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.

Clinical profile and outcomes of COVID-19 infection during the first wave in children with hematological illnesses and cancer: An observational study from a tertiary care center in North India

Background: Patients with cancer are at a higher risk of getting infected with the severe acute respiratory syndrome coronavirus 2 owing to their immunocompromised state. Providing care to these patients amidst the first wave of the coronavirus disease-2019 (COVID-19) pandemic was extremely challenging. Objective(s): This study was aimed at evaluating the clinical profile and disease-related outcomes of pediatric patients with hematological illnesses and cancer. Material(s) and Method(s): This retrospective study was conducted at a tertiary care center in North India during the first wave of the pandemic from March 2020 to December 2020. Children aged up to 18 years, who were treated for a hematological illness or malignancy or underwent hematopoietic stem cell transplantation (HSCT) and tested positive for COVID-19 regardless of symptoms were included in the study. Baseline demographic data related to the age, diagnosis, treatment status, and chemotherapy protocol used were collected. Outcomes including the cure rates, comorbidities, and sequelae were recorded. Result(s): A total of 650 tests for COVID-19 were performed for 181 children;22 patients were found to be COVID-19 positive. The most common diagnosis was acute leukemia (63.6%). None of the patients developed COVID-19 pneumonia. The majority of patients had asymptomatic infection and were managed at home. Among those with a symptomatic infection, the most common symptoms were fever and cough. A total of 3 (13.6%) patients needed oxygen therapy, one developed multisystem inflammatory syndrome of children leading to cardiogenic shock. Three patients required intensive care or respiratory support;all the patients had favorable clinical outcomes. The median time from the onset of COVID-19 to a negative result on the reverse transcription-polymerase chain reaction test was 21.3 days. Cancer treatment was modified in 15 patients (68.2%). Conclusion(s): Our results suggest that children with hemato-oncological illnesses rarely experience severe COVID-19 disease. The impact of the first wave of COVID-19 primarily manifested as disruptions in the logistic planning and administration of essential treatment to these children rather than COVID-19 sequelae.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.

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.

Features of the course and medical and social aspects of a new coronavirus infection in the Republic of Tajikistan

The aim - to assess some medical and social aspects of the epidemic process during the first wave of a new coronavirus infectious disease - COVID-19 in the Republic of Tajikistan. Material and methods. The retrospective study was conducted on the basis of an epidemiological analysis of official statistics as part of the epidemiological surveillance of COVID-19 from April 2020 to April 2021. Results and discussion. At the beginning of April 2021, a total of 13 308 cases of COVID-19 were registered, of which the proportion of recovered was 99.3% (13 218 cases), and the number of cases with a fatal outcome was 0.68% (90 cases;the average age of the deceased was 62.3+/-0.07 years). The peak of infection during the first wave occurred in May and June 2020, when the average daily increase was 97 people. For 2 months of the epidemic in the republic, 44.6% of the total number of patients with COVID-19 became infected, and the number of deaths reached 52 people or 57.7%. Among the patients, men prevailed (65%). The largest number of deaths (76.7%;n=69) was among older people with comorbidities (diabetes mellitus, cardiovascular disease, chronic lung disease, metabolic syndrome, etc.). An analysis of the age structure showed that the main proportion of cases fell on the age group of 40-60 years (42.6%). It was found that a significant proportion of patients with COVID-19 was detected in the Sughd region (33.0%) and Dushanbe (30.1%). Conclusion. The COVID-19 pandemic showed that the national healthcare system of the Republic of Tajikistan was not sufficiently prepared for such a development of the COVID-19 epidemic process. There was an acute shortage of medical and preventive specialists in the republic. Given the current situation in the Republic of Tajikistan, within the framework of epidemiological surveillance, the features of the course of the COVID-19 epidemic process were analyzed, adequate emergency measures were developed and proposed to limit the spread of the virus and reduce the negative impact of COVID-19 on public health. The number of beds has been reasonably expanded, the capacity of the laboratory service has been increased, mass vaccination of the population has been started according to epidemic indications.Copyright © 2022 Geotar Media Publishing Group

First wave of COVID-19 impact on emergency general surgery in a Spanish tertiary hospital. A cohort study.

