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1.
Infezioni in Medicina ; 30(3):432-439, 2022.
Article in English | EMBASE | ID: covidwho-2033632

ABSTRACT

Introduction: Liposomal amphotericin use is limited in developing countries due to its extremely high cost and availability. Therefore, the study aimed to evaluate deoxycholate amphotericin B’s utility and adverse effect profile in patients with mucormycosis. Methodology: This retrospective cohort study from 2019 to 2021 included patients with proven mucormy-cosis who received deoxycholate amphotericin B for more than or equal to five days and had at least three creatinine values on treatment. Baseline demographic details, risk factors and treatment details of all the patients were recorded. In addition, the details of treat-ment-related adverse effects and outcomes were ascer-tained. Results: Of the 57 included patients, a history of diabe-tes, COVID-19 and steroid use was present in 49 (86%), 43 (75.4%) and 33 (57.9%) patients, respectively. Isolat-ed rhino-orbital mucormycosis was the most common presentation (n=49, 86%). The median time of fol-low-up was 48 (30.5-90) days. A total of 8 (14%) pa-tients died during the hospital stay. The median dura-tion of amphotericin treatment was 21 (14-40) days. Thirty-nine patients (68.4%) developed hypokalaemia on treatment, while 27 (47.4%) patients developed hy-pomagnesaemia. A total of 34 (59.6%) patients developed AKI on treatment. The median day of development of AKI was 6 (4-10) days. The median baseline, highest and final creatinine values were 0.78 (0.59-0.94) mg/dl, 1.27 (0.89-2.16) mg/dl and 0.93 (0.74-1.59) mg/ dl respectively. The median percentage change from baseline to highest value and last follow-up value was 45% (0.43%-161%) and 25% (-4.8%-90.1%) respectively. The final creatinine was less than 150% of the baseline in 36 (63.2%) patients. Conclusion: Deoxycholate amphotericin is an accept-able alternative for treating mucormycosis in re-source-constrained settings.

2.
Infezioni in Medicina ; 30(3):412-417, 2022.
Article in English | EMBASE | ID: covidwho-2033630

ABSTRACT

To reduce the overburden in the hospital, during the COVID-19 pandemic, some “COVID Committed Home Medical Teams” (CCHTs) were created in Italy. These units consist of a small pool of general practitioners who aim to evaluate all patients with COVID-19 who require a medical examination directly at home. After the first visit (which can end with patient hospitalisation or home management), CCHTs periodically monitor the patients’ clinical conditions and vital signs (usually a re-valuation every 24-48 hours, except for a sudden wors-ening). However, this strategy-which reduces the pres-sure on hospitals-has never been evaluated for patient safety. Our study aims to determine whether a home-based monitoring and treatment strategy for non-severe COVID-19 patients was safe as direct hospital admis-sion by the emergency department. We conducted a retrospective observational study about 1,182 patients admitted to the hospital for COVID-19 between September 2020 and April 2021, confronting in-hospital and 30-day mortality in both CCHT-referred (n=275) and directly admitted by emergency department (n=907). Patients assessed by the CCHT had lower in-hospital and 30-day mortality (18% vs 28%, p=0.001;and 20% vs 30%, p=0.002);but, in the propensity score matching comparison, there was no characteristic between the two groups turned out significantly different. CCHT did not correlate with in-hospital or 30-day mortality. CCHT is a safe strategy to reduce hospital overburden for COVID-19 during pandemic surges.

