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BackgroundRestrictions on outdoor movements due to the coronavirus disease (COVID-19) pandemic have led to a decreased physical activity;this can lead to sarcopenia and frailty in older adults. Our recent study has demonstrated a significant decrease in the trunk muscle mass immediately after the pandemic's first wave (April–May 2020) among Japanese community-dwelling older women. In the present study, we further examined whether muscle mass recovery or deterioration occurs after 1 year of the pandemic's first wave by comparing physical measurements among the following assessment periods: before the first wave, immediately after the first wave, and at 1-year follow-up thereafter.MethodsThis study included 77 women (78.0 ± 5.7 years) who underwent physical measurements for muscle mass, grip strength, one-leg stand-up ability (3 s), and oral motor skills and answered questionnaires on sociality (social network, participation, and support) in the three assessment periods.ResultsThe frequency of going out and the subjective vitality were significantly decreased immediately after the first wave;these recovered at the 1-year follow-up (P < 0.001). When comparing muscular measures, the trunk muscle mass index preferentially decreased immediately after the first wave but recovered significantly at the 1-year follow-up (P < 0.001). Conversely, the appendicular skeletal muscle mass index (ASMI) and grip strength continued to decrease until the 1-year follow-up (P < 0.001 and P = 0.03, respectively). The ability to perform a one-leg stand-up for 3 s and the oral motor skills did not change significantly across the assessment periods. The prevalence of pre-sarcopenia and sarcopenia tended to increase during these periods (P = 0.068). The reduction and subsequent recovery patterns for sociality were similar to those observed for the trunk muscle mass.ConclusionsOur findings demonstrated differences in the reversibility of skeletal muscle mass and strength at 1 year after the first wave of the COVID-19 pandemic: the trunk muscle mass declined acutely and recovered rapidly, whereas the ASMI and grip strength declined continuously. These differences in the skeletal muscle recovery and deterioration might help formulate short-term or long-term strategies for COVID-19-related sarcopenia prevention in community-dwelling older adults.
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The liver can be damaged due to the virus's direct cytotoxic effect, immune-mediated damage, medication side effects, stasis due to myocardial damage, hypoxia, and ischemic damage due to hypoperfusion (6). The laboratory results were as follows: hemoglobin 14.3 g/dL, leukocytes 6.2 109/L, platelets 175 109/L (200-445 109), CRP 0.005 g/L (0-0.005), procalcitonin 0.04 pg/L, aspartate aminotransferase (AST) 393 U/L (0-46), alanine aminotransferase (ALT) 726 U/L (0-32), total bilirubin 0.5 mg/dL, direct bilirubin 0.2 mg/dL, lactate dehydrogenase (LDH) 548 U/L, gamma glutamyl transferase (GGT) 35 U/L. The biopsy, however, showed no virus particles. Since the patient had no known underlying disease, pathological findings in the liver were thought to be related to SARS-CoV-2 infection or the drugs used (11). According to reports, an increase in liver enzymes has no prognostic significance.
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[...]in order to reduce the spread of the disease, family clustering should be determined and quarantine measures should be taken. The predominance of with many children traditional lifestyle may cause increased domestic clustering. [...]during this period, various control measures were taken for children, with some restrictions, and travel bans were imposed except when necessary (9). Contact screening and isolation of children is important in epidemic control, due to the detection of asymptomatic SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) positive children and increasing rate of domestic positivity. According to this guideline, in the presence of epidemiological and clinical findings, SARS-CoV-2 RNA RT-PCR positive cases were accepted as confirmed cases, and SARS-CoV-2 RT-PCR negative cases were accepted probable cases (10).
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Lymphopenia, Increased B cell count, reversal of the CD4/CD8 ratio, and Increased active T cell count may be beneficial In the early diagnosis of MIS-C. Since It Is thought that the cytokine storm causes complications In MIS-C, Immediate administration of IVIG treatment Is considered essential. The disease was considered a new multisystem inflammatory syndrome, and with the increase in awareness, it has been reported more frequently in children (MIS-C) in Europe and the United States (2,3). Since the disease is thought to cause complications by leading to cytokine storms, immediate administration of intravenous immunoglobulin (IVIG) treatment is deemed important, and it is also essential to emphasize that IVIG treatment leads to marked cellular changes. Case 2 A nine-year-old male patient presented with fever, abdominal pain, headache, and diarrhea that had been present for five days, followed by a rash, conjunctivitis, and cervical lymphadenopathy. [...]the patient was considered to have atypical Kawasaki disease. According to a review, the most common signs and symptoms reported during MIS-C consisted of abdominal pain (61.9%), vomiting (61.8%), skin rash (55.3%), diarrhea (53.2%), hypotension (49.5%), and conjunctivitis (48.4%), and particularly gastrointestinal (90.9%), cardiovascular (86.5%), or dermatological or mucocutaneous (70.9%) involvement (2).
