How do the sectoral indices react to COVID-19? Evidence from an emerging economy

The study empirically examines the impact of the COVID-19 on different sectoral indices of the National Stock Exchange (India) using the event study method and a generalised autoregressive conditional heteroskedasticity (GARCH) model. We provide evidence of positive impacts on the auto, oil and gas, healthcare, and pharma sectors. While the bank, financial services, and private bank sectors are the most adversely impacted sectors, the PSU bank, media, and reality sectors are the least impacted, and the rest are moderately impacted sectors. The overall impact of COVID-19 was negative until the implementation of nationwide lockdowns and the announcement of stimulus packages. The GARCH results exhibit more substantial evidence for the negative impact of the pandemic on the FMCG, IT, metal, oil and gas, and PSU bank sectors. We also find a more favourable impact on FMCG, pharma, and healthcare sectors in India.

Comparison of Obstetric Outcomes in First and Second COVID-19 Waves: Analysis from a COVID-19-dedicated Tertiary Care Hospital

Introduction: The physiological changes in the respiratory and cardiovascular systems in the immunosuppressed state of pregnancy may exacerbate clinical features and deteriorate outcomes due to COVID-19 infection. We aimed to compare the maternal and neonatal adverse effects in the first and second COVID-19 waves. Methodology: This study was a prospective cohort study conducted in a tertiary care COVID-19-dedicated hospital. In total, 104 (group A) and 96 (group B) COVID-19-positive pregnant women admitted during the first and second waves, respectively, were included in the study. Data on baseline variables, associated comorbidities, clinical presentations, management strategies, and neonatal and maternal outcomes were collected and compared using parametric and nonparametric tests and analyzed. Result(s): Around 2.08% in group A and 6.72% in group B of COVID-19-infected pregnant women, respectively, had moderate-to-severe disease and required intensive care unit stay. Almost 1.04% in group A and 3.84% in group B had maternal mortality, 13.4% and 19.8% babies of groups A and B required admission in neonatal intensive care units, and 8.6% and 7.3% of newborns in groups A and B had COVID-19-positive reports by reverse transcriptase polymerase chain reaction (RT-PCR) at birth, respectively. Of them, 2.1% newborns in group B had RT-PCR positive on day 7 of life and beyond, whereas none had positive RT-PCR reports on 7 days and beyond in group A. Conclusion(s): Dreadful maternal outcomes like requirement of ICU and mechanical ventilator and persistence of neonatal infections were higher during the second wave.Copyright © The Author(s). 2023.

An Observational Study of COVID-19 Infection in Pregnant Women at a Tertiary Care Center

Background: COVID-19 infection is a disease caused by severe acute respiratory syndrome coronavirus 2. The manifestations, effects, and severity of the infection are varied in different waves, especially during pregnancy. Material(s) and Method(s): The study was conducted in two equal time periods during the first and second waves. During the first wave, the period of study was between June and August 2020 corresponding to the peak of the first wave, and in the second wave, the study period was between May and July 2021 corresponding to the peak of the second wave. Result(s): A total of 3,791 pregnant women was screened for COVID-19 infection during the first wave and second wave, the pregnant mothers with COVID-19 positive were 4.2 (n = 163) and 5.1% (n = 191), respectively. Around 60% were antenatal mothers and 37% were postnatal mothers who were COVID-19-positive. The predominant age group affected was between 20 and 25 years of age. Gestational diabetes mellitus (GDM), gestational hypertension, anemia, previous lower segment cesarean section (LSCS), postdated pregnancy, and past history of infertility were the high-risk factors observed during the study. Hypoxia was observed in 15% of patients in the second wave. About 49.7% (n = 95) of the COVID-19-positive mothers in the second wave required steroids, anticoagulants, and antiviral drugs. Conclusion(s): The incidence of COVID-19 infection was mild and asymptomatic during the first wave and symptomatic as well as with complications during the second wave. The disease severity, intensive care unit (ICU) admissions, duration of stay, LSCS delivery, and need for antivirals, anticoagulants, and steroids were more during the second wave of COVID-19.Copyright © The Author(s). 2023.

