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1.
Polimery/Polymers ; JOUR(7-8):355-374, 67.
Article in English | Scopus | ID: covidwho-2090963

ABSTRACT

Because of the present pandemic researchers are seeking for phytocandidates that can inhibit or stop SARS-CoV-2. The main protease (Mpro) of SARS-CoV-2 and spike glycoprotein (S) are both suppressed by bioactive compounds found in plants that work by docking them together. The Mpro proteins 6LU7 (complex with an inhibitor N3) and 5C3N (space group C2221) were employed in docking research. PyRx and AutoDock Vina software were used as docking engine. 22 identified phytoconstituents were selected from IMPPAT, a manually curated database, on the basis of their antiviral effects. Docking studies showed that phytoconstituents β-amyrin (-8.4 kcal/mol), withaferin A (-8.3 kcal/mol), oleanolic acid (-7.8 kcal/mol), and patentiflorin A (-8.1 kcal/mol) had the best results against 5C3N Mpro protein whereas kuwanon L (-7.1 kcal/mol), β-amyrin (-6.9 kcal/mol), oleanolic acid (-6.8 kcal/mol), cucurbitacin D (-6.5 kcal/mol), and quercetin (-6.5 kcal/mol) against 6LU7 Mpro protein. All the compounds were examined for their ADMET characteristics using SwissDock. Present research reports that the phytoconstituents along with docking score will be helpful for future drug development against Covid-19. © 2022 Industrial Chemistry Research Institute. All rights reserved.

2.
Journal of Clinical and Experimental Hepatology ; 12:S30, 2022.
Article in English | EMBASE | ID: covidwho-1996318

ABSTRACT

Background and Aim: Hepatic encephalopathy (HE) in acute-on-chronic liver failure (ACLF) is associated with significant morbidity and mortality. There is limited evidence regarding HE management in patients with ACLF. We conducted a prospective, randomized controlled clinical trial to study the efficacy of intravenous branched chain amino acids (IV-BCAA) with lactulose versus lactulose alone for improvement in HE at 24h, day 3 & day 7. Duration of ICU stay and survival at days 7 and 28 was compared. Methods: CANONIC ACLF patients with HE grades>=2 were randomized into two groups - experimental arm (IV-BCAA - 500mL/day for 3 days + Lactulose;n=39) and comparator arm (Lactulose alone;n=37). Six patients developed COVID-19 after randomization & were excluded (4-experimental arm & 2-comparator arm). HE Grade was assessed by West Haven Classification and Hepatic Encephalopathy Scoring Algorithm (HESA). ACLF severity was determined by CLIF-C ACLF and MELD scores. All patients received standard of care. Results: Both groups were similar in baseline characteristics including grade of HE (2.85 ± 0.75 vs 2.82 ± 0.66;P = 0.864) and CLIF-C ACLF score (54.19 ± 5.55 vs 54.79 ± 5.74;P = 0.655). Overall survival was 40% at 28 days (48.5% vs 31.4%;P=0.143). Significant improvement in HESA score by 1 grade at 24h was seen in 14 patients (40%) in BCAA arm and 6 patients (17.14%) in control group (P=0.034) which translated to shorter ICU stay in the BCAA arm. Median change in HESA score at 24h was significantly more in BCAA arm than control arm (P=0.006), however, this was not sustained at day 3 or 7. Ammonia levels did not correlate with HE grade (Spearman correlation coefficient (-0.0843;P=0.295). Conclusion: Intravenous BCAA leads to early but ill-sustained improvement in grade of HE and reduced ICU stay in ACLF.