3.
Infezioni in Medicina ; 30(3):403-411, 2022.
Article in English | EMBASE | ID: covidwho-2033629

ABSTRACT

Cases with SARS-CoV-2 RT-PCR negative pneumonia are an understudied group with uncertainty remain-ing regarding their treatment approach. We aimed to compare the clinical and radiological characteristics of RT-PCR positive and clinically diagnosed RT-PCR negative COVID-19. This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age ≥18 years) with suspicion of COVID-19 with SARI (severe acute respiratory infec-tions) who were subjected to RT-PCR testing (nasal/ oropharyngeal swab) were included. Based on RT-PCR results, patients were categorized and compared for demographic, clinical, and biochemical characteristics and outcomes. Out of 500 patients, 339 (67.8%) found RT-PCR positive. Except for the radiological findings, both groups differ in clinical presentation, disease severity (inflammatory markers), and outcome. RT-PCR-positive patients had raised ferritin, NLR (Neutrophil-Lymphocyte ratio), LDH, and high mortality compared to the swab-negative group. In-hospital mortality was also significantly high in RT-PCR positive group (HR=1.9, 95% CI=1.4-2.5, p=0.001). On mul-tivariate analysis, NLR, ferritin, and d-dimer were the independent predictors of mortality in RT-PCR-posi-tive (p=0.038, 0.054, and 0.023). At the same time, raised TLC (total leukocyte count) and procalcitonin were the risk factors for poor outcomes in RT-PCR-negative patients (p=0.041 and 0.038). We found significantly raised ferritin, NLR, and LDH levels and increased mortality in RT-PCR positive patients compared to RT-PCR neg-ative. Incorporating clinical features, radiological, and biochemical parameters could be prudent while managing the RT-PCR-negative patients.

4.
Infezioni in Medicina ; 30(3):344-352, 2022.
Article in English | EMBASE | ID: covidwho-2033628

ABSTRACT

Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition, has been reported approxi-mately 2-4 weeks after the onset of COVID-19 in children and adolescents, causing inflammation in multiple systems, including cardiovascular and respiratory, digestive, and central nervous systems. This condition is also known as hyperinflammatory shock, Kawa-saki-like disease, and Pediatric Inflammatory Multi-system Syndrome (PIMS). The signs and symptoms include but are not limited to fever, rash, peripheral edema, gastrointestinal symptoms, conjunctivitis, and shock. Thirty-eight studies met our criteria, with a to-tal of 5822 patients. The most affected population was between 5-18 years of age. We noted that MIS-C pre-sented with a wide range of signs and symptoms that overlap with Kawasaki Disease, including high fever, sore throat, malaise, tachypnea, tachycardia, conjunc-tival injection, mucosal edema, cardiac involvement, and gastrointestinal symptoms. It causes an increase in IL-17A, IL-6, and arterial damage, a distinct differ-ence from Kawasaki disease. The laboratory findings in MIS-C showed an increase in inflammatory markers like CRP, ESR, ferritin, leukocytes, and TNF-α. WHO stated that 23% of affected children with MIS-C had underlying conditions like chronic lung diseases, cardiovascular disease, and immunosuppression. In most affected children, aspirin and IVIG were success-ful, which resulted in a decrease in the inflammatory markers. We find that MIS-C is a rare, but potential-ly fatal pediatric complication, after COVID-19 infec-tion. The aim of this article is to study the emerging relationship between COVID-19 and MIS-C in children and adolescents affected by this condition, to discuss the immunological mechanisms, and explore potential therapies.

5.
Anales de la Real Academia Nacional de Farmacia ; 88(2):123-130, 2022.
Article in English | EMBASE | ID: covidwho-2033626

ABSTRACT

Objetive: Description of the different isolated microorganisms and their prevalence in infections associated with health care, in addition to determining their patterns of resistance to antibiotics in patients admitted with a confirmed or suspected diagnosis of COVID-19 in the Intensive Care Unit, during a third-level medical center with hospital reconversion. Method: Patient demographic data was obtained from the clinical record, with defined criteria. Antibiotic resistance patterns were evaluated as well as the identification of isolated bacteria in cultures of expectoration, pleural fluid, catheter tips. For bacterial identification and resistance mechanisms, automated equipment and phenotypic tests were used, following the CLSI (Clinical & Laboratory Standards Institute) criteria. Results: A total of 100 patients with bacterial infection added to the main COVID-19 picture were obtained, representing pneumonia, urinary tract infection, catheter infections and bacteremia. A total of 100 strains were isolated, of which 84 are Extremely Drug Resistant, 12 Multidrug Resistant and only 4 variable sensitivity. The bacteria with the highest prevalence is Staphylococcus aureus with, followed by Pseudonomas aeruginosa and Stenotrophomonas maltophilia. 100% of the patients admitted to the ICU (Intensive Care Unit) had death. Conclusion: The increase in resistance to antibiotics in the COVID-19 pandemic has set off alarms due to the complication that this brings, and the improper use of drugs as prophylaxis or attempted treatment only generates selective pressure that leads to an increase in resistance as observed in the isolated strains in this study, where the vast majority present enzymes as well as other resistance mechanisms that confer them to be XDR (Extremely Drug Resistant).