Power relations and COVID-19 in New York City

With the Bronx as its metropolitan regional epicenter during the early American COVID-19 epidemic, New York City acted as the national epicenter. Because of a decades-long history of New York as epicenter of such contagious ills as AIDS, violent crime, and tuberculosis, identification of the neighborhood(s) which may act as municipal and metro regional epicenter of future epidemics assumes great importance. After the April 2020 COVID crest, how quickly a neighborhood declined in COVID markers indexed the vulnerability of that neighborhood to a second wave and to other contagious phenomena. With ZIP code areas of the four central boroughs having populations over 10,000 as the neighborhoods for analysis, the following measures allowed identification of vulnerability: (1) Decline in percent positive swab tests between specific post-crest dates. (2) Whether the area accumulated over 3000 cases per 100,000. (3) Percent increase in cumulative case rates between specific post-crest dates. (4) Increase in cases per square mile between specific post-crest dates. These markers reflect both vulnerability (socioeconomic and physical) and adequacy of authorities' response. Three sets of criteria qualified areas qualified as potential epicenters: Criteria set 1: Over 3000 cumulative cases per 100,000, above median percent positive swabs on the specific date, and above median percent increase in cumulative case rates between two specific dates. Criteria set 2: Over 3000 cumulative cases per 100,000, above median percent positive swabs on the specific date, and above median new cases/sq mi accrued between specific dates. Criteria set 3: Increase in new cases above 50 per sq mi between specific dates. Criteria set 1 was applied to July 28 data, as well as to August 17 data. Criteria sets 2 and 3 were applied only to August 17 data. Thus, four lists of qualified ZIP code areas arose: Criteria set 1 applied to two intervals and criteria sets 2 and 3 to one. Qualifying areas were mapped. Only Bronx areas appeared on all four lists. Mapping showed that Bronx areas formed large clusters for each of the four lists, the largest clusters for any borough. With the exception of ZIP code area 10035 in East Harlem, Manhattan areas appeared only on the map for criteria set 3. Several Upper Manhattan areas exceeded 100 new cases per sq mi amassed between July 28 and August 17. Several wealthy Manhattan areas also qualified, indicating vulnerability. The Queens cluster of "red alert" areas near LaGuardia Airport has a high proportion of foreign-born residents, a likely high number of airport employees and of essential workers. With its long history of authority-sponsored segregation and community-destroying modes of discrimination, the Bronx emerged as the likely future epicenter. Two strategic paths reduce the probability of epicenter development: (1) increase residential stability above the threshold for development of numerous large interacting social networks and (2) accelerate social network formation with deliberate organizing. The first step would outlaw all processes that destroy housing or push people out of their homes or decrease availability of low-cost housing. Areas without social organization are powerless against predatory forces whether they be capitalist entities such as landlords or government acting for capitalist entities. Further exploration of the epidemiological condition of the Upper Manhattan and wealthy areas with high new case densities would be wise. Manhattan had been the epicenter of AIDS, TB, violent crime, and low birthweight epidemics in the NYC metro region. Destabilized by massive emigration of wealthy white residents, gentrified Manhattan could be newly vulnerable. Residential destabilization is an enemy of public health and of community empowerment. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

Readiness of health facilities to manage individuals infected with COVID-19, Uganda, June 2021.