INTRODUCTION: The need to care for patients with emergency symptoms still continues during the COVID-19 pandemic. The number of emergency surgery procedures performed in Spanish hospitals decreased significantly during the first wave of COVID-19. PATIENTS AND METHODS: We performed a retrospective cohort study comparing the emergency surgery activity in a Spanish tertiary Hospital during the COVID-19 pandemic and emergency surgery activity registered in 2019 during the equivalent time period. RESULTS: A total of 1802 patients were included in control group (CG) versus 756 in pandemic group (PG). Mean number of patients who underwent emergency surgery during the control and pandemic periods was 3.42 patients per day, in contrast to 1.62 during the pandemic period, which represents a 52.6% decrease in emergency surgery activity. During the pandemic period, most of the patients consulted after more than 72 h of symptoms, representing a delay in presenting in the ER of 23.7% when compared to CG. Surgeries due to complications from previous elective procedures decreased (12% vs. 6.1%) in PG, probably because elective procedures are being postponed. We had a 13.1% COVID-19 positivity rate. Morbidity was higher during pandemic (52.5% vs. 35.2%). Mortality rates in patients undergoing emergency surgery was higher in PG (12.1% vs. 4.8%). CONCLUSIONS: The impact of the first wave of COVID-19 in emergency surgery activity has been profound. A significant reduction in emergency surgery was observed, along with longer time periods between patients' onset of symptoms and their arrival at the Emergency Department. Higher morbidity was also observed during the pandemic period.

Population Older than 69 Had Similar Fatality Rates Independently If They Were Admitted in Nursing Homes or Lived in the Community: A Retrospective Observational Study during COVID-19 First Wave.

The aim of this study is to assess the influence of living in nursing homes on COVID-19-related mortality, and to calculate the real specific mortality rate caused by COVID-19 among people older than 20 years of age in the Balaguer Primary Care Centre Health Area during the first wave of the pandemic. We conducted an observational study based on a database generated between March and May 2020, analysing COVID-19-related mortality as a dependent variable, and including different independent variables, such as living in a nursing home or in the community (outside nursing homes), age, sex, symptoms, pre-existing conditions, and hospital admission. To evaluate the associations between the independent variables and mortality, we calculated the absolute and relative frequencies, and performed a chi-square test. To avoid the impact of the age variable on mortality and to assess the influence of the "living in a nursing home" variable, we established comparisons between infected population groups over 69 years of age (in nursing homes and outside nursing homes). Living in a nursing home was associated with a higher incidence of COVID-19 infection, but not with higher mortality in patients over 69 years of age (p = 0.614). The real specific mortality rate caused by COVID-19 was 2.270/00. In the study of the entire sample, all the comorbidities studied were associated with higher mortality; however, the comorbidities were not associated with higher mortality in the infected nursing home patients group, nor in the infected community patients over 69 years of age group (except for neoplasm history in this last group). Finally, hospital admission was not associated with lower mortality in nursing home patients, nor in community patients over 69 years of age.

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.

China-Europe freight transportation under the first wave of COVID-19 pandemic and government restriction measures

International freight transportation experienced significant disruptions during the COVID-19 pandemic. The impact of the pandemic and related government restriction measures on international freight transportation is worth analysing for the development of transportation policies and practices in the post-pandemic period, but has received limited attention. To fill the gap, this study applies structural equation models to analyze the impact of the COVID-19 pandemic on the international transportation market and the relationships among the pandemic, government restriction measures, and international transportation market. The impact is also differentiated for different modes of transportation. Results confirm that both demand and supply of interna-tional transportation services have been negatively affected by the first wave of the pandemic, with sea trans-portation being more affected by the reduction of demand and air transportation more by the supply volatility. The government restriction measures are found to play a mediation role, in the way that the impact of the pandemic on the supply of transportation service is suppressed through the government restriction measures. Our findings provide important guidance for transportation industry players and governments in their decision-making process facing with global market shocks such as a pandemic.