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The lymphocyte count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), C-reactive protein (CRP), neutrophillymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) obtained from the patients' complete blood count were evaluated. Children are less affected by COVID-19 than adults (1). Since the first case was reported by Chan et al. on January 20, 2020, the number of cases has been gradually increasing (2). According to the inclusion criteria, patients under 18 years of age with positive PCR test were included in the study. Electronic impedance + optical scatter and blood gas tests were performed on an ABL80 FLEX BASIC analyzer using the electrochemical biosensor method in the Diyarbakır Pediatric Disease Hospital laboratory.
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According to the recommendations of the national guidelines and also the advices of the authorities worldwide, at the beginning of the pandemic through August, 2020, HCQ sulfate, was administered orally at a dosage of 6.5 mg/kg/dose twice daily on the first day (maximum dose on the first day was 400 mg/dose);then 3.25 mg/kg/dose twice daily on days two through five (maximum dose on days two through five was 200 mg/dose) (6). According to the protocol of the hospital, serum glucose-six-phosphate dehydrogenase (G6PD) deficiency was screened (7). According to the statements of remaining 60 caregivers on phone, there was no mortality or complaints among the patients associated with HCQ during the long time period. [...]of a meta-analysis, there was no progress of clinical courses such as a significant decline in mortality with HCQ use, but a higher risk of ECG abnormalities and arrhythmia was associated with HCQ therapy (10).
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According to the 2018 Hacettepe University Population and Health Survey report, of the married women between 25-49 age group;39% get married before the age of 20, 21% before the age of 18 and 4% before the age of 15 (1). According to the WHO report, in 2019, abortion was reported at a rate of 55% in unplanned pregnancies in adolescents, especially in countries with limited resources (2). According to CDC data, it has been reported that the Tdap vaccine administered in the 27-36 weeks of the pregnancy, reduces pertussis disease by 78% in the first two months of their infants, and it reduces the infant hospitalizations due to whooping cough by 90% (6-8). [...]the first dose is given at the first visit, the second dose is administered four weeks later, the third dose is given 6-12 months after the second dose, and the vaccination schedule is completed in three doses (3,8).
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Corona virus disease 2019 (COVID-19) caused by severe acute respiratory corona virus 2 (SARS-COV-2) is mainly respiratory disease occurring since December 2019 and first detected in Wuhan province of China. The complexity of SARSCOV-2 is centered on the unpredictable clinical course of the disease that can rapidly develop causing severe and deadly outcomes. The pandemic COVID-19 is a scientific, medical, and social challenge. In this review, the basic pathological and biochemical changes in COVID-19 are described, also how it influences in predicting the disease progression thereby helping in early interventions to prevent complications.
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A 24-year-old female presented with blurring of vision, chemosis, protrusion of eyeball, restriction of movements of right eye, numbness over the right side of the face with severe headache, stiffness of neck, and fever of 2 days duration. She gives a history of recent Covid-19 infection 3 weeks back. She was treated symptomatically and recovered fully. On examination, there was proptosis, chemosis, third, fourth, fifth, and sixth nerve palsy on the right side, and nuchal rigidity. She was started on broad spectrum antibiotics, analgesics, anticoagulant, and prophylactic antifungal thinking in line of post-Covid orbital cellulitis or mucormycosis. Her investigations revealed raised total leucocyte count and erythrocyte sedimentation rate with normal ultrasound abdomen and chest X-ray. Blood culture and culture of nasal swab and oral cavity for fungus were sterile. Contrast-enhanced magnetic resonance imaging brain, orbit, and sinus showed proptosis, myofascial edema, superior ophthalmic vein thrombosis, right cavernous sinus and deep cervical vein thrombosis, sphenoid and bilateral ethmoid sinusitis with narrow lumen of the internal jugular vein. She responded very well to the treatment. Her inflammatory parameters came down drastically and clinically, she started opening her eyes and ophthalmoplegia subsided within a week. By the 10th day she was asymptomatic. Repeat MRI showed reduction of proptosis, myofascial edema with partial recanalization of right superior ophthalmic vein, right cavernous sinus, and right deep cervical vein. She was discharged on injectable anticoagulant and antibiotics for another 10 days.
