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Learning from the SARS-CoV-2 consequences is essential in order to anticipate future pandemics. Moreover, it is a compelling reason to make substantive improvements in both public health and prevention systems. However, preparedness seems a difficult task when people show pandemic fatigue or question decisions that would affect their personal sphere. To deal with such reactions, it seems important to leave open some avenues for citizens' involvement, a strategy recommended by the World Health Organization and the European Commission. Here the main argument is in favor of a civic approach of prevention: (1) Preparedness to anticipate future pandemics is a duty;(2) But, so far, it is not a priority issue for the political agenda;(3) Neither is citizens' collaboration in the governance of health policy. Therefore, we could ask about the channels of communication and participation that are available to citizens, entities or stakeholders, to discuss public health issues.
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Food supply has been a constant source of concern for mankind. In the present context, with food security a priority of European and national policies, an analysis of pig farming in a representative NUTS2 administrative level of Romania that emphasizes the proportion of households raising at least one pig and the main factors influencing farmers to adopt or give up swine breeding could allow a much clearer understanding of this phenomenon that lies at the border between cultural tradition and socio-economic necessity. This study uses mixed methods that complement each another to help reveal this complex phenomenon in the analyzed territory. Cluster analysis shows the concentration of swine breeding and maps its spread in terms of both subsistence and larger farms, and qualitative interviews prove the motivation of farmers to continue in this occupation. As a primary result, the study visualizes the spatial distribution of pig farming in the rural environment of Valcea county, Romania, from a diachronic perspective in the post-communist period. It also reveals areas of differing concentrations of both very small-sized farms, which prioritize meeting their own food needs, and larger farms, which prioritize commercial production to supplement their revenue streams. Both categories, but particularly the latter, are of particular interest in a period in which the socio-economic environment after 1990 - marked by economic restructuring, unemployment, population migration, the economic crisis of 2008-2010, the pandemic of 2020-2021, and the most recent energy crisis - periodically highlights the importance of rural areas in ensuring food security and sufficiency at both the local and regional levels.
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AIM: The study aimed to assess the effectiveness of the ChAdOx1 nCoV-19 vaccine in preventing laboratory-confirmed COVID-19. METHODS: It was a test-negative, case-control study conducted at Sharda Hospital, Greater Noida, India, between March 2021 and May 2021. An equal number of cases and controls were included in the study after taking proper informed consent. The individuals with positive reverse transcriptase-polymerase chain reaction test reports were taken as cases, whereas those with negative reports were included as controls. Data were analyzed and the groups were compared using multivariable logistic regression to calculate the odds ratio (OR), with adjustment for gender and presence or absence of comorbidities. The effectiveness of vaccine was calculated by the formula (1-adjusted OR) x100%. RESULTS: On analyzing the data from 560 case-control pairs, the vaccine effectiveness was calculated as 57.46% (95% confidence interval [CI]: 53.85-61.02) and 60.09% (95% CI: 56.32-63.77) for single dose and two doses, respectively. The effectiveness of complete and single-dose vaccination against the moderate-to-severe disease was calculated as 63.79% (95% CI: 58.58-68.77) and 56.19% (95% CI: 51.30-61.0), respectively. CONCLUSION: The ChAdOx1 nCoV-19 vaccine was found to be effective against COVID-19, with protection after two doses being a little more than that after a single dose. It also proved effective in protecting against the severe form of the disease.
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Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al- Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.
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Background and Objectives: Statins, which are primarily used for controlling blood cholesterol levels, have a well-known role in inhibiting the inflammatory process and reducing mortality rate of infectious diseases. This study aims to evaluate the effect of atorvastatin along with standard treatment protocol in hospitalized adults with COVID-19. Methods: This randomized controlled clinical trial was conducted on adults hospitalized due to COVID-19 infection at Shahid Beheshti Hospital in Qom, Iran from April to September 2020. They were randomly divided into groups of treatment (n=37, receiving atorvastatin 40 mg daily for 30 days plus standard treatment protocol) and control (n=37, receiving standard treatment protocol alone). The data were analyzed in SPSS v.22 software using chi-square, paired t-test, and ANOVA. P < 0.05 was statistically significant. Results: The CRP level in the atorvastatin-treated group decreased significantly such that there was a significant difference between the two groups after 30 days (P=0.01). There was no significant difference in Spo2 level on the discharge day. The length of hospitalization in the atorvastatin-treated group was significantly reduced compared to the control group (P < 0.05). Conclusion: The use of atorvastatin as an adjunctive treatment method, can significantly reduce the length of hospitalization and CRP level after 30 days in hospitalized patients.
