over the Indo-Gangetic Basin (IGB) in north India during the lockdown period in 2020 with respect to the previous year 2019, when no such lockdown was in effect. Further, near-surface air pollutants were investigated at an urban megacity Delhi during 01 March to 31 May 2020. Except O3, a drastic reduction in PM10, PM2.5, NO, NO2 and CO concentrations were observed by ~58%, 47%, 76%, 68% and 58%, respectively during the lockdown period of 2020 as compared to 2019. While, O3 was low in the initial phase and gradually increased with progression of lockdown phases, the mean O3 during the entire lockdown period was nearly similar in both the years. Though, all the measured pollutants showed significant reduction during the entire lockdown, a phase-wise enhancement, associated with the conditional relaxations was observed in their concentrations. Thus, the present results may help, not only to assess the impact of outbreak on air quality, but also in designing the mitigation policies in urban megacities in more efficient ways to combat the air pollution problems.

5.
Front Psychiatry ; 11: 619540, 2020.
Article in English | MEDLINE | ID: covidwho-1058465

ABSTRACT

Objectives: The study aimed to assess the mental health outcomes and associated factors among health care workers during COVID 19 in Saudi Arabia. Design, Setting, and Participants: We conducted a cross-sectional survey of health care workers from tertiary care and ministry of health Centers across the Central, Eastern, and Western regions of Saudi Arabia. There were 1,130 participants in the survey, and we collected demographic and mental health measurements from the participants. Primary Outcomes and Measures: The magnitude of symptoms of depression, anxiety, and insomnia was measured using the original version of 9-item patient health questionnaire (PHQ-9), the 7-item generalized anxiety disorder scale (GAD-7), and 7-item insomnia severity index (ISI). We use the multiple logistic regression analysis to identify the associated risk factors of individual outcomes. Results: The scores on the PHQ-9 showed that the largest proportion of health care workers (76.93%) experienced only normal to mild depression (50.83 and 26.1%, respectively). The scores on the GAD-7 showed that the largest proportion of health care workers (78.88%) experienced minimal to mild anxiety (50.41 and 28.47%, respectively). The scores on the ISI showed that the largest proportion of health care workers (85.83%) experienced absence to subthreshold insomnia (57.08 and 28.75%, respectively). The risk factors for depression in health care workers were Saudi, living with family, working from an isolated room at home and frontline worker. For anxiety, being female was risk factor and for insomnia, being frontline worker was risk factor. Conclusion: It was observed that the symptoms of depression, anxiety, and insomnia were reported in a lower proportion of health care workers in our study. The participants who were female, frontline workers, Saudi, living with family, and working from home in isolated rooms were predisposed to developing psychological disorders.

6.
Infect Dis Ther ; 10(1): 253-268, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-898177

ABSTRACT

INTRODUCTION: Ibuprofen disappeared from the pharmacy shelves during the 2019 coronavirus (COVID-19) pandemic. However, a while later, information circulated that ibuprofen should be avoided as it could worsen COVID-19 symptoms. The aim of our study was to assess the association of acute and chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs) with worse COVID-19 outcomes. METHODS: We did a prospective cohort study between April 12 and June 1, 2020. Adults consecutively diagnosed with COVID-19 were included. Information on NSAID use was collected through a telephone questionnaire, and patients were followed up for COVID-19 infection outcomes, including death, admission, severity, time to clinical improvement, oxygen requirement and length of stay. RESULTS: Acute use of ibuprofen was not associated with a greater risk of mortality relative to non-use (adjusted hazard ratio [HR] 0.632 [95% CI 0.073-5.441; P = 0.6758]). Chronic NSAID use was also not associated with a greater risk of mortality (adjusted HR 0.492 [95% CI 0.178-1.362; P = 0.1721]). Acute ibuprofen use was not associated with a higher risk of admission compared to non-NSAID users (adjusted odds ratio OR 1.271; 95% CI 0.548-2.953). NSAID users did not have a significantly longer time to clinical improvement or length of stay. CONCLUSION: Acute or chronic use of ibuprofen and other NSAIDs was not associated with worse COVID-19 disease outcomes.

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