BACKGROUND: The COVID-19 pandemic overwhelmed the capacity of health facilities globally, emphasizing the need for readiness to respond to rapid increases in cases. The first wave of COVID-19 in Uganda peaked in late 2020 and demonstrated challenges with facility readiness to manage cases. The second wave began in May 2021. In June 2021, we assessed the readiness of health facilities in Uganda to manage the second wave of COVID-19. METHODS: Referral hospitals managed severe COVID-19 patients, while lower-level health facilities screened, isolated, and managed mild cases. We assessed 17 of 20 referral hospitals in Uganda and 71 of 3,107 lower-level health facilities, selected using multistage sampling. We interviewed health facility heads in person about case management, coordination and communication and reporting, and preparation for the surge of COVID-19 during first and the start of the second waves of COVID-19, inspected COVID-19 treatment units (CTUs) and other service delivery points. We used an observational checklist to evaluate capacity in infection prevention, medicines, personal protective equipment (PPE), and CTU surge capacity. We used the "ReadyScore" criteria to classify readiness levels as > 80% ('ready'), 40-80% ('work to do'), and < 40% ('not ready') and tailored the assessments to the health facility level. Scores for the lower-level health facilities were weighted to approximate representativeness for their health facility type in Uganda. RESULTS: The median (interquartile range (IQR)) readiness scores were: 39% (IQR: 30, 51%) for all health facilities, 63% (IQR: 56, 75%) for referral hospitals, and 32% (IQR: 24, 37%) for lower-level facilities. Of 17 referral facilities, two (12%) were 'ready' and 15 (88%) were in the "work to do" category. Fourteen (82%) had an inadequate supply of medicines, 12 (71%) lacked adequate supply of oxygen, and 11 (65%) lacked space to expand their CTU. Fifty-five (77%) lower-level health facilities were "not ready," and 16 (23%) were in the "work to do" category. Seventy (99%) lower-level health facilities lacked medicines, 65 (92%) lacked PPE, and 53 (73%) lacked an emergency plan for COVID-19. CONCLUSION: Few health facilities were ready to manage the second wave of COVID-19 in Uganda during June 2021. Significant gaps existed for essential medicines, PPE, oxygen, and space to expand CTUs. The Uganda Ministry of Health utilized our findings to set up additional COVID-19 wards in hospitals and deliver medicines and PPE to referral hospitals. Adequate readiness for future waves of COVID-19 requires additional support and action in Uganda.

Comparison between the demographic shift clinical severity and outcome of the first two waves of COVID-19 in pregnancy in a tertiary hospital in India.

OBJECTIVE: To study and compare the maternal and neonatal outcomes of COVID-19 in pregnancy during the two waves of the pandemic in India. METHODS: This observational, retrospective cohort study on pregnant women with SARS-CoV-2 infection was conducted in a 2700-bed tertiary referral center in South India from March 1, 2020 to June 30 2021. The clinical presentation, severity, and maternal and neonatal outcomes of COVID-19 were compared between the two waves. RESULTS: A total of 623 pregnant women tested positive for SARS-CoV-2 infection in our institute; 379 (60.8%) were diagnosed during the first wave and 244 (39.2%) in the second wave. Most of the affected women (81.1%) were in their third trimester. Maternal mortality rate was 823 per 100 000 live births. Composite maternal outcome (increasing requirement for ventilation, pulmonary embolism, disease progression) were more pronounced during the second wave (2.1% vs 6.1%). Between the two waves, both maternal (1 vs 3; P = 0.162) and perinatal (3.2% vs 6.7%; P = 0.065) deaths were higher during the second wave. The cesarean section rate was high during the first wave (48% vs 32.4%; P < 0.001). Preterm births were comparable between the two waves (19.5% vs 22%; P < 0.500). CONCLUSION: The women presented with more severe illness during the second wave of COVID-19. There was higher perinatal mortality, but the maternal mortality was similar between the two waves.

[Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave]. / Pacientes con EPOC hospitalizados por COVID-19 en España: comparación entre la primera y la segunda ola.

Objective: This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. Material and methods: This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. Results: Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1,128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. Conclusions: Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.

Public Perception About Pandemic Situation and Preparedness Towards a Probable Lockdown in an Affected Indian State Amidst the Second Wave of the Covid-19 Pandemic.