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Aim: To analyze the impact of corona virus disease-19 (COVID-19) pandemic and various containment measures taken for the pandemic control on hospital admissions of acute coronary syndrome (ACS). Materials and Methods: This study is a single-center, comparative study conducted at a tertiary care center situated in the southern part of India. The study period was from March 1, 2020 till May 31, 2020, including the first lockdown period in India. All patients admitted with a diagnosis of ACS to our hospital during the study period were included in the study (study group). This group was compared with the patients admitted with ACS into our hospital during the corresponding period of the previous year (control group). Patients with ST-elevation myocardial infarction (STEMI) were compared with the control group for clinical profile, treatment, hospital course, outcome, and incidence rate ratio (IRR) of admissions. Results: There was a significant reduction of mean daily admissions of ACS cases in the study group with IRR of 0.702;95% confidence interval (CI), 0.719–1.02;P < 0.001. The reduction rate of ACS cases was 29.74% (study period, n = 215;control period, n = 306), and it was mostly related to a decline in the number of non-ST-elevation myocardial infarction (NSTEMI) and unstable angina. No significant reduction of patients with STEMI was observed between the groups. However, patients with STEMI had more left ventricular (LV) dysfunction, LV thrombus, and a significantly higher incidence of mitral regurgitation (13.3% vs. 8.8%, P < 0.05). The impact of the COVID-19 outbreak on the patients with ACS revealed a parallel reduction of hospital admissions with an increasing number of COVID-19 cases in the community. Conclusion: The COVID-19 pandemic and concomitant social restrictions resulted in a significant decline in hospital admissions due to ACS in this tertiary care center, but without any effect on the number of admissions with STEMI. A parallel reduction of hospital admissions for ACS cases with a rising number of COVID-19 cases in the community was also observed in this study.
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Background: The cytokine cascade in COVID-19 is responsible for its clinical manifestations. Timely management of patients with dismal prognosis may improve their clinical outcome. The study aimed to analyze the hematological and biochemical parameters among COVID-19 patients and the factors associated with laboratory changes and COVID-19 infection. Materials and Methods: A retrospective, cross-sectional study was conducted in a designated district COVID hospital. COVID-19 patient’s medical records were converted into an electronic database which included demographic data, recent exposure history, existing co-morbidities, symptoms, and laboratory findings. Results: Out of the 1340 patients, 69.25% were males. Symptomatics accounted for 57.61%. The common co-morbidities among infected patients were diabetes mellitus (13.88%), hypertension (15%), and chronic obstructive pulmonary disease/asthma (2.16%), which had a significant positive correlation with COVID-19. The common symptoms were fever (50.39%), dry cough (46.24%), dyspnea (30.7%), and myalgia (28.5%). Leucocytosis, neutrophilia, lymphopenia, and thrombocytopenia were reported in 5.22%, 11.34%, 27.16%, and 3.41% of patients, respectively. Elevated aspartate aminotransferase, alanine aminotransferase, hypoalbuminemia, and hyperglobulinemia were observed in 13.88%, 19.4%, 24.77%, and 10% of patients, respectively. Symptomatics had significantly higher values for neutrophil percentage, neutrophil–lymphocyte ratio (NLR), derived NLR, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, lymphocyte–leucocyte ratio, systemic immune-inflammatory index, blood urea, and indirect bilirubin levels and significantly lower values for lymphocyte percentage, absolute lymphocyte count, and serum albumin. The logistic regression analysis revealed a significant association of deranged laboratory parameters among symptomatic COVID-19 patients and those with pre-existing co-morbidities. Conclusion: Neutrophilia, lymphopenia, and deranged liver function tests were significantly present in COVID-19 patients. The inflammation in COVID-19 is exhibited as remarkable hematological and laboratory changes whose careful interpretation can offer a clinical window for risk stratification and appropriate therapeutic interventions.