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Coronavirus disease 2019 (COVID19) is the recently reported disease caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID19 spreads among population through the close/direct contact and nasal droplets when an infected person sneezes, coughs, talks or breaths. On an average, COVID19 infected patient develops clinical symptoms 5-6 days after the infection and some develops symptoms even after 14 days of infection. Detailed study on the symptoms shown by COVID19 patients can help in identifying individuals so that proper identification and isolation of patients can be done and transmission of virus can be reduced significantly. In this study, a total of 99 (66 males and 33 female) COVID19 infected symptomatic patients without any comorbidities were included. Nasopharyngeal and oropharyngeal swabs were used for the collection of samples from the suspected patients to extract total RNA and perform real time PCR for the detection of genetic material for SARS-CoV-2. Samples with Ct value = 36 in case of Orf1ab gene and E gene with good sigmoidal curve were reported as positive for novel SARS-CoV-2. Fever, shortness of breath, dry cough and cough with sputum production persisted for longer timer and were more common symptoms reported by the COVID19 infected patients. In conclusion, understanding of the clinical symptoms shown by COVID19 infected patients can help in identification and isolation of patients so that transmission of virus can be reduced significantly.
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Many studies have dealt with the medicinal properties of Jatropha curcas;however, there are limited studies on the scope of its antiviral potential. This is a fact associated with the current challenges posed by HIV-AIDS and COVID-19, which has reinforced the need to expand the knowledge about its antiviral resource. Based on the search for natural products with anti-HIV-1 and anti-SARS-CoV-2 activities, this work analyzed the extract of J. curcas seed, the structure of the plant whose antiviral references were not found in the literature, and the compounds that can potentiate it as a candidate for herbal medicine. GC-MS analysis was used to screen for the active substances of the J. curcas seeds, and the literature was searched to find those with anti-HIV-1 and anti-SARS-CoV-2 indication. The results showed they have 27 compounds, of which glycerol 1-palmitate, stigmasterol and gamma-sitosterol were shown to have antiviral action in the literature. Regarding glycerol 1-palmitate, no detailed description of its antiviral action was found. Stigmasterol and gamma-sitosterol act as anti-HIV-1 and anti-SARS-CoV-2, respectively, inhibiting the reverse transcriptase of HIV-1, the proteases 3CLpro, PLpro and the spike proteins of SARS-CoV-2. However, despite the fact that the extract of J. curcas seeds consist of antiviral compounds that fight against the etiological agents of HIV-AIDS and COVID-19, it is concluded that there is a need to deepen this evidence, by in vitro and in vivo assays.
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BACKGROUND: Knowledge of social and gender determinants, which influence the places where people are exposed to COVID-19, may be relevant in the development of preventive and control strategies. The aim of this paper was to determine the context in which COVID-19 cases were infected (household, work/labor, health, social-health, and social-leisure settings) according to country of origin, occupational social class and gender, which is essential in order to designing public health strategies. METHODS: A cross-sectional study of an epidemiological registry of 56,628 COVID-19 incident cases was made, whose exposure/ contagion setting was studied according to the previous variables from June 15 to December 23, 2020, in the Region of Murcia (Spain). An exact Fisher test was used to study the distribution of COVID-19 cases based on the above variables. RESULTS: The cumulative incidence was higher in people from Africa (5,133.5 cases/100,000 inhabitants) and Latin America (11,351.1) than in non-immigrants (3,145.7). It was also higher in women (3,885.6) than in men (3,572.6). It is noteworthy, that 53.3% of the cases with employment were workers in industry or construction, artisans, agricultural workers, or elementary occupations. In contrast, during the second semester of 2020, 41.3% of the employed population in the Region of Murcia performed such jobs. The household was the main exposure setting (56.5% of cases with a known setting), followed by social-leisure (20.7%) and work/labor (18.2%). The labor settings were more important in immigrants from Africa (28.4%) and Latin America (35.7%) than in non-immigrants (12%), inversely to social-leisure settings. Labor context was more important in women (19.6%) than in men (16.5%) and in manual workers (44.1%) than in non-manual workers (26.6%). CONCLUSIONS: The context in which COVID-19 cases were infected is different according to social inequalities related to country of origin, gender and occupational social class.