3.
Journal of Clinical and Experimental Hepatology ; 12:S87, 2022.
Article in English | EMBASE | ID: covidwho-1977441

ABSTRACT

Background and Aim: We aimed to study the healthcare disparity among elderly patients with cirrhosis and its impact on composite outcomes during the COVID pandemic. Methods: We conducted a prospective observational study between July 21- May 2022 via telephonic interview or physical consultations at 2 large tertiary care centers in India. The data was captured using pre-validated questionnaires to assess healthcare disparity amongst elderly patients with cirrhosis. Results: Of 475 elderly (≥65years) patients with cirrhosis (based on imaging) were included with mean age of 72.1years, male:female(3.8:1) with aetiology of cirrhosis being NAFL/NASH (58%), alcohol(32%) in majority. 323 (69%) had access to internet, however amongst them only 247 (52%) were conversant with use of WhatsApp, the preferred platform for tele-consultations in most hospitals in India. 147(31%) had walkability and accessibility to hospitals and 223(47%) had access to a family physician or community nurse, 271 (67%) had laboratory access. 295(62%) had taken both Covid vaccines, 349(74%) had first dose alone and only 38(8%) had booster dose. 213 (45%) felt that they needed admission/ expert opinion at least once during the period with 137 (29%) needed inpatient treatment. 266 (56%) missed at least 15 days doses of drugs with 85(32%) citing unavailability and 48(18%) unaffordability. Cancellation/rescheduling of medical services was widely prevalent with 74(15.5%) needing to reschedule endoscopy, 132 (28%) had cancellation of imaging of any form at least once, loco-regional therapy was rescheduled in 14(18%) patients of HCC. Advanced age, presence of >1 co-morbidity, tense ascites, hepatic encephalopathy, lack of caregivers were signi cantly associated with poor quality of life, restricted access and utilization of healthcare Conclusions: Elderly patients with cirrhosis had significant barriers in seeking healthcare during Covid19 pandemic highlighting the disparity and need for concerted e orts to improve their access to care.

4.
INDIAN JOURNAL OF COMMUNITY HEALTH ; 34(1):42-48, 2022.
Article in English | Web of Science | ID: covidwho-1970055

ABSTRACT

Background: - COVID-19 is the most important public health problem of recent time. Many people require hospitalization after infection. COVID vaccination is the most effective way to prevent the disease. Due to extensive negative publicity through social media channels/platforms,significant number of individuals are not coming forward for vaccination. Therefore, study is needed to evaluate adverse effects associated with different vaccines available in India. Objectives: - To assess the adverse effects associated with COVID-19 vaccination and compare the side effect of two most commonly used COVID vaccines in India. Methods:- In the current report, a cross sectional study was conducted among beneficiaries of COVID-19 vaccines at the vaccination center of the LLRM Medical college, India. After institutional ethical clearance and informed consent, patients were asked about the symptoms they experienced after vaccination. A very simple random sampling approach was used to select beneficiaries. Information was collected on predesigned Google form and total 391 patients submitted the responses. Results:- Out of total respondents 77 % individuals reported one or more symptoms. Fever was reported to be most common problem (59.3%) followed by body ache (57.5%). Out of total beneficiaries, 68.3% experienced mild symptoms while 23% remain asymptomatic. Only few subjects reported moderate adverse effects (8.7%). None of the respondent reported severe and serious adverse effect. Conclusions:- Vaccine associated adverse effects were found less than 3 days and of mild variety in most of the beneficiaries. There was no difference in adverse effect profile of two commonly used vaccines in India. People must come forward for vaccination in mass without fearing of adverse effects of vaccines.