OBJECTIVE: The COVID-19 second wave badly affected India. This study assessed public preparedness and attitude towards a new lockdown in the state of West Bengal (WB) along with perception about the COVID pandemic situation. METHODS: An anonymous questionnaire was administered to all willing adult attendees of a COVID vaccination centre in Kolkata, capital city of WB. Logistic regression was applied to find the relationship between attitude towards lockdown and other selected independent variables. RESULTS: Of the 839 persons analyzed, 72.0% were non-health workers; and 55.4% thought that available vaccines reduce COVID-19 risk. Among them, 54.4% wanted stricter guidelines imposed. For preparedness, 42.6% and 28.8% said they would stock additional food and medicines respectively. On multiple logistic regression, being female, having elderly family members, perceiving the second wave as worse, and favouring stricter restrictions, all had odds of favourable attitude towards the new, proposed lockdown. CONCLUSIONS: A new lockdown was favoured by the majority. However, a well-planned and phased approach for this is needed in the light of many concerns about the previous lockdown. Mental health issues, financial security, medical help at hand, and ease of travel to workplaces are important issues that need to be addressed in case of future lockdown(s).

Knowledge, attitude, and practices regarding second waves of COVID-19: A cross-sectional study among rural population in India

Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people, and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. The best way to prevent and slow down transmission is to be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. The aim of the present study was assess the Knowledge, attitude, and practices regarding of COVID-19: among rural population.Cross-sectional questionnaire-based study was conducted on rural people A total of 200 participants hailing from rural areas were enrolled. Result(s): Most common source of information for the participants was through television (54.8%) and radio (49.2%). Only 77% claimed that they were using face mask and 72% claimed to be following social distancing. A large (60%) proportion of the participants did not know that COVID-19 could spread from asymptomatic patients. The mean (percentage) scores of knowledge, attitude, and practice were 21.26 (82%), 9.37 (92%), and 10.32 (86%), respectively. Education of participants was a key determinant for use of social distancing and face mask as a preventive tool. With increasing age, the practice of social distancing and the use of face mask were decreasing in our study. Conclusion(s): Television/Radio channels form an important source of information and need to be used more effectively to educate the people about the disease and create awareness about effective preventive measures. People need to be educated about the role of asymptomatic carriers in spreading the disease.Copyright © 2020 Ubiquity Press. All rights reserved.

Atrial inflammation and microvascular thrombogenicity are increased in deceased COVID-19 patients.

BACKGROUND: Histopathological studies have shown inflammation, cardiomyocyte injury, and microvascular thrombosis in the ventricular myocardium of patients with coronavirus disease 2019 (COVID-19). However, although atrial dysfunction is common in COVID-19, little is known about histopathological changes in the atria of the heart. We therefore analyzed inflammation, cardiomyocyte injury, and microvascular thrombogenicity in the atria of deceased patients with COVID-19. METHODS: Atrial tissue was obtained from autopsied COVID-19 (n=16) patients and control patients (n=10) and analyzed using immunohistochemistry. The infiltration of CD45+ leukocytes, CD3+ T lymphocytes, CD68+ macrophages, MPO+ neutrophils, and Tryptase+ mast cells were quantified as well as cardiomyocyte damage and microvascular thrombosis. In addition, Tissue Factor (TF) and Factor XII (FXII) were quantified as markers of microvascular thrombogenicity. RESULTS: The numbers of lymphocytes, macrophages, and neutrophils were significantly increased in the atrial myocardium and epicardial atrial adipose tissue of COVID-19 patients compared with the control group. This was accompanied by dispersed cardiomyocyte injury, the occasional presence of microvascular thrombosis, and an increased presence of TF and FXII in the microvascular endothelium. CONCLUSIONS: Severe COVID-19 induces inflammation, cardiomyocyte injury, and microvascular thrombosis in the atria of the heart.

Clinical characteristics & severity profile of children with COVID-19 during the second wave pandemic: An experience from tertiary care hospital in Mumbai.

This retrospective observational study was aimed at defining the demographic and clinical characteristics as well as severity profile of COVID-19 disease in children admitted to dedicated COVID-19 tertiary care hospital in Mumbai, India, during the second wave. COVID-19 infection detected in children (1 month-12 years) by the rapid antigen test or reverse transcriptase polymerase chain reaction or TRUENAT from March 1 to July 31, 2021 on throat/nasopharyngeal samples were enrolled and their clinical features and outcomes were studied. During the study period, 77 children with COVID-19 infection were admitted, of whom two-third (59.7%) were <5 yr old. The common presenting symptom was fever (77%), followed by respiratory distress. Comorbidities were noted in 34 (44.2%) children. Most of the patients belonged to the mild severity category (41.55%). While 25.97 per cent of patients presented in severe category and 19.48 per cent were asymptomatic. Admission to intensive care was needed in 20 (25.9%) patients, with 13 patients needing invasive ventilation. Nine patients succumbed while 68 were discharged. The results might help understand the course, severity profile and outcomes of the second wave of the COVID-19 pandemic in the paediatric population.

Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave.

OBJECTIVE: This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. MATERIAL AND METHODS: This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. RESULTS: Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. CONCLUSIONS: Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.

Commuting behaviour in times of the COVID-19 pandemic: a comparative first and second wave study from Latvia

Since early 2020 Europe has been coping with previously unfamiliar economic and social distress caused by the COVID-19 pandemic, the virus's uncontrollable spread (SARS-CoV-2) has thoroughly affected behavioural patterns, societal well-being, and everyday activities. With this study, we aim to contribute to the differences in daily commuting patterns between the first and second waves of the COVID-19 pandemics. Moreover, we seek to uncover factors and territorial differences in population mobility behaviour during the "COVID crisis”. As a method for insight into this, we used a CAWI population survey. Survey took place in March 2021 with a total sample of n=1023 respondents. Comparatively, we asked to report on the situation in 2020 and 2021, representing the first and second waves of the outbreak in Latvia. The paper we structured around three research questions: 1) What are the differences in daily commuting patterns during Latvia's first and second COVID-19 wave? 2) How do commuting patterns translate into regional differences? 3) What sociodemographic characteristics influence commuting habits? The findings suggest that around one-third of the population started working from home (WFH) along with the implemented restrictions. We find that the distinct ability to perform WFH is a pivotal contributor to socioeconomic disparities in commuting behaviour. No significant differences in daily commuting habits in Latvia were found when comparing the first and second waves. However, the heterogeneity of the findings appears when comparing the results among regions, age groups, education and occupations. We found a low "COVID crisis” impact on travel behaviour for less advanced population groups. And high impact or even far-reaching socioeconomic inequalities compared to students or those WFH with higher education, qualified specialists, managers, company owners and persons employed in the tertiary sector, as they are those coping with the most evident changes in their daily lives. © 2022 Societe Belge de Geographie. All rights reserved.

Challenges Faced by Hilly Hospitals during Covid-19 Second Wave Disaster: Quantitative Study in Garhwal Region, Uttarakhand

Covid -19 second wave was considered a disaster in India as it was more havoc than the first one. Shortness of breath in patients leads to more demand for oxygen and hospitalization. So, there was a challenge for the hospitals to combat this disease. In the covid second wave, moderate to severe cases were treated at three hospital levels (CHC, Sub-district, and District hospital). This disease was not limited to bigger cities but spread to rural and hilly areas. We conducted quantitative research among government hospitals in five hilly districts of Uttarakhand at three levels of hospitals. Data were collected from a close-ended questionnaire using a judgmental sampling technique and analysed with the help of tables and bar charts. Questions were set based on the pilot study. The challenges explored through this study were divided into five main headings and eleven sub-headings. The main headings were Manpower, Surge capacity, logistics, coordination, and management of non-covid patients. Sub-headings were a shortage of medical staff, shortage of paramedical staff, shortage of sweepers, shortage of ambulance drivers, shortage of ICU beds, shortage of oxygen beds, shortage of covid drugs (Remdesivir and Steroids), oxygen cylinders, PPE kits, difficulty in coordination with staff and difficulty in managing non- covid patients.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Modeling and Prediction of COVID-19 Spread in India for Growth Rate Estimation

With over a year of spread of COVID-1 9 in India, it is seen that there are significant differences in the transmission characteristics across various states. Propagation analysis of COVID-19 can help us to evaluate the significance of the climatic and geographic factors, in the growth of COVID-19 cases. Individual research correlating geographical or climatic factors with COVID-19 transmission showed varying results and few contradicting also. This study aims to investigate the relation using a combination of these factors to get better understanding. With extensive data available, it is possible to develop machine learning models with high accuracy. The proposed model learns the correlations of the weather and population density with the rate of change in the number of detected cases based on the data of the regions affected in the second wave of COVID-19 in India. The model can be used to assess the disease spread risks of a region by predicting expected change in the growth rate. The prior knowledge can assist in planning region specific pandemic management in the event of future outbreak. © 2023 DMICS.