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Context: The contemporary workplace creates a challenge toward physicians and their teams. They are forced into a situation, in which to be competitive they must have skills outside of their medical specialty, such as health management, pedagogy, and information and communication technologies. Aim: To analyze the level of stress and burnout among the medical employees in the hospital care. Settings and Design: Healthcare professionals from three private, municipal, and regional hospitals filled a questionnaire in the time period January-March 2021. Methods and Material: An adapted Maslach Burnout Inventory 55 question questionnaire was used and analyzed. Statistical Analysis Used: One-way ANOVA, correlation, and multiple regression analysis in SPSS. Results: We identified high levels of emotional exhaustion (> 62% report high signs or above), high levels of depersonalization (> 70% report signs of depersonalization), and low levels of personal accomplishment (< 39% have below average sense of achievements). Conclusions: Despite the physicians and their teams reporting high levels of workload and stress, the satisfaction from work has not diminished and the evaluation for the quality of provided work is still high. Additional research into the topic is required with focus on comparison between hospital physicians and primary care physicians.
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Complete basic immunization consists of 1 dose of hepatitis B, 1 dose of BCG, 3 doses of DPT-HB-Hib, 4 doses of polio drop, and 1 dose of measles. The target for complete basic immunization in 2019 is 93% with a complete basic immunization achievement of 57.9%. The impact of not getting complete immunization is the incidence of morbidity and mortality due to tuberculosis, poliomyelitis, measles, hepatitis B, diphtheria pertussis, and tetanus neonatorum. This study aims to find out factors that affect the completeness of basic immunization for infants aged 12 months old during the COVID-19 pandemic in the Gunung Sari Health Center Work Area, Way Khilau District in 2022. This research is quantitative with a cross-sectional design. The population in this study were all mothers who had infants aged 12 months old in the working area of the Gunung Sari Health Center. The sample in this study were 81 peoples. The sampling technique was purposive sampling. Data analysis was analyzed using univariate, bivariate, and multivariate analysis. The results of this study indicate that there was a relationship between maternal age (p = 0.000), education (p = 0.000), knowledge (p = 0.001), family support (p = 0.003), and support from health workers (p = 0.042) with the completeness of basic immunization for infants aged 12 months old during the Covid-19 pandemic. The most dominant factor in influencing the completeness of basic immunization in infants aged 12 months old was the knowledge variable. Suggested for mothers can be more active in seeking information about basic immunizations that should be given to children so that no more children have incomplete immunization status.
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Background: The SARS-CoV-2 pandemic led to the restructuring of traditional clinical activity;hence, globally, 58% of countries implemented the use of telemedicine to meet their healthcare needs. Background: To examine patients' satisfaction with telemedicine medical service and experience at the level of primary care in the Kingdom of Bahrain. Methods: A retrospective cross-sectional study was conducted on 335 patients who used teleconsultations in January 2022 in primary care. A validated questionnaire was modified to assess patients' satisfaction with teleconsultation medical services and experience during the COVID-19 pandemic. Results: A total of 315 responses were included in the final analysis (response rate 94%). Almost all expressed extreme satisfaction with the medical service as they were able to easily explain their medical problem over the phone and fully understood their illness after the consultation. They were also satisfied with the ability of the doctor to understand their problem, explain their treatment, and provide appropriate management over the phone. Over 90% were satisfied with the consultation time that it does not require transportation and would like to use it in the future. Sharing private or personal information over the phone received the lowest satisfaction rate (77.5%). Conclusion: The overall satisfaction expressed by respondents of this survey with the teleconsultation medical service and experience is very high. Such a result confirms that patients have a positive attitude towards telemedicine services in primary care and are willing to use it again and, therefore, must be adopted as a proactive strategy to ensure long-term sustainability.