5.
Gastroenterology ; 162(7):S-1247, 2022.
Article in English | EMBASE | ID: covidwho-1967428

ABSTRACT

Introduction Vaccines have emerged as our primary line of defence against the scourge of COVID-19. Patients with cirrhosis have a higher risk of severe COVID-19 and mortality and are thus high priority patients for vaccination. However, cirrhotics were excluded from the phase 2 and 3 trials of COVID-19 vaccines. Hence, we aimed to assess the seroconversion rate and safety of currently available COVID-19 vaccines in India, namely COVISHIELD (ChAdOx1 nCoV-19) and COVAXIN (BBV 152), in patients with cirrhosis. Methods All patients who had attended tele-hepatology services at our institute from March 2020 to June 2021 and diagnosed with cirrhosis as per their medical records were telephonically interviewed in July 2021 using a pre-specified questionnaire. Patients who had completed full course of vaccine (with the 2nd dose being administered at least 2 weeks back) and without history of documented COVID-19 infection (pre or post vaccination) were tested for SARS-CoV-2 IgG antibodies using an automated chemiluminescent assay (Orthoclinical Diagnostics). Our primary outcome was seroconversion in patients with cirrhosis who had received complete COVID-19 vaccination. Secondary outcomes included vaccine acceptance, documented COVID-19 infection post-vaccination and adverse effects of COVID-19 vaccines in cirrhosis. Results We identified and interviewed 784 patients with cirrhosis [compensated: 213 (27.2%), decompensated 561 (72.8%)] with a mean age of 51.07 ± 8.53 years. Two eighty-three (36.1%) patients had received at least 1 dose of COVID-19 vaccine [COVISHIELD: 231 (29.5%), COVAXIN: 52 (6.6%)] and 159 (20.3%) patients had completed full course of vaccination with 2 doses [COVISHIELD: 134 (17.1%), COVAXIN: 25 (3.2%)]. Documented COVID-19 (on RT-PCR) was reported in 3.2% (9/283) patients who had received at least one dose of COVID-19 vaccine while breakthrough COVID-19 (at-least 2 weeks after administration of 2nd dose) was reported in 3.1% (5/159). Adverse events were reported by 19.8% (56/283) patients with the most common being fever (13.1%), myalgia (5.6%) and sore throat (1.1%). No grade III/IV adverse events were reported. So far, 100 fully vaccinated patients (COVISHIELD: 88, COVAXIN: 12) have been tested for seroconversion. Seroconversion rate with COVISHIELD and COVAXIN were 92% (81/88) and 91.7% (11/ 12), respectively. Seropositive patients were divided into high, moderate, and low antibody responses based on the observed signal/cut-off response and no differences were observed between patients with compensated and decompensated cirrhosis (Table 1). There was no correlation between antibody signal/cut-off ratios and CTP (tau: 0.07, p=0.32) or MELD (tau: 0.08, p=0.29) scores. Conclusion Our preliminary data suggests that currently available COVID-19 vaccines in India are safe with high seroconversion rates in patients with cirrhosis. (Table Presented)

6.
Journal of Engineering Science and Technology Review ; 15(2):198-207, 2022.
Article in English | Scopus | ID: covidwho-1934913

ABSTRACT

We have investigated the time series of constituents of the Dow Jones Industrial Average (DJIA) for a period of 18 years (2000-2018). DJIA is a dominant stock market index comprising of thirty US based companies. We have applied the Random Matrix Theory (RMT), complex network analysis and hierarchical clustering techniques to extract out the information from the time series of DJIA stocks. The impact of sub-prime crisis of 2008(FC08) on structure and dynamics of network of DJIA stocks is studied by diving the periods under consideration into three distinct periods;pre crisis (PRC), during crisis (DUC) and post crisis (POC) on the basis of volatility. The RMT analysis shows that data analyzed contain important information. Network analysis reveals high correlation among the stocks in the DUC period. The MST and hierarchical clustering techniques support the results of RMT analysis. Degree centralities, closeness centralities and clustering coefficients of DJIA networks increases in DUC period. High correlation and closeness among stocks in DUC period is depicted in various analyses. The dynamic analysis is also carried out which detect various extreme events such as Covid-19. In conclusion, investigation shows that during the period of crisis, there are significant changes in the structure and dynamics of DJIA network. The findings of investigation can be utilized as risk indicator and detection of such crises in future. © 2022. School of Science, IHU. All rights reserved.