6.
Pakistan Journal of Medical and Health Sciences ; 16(7):485-487, 2022.
Article in English | EMBASE | ID: covidwho-2033625

ABSTRACT

Background: Because of the recent outbreak of Covid-19, the globe is now facing a number of difficult challenges. The morbidity and mortality rate varies depending upon numerous factors. Objective: The objective of the study was to find out the mortality and morbidity rate of Covid-19 in a tertiary care hospital of Swat Methodology: This descriptive cross-sectional study was carried out at the Department of Pathology, Swat Teaching Hospital, Swat, Khyber Pakhtunkha Pakistan for duration of one year from April 2020 to March 2021. Nasopharyngeal or Oropharyngeal swabs were taken from all the enrolled patients and sent to the national institute of health Islamabad or swat public health laboratory for the diagnosis of Covid-19. The rate of morbidity and mortality for all the enrolled patients was recorded. All the data analysis was done by using IBM SPSS version 23. Results: In the current study, totally 11609 patients were enrolled. There were 7329 (63.13%) males and 4280 (36.87%) females. The overall morbidity rate of covid-19 was 18.25% (n= 2089) whereas the overall mortality rate was13.16% (n=275) patients. Conclusion: Our study concludes that the rate of morbidity and mortality of covid-19 is high in district Swat Khyber Pakhtunkhwa, Pakistan. The burden of covid-19 was high in males as compared to females and the mortality rate increases with the increase in age. All the people residing in the district Swat should be vaccinated to decrease both the morbidity and mortality rate of covid-19.

7.
Pakistan Journal of Medical and Health Sciences ; 16(7):474-478, 2022.
Article in English | EMBASE | ID: covidwho-2033624

ABSTRACT

Objective: Healthcare providers (HCPs) are at the forefront and are at risk of being exposed to suspected cases of COVID-19. The objective of our study was to evaluate knowledge, attitude and practices of HCPs about COVID-19 in Khyber Pakhtunkhwa (KPK) province of Pakistan. Methods: A cross-sectional survey was conducted online among HCPs that included physicians, dentists, pharmacists, nurses and technicians in KPK province. The validated questionnaire (Cronbach alpha= 0.61 & 0.69 respectively for knowledge & practice sections) related to COVID-19 including socio-demographics was asked. Data was analyzed using SPSS version 22.0. Result: Out of 480 HCPs, 83.8% (n=402) were physicians & dentist, while 12.5% (n= 60) were pharmacist, nurses and technicians. We found that 86% of the HCPs had adequate knowledge. Most common reason for being worried about COVID- 19 was risk to members of family and friends (98%), followed by dangers of disease itself (93%). Fear of infection and carrying it home was as high as 93% and 97% respectively. Around 75% of the HCPs had adequate score about practices. Conclusion: HCPs in Pakistan has good knowledge and attitude related to COVID-19. However, one-fourth of the HCPs did not report good practices, which is alarming. There is a need to reinforce knowledge and monitor practices of HCPs regarding standard infection control practice.

8.
Indian Journal of Forensic Medicine and Toxicology ; 16(3):208-213, 2022.
Article in English | EMBASE | ID: covidwho-2033603