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Introduction: The Indonesian Government's plan to contain the COVID-19 pandemic, aside from implementing health protocols, also involves vaccinating everyone with the inactivated SARS CoV2 vaccine until herd immunity is reached. The aim of this study was to assess the post-vaccination immune response to inactivated SARS CoV2 vaccine, namely Sinovac/Sinopharm, by measuring the antibodies (IgM and IgG) in subjects after their second dose of vaccination. Materials and Methods: The design of the study was a cohort study using simple random sampling with 51 respondents aged 18-56 years who had received two doses of inactivated SARS-CoV-2 vaccine. All respondents were screened for SARS-CoV-2 infection prior to inclusion. Serum IgM and IgG antibodies were detected using a specific and sensitive automated chemiluminescent immunoassay (CLIA). CLIA uses the Cut Off Point (COI) value of >1 AU/ml for IgM and the Reactive Value of >10 AU/ml for IgG. Results: This study showed that the IgM levels using a reactive Cut Off Point (COI) >1 were 18% in the first month, 14% in the third month, and 10% in the sixth month. There was a constant decline in the third comparison. Meanwhile, compared to the first month, 59% of respondents had IgG levels with reactive values over 10 AU/ml, which after decreasing by 35% in the third month, the number increased by 47% in the sixth month. Conclusion: It has been evident that IgG and IgM antibody response could be induced by inactivated SARS-CoV-2 vaccine which can be influenced by age and detection time after the second dose of vaccination. Boosters, however, must be given after six months of the second dose, since antibody levels were seen to decrease after this period.
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Introduction: Proper and effective triage of patients suspected to COVID-19, the diagnosis of their high risk situation and then hospitalization in order to carry out treatment measures are of particular importance. This study was conducted with the aim of determining the triage status of patients suspected of COVID-19. Methods: This descriptive cross-sectional study was performed in the period between April and June 2020 in one of hospitals in Tehran. Triage information related to 1010 patients suspected of COVID 19 were assessed. Some of these patients were hospitalized and the rest were advised to rest at home. Clinical, laboratory and survival or death data of hospitalized patients were collected from their hospital documenttaion. Patients who were discharged from triage without the need for medical intervention and were advised to rest at home were contacted by phone. Then their condition after discharge from triage, re-referral to other hospitals due to the symptoms of the disease, other symptoms that appeared at home, and treatment measures performed in case of re-referral to the hospital were asked. The collected data was analyzed using descriptive statistics and logistic regression modeling and t-test and chi-square statistical tests using SPSS 16. Results: The results showed that among the 1010 assessed patients, 360 people (35.5%) were admitted to the hospital with a definite diagnosis of COVID-19, and 650 people (64.5%) did not need to be hospitalized according to the triage performed. Among the 650 patients sent home, the information of 57.5% of the patients could not be followed up due to the lack of answering the phone, and only 276 people (42.5%) answered the phone call, and none of them needed hospitalization in other hospitals. Among the patients admitted to the hospital, 14.8% had died. The results of adjusted odds ratio based on multivariate logistic regression modeling for predictors of mortality showed that after adjusting the variables in the model, none of the variables showed a significant relationship with mortality (P>0.05 in all cases). Conclusion: Results showed that all patients who were admitted to the hospital after triage were finally infected with COVID-19. Other patients who did not require hospitalization and were advised to rest at home were not hospitalized in other medical centers either. The results showed that the triage performed for patients was able to identify COVID 19 critically ill patients who need hospitalization.
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Background: Hospitalization of coronavirus disease 2019 (COVID-19) patients can lead to burden of care and cause health problems for family members of the patients. The aim of this study was to investigate the relationship between burden of care and mental health of family members of hospitalized patients with COVID-19. Methods: This cross-sectional correlation study was conducted from November 2021 to February 2022. The study population consisted 84 family members of COVID-19 patients who were hospitalized in Shariati Hospital affiliated with Tehran University of Medical Sciences. The subjects were selected via consecutive sampling. Data collection was done using a demographic information form, the Depression Anxiety Stress Scales-21, the Zarit Burden Interview, and the 12-item General Health Questionnaire. Data were analyzed using SPSS 16 and at significance level of 0.05. Results: More than half of the participants (51.22%) experienced mild to moderate level of care burden, while 17.07% of them experienced moderate to severe level of care burden. The mean score of mental health in the participants was 16.925+or-1.953. By adjusting the demographic variables and the Depression Anxiety Stress Scales-21, the level of stress of family members led to more burden of care (coefficient beta= 0.608, 95% confidence interval= 0.451-1.556, P=0.001). Conclusion: Paying attention to the issue of stress in the family members of hospitalized patients with COVID-19 and supporting these individuals can help to provide better care to the patients and reduce health challenges.