7.
World Heart Journal ; 13(4):499-517, 2021.
Article in English | EMBASE | ID: covidwho-1849296

ABSTRACT

The immune system is comprised of lymph glands, lymph nodes, thymus gland, spleen, bone marrow, lymphocytes, and molecules such as antibodies and cytokines. It has a vast array of functionally different cells such as T and B lymphocytes, macrophages, neutrophils and mast cells. The ontogenesis of the immune system is comprised of the innate immune cells and the adaptive immune cells, where innate immune cells are the first defense mechanisms to respond to pathogenic environmental factors. There are multiple components of the adaptive immune cells, including immunoglobulins (Igs), T-cell receptors (TCR), and major histocompatibility complex (MHC) responsible for adaptive immunity. However, many elements of both the innate and adaptive immune systems are conserved in our bodies. The adaptive immunity is a type of immunity that develops when a person’s immune cells respond to a pathogen such as microorganism or vaccination. Environmental factors such as pathogenic bacteria or viruses, solar exposure, age, exercise, stress, diet, sleep quality and air pollutants can influence the immune system. There may be marked decline in the immune function due to attack of COVID-19. Most patients with mild COVID-19 develop an appropriate immune response that culminates with viral clearance. However, severe disease manifestations have been linked to lymphopenia and immune hyper-responsiveness leading to cytokine storm. It has been observed that in COVID-19, alveolar macrophages are epigenetically altered after inflammation, leading to long-term lung immune-paralysis. Western diets are known to have adverse effects on the immune function. However, Mediterranean-type diets rich in short-and long-chain polyunsaturated fatty acids (PUFA), vegetables, nuts and fruits, dairy products and fish and red wine, due to high content of vitamins, minerals and flavonoids may be useful in boosting immunity. Moderate physical activity may also cause an extensive increase in numerous and varied lipid super-pathway metabolites, including oxidized derivatives called oxylipins. Emerging evidence suggests that dietary supplements containing flavonoids, carotenoids, coenzyme Q10 (CoQ10), vitamins, minerals and antioxidants modulate gene and protein expression and thereby modify endogenous metabolic pathways, and consequently enhance the immunity. Mediterranean-type diet and multiple bioactive nutrients, fatty acids, amino acids, vitamins and minerals as well as moderate physical activity may be crucial for enhancing immunomodulation.

8.
2021 IEEE International Conference on Technology, Research, and Innovation for Betterment of Society, TRIBES 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1831872

ABSTRACT

In the current scenario, almost all the countries face one of the biggest disasters in COVID-19. This paper has to analyze the tweets related to COVID 19 and discuss the various machine learning algorithms and their performance analysis on the tweets associated with COVID-19. The implemented classification algorithms are applied to classify the sentiments to predict whether they relate to COVID-19 or non-COVID-19. Ten most popular classification algorithms implemented. The Linear Support Vector Machine (LSVM) achieved the highest test accuracy in these algorithms with 90.3%. Logistic regression has performed better in recall with 96.06%, F1 score of 90.46%, ROC_AUC with 90.48%. Random forest classifier has achieved the better specificity and precision of 99.16% and 96.3%, respectively. Out of all, stochastic gradient descent (SGD) has attained better results in all the computational parameters. © 2021 IEEE.

9.
Decision Sciences ; : 22, 2022.
Article in English | Web of Science | ID: covidwho-1819889

ABSTRACT

We examine the role of firm-initiated social media communication using Twitter in mitigating the negative impact of large-scale disruptions, such as the Covid-19 pandemic, on the shareholder value of firms. We develop our hypotheses using signaling theory and test them using data collected from Twitter and Bloomberg (R). Our data set consists of 121,988 firm-generated tweets from 467 S&P 500 firms collected in March 2020 at the time of the lockdown announcement in the United States. We find that frequent and relevant communication reduces latency and increases the observability of messages, preserving a firm's shareholder value. We also find that a positive outlook and extent of interest from stakeholders results in preserving shareholder value. On average, firms lost about 1.08% of their market value per day (about 9.72% during the 9-day period around the lockdown announcement). Our study contributes to the extant literature in three ways: (1) adds to the literature on disruptions-shareholder value by considering large-scale disruptions such as the Covid-19 pandemic, (2) highlights informational and communication elements of risk management strategy, and (3) adds to the growing body of literature on Twitter by considering firm-generated tweets. The results of our study are of importance to managers as well. For instance, firms tweeted about 57 times per week, and each additional tweet could preserve about $5.85 million of a firm's market valuation, on average. Also, it is not enough that the firms took appropriate actions during a large-scale disruption;they also need to communicate their actions and its implications to their stakeholders effectively. These results can help managers devise their Twitter communication strategy during large-scale disruptions.