COVID-19 complications and entrepreneurial intention among the entrepreneurs of Pakistan: evidence from the second wave of the pandemic

PurposeAt present, nearly the whole globe is facing a severe threat of COVID-19. This study aims to examine the COVID-19 complications and entrepreneurial intention among the entrepreneurs of Pakistan.Design/methodology/approachThe study used a deductive approach. An online survey is conducted to collect cross-sectional data from entrepreneurs of Pakistan. Convenience sampling is applied to target the respondents. In total, 278 usable answers proceed for final analysis. The structural equation model (SEM) is used to infer the results.FindingsThe findings of the study highlight a significant negative effect of fear of COVID-19 (FO19), perceived susceptibility (PSU) and perceived severity (PSE) on entrepreneurial intention (EI) among the entrepreneurs.Practical implicationsThe study would provide the guidelines for policymakers and planners to combat the barriers of fear, PSU and PSE during a pandemic. The findings of the second wave of COVID-19 may provide a warning to the government to take preventive measures to face the severe effect of the pandemic. Finally, the outcomes of the study may enrich the depth of COVID-19 literature globally.Originality/valueThis study is the first study highlighting factors such as fear, PSU and PSE toward EI in COVID-19 second wave.

Evaluation of Characteristics and Outcomes of COVID-19 Between First Wave and Second Wave: Study From a Tertiary Cancer Care Centre, Delhi, India.

Background and objectives The second wave of coronavirus disease-19 (COVID-19) had several severe consequences in the form of rising cases, deaths, and overwhelming health infrastructure in India. However, the similarities and differences between the characteristics of the first and second waves have yet to be explained. The objectives of the study were to compare the incidence, clinical management, and mortality rates between two waves. Methods The COVID-19 data collated from Rajiv Gandhi Cancer Institute and Research Centre, Delhi between the first wave (1 April 2020 to 27 February 2021) and second wave (1 March 2021 to 30 June 2021) were evaluated in terms of incidence, the clinical course of the disease, and mortality rates. Results The number of subjects hospitalized in the first and second waves was 289 and 564, respectively. Compared to the first wave, the proportion of patients with severe disease was higher (9.7% vs. 37.8%). Several parameters such as age group, grade of disease, the reason for hospitalization, values of peripheral oxygen saturation, type of respiratory support, response to therapy, vital status, and others show statistically significant differences between the two waves (P<0.001). The mortality rate in the second wave was significantly higher (20.2% vs. 2.4%, P<0.001) than in the first wave. Interpretation and conclusions The clinical course and outcomes of COVID-19 significantly differ between the first and second waves. There is a higher incidence of hospitalized patients (66.1% vs. 33.9%) with drastically increased case fatality rate in the second wave. Disease severity in the first wave is four times lower than in the second wave. The second wave was quite devastating, which led to the shortage of critical care facilities and the loss of a significant number of lives.

Profile and outcome of COVID-19 patients treated at a secondary hospital in Central India during the second wave of the pandemic.