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The taxonomic diversity and the richness of the region of Seraidi (North-East Algeria) in medicinal plants, as well as the appearance of diseases of viral origin, in particular, the current pandemic of SARS-CoV-2, led us to the realization of an ethnobotanical survey of plants with antiviral interests. The survey was conducted based on a pre-established quiz, with 120 people from different categories of the population of Seraidi, with the aim of listing the medicinal plants used in the treatment of viral diseases and collecting as much information as possible on this subject. After analyzing, the information provided by the people interviewed, we listed 32 species belonging to 20 families, of which the Lamiaceae family is the most represented. Older women are the most affected by the use of plants;people without a higher intellectual level have the most knowledge about the use of plants with antiviral interest. The leaf is the most widely used organ, in the form of a decoction or infusion, administered orally.
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Objective: To present in-hospital COVID-19 mortality and the associated factors at a public sector tertiary care hospital in Karachi Methodology: The current prospective, observational study was conducted at Jinnah Postgraduate Medical Center, Karachi, Pakistan from June 1 to August 30, 2021 with the approval of the hospital ethics committee. Data was collected prospectively from patients' medical record files. COVID-19 infection positive cases were diagnosed according to the guidelines of the WHO on laboratory investigation of real time polymerase chain reaction tests on a nasopharyngeal or oropharyngeal swab. Result: Total 143 patients were enrolled in the study with median (IQR) age of 58 (48-69). The majority of the patients were males (n=96, 67.13%) and had moderate to severe disease (n=128, 89.51%). During their hospital stay, patients developed the following complications;pneumonia (n=99, 69.23%), ARDS (n=19, 13.28%), sepsis (n=11, 7.69%), septic shock (n=5, 3.49%) and pedal edema (n=2, 1.39%). As many as 104 (72.72%), 69 (48.25%), and 42(29.37%) patients required pharmatherapy, non-invasive ventilation, and mechanical ventilation respectively. While 54 (37.76%) patients died during their hospital stay. On multivariable model, pneumonia, use of non-invasive ventilation, and mechanical ventilation, were identified as independent predictors of mortality. Conclusion: Most of the patients in our study had moderate to severe disease. Therefore, the study indicates that timely presentation to the hospital is of great importance to avoid adverse events which are significantly associated with mortality.
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Introduction: Patient satisfaction with services is generally considered the main component of quality of care and can be described as the subjective perception of service quality resulting from the matching of expectations about services with actual experience and results. Therefore, the purpose of this study is to investigate the level of satisfaction of hospitalized patients with a definite or suspected diagnosis of covid-19 from the care staff of covid-19 wards. Methods: In this cross-sectional descriptive study, 172 patients with covid-19 who were admitted to Peymaniyeh Hospital in Jahrom city in 2019 with the diagnosis of corona virus disease were examined. The data collection tool in this study included two questionnaires for demographic information (age, sex, underlying disease, duration of hospitalization, etc.) and a satisfaction questionnaire for the medical staff. Data analysis was done using spss software version 21 and descriptive and inferential statistical tests. Results: The most frequent age was 31-40 years old (22.1%). The satisfaction level of the majority of hospitalized patients from the treatment staff was high, 133 patients (77.3%), the satisfaction level of 37 patients (21.5%) was average, and the satisfaction level of only 2 patients (1.2%) was low. Conclusion: Based on the results of the present study, the level of satisfaction of the majority of patients was reported at a high level. However, the demographic variables (age, sex, marriage, education, occupation, economic status, etc.) of the patients did not have a statistically significant relationship with the level of satisfaction of hospitalized patients with a definite or suspected diagnosis of Covid-19 from the medical staff. Therefore, by implementing continuous training programs and investigating cases of dissatisfaction, we can try to improve the satisfaction of patients as much as possible.