10.
3rd IEEE International Virtual Conference on Innovations in Power and Advanced Computing Technologies, i-PACT 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1759052

ABSTRACT

Understanding the hotspots attracting massive crowds is a huge necessity during this pandemic times. The knowledge of analyzing crowds will help to plan and avoid the spread of the virus to a large extent by identifying exact hotspots. Understanding where the crowds flock and whether they are following the guidelines or not will help in taking appropriate actions, allotting concerned personnel in advance, and closing of areas which are at higher risks can be advantageous. In order to realize the situation, real-time analysis of the pandemic rules like social distancing, wearing masks is necessary. This paper proposes the use of video surveillance and provides a combined application to check the factors necessary during crowd situations as per rules set by the Government. This work uses python as a coding language, and YOLOv4 algorithm along with various libraries like darknet to improve video and image analysis for the identification of exact requirements. This work also uses Cuda software and Cudnn library for the acceleration of processing. The paper proposes importantly, counting people passing through a particular area, detecting whether people are following social distancing, detecting if the participants are wearing a mask, and counting the number of vehicles passing through an area. The knowledge of analyzing crowds will help to plan and avoid the spread of the virus to a large extent by identifying exact hotspots. All the applications are connected to the graphical user interface (GUI) and depending on the input each application proposed considers different analysis. The types of input are image, video, image directory and live feed are considered to obtain better results. © 2021 IEEE.

11.
European Journal of Public Health ; 31:1, 2021.
Article in English | Web of Science | ID: covidwho-1609696
12.
European Journal of Public Health ; 31:205-205, 2021.
Article in English | Web of Science | ID: covidwho-1609695
13.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1515030

ABSTRACT

Issue With livelihood loss, uncertain earning, slum families are often food insecure, at risk of undernutrition particularly during COVID-19 in Indian and other LMIC cities. While wheat flour was provided free during lockdown, later at subsidized costs and during non-COVID times, vegetables need to be bought at market price. Methods UHRC provided seeds, encouraged families to grow vegetables in slums of Indore, India for five years. In 2019-20 and 20-21, data was gathered through interviews, observations in 20 slums (where >15 families grew vegetables). Results Uptake of seeds increased from 900 families in 2019-20 to 1200 in 20-21. With sharing of surplus harvest, 70,000 persons benefited in 2020-21. Families overcame food insecurity by arranging just wheat flour and cooked a vegetable for a meal. Used paint tubs, broken buckets and small spaces were used. Creepers were made to climb on roofs, walls, trees. Green cover increased to > 8 acres in 2021. The practice saves valuable family resources particularly in COVID-19 distress through provision of vegetables for family consumption. Lessons Perseverant efforts are key and help build a ‘fairer, healthier world'. Yield per family increased as they grow with incremental confidence. Despite small spaces slum families creatively grew vegetables. Children and youth help overcome constraints and are key actors. Early adopters serve as motivators and champions for subsequent adopters who begin growing vegetables on observing neighbours, friends grow vegetables and share with them. Nurturing plants, seeing vegetables grow fostered positivity, hope, motivation to grow every year, enhanced self-worth, and a positive feeling about their abode. People particularly children and youth learn how eating home-grown vegetables reduces carbon footprint of purchased vegetables transported to urban markets, save cost and overcome food insecurity. They reduce ambient air temperature to cool urban spaces. Key messages Despite small spaces, slum families grow, share vegetables, feel accomplished, enable food security, social cooperation, all crucial to well-being of slum populations. Methods used and lessons learnt of perseveringly motivating slum families have the potential of replication/adaptation in cities of India and other LMICs.