ABSTRACT

Background: The COVID-19 pandemic has spread worldwide, forcing governments to implement quarantines as a preventive measure against the spread of the virus. Quarantine causes changes in lifestyle and anthropometry status among communities. Objective: To describe the lifestyle and anthropometric status of medical students batch 2018 FM UA during the pandemic. Methods: This was a descriptive study using online questionnaires from September 2020 to February 2021. Results: There were variations in students’ anthropometry. Students’ average height is 161.110 cm, the average weight is 60.308 cm, the average body mass index is 23.193 cm, the average upper arm circumference is 27.846 cm, and the average abdominal circumference is 79.621 cm. Furthermore, 145 respondents (81.9%) stated that they experienced changes in their lifestyle during the pandemic. A total of 89 respondents (50.3%) continued to exercise and the other 88 respondents (49.7%) did not. Regarding the sleep pattern, 108 respondents (61%) had quite good sleep quality and 50 respondents (28.2%) had quite poor sleep quality. For the food consumption pattern, 46 respondents (26%) ate more sweet foods. Furthermore, 156 respondents (88.1%) did sedentary activities, with 77 respondents (43.5%) doing sedentary behavior for more than 6 hours a day. Conclusion: During the COVID-19 pandemic, the anthropometric status of medical students batch 2018 FMUA varied;and tend to maintain their physical activity, have quite good sleep quality, prefer eating sweet foods, and do a sedentary behavior for a longer duration

9.
Acta Pharmaceutica Hungarica ; 91(3-4):95-96, 2021.
Article in English | EMBASE | ID: covidwho-2033587

ABSTRACT

Introduction Pfizer-BioNTech collaboration started in 2018 in order to develop mRNA flu vaccine. Because of the covid19 pandemic the two companies started to focus on mRNA vaccine development for the prevention of covid19 infection. In March they signed the Letters of Intent. Initially there were four vaccine candidates including unmodified mRNA, nucleoside-modified mRNA and self-amplifying mRNA. For further development the nucleoside- modified mRNA was chosen. In April Phase 1/2 study was completed in Germany and in May in the USA. Two 30 μg doses 3 weeks apart induced neutralizing antibody titers comparable to natural infection and strong CD4+ and CD8+ Tcell responses were observed. Phase 2b/3 clinical trial started in July involving more than 43.000 participants in 153 sites. The result showed 95% efficacy with mild and moderate local and systemic events. For safety reason all participants will be followed for 2 years after the second dose. Based on rolling review regulatory agencies were able to approve within a short period of time in December 2020, first MHRA in UK, then FDA authorized for Emergency Use and EMA granted Conditional Marketing Authorization on 21 December 2021 for 16 years old and older. The first shipments were sent all European countries on 27 December. Direct shipments to vaccination centers on ultra-low temperature (minus 9060 degree of centigrade) using dry ice. Each thermal shipping container has a temperature monitoring device. All shipments are tracked via GPS monitoring device to ensure end-to-end distribution within required temperatures. In May EMA granted an extension of indication for covid-19 vaccine to include in children aged 12-15. The effect of vaccine was investigated in 2260 children aged 12-15, about half of them received dummy injection. Of the 1,005 children receiving the vaccine, none developed COVID-19 compared to 16 children out of the 978 who received the dummy injection. This means that, in this study, the vaccine was 100% effective at preventing COVID-19. The most common side effects in children aged 12 to 15 are similar like those in people aged 16 and above. They include pain at the injection site, tiredness, headache, muscle and joint pain, chills and fever. These effects are usually mild or moderate and improve within a few days from the vaccination. EMA granted approval for booster dose (third dose) for immune weakened people 28 days after the second dose, and 6 months after the second dose for 18 years of age and older. Approval is based on the clinical program evaluating the safety, tolerability and immunogenicity of a booster dose of covid-19 vaccine. A booster dose of the vaccine elicited significantly higher neutralizing antibody titers against the initial SARS-CoV-2 virus (wild type), as well as the Beta and Delta variants, when compared with the levels observed after the two-dose primary series. The reactogenicity profile within seven days after the booster dose was typically mild to moderate, and the frequency of reactions was similar to or lower than after dose two. The efficacy is this trial was 95,6%. In October 2021 FDA authorized for emergency use of covid-19 for children 5 through 111 years of age. For this age group, the vaccine is to be admin-istered in a two-dose regimen of 10 μg (0,2 ml) doses given 21 days apart. EUA is supported by clinical data showing a favorable safety profile and high vaccine efficacy of 90.7% in children 5 through 11 years of age during a period when Delta was the prevalent strain. In 2021 we have already distributed 1,8B doses to 146 countries by end of September. In 2022 we plan to distribute 4B doses. (Figure Presented).