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Aim: The global COVID-19 pandemic and new variants continue to seriously threaten society. In this study;It was aimed to investigate surveillance of SARS CoV-2 and other respiratory viruses in respiratory tract samples in the winter season of 2020-2021 in Sakarya province. Material and Method: The study was carried out at Sakarya Training and Research Hospital between 2020-2021. e study was carried out with respiratory tract samples (Nasopharyngeal swab) stored in the laboratory. Clinical samples included in study were stored in a Bio-SpeedyRvNATRtransfer tube (Bioeksen,Turkey) and no extraction was performed in accordance with manufacturer's instructions. All analyzes were recorded on BIO-RAD CFX-96C1000 Touch Real-time system device using Diagnovital influenza A/B, SARS CoV-2, RSV multiplex Real Time PCR amplification kit. Results: Of the 200 patients diagnosed with URTI/LRTI, 54.5% were male and 45.5% female. e most common clinical symptoms;sore throat 74%, cough 73.5%, fatigue 71%, fever 57%, runny nose 56%, headache 48.5%, sneezing 41.5%, loss of smell / taste 39.5%, diarrhea 36%, dyspnea was 31.5% and myalgia was 23.5%. PCR positivity rates of samples were analyzed as 28.5% for SARS COV-2 and 1.5% for RSV, respectively. PCR positivity for influenza A/B was not defined in the study. Considering the statistical significance between PCR results and COVID-19 symptoms in patients;symptoms of dyspnea (n=63), fever(n= 62) and sneezing(n=56), respectively, were statistically significant(p<0.05). Conclusion: Due to the circumstances, only three main viral agents could be investigated in the study. RSV was frequently identified as an important factor in pediatric patients, whereas influenza-which may be related to social and individual measures (mask,distance,hygiene)- was not detected in any sample. More comprehensive scientific studies are needed to support the data.
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OBJECTIVES: Globally, the case fatality ratio is more in males versus females. Some studies have suggested estrogen hormone decreases susceptibility to SARS CoV-2. We have analyzed the observed sex differences in COVID-19 behavior in males and females and the clinical profiles of females of different age groups of COVID-19 patients and discussed their symptoms, laboratory evaluations, and associated comorbidities. MATERIAL AND METHODS: The patients were tested for COVID-19 through real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assay. The data obtained were studied for the epidemiological, clinical, and laboratory characteristics from their medical records. RESULTS: The mortality rate in females was 12.33% (36/292) whereas mortality in males was 19.63% (84/428). In between group analysis, 8.7% (14/161) of females died in the <40 years age group versus 16.8% (22/131) in more than 40 years age group whereas in males, the mortality was 13.7% (21/153) in <40 years versus 22.9%(63/275). The mortality rate in women older than 40 years was greater than mortality in younger females emphasizing the protection provided by estrogen hormone in them. The proportion of patients who expired due to COVID-19 significantly differs by age cutoff of 40 years, X2 (1, n=428). The difference is statistically significant at P < 0.05. Males more than 40 years are more likely to expire. CONCLUSION: Sex-related differences in coronavirus pandemic have been found pointing toward the protective role of estrogen hormone and other differences in immunological behavior in males and females. Downregulation of ACE2 expression, thereby reducing viral entry, might also be contributory to decreasing mortality in females.
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Objective: To determine the frequency of contraceptive usage, the social barriers affecting their use, and the frequency of unplanned pregnancies during the COVID-19 pandemic Methodology: This is a prospective cross-sectional study carried out at the Department of Obstetrics and Gynaecology, Fazaia Ruth Pfau Medical College & PAF Hospitals from July 2020 to September 2020. All women of reproductive age attending the outpatient department were consecutively included. A pre-structured questionnaire was used for the purpose of collection of data. We obtained information regarding the use of contraception before and during the COVID-19 pandemic and the contraception methods used by these women. Furthermore, reasons for discontinuing contraception amongst those women who were using it earlier. The occurrence of pregnancy during pandemic was also noted. Results: Of the 350 women, 306 (87.4%) women practiced contraception before and 288 (82.3%) practiced it during the lockdown. Of 306 women practicing contraception before the lockdown, 265 (86.6%) continued practicing during the lockdown as well. Condom 145 (50.3%) and withdrawal method 116 (40.3%) were the most used methods amongst the 288 women practicing contraception during the lockdown. The noticeable increase in the number of those using withdrawal method was due to the lack of consultation following the fear of getting COVID (17 women, 41.5%) and no access to the clinic (14 women, 34.1%). These were the most common reasons for not using contraception, amongst the 41 women practicing contraception before the pandemic. Pregnancies were reported by 93 (26.6%) women out of whom 75 (80.6%) reported these to have been unplanned. Conclusion: The COVID pandemic has largely affected the utilization of contraceptives among women who were already practicing different contraceptive methods. Moreover, unplanned pregnancies are increasingly reported by women.