Not dead yet: Protest, process, and germany's constitutional democracy amid the coronavirus response

The COVID-19 response in the Federal Republic of Germany (FRG) did not entail a declaration of a state of emergency. No provisions or procedures of the German constitution were suspended at any point. To be sure, the FRG's COVID response - including lockdowns, travel bans, hygiene rules, mask guidelines, distancing, testing, tracing, immunization plans, and so on - represents something other than business as usual. According to the Federal Ministry of Health, Germany's first official case of COVID-19 occurred in a man in the southern state of Bavaria on 27 January 2020. Germany's success with the first wave may have wrongly inflected overly buoyant expectations about successive waves - at all levels of politics and society - for better and worse. Either way, things were about to get weird in the FRG, although at first, the summer seemed to be shaping up rather nicely as SARS-CoV-2 restrictions eased. © 2023 John Wiley & Sons, Inc.

Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic.

Excessive inflammatory response has been implicated in severe respiratory forms of coronavirus disease 2019 (COVID-19). Trace elements such as zinc, selenium, and copper are known to modulate inflammation and immunity. This study aimed to assess the relationships between antioxidant vitamins and mineral trace elements levels as well as COVID-19 severity in older adults hospitalized. In this observational retrospective cohort study, the levels of zinc, selenium, copper, vitamin A, ß-carotene, and vitamin E were measured in 94 patients within the first 15 days of hospitalization. The outcomes were in-hospital mortality secondary to COVID-19 or severe COVID-19. A logistic regression analysis was conducted to test whether the levels of vitamins and minerals were independently associated with severity. In this cohort (average age of 78 years), severe forms (46%) were associated with lower zinc (p = 0.012) and ß-carotene (p < 0.001) concentrations, and in-hospital mortality (15%) was associated with lower zinc (p = 0.009), selenium (p = 0.014), vitamin A (p = 0.001), and ß-carotene (p = 0.002) concentrations. In regression analysis, severe forms remained independently associated with lower zinc (aOR 2.13, p = 0.018) concentrations, and death was associated with lower vitamin A (aOR = 0.165, p = 0.021) concentrations. Low plasma concentrations of zinc and vitamin A were associated with poor prognosis in older people hospitalized with COVID-19.

The Impact of the First and Second Waves of COVID-19 Pandemic in Nigeria.

In recent times, the COVID-19 pandemic has been the subject of global concern. It has so far claimed over 5.4 million lives globally, with over 291 million cases recorded worldwide as of 5 January 2022. It is known to have different waves and variants, thus making it difficult to handle/manage. This study investigates the impact of the first and second waves of COVID-19 in Nigeria, West Africa. The data used is for the 36 states of Nigeria archived at the National Centre for Disease Control from February 2020 to April 2021. Results from the study reveal that the highest number of COVID-19 cases during the first/second wave was recorded at Lagos (23,238/34,616), followed by the Federal Capital Territory (FCT) (6,770/12,911) and alternates between Plateau (3,858/5,170) and Kaduna (3,064/5,908). Similarly, the highest number of deaths (during the first/second wave) was also recorded in Lagos (220/219), followed by Edo (112/73), and then FCT (83/81). The Case Fatality Ratio (CFR) was observed to be higher mostly in northern Nigeria during the first wave and the southeast during the second wave of the pandemic. On the average, the number of cases/deaths recorded during the second wave was higher than those of the first wave, but a decrease in the CFR values was observed during the second wave. Higher values of COVID-19 cases/death were mostly recorded in Nigeria during; maximum relative humidity (RH) (>70%) with minimum Temperatures (<25°C), Low temperatures, and low RH which is mostly observed during the cold/dusty periods.

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.

Increased risk of early-onset preeclampsia in pregnant women with COVID-19.