10.
Journal of Advances in Medical and Biomedical Research ; 30(142):452-457, 2022.
Article in English | EMBASE | ID: covidwho-2033568

ABSTRACT

Background & Objective: Individuals with opioid use disorder are a marginalized population in any society. They commonly have a weaker immune system, greater stress vulnerability, poorer health, more high-risk behaviors, and less access to healthcare services compared to the general population, which can expose them to a risk of severe COVID-19 complications. This study aimed to evaluate the effects of opioid use disorder on mortality in patients with SARS-CoV-2. Materials & Methods: This registry-based retrospective cohort study was conducted on 2362 consecutive inpatients with a confirmed diagnosis of SARS-CoV-2 between March 5, 2020 and March 21, 2021, presenting to a university hospital in Ilam in the southwest of Iran. Forty-five patients with opioid use disorder were identified in this study and matched to 100 patients without opium addiction. All patients with a history of opium addiction were included in the study group, and age-and sex-matched patients without opioid use disorder were randomly recruited as the controls. After adjusting for the effects of age and comorbidities, data were analyzed in STATA version 10, using logistic regression models. Results: The mortality of patients with opioid use disorder increased following COVID-19 (adjusted OR: 6.59;95% CI: 1.84–23.59;P=0.004). Hypertension (adjusted OR: 8.17;95% CI: 2.21–30.15;P=0.002) and advancing age (OR: 1.06;95% CI: 1.01–1.11;P=0.01) were significantly associated with increased COVID-19 mortality. Conclusion: Based on the present findings, opioid use disorder is a possible risk factor for mortality following COVID-19. The findings of the present study can be applied in the implementation of preventive measures and policies and prioritization of COVID-19 vaccination. However, further relevant research is recommended.

11.
Voprosy Ginekologii, Akusherstva i Perinatologii ; 21(3):28-35, 2022.
Article in Russian | EMBASE | ID: covidwho-2033519

ABSTRACT

Objective. To assess the effectiveness of different preventive measures for novel coronavirus infection in pregnant women. Patients and Methods. This study included 125 pregnant women hospitalized with moderate to severe laboratory-confirmed SARS-CoV-2 infection between September and November 2021 (the fourth pandemic wave), and 175 pregnant women who were not infected with COVID-19 during the same period. All women in these two groups were comparable for gestational age (II–III trimesters, 24–39 weeks), age (20–40 years), social status, parity, body mass index, and had no known COVID-19 risk factors. Results. Our findings revealed that vaccination 3-5 months before pregnancy (OR = 4.12;95% CI 1.28–13.27;χ2 = 0.022), inconsistent use and/or non-timely replacement of face masks (OR = 5.71;95% CI 2.83–11.51) were associated with the increased risk of COVID-19 in the second and third trimesters of gestation. It was showed that systematic (once in the morning at 24–48-hour intervals) intranasal administration of recombinant interferon alpha-2b (IFN-α;Grippferon) as compared with a single application after exposure to COVID-19 reduced the disease incidence rate and there was no evident risk of illness (OR = 0.08;95% CI 0.05–0.14;19.2% vs 74,3%, p < 0.001). This can be explained by the fact that women were mostly infected in unpredictable conditions (e.g., 29.2% of pregnant women were infected from family members, 23.9% had unknown source of exposure). The use of umifenovir, not currently authorised for the medication-assisted prevention of COVID-19 in pregnant women, and rectal administration of IFN-α suppositories did not reduce the disease incidence rate. Rectal use of IFN-α suppositories by pregnant women off-label increased the incidence (32.0 vs 15.4%, p = 0.001) and risk of developing novel coronavirus infection (OR = 2.58;95% CI 1.48–4.50). Conclusion. There is a need to improve awareness among pregnant women about the mandatory and timely vaccination against COVID-19 during pregnancy and the importance of strict adherence to wearing face masks. Increased efforts should be made to monitor and inform pregnant women about the use of only authorised medication-assisted preventive measures of SARS-CoV-2 infection, such as intranasal administration of recombinant IFN α-2b (Grippferon). During the epidemic rise in COVID-19 cases, the systematic intranasal administration of recombinant interferon-based medication Grippferon (once in the morning at 24–48-hour intervals) is recommended for pregnant women.