14.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514745

ABSTRACT

Background The study aims to understand the effect of COVID lockdown on MCH for slum dwellers and coping mechanisms adopted in Indore and Agra, India. Slum women's perspectives on seeking, delaying, avoiding healthcare in COVID-19, barriers and facilitators were explored. Methods In-person qualitative interviews were conducted in slums in Sept-Oct 2020 with mothers who had deliveries;pregnant women needing ante-natal care;mothers with children <2 yrs needing immunization during COVID lockdown. 30 mothers requiring these MCH services during April -June 2020 (lockdown phase) were interviewed. We chose qualitative study over quantitative as a shorter and useful precedent to replicate in similar situations. Results Govt. and most private hospitals refused non-COVID services during lockdown.;Police restricted movement on roads. Being on COVID duty, frontline health functionaries were not doing outreach health sessions. Women missed ante-natal check-up, Iron Folate, Tetanus toxoid;Demand side challenges included fear of COVID infection, lack of money due to livelihood loss;Home deliveries by self, neighbors were resorted to;Maternal, neonatal deaths ensued;Children missed immunization e.g., Measles, DPT. Few peri-urban slum families visited nearby rural health facility for delivery. Some families borrowed money from community saving's groups for delivery in private hospitals. Few families visited low-cost private doctor/nurse for immunization of pregnant mother, children. Conclusions Demand and supply side factors led to pregnant women and children not receiving care during lockdown. Peri-urban slum families should be encouraged to link with nearby rural health facility for MCH services during COVID-19 or similar situations. Govt. partnering with private providers near slums will help access during challenging times. Promoting community savings groups as mandated under National Urban Health Mission can enable slum families borrow with ease when in need. Key messages Government health system should set up emergency (e.g., mobile clinic) MCH services for future epidemic, disaster, should partner with private doctors/nurses near slums. Rural health infrastructure serving nearby peri-urban slums formally recognized by Govt. despite separate jurisdictions is an approach adaptable in LMIC cities.

15.
Hepatology ; 74(SUPPL 1):382A, 2021.
Article in English | EMBASE | ID: covidwho-1508764

ABSTRACT

Background: The suitability of teleconsultation is crucial for the effective delivery of health care services. Therefore, we evaluated the factors determining the suitability of teleconsultations for hepato-biliary diseases during the COVID-19 pandemic. Methods: In a prospective study conducted between March 2020 and January 2021, we asked the hepatologists delivering the tele-consultations in a tertiarycare center to fill a pre-validated questionnaire to assess the suitability of the given consult in real-time. The patient's sociodemographic and clinical details were noted. Patients were interviewed telephonically seven days after the consultation, and the level of understanding and hospitalization rate was assessed. A consult was deemed suitable when the physician reported its suitability in the absence of hospitalization. Factors determining the suitability of tele-consultations were evaluated on univariable analysis and machine learning models such as decision tree and extreme gradient boosting (XGB). Results: Of 1419 registrations, 1118 (87.2%) patients with male-gender (71%), age of 46 years (IQR: 18-68), and a rural background (72.7%) were analyzed. On univariable analysis, patients with skilled occupation, higher education, paying status, hepatitis B, C, and non-alcoholic fatty liver disease (NAFLD) were likely to be suitable (p<0.05). Patients with cirrhosis (compensated or decompensated), acute-on-chronic liver failure (ACLF), and biliary obstruction were likely unsuitable (p<0.05). A decision tree was developed from the significant variables on univariable analysis and important variables derived from the XGB-model. Patients with compensated cirrhosis who were educated or involved in a skilled occupation with an age of <55 years had a probability of 78% towards suitability. Hepatocellular carcinoma, decompensated cirrhosis, and ACLF patients were unsuitable with a probability of 60-95%. In non-cirrhotic liver diseases, hepatitis B, C, NAFLD were suitable with the probability of 89.7%. Extrahepatic biliary obstruction and previous failure of teleconsultation were unsuitable with a probability of 70%. Other tropical illnesses, extrahepatic portal venous obstruction, noncirrhotic portal fibrosis, dyspepsia, dysphagia not requiring any intervention were suitable with a probability of 88%. Conclusion: A simple decision tree can reliably guide physicians for conducting tele-consults for hepatobiliary diseases during the COVID-19 pandemic and beyond.