OBJECTIVE: To estimate incidence, risk of early and late-onset preeclampsia (PE) and understand their relationship with severity of COVID-19. METHODS: Pregnant women with COVID-19 (n = 1929) were enrolled from 1 April 2020 to 24 February 2022. Primary outcome measure was incidence and risk of early onset PE in women with COVID-19. RESULTS: The incidence of early and late-onset PE was 11.4% and 5.6%. Moderate to severe COVID-19 was associated with eight times higher risk of early onset PE [aOR = 8.13 (1.56-42.46), p = 0.0129] compared to asymptomatic group. CONCLUSIONS: Risk of early onset PE was higher in pregnant women with symptomatic COVID-19 as compared to asymptomatic women.

Discrepancy between biomarkers of lung injury and 1-year mortality in COVID-19.

BACKGROUND: COVID-19 global pandemic started in late 2019 with the first wave. In this cross-sectional and observational study, we evaluated the associations between the biomarkers, COVID-19 pneumonia severity and 1-year mortality. METHODS: A sample of 276 polymerase chain reaction (PCR)-positive patients for SARS-CoV-2 was included. Computerized tomography severity score (CT-SS) was used to assess the severity of COVID-19 pneumonia in 222 cases. Multivariate analyses were performed to find the predictors of CT-SS, severe CT-SS (≥20) and 1-year mortality. Biomarkers of ferritin, high-sensitive C-reactive protein (CRP), lactate dehydrogenase (LDH), cardiac troponin (cTn), neutrophil-to-lymphocyte ratio (NLR), uric acid (UA) and d-dimer were routinely measured. RESULTS: Severe CT-SS (>20) was observed in 86 (31.2%) cases. Mortality was observed in 75 (27.2%) patients at 1 year. LDH displayed the highest predictive accuracy for severe CT-SS (AUC 0.741, sensitivity = 81% and specificity = 68%, cut-off value: 360 mg/dl). Linear regression analysis displayed that LDH predicted CT-SS [B = 11 (95% CI for B = 5-17, p < .001)]. Age was the most significant parameter that was associated with severe CT-SS (OR 0.96, 95% CI 0.92-0.99, p = .015). d-dimer was the only biomarker that predicted with 1-year mortality (OR 1.62, 95% CI 1.08-2.42, p = .020). CONCLUSION: LDH is a sensitive and specific biomarker to determine patients with severe lung injury in COVID-19. d-dimer is the only biomarker that predicts 1-year mortality. Neither LDH nor CT-SS is associated with 1-year mortality.

Comparative Study of COVID-19 Pneumonia in First and Second Waves

Background: The main aim of the study was to evaluate the different parameters of the COVID-19 pneumonia in India during the first and second waves.Method: Five hundred RT-PCR positive and HRCT documented COVID-19 pneumonia patients each from first wave (June 2020-December 2020) and second wave (March 2021-May 2021) were selected. The results were evaluated in terms of age groups affected, gender wise distribution, and CT severity score on HRCT. The final conclusion was done by comparing these variables from first wave with the ones during the second wave and inferences drawn upon thereof. Results: During the first wave, majority of the population involved belonged to more than 45years category whereas during the second wave majority belonged to the 18-45years category. Further, the severity of the disease was more during the second wave than the first wave with more males being affected than females in both the waves.Conclusion: Second COVID-19 wave in India was more severe than the first wave in terms of the number of patients affected as well as the severity of the pneumonia in the involved patients, likely due to continuously mutating variants of the virus & lifting up of the restrictions. © 2023 JK Science.

Evolution of SARS-CoV-2 during the first year of the COVID-19 pandemic in Northwestern Argentina.