12.
GERMS ; 12(2):169-179, 2022.
Article in English | EMBASE | ID: covidwho-2033510

ABSTRACT

Introduction The COVID-19 pandemic context led to a relevant burden on essential sectors of society;hospital sector capacity is tested in this period. Methods A cross-sectional study of admissions in hospitals reporting DRG data for 2018-2020. Trend analysis of admissions and deaths in hospitals was carried out for identifying annual patterns and deviations from the 2010-2020 trend. Data aggregated by year, month, diagnosis, death in hospital. Graph analysis for time and diagnosis comparisons and correlation identifying associations. Results There is an annual change in admission and death patterns recorded in Romanian hospitals. An important contraction in number of acute hospital admissions was recording during the COVID-19 pandemic;patients’ hesitancy to seek healthcare and limited capacity to treat patients other than COVID-19 patients due to legal regulations limiting the admissions number could explain this pattern of admission only for serious condition or emergency surgery. In Romania excess deaths in second half 2020 was generally greater than COVID-19 deaths. Overall, excess mortality between March and December 2020 was more than double than reported COVID-19 deaths. The same mortality pattern persists, but with significant decreases for some diagnoses. Conclusions The Romanian healthcare system has been challenged due to COVID-19 pandemic, leading to temporary reorganization of hospitals with consequences on all acute care diagnostics and therapeutic pathways. It is a challenge to identify causes of reduced inpatient treatment rates and to provide evidence on hospital activity for understanding future optimal management of patients with COVID-19, but also with other acute and chronic conditions.

13.
Iranian Journal of Parasitology ; 17(2):393-401, 2022.
Article in English | EMBASE | ID: covidwho-2033509

ABSTRACT

Background: Dermatoparasitic infestations due to the mites Demodex spp. and Sarcoptes scabie are prevalent dermatological disorders worldwide. Methods: Referral patients from the Departments of Dermatology, Infectious Diseases, and from the psychologists, in some cases, to the laboratory of Medical Helminthology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran were examined and documented for demodicosis and scabies from March 2009 to December 2020. All patients’ data were collected and then analyzed statistically by SDATA version 14, using the Chi-square test. Results: Out of 494-suspected patients suffering from dermal disorders, 99 patients (20.04%) and 20 cases (4.04%) were found infested with demodicosis and scabies, respectively. Most demodicosis cases belonged to the 46-60 year age group while the infestation rate of scabies was higher in the age group under 5 years (P=<0.0001). Demodicosis was seen more prevalent in women than men, and scabies were higher in men (P=0.15). The cases of demodicosis in fall and scabies in winter and spring were more frequent. Demodicosis picked up in 2015 and 2017 (P=0.03), while the prevalent year for scabies was in 2016 (P=0.77). Both current ectoparasites declined dramatically by Covid-19 pandemic. Conclusion: Demodicosis and scabies have been found correlated with age, and no statistical association was seen between the gender and seasonal factors. Besides, the obvious decline of demodicosis and scabies infestation rates during the Covid-19 outbreak can mention that social distance and hygiene standards have negative effects on dermatoparasites transmission.

14.
Acta Medica Iranica ; 60(6):338-344, 2022.
Article in English | EMBASE | ID: covidwho-2033505

ABSTRACT

Dyspnea and decreased O2 saturation are the most common causes of hospitalization in noncritical COVID-19 patients. Breathing exercises and chest physiotherapy are used for managing the patients. These treatments are, however, not well supported by scientific evidence. In a randomized controlled trial, 80 patients were randomly assigned to planned breathing exercises (n=40) and control groups (n=40). The participants in the intervention group were instructed to blow into a balloon five times a day while lying down. Other therapies were similar in both groups. The severity of dyspnea at rest/after activity and peripheral oxygen saturation (SpO2) with/without O2 therapy were compared between the two groups on the first, second, and third days. The study findings showed no statistically significant difference in SpO2 with/without O2 therapy on the first, second, and third days between the two groups. Although the severity of dyspnea showed no significant difference between the two groups, the mean score of dyspnea at rest (2.72±2.25 vs. 1.6±1.21, P=0.007) and after activity (4.53±2.04 vs. 3.52±1.66, P=0.017) improved in the intervention group on the third day. Balloon-blowing exercise improves dyspnea in noncritical Covid-19 patients, but it does not significantly improve oxygenation.