Background: The second wave of the coronavirus disease 2019 (COVID-19) pandemic resulted in a significant rise in the number of infections and deaths as compared to the first wave. The published literature till now is limited to tertiary hospitals. We did this study to describe the demographic characteristics and outcomes of patients admitted to a secondary care hospital in central India during the second wave of the pandemic. Methods: This was a single-center, retrospective observational study conducted in a secondary hospital in central India. The data of patients with COVID-19 infection admitted between March 25 to May 25, 2021, were retrieved and analyzed. Results: A total of 184 patients were included in the study. The mean age was 54.8 ± 14.5 years. Comorbidities included hypertension (40.2%), diabetes mellitus (29.9%), hypothyroidism (4.3%), and asthma (2.7%). The most common presenting complaints were cough (78.8%), breathlessness (61.4%), and fever (60.9%). The mean duration of symptoms was 5.4 ± 2.6 days. According to High-Resolution Computerised Tomography (HRCT) chest severity score, 29/181 (16%) patients had mild disease, 135/181 (74.5%) patients had moderate disease, and 17/181 (9.5%) patients had severe disease. The majority of the patients received remdesivir (90.2%) and 123 patients (66.8%) received corticosteroids. Half the patients (52.2%; n = 96) required intensive care unit admission, 79.3% (145 patients) required oxygen support, and 8.1% (15 patients) required non-invasive ventilator support. Conclusion: Our study from a secondary hospital setup showed that the second wave was very severe with a high requirement of oxygen support and intensive care monitoring.

Knowledge, attitudes and practices of university students toward COVID-19 in Southern region, Afghanistan: a cross-sectional study.

BACKGROUND: Successful implementation of preventive measures and level of awareness in particular among university students in Afghanistan could play a crucial role in spreading the information for better control of the ongoing pandemic. Therefore, the aim of this study was to determine the level of knowledge, attitudes and practices (KAP) regarding COVID-19 among Kandahar university students. METHODS: A cross-sectional study conducted among undergraduate students to investigate their KAP regarding COVID-19 from January to March, 2021. The data were collected using a structured questionnaire (socio-demographic characteristics, KAP questionnaire) by phone call interviews. RESULTS: From 359 participants, 88.9% were males, 81.3% were single, 65.1% lived in urban areas, and more than 64% of the students were less than 23 years old. Overall, 86.6% of the study participants had adequate level of knowledge and 87.5% had positive attitudes toward COVID-19. Almost one-third of the participants had good practices regarding COVID-19. All KAP scores were higher in male students. Significant difference of good practice (p < 0.001) was observed among students who were in high socioeconomic status (SES) group. In univariate analysis, female sex (ß: -0.75, p = 0.007) was negatively and watching television (ß: 0.44; p = 0.014) was positively associated with knowledge score. However, in multivariate linear regression analysis, the knowledge score was significantly associated with age (ß: -0.115; p = 0.004); attitude score was significantly associated with female sex (ß: -2.776; p < 0.001) and radio use (ß: -0.974; p = 0.031); and practice score was significantly associated with female sex (ß: -3.704; p = 0.002) and urban area (ß: 1.702; p = 0.016). CONCLUSIONS: The overall knowledge and attitudes regarding COVID-19 among university students were desirable. Higher university year, young age, male sex and living in urban areas were significantly associated with good KAP regarding COVID-19. Good practices towards COVID-19 should be increased through awareness programs.

Comprehensive analysis of ambient air quality during second lockdown in national capital territory of Delhi.

The lockdown imposed in Delhi, due to the second wave of the COVID-19 pandemic has led to significant gains in air quality. Under the lockdown, restrictions were imposed on movement of people, operation of industrial establishments and hospitality sector amongst others. In the study, Air Quality Index and concentration trends of six pollutants, i.e. PM2.5, PM10, NO2, SO2, CO, and O3 were analysed for National Capital Territory of Delhi, India for three periods in 2021 (pre-lockdown: 15 March to 16 April 2021, lockdown: 17 April to 31 May 2021 and post-lockdown: 01 June to 30 June). Data for corresponding periods in 2018-2020 was also analysed. Lockdown period saw 6 days in satisfactory AQI category as against 0 days in the same category during the pre-lockdown period. Average PM2.5, PM10, NO2 and SO2 concentrations reduced by 22%, 31%, 25% and 28% respectively during lockdown phase as compared to pre-lockdown phase, while O3 was seen to increase. Variation in meteorological parameters and correlation of pollutants has also been examined. The significant improvement arising due to curtailment of certain activities in the lockdown period indicates the importance of local emission control, and helps improve the understanding of the dynamics of air pollution, thus highlighting policy areas to regulatory bodies for effective control of air pollution.