Studies about the evolution of SARS-CoV-2 lineages in different backgrounds such as naive populations are still scarce, especially from South America. This work aimed to study the introduction and diversification pattern of SARS-CoV-2 during the first year of the COVID-19 pandemic in the Northwestern Argentina (NWA) region and to analyze the evolutionary dynamics of the main lineages found. In this study, we analyzed a total of 260 SARS-CoV-2 whole-genome sequences from Argentina, belonging to the Provinces of Jujuy, Salta, and Tucumán, from March 31st, 2020, to May 22nd, 2021, which covered the full first wave and the early second wave of the COVID-19 pandemic in Argentina. In the first wave, eight lineages were identified: B.1.499 (76.9%), followed by N.5 (10.2%), B.1.1.274 (3.7%), B.1.1.348 (3.7%), B.1 (2.8%), B.1.600 (0.9%), B.1.1.33 (0.9%) and N.3 (0.9%). During the early second wave, the first-wave lineages were displaced by the introduction of variants of concern (VOC) (Alpha, Gamma), or variants of interest (VOI) (Lambda, Zeta, Epsilon) and other lineages with more limited distribution. Phylodynamic analyses of the B.1.499 and N.5, the two most prevalent lineages in the NWA, revealed that the rate of evolution of lineage N.5 (7.9 × 10-4 substitutions per site per year, s/s/y) was a ∼40% faster than that of lineage B.1.499 (5.6 × 10-4 s/s/y), although both are in the same order of magnitude than other non-VOC lineages. No mutations associated with a biological characteristic of importance were observed as signatures markers of the phylogenetic groups established in Northwestern Argentina, however, single sequences in non-VOC lineages did present mutations of biological importance or associated with VOCs as sporadic events, showing that many of these mutations could emerge from circulation in the general population. This study contributed to the knowledge about the evolution of SARS-CoV-2 in a pre-vaccination and without post-exposure immunization period.

Stress among nursing staff and interventions in Austrian nursing homes: Results of a survey in the first and the second waves of COVID-19.

Background: Most of the limited number of studies that have been carried out on COVID-19 in nursing homes have not included primarily nursing staff. Nevertheless, knowledge about staff experiences will help to provide recommendations for the future. Aim: The aim of this study was to describe stress experienced and interventions performed by nursing staff and to identify factors that are associated to the perceived stress among Austrian nursing home staff during the first and the second waves of COVID-19. Methods: A secondary data analysis of two cross-sectional surveys performed in 2020 and 2021 among nursing home staff was performed. We did descriptive analysis as well as univariate and multivariate logistic regression analyses. Results: A total of 449 nurses participated in the first survey and 300 in the second survey. 12.7% experienced high stress levels in the first wave, while 26.0% experienced high stress levels in the second wave (p < 0.001). The analysis showed that nursing staff in the second wave had a 2.195-fold higher relative chance of experiencing a high stress level compared to nursing staff in the first wave (p < 0.001). Caring for COVID-19 residents (odds ratio [OR] 1.827; p = 0.007) and being female (OR 1.992; p = 0.018) also significantly increased the relative chance of experiencing a high stress level. Some protective interventions, such as the use of FFP masks, increased between the two waves, while others decreased, such as the practice of airing the residents' rooms. Conclusion: Austrian nursing staff in nursing homes experienced more stress during the second wave, illustrating the heavy burden of the long pandemic on staff. Nursing management should plan appropriate supportive interventions such as psychological help, stress relief measures and financial incentives for nursing staff, especially for the identified high-risk groups. Supplementary Information: The online version of this article (10.1007/s16024-022-00395-x) contains supplementary material, which is available to authorized users.

Epidemiology, Clinical Profile, Intensive Care Needs and Outcome in Children with SARS-CoV-2 Infection Admitted to a Tertiary Hospital During the First and Second Waves of the COVID-19 Pandemic in India.