15.
Acta Medica Iranica ; 60(6):329-337, 2022.
Article in English | EMBASE | ID: covidwho-2033504

ABSTRACT

Solid-organ transplantation recipients were assumed highly vulnerable to coronavirus disease 2019 (COVID-19). However, the results of previous studies in patients with orthotopic heart transplantation (OHT) under immunosuppressive therapy are contradictory. Therefore, we aimed to assess the prevalence of COVID-19 infection and associated risk factors, along with the six-month outcomes in COVID-19 positive OHT patients. This single-center telephone-based survey was conducted on OHT patients. Using a detailed questionnaire, exposure to COVID-19, related symptoms, and preventive self-care measures were collected. Outcomes of COVID-19-positive patients were reassessed using another survey six months later. 118 OHT patients (male: n=87, 73.7%) were included with a mean age of 45.3±13.1 years. Sixteen patients (13.5%) reported one or more symptoms compatible with COVID-19, of whom 12 (10.2%) tested positive. Our results indicated no statistically significant association between COVID-19 and comorbidities. Poor adherence to self-care measures and contact with positive index cases were both significantly associated with COVID-19 infection (P<0.001). A later six months follow-up showed that two out of 12 (16.6%) COVID-19 positive OHT patients died. There was no statistically significant difference between the prevalence of COVID-19 in our patients compared to Iran’s general population (P=251.0). Non-compliance with personal protective protocols and a history of contact with COVID-19 cases were the most risk factors for COVID-19 infection in OHT patients.

16.
Pulmonologiya ; 31(6):701-709, 2021.
Article in Russian | EMBASE | ID: covidwho-2033500

ABSTRACT

Although antibiotics (ABs) are ineffective against COVID-19, they are often prescribed to patients with the new coronavirus infection. Many of these prescriptions are uncalled for. The aim of the work is to assess the frequency of prescribing antibiotics to hospitalized patients with confirmed COVID-19, identify the most commonly prescribed ABs, and determine the significance of various biomarkers for the diagnosis of bacterial infection. Methods. A retrospective analysis of 190 inpatient cases with confirmed COVID-19 was carried out. The records of COVID-19 patients who were admitted to the intensive care unit were excluded from the analysis. Two groups were formed: 30 patients (group 1) with COVID-19, emergency or elective surgery, and exacerbation of chronic infectious diseases, and 160 patients (group 2) with manifestations of COVID-19 only. Results. ABs were prescribed to 189 patients upon admission to the hospital. The most frequently prescribed ABs included macrolides (63.5%), respiratory fluoroquinolones (49.7%), and third or fourth-generation cephalosporins (57.1%). ABs were administered starting from the first day of admission and until the discharge. The patients in group 2 were more often prescribed respiratory fluoroquinolones and, less often, III – IV generation cephalosporins. Moreover, macrolides were used in the treatment regimens of both groups. Longer administration of respiratory fluoroquinolones to patients in group 2 than patients in group 1 (p < 0,05) was noted. Group 2 also tended to receive longer therapy with macrolides. On admission, the patients with signs of bacterial infection had more significant leukocytosis with a neutrophilic shift, a more common increase in ESR of more than 20 mm/h and an increase in the level of procalcitonin ≥ 0,5 ng/ml. Conclusion. ABs were administered to the overwhelming majority of hospitalized patients in the absence of clear therapeutic indications. The ABs are likely to have a minimal benefit as empirical treatment of COVID-19 and are associated with unintended consequences, including adverse effects and increased antibiotic resistance. According to our data, the most informative markers of a secondary bacterial infection in patients with COVID-19 are leukocytosis with a neutrophilic shift, an increase in ESR of more than 20 mm/h, and a procalcitonin level of more than 0,5 ng/ml.