16.
Hepatology ; 74(SUPPL 1):332A-333A, 2021.
Article in English | EMBASE | ID: covidwho-1508732

ABSTRACT

Background: Coronavirus disease of 2019 (COVID-19) has emerged as a major public health crisis across the globe. Severity of COVID-19 and the presence of underlying comorbidities are the key determinants of prognosis. In general, non-severe COVID-19 is associated with relatively good outcomes. However, the natural history of non-severe COVID-19 in patients with liver disease has not been well studied. We report our experience with non-severe COVID-19 in patients with liver disease. Methods: Patients with liver disease and positive COVID RT-PCR presenting to the emergency department at a tertiary care centre were prospectively recruited from August 2020 to November 2020. Patients with severe COVID-19 were excluded. All patients were followed up for 30 days. Results: Out of 52 patients with COVID-19 and underlying liver disease, 6 patients (11.53%) presented with severe COVID-19 and were excluded from further analysis. Out of the 46 patients with non-severe COVID-19, 39(84.78%) patients had underlying cirrhosis and 6(13.04%) patients were post liver transplant (LT). The median age of the cohort was 45[35-56.5] years and the majority were males (n=38;82.60%). Comorbidities were present in 37 patients (80.4%;12 (32.43%) diabetes mellitus;5(13.51%) hypertension;9(24.32%) obesity;7(18.91%) chronic kidney disease;2(5.4%) coronary artery disease and 2(5.4%) obstructive airway disease). Most of the patients were admitted with liver related complaints (22(47.82%) acuteon-chronic liver failure;15(32.6%) acute decompensation;1(2.17%) acute liver failure - Hepatitis E related;1(2.17%) post-LT rejection and 1(2.17%) post-LT non-anastomotic stricture with acute cholangitis). Only 14 patients (30.43%) were symptomatic for COVID-19. Twenty-three patients died at 30 days, including 1 post-LT recipient. Mortality at 30-days was 52.2% on Kaplan-Meier analysis. COVID-19 related deaths were seen in 8(34.78%) patients while liverrelated deaths were seen in 15(65.21%) patients. Thirty-day survival in patients who presented with ACLF was significantly worse than those without ACLF (18.2% vs 75%;p<0.001). On multivariate Cox proportional hazard analysis, younger age, high serum bilirubin and elevated D-Dimer were significant predictors of mortality. Conclusion: Non-severe COVID-19 is associated with high 30-day mortality in patients with liver disease. The presence of ACLF portends a particularly poor prognosis. Intriguingly, the presence of comorbidities did not influence survival.

17.
Journal of the American Society of Nephrology ; 32:76, 2021.
Article in English | EMBASE | ID: covidwho-1489507

ABSTRACT

Background: The COVID-19 pandemic has impacted nearly all aspects of the care of patients, particularly those with chronic conditions. There is a need for higher quality of evidence to better identify populations at risk, in various clinical situations. We analyzed the difference in demographic characteristics in patients with end stage kidney disease (ESKD) who were started on hemodialysis (HD) in 2020 and contracted COVID-19, with those who remained free of the infection in a large multicenter cohort. Methods: We performed a retrospective multi-center cohort study using TriNetX Research Network database, a federate medical records network, to identify 7405 unique adult patients ≥ 18 years from 37 healthcare organizations (HCOs), mostly in the United States, for whom maintenance HD was initiated for ESKD between 1/1/2020 and 12/31/2020 (study period). From this group, we then identified patients who had a confirmed diagnosis of COVID-19 infection during the study period. We calculated the odds ratio (OR) and 95% confidence interval (CI) of mortality in the first three months of initiation of HD for the COVID group. Results: 903 patients (from 33 HCOs) had a confirmed diagnosis of COVID-19 infection. Patients in the COVID-positive group were less likely to be white (p=0.019), and more likely to: -be of Hispanic/Latino ethnicity (p<0.0001), -have had a previously failed kidney transplant (p<0.0001) -have diabetes mellitus (DM) (<0.0001), and -have a BMI above 31 (p=0.003). A total of 628 patients died during the study period. After propensity matching, COVID exposure was associated with higher odds of mortality (OR: 2.32;CI: 11.66, 3.24). The survival probability at the end of 3 months was 84.4% for the COVID group, compared with 92.5% for the no-COVID group (p<0.0001). Conclusions: During the study period, among the patients who were started on HD for ESKD, those who contracted COVID-19 infection were more likely to be Hispanic/ Latino, less likely to be white, more likely to have a previously failed kidney transplant, more likely to have DM, and to have a BMI above 31. The COVID-positive group also had a higher mortality and a lesser 3-month survival probability compared to the control group.