OBJECTIVES: To compare the epidemiological, clinical profile, intensive care needs and outcome of children hospitalized with SARS-CoV-2 infection during the first and second waves of the pandemic. METHODS: This was a retrospective study of all children between 1 mo and 14 y, admitted to a dedicated COVID-19 hospital (DCH) during the first (1st June to 31st December 2020) and second waves (1st March to 30th June 2021). RESULTS: Of 217 children, 104 (48%) and 113 (52%) were admitted during the first and second waves respectively. One hundred fifty-two (70%) had incidentally detected SARS-CoV-2 infection, while 65 (30%) had symptomatic COVID-19. Comorbidities were noted in 137 (63%) children. Fifty-nine (27%) and 66 (30%) children required high-dependency unit (HDU) and ICU care respectively. Severity of infection and ICU needs were similar during both waves. High-flow oxygen (n = 5, 2%), noninvasive ventilation [CPAP (n = 34, 16%) and BiPAP (n = 8, 5%)] and invasive ventilation (n = 45, 21%) were respiratory support therapies needed. NIV use was more during the second wave (26% vs. 13%; p = 0.02). The median (IQR) length (days) of DCH stay among survivors was longer during the first wave [8 (6-10) vs. 5.5 (3-8); p = 0.0001]. CONCLUSIONS: Disease severity, associated comorbidities, PICU and organ support need and mortality were similar in the first and second waves of the pandemic. Children admitted during the second wave were younger, had higher proportion of NIV use and shorter length of COVID-19 hospital stay.

The impact of pandemic of COVID-19 on routine immunization: A cross-sectional study in tertiary care centre at Pune

Background: Due to COVID-19 pandemic there was implementation of preventive measures like lockdown, mobility restriction and fear had an impact on routine immunization of children. There are significantly increases the susceptibility window for vaccine preventable diseases due to delayed vaccination in under five children. The objective of study is to know the trend of routine immunization of previous five year and to assess the impact of COVID-19 pandemic on routine immunization of children of age group up to 7 years at tertiary care hospital at Pune. Method(s): A hospital-based cross-sectional study was conducted in a tertiary care hospital of Pune city from the month of January 2017 to December 2021. All the data of immunization from age group 0 to 7 years present at tertiary care center Pune, was compared and analysed. Data is expressed as numbers and percentages and means. Chi-square test was used to compare observed results with expected results. Result(s): In year 2020, there was a declining trend of all vaccines among children compared to previous 3 years. In year 2019, 2020, 2021, number of children vaccinated are 6547, 4052, and 5062 respectively. Out of this 1078(16%), 1089(26.9%), 1165(23%) children had delayed vaccination in year 2019, 2020, 2021 respectively. There was highly significant increase in delayed vaccination of children in COVID-19 period. Conclusion(s): The routine immunization of children was decreased and delayed due to COVID-19 pandemic. This is an alarming finding to prevent reappearance of new epidemics of vaccine preventable diseases.Actions should be taken to avoid delayed routine immunization in future. Copyright © 2022 Ubiquity Press. All rights reserved.

Relation of spice consumption with COVID-19 first wave statistics (infection, recovery and mortality) across India

Background & Objectives: The recovery and mortality statistics for COVID-19 first wave considerably differed in different states & Union territories (UT) of India. Spices are an essential part of Indian cuisine. Apart from adding flavors and colors to the food, their importance is traditionally known in disease prevention and cure. Thus, present study was carried out to assess relation of spice consumption with COVID-19 first wave statistics in India. Methods: The spice consumption data of ginger, garlic, cumin, coriander, turmeric, black pepper, chili, tamarind and 'other spices' were retrieved from 'Household Consumption of Various Goods and Services in India' from 68th round (2011-12) of survey conducted by National Sample Survey Organization (NSSO). The first wave data for individual states and UTs were retrieved as total number of cases, number of cured/discharged/migrated cases and total number of deaths, in a cumulative normalized form. The correlation of these was analyzed. Results and Conclusions: Spices were consumed across India with a varied range. The highest consumed spice was ginger. The highest consumption of 'Other spices' were observed in Lakshadweep (149 gm/30 days), which incidentally reported zero cases. Tamarind had positive correlation (r = 0.4724) with total number of cases and recovered/migrated/cured cases (r = 0.4948). Cumin consumption exhibited weak positive correlation (r = 0.5011) with total deaths per million population. However, most of these correlations were statistically insignificant. These findings can help to predict preventive/mitigating or curative usage of these spices. The unspecified and under-explored 'Other spices' category showed promising correlation.