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Context: The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China, in December 2019. The management plan is supportive care with oxygen supplementation and mechanical ventilation. US FDA approved convalescent plasma (CP) for COVID-19 for clinical trials and as an emergency investigational new drug. Although numerous trials are currently investigating the safety and efficacy of CP in COVID-19 patients, there is a paucity of ongoing and published studies evaluating the CP donors’ side. This retrospective study reports the CP donors’ selection and deferrals. Aim: To evaluate and analyze the donor deferral pattern and its causes among CP donors in a tertiary care hospital blood bank apheresis unit. Settings and Design: Hospital-based retrospective analysis. Subjects and Methods: Donors aged 18–65 years who had recovered from COVID-19 at least 4 weeks previously coming for plasma donation were retrospectively analyzed from July 25, 2020 to January 24, 2021 for a period of 6 months at blood bank apheresis unit, Assam Medical College and Hospital. Results: A total of 396 potential plasma donors were screened during the study period. The donor deferral rate was 39.1%. The permanent deferral was 36.8%, and the temporary deferral was 63.2%. The maximum number of donors deferred because of low antibody (18.7%) followed by low hemoglobin (14.8%). Associated comorbidities, low platelet count, repeat reverse transcription-polymerase chain reaction positivity, transfusion transmitted infection reactivity, intake of medicines, infections, vaccination, and underweight were other causes identified. Conclusion: The pattern of donor deferral is an important tool for blood safety and also provides key areas to focus on a demographic region or policy formulation for donor selection as well as to ensure donor safety.
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Background: COVID-19 pandemic poses a challenge to mental health. The perception of stress and its adaptation are determined by individual’s risk perception and coping mechanisms. Aim: The study aimed to evaluate the perceived stress and behavioral responses owing to COVID-19 pandemic. Materials and Methods: The online survey recruited 621 respondents. The survey included (1) sociodemographic variables, (2) Perceived Stress Scale (PSS)-10 item inventory, (3) four items on experience of stress, and (4) eight items on mental health-related lifestyle changes and societal support during the pandemic. Results: Out of 621, majority were females (54.1%) and belonged to the age group of 18–30 years (66.02%). Moderate perceived stress was observed in 67.1% of the respondents. The mean PSS scores were significantly higher among females, age group of 18–30 years, unmarried, educational qualification below undergraduation, and students. Higher perception of work and financial stress were present in 52.67% and 48.3%, respectively. Increased concern about family and vulnerability was confirmed by 89.05% and 54.59%, respectively. Increased work stress was negatively associated with attention toward mental health, emotional support, physical activity, and hobbies. Greater concern for family and vulnerability had showed positive association with attention toward mental health, emotional support, and protective behavior. Conclusion: In COVID-19 pandemic, females, younger age, and students had significantly higher stress perception. Work and financial stress were associated with maladaptive responses, whereas concern about family and feeling vulnerable were accompanied by positive adaptive responses. Thus, evaluating the cognitive and behavioral responses to stressors is imperative to quantify individual’s stress perception during exposure to a stressful situation such as pandemic.
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Introduction: COVID-19 has now become a pandemic. It has spread from Wuhan, China in 2019 to all over the world. The outbreak and spread of Severe Acute Respiratory Illness related to COVID-19 has let to global health and economic crisis. Aim : The present study was done to understand the clinical epidemiological and laboratory characteristics of COVID-19 patients that could give an insight of the disease and help in evolving management strategies in terms of diagnosis, isolation and prevention of further spread. Methodology : This is a descriptive cross sectional study of COVID-19 patients admitted in 2 COVID care centres from 1-6-2020 t o 31-7-2020. The patients were diagnosed with RT-PCR. Demographic clinical and laboratory data were collected. Presence of fear, awareness, emotional and financial impact was interrogated. Results : There was a male preponderance with the disease mainly infecting adolescent and younger adults. There was positive correlation of the disease exposure with travel history, occupation and, disease severity with co-morbidities, vaccination and leucocyte counts. Extra pulmonary symptoms like anosmia, diarrhoea, myalgia and also predominance of fear emotion and financial insecurity were present among the study subjects. Conclusion : Active targeted surveillance among elderly and those with comorbidities for early detection and avoiding COVID-19 complications, adequate awareness in public and workplace with proper SOP (standard operating procedure), early isolation with medications for suspected patients with extra pulmonary symptoms and total counts based on clinical epidemiological guidance even before arrival of COVID-19 reports should be done Addressing the psychological aspects of the disease with due equality.
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Bu durum toplumsal bağışıklık eşik değeri (herd immunity threshold) olarak adlandırılır. The basic reprodiction number (R0) of measles: a systematic review. [CrossRef] 8. https://www.nytimes.com/interactive/2020/world/asia/china-coronavirus-contain.html.