18.
Journal of the American Society of Nephrology ; 32:775, 2021.
Article in English | EMBASE | ID: covidwho-1489267

ABSTRACT

Background: The COVID-19 pandemic has had an impact on almost every aspect of human life. With more than 170 million cases and more than 3.5 million deaths worldwide (as of May 30, 2021), new facets of the fallout are being uncovered day after day. We analyzed the effects of COVID-19 on end stage kidney disease (ESKD) patients and compared the demographic profile and mortality in patients on hemodialysis (HD) to those who received kidney transplant (KT) in a large multicenter cohort. Methods: We performed a retrospective multi-center cohort study using TriNetX Research Network database, a federated electronic medical records network, to identify 3601 ESKD patients ≥ 18 years who had either received a kidney transplant (KT) (n=1849 from 34 healthcare organizations [HCOs]) or had been started on hemodialysis (HD) before 12/31/2019 (n=1752 from 31 HCOs) and who had been diagnosed with COVID-19 infection between 1/1/2020-12/31/2020. We used the KT group as the reference and calculated the comparative risk of 6-month mortality after COVID-19 infection for the HD group, reported as the odds ratio (OR) and 95% confidence interval (CI). Results: Compared with KT patients, HD patients were more likely to be older at the time of COVID-19 infection (57.4±14.5 vs. 53.3±13.8 years;p<0.0001), more likely to be African-American (<0.0001), diabetic (p<0.0001), hypertensive (p=0.0002), and with a history of coronary artery bypass graft (CABG) (0.0021). A total of 366 patients died within 6 months of diagnosis of COVID infection. After propensity matching, COVID-19 positive patients on HD had a higher odds of mortality (OR: 1.48;CI: 1.14, 1.90) compared with COVID-positive patients with a KT. Conclusions: Among ESKD patients who contracted COVID-19 infection during 2020, the patients on HD were more likely than patients who had received a KT to be African-American, to have a history of diabetes, hypertension and CABG. HD patients were more likely to die within 6 months of COVID diagnosis compared to patients who received a KT.

19.
American Journal of Blood Research ; 11(2):180-190, 2021.
Article in English | EMBASE | ID: covidwho-1431588

ABSTRACT

Background: COVID-19 is a systemic viral infection with a significant impact on the hematopoietic system, hemostasis as well as immune system. It would be of utmost importance to explore if the most routinely used tests could serve as an aid in determining patient’s clinical status or predicting severity of the disease. Methods: A pro

20.
6th IEEE International Conference on Communication and Electronics Systems, ICCES 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1393709

ABSTRACT

In this research paper, an IOT based health monitoring is discussed, which will help us in keeping a check on the temperature, humidity and pulse rate of a patient's body through a mobile phone. Such a system has been proposed sut to its importance in performing a regular check on the patient's health in the situation of casualties, which are very prevalent in this pandemic situation of COVID. In such a situation, when the patient cannot be monitored closely by face-to-face monitoring, the proposed system helps in the monitoring of health parameters. Here, a fingertip heartbeat sensor to calculate the pulse rate along with DHT11 sensor to calculate the temperature and humidity of the patient's body is used. Also, Node MCU as a microcontroller is employed, a Wi-Fi module is already in it and an I2C module is used to convert serial data to parallel data for LCD screen. © 2021 IEEE.

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