17.
Erciyes Medical Journal ; 44(5):508-511, 2022.
Article in English | EMBASE | ID: covidwho-2033490

ABSTRACT

Objective: The aim of this study was to determine the methods of pain self-care used by patients in Türkiye with chronic musculoskeletal pain who could not access a healthcare provider during the coronavirus 2019 (COVID-19) pandemic. Materials and Methods: A total of 255 participants (mean age 40.8±13.2 years) diagnosed with chronic musculoskeletal pain were included in the study. The Nordic Musculoskeletal Questionnaire and a form created by the researchers were used to assess the prevalence of musculoskeletal symptoms and methods of pain management. Results: The primary site of symptoms during the previous 12-month period was the low back, neck, and upper back regions (69%, 64.7%, and 60% respectively). The detailed assessment revealed that in the prior 7 days, patients experienced symptoms most often in the lower back (56.9%), upper back (45.1%), and neck (43.9%). The most frequently used methods of pain self-care were massage (71%), pain relief medication (68.2%), and topical analgesics (55.3%). Conclusion: Patients most often reported symptoms in the spinal area, and the most used means of self-care for pain management were massaging the painful area, pain medication, and topical analgesics. Self-care initiatives can be very valuable, however, at least some initial guidance from health professionals is advisable. Additional exploration of technological means of intervention and awareness of appropriate self-care could be of substantial benefit individuals and society.

18.
NeuroQuantology ; 20(10):4249-4257, 2022.
Article in English | EMBASE | ID: covidwho-2033479

ABSTRACT

Background: With the advent of the coronavirus pandemic, Higher Education Organizations (HEOs), including medical schools, started using online education to effectively teach, and evaluate students’ performances. An increasingly popular contemporary modality offered by the digital e-learning market is a Learning Management System (LMS). Aims and Objectives: The aim isto assess Moodle v. 3.9 as a tool to conduct online medical examinations. The objectives are: 1. To collect student feedback 2. To discuss technical aspects with Moodle experts 3. To implement necessary changes based on the feedback and discussion Material and Methods: A short-term longitudinal observational study was conducted at the Symbiosis Medical College for Women, Pune, India to collect feedback from 143 students with regards to their online exam experience with Moodle and the technical difficulties they faced were noted. In collaboration with software experts, certain technical changes pertaining to bandwidth requirements were implemented. Results: We observed that the students require extra time as compared to the online exam scenario for conversion of their answer sheets into PDFs, and this technical aspect needs to be considered while designing such exams. We also established the server bandwidth that is essential for an uninterrupted online exam experience at the institute level. Lastly, student feedback suggested that the online examination environment is perceived as more stressful, compared to its live counterpart. Conclusion: We conclude that cost-effectiveness, user-friendly interface, and a multitude of assessment-related features make Moodle an efficient tool for conducting online medical examinationsattheundergraduatelevel.

19.
NeuroQuantology ; 20(10):2908-2915, 2022.
Article in English | EMBASE | ID: covidwho-2033475

ABSTRACT

Background: A severe antibody-mediated inflammatory demyelinating disease of the central nervous system is neuromyelitis optica spectrum disorder (NMOSD). Azathioprine (AZA) and Rituximab (RTX) were used to treat NMO-SD patients though not FDA approved yet. Aim of the study: To compare the effectiveness and safety of rituximab treatment versus azathioprine in treating individuals with NMOSDs. Methods: Seventy four Egyptian individuals with NMOSDs in this retrospective observational study and collecting their medical records from multiple sclerosis (MS) clinics, Neurology Departments, El-Maadi Military Hospital, and Cairo University hospitals. Fourty four patients received either treatment over two year duration, Group 1 (rituximab group) consisted of 19 patients, while group 2 (azathioprine group) consisted of 25 patients. Their full medical history, general and neurological examination, MRI brain and spinal cord results, and laboratory investigation were collected including immune assays and AQP-4 antibody. Results: There was no statistically significant difference between the groups in terms of brain MRI data at the baseline and outcomes. Between the two groups, there were statistically significant differences in last observer spinal MRI (p=0.025), annual relapse rate before treatment with RTX group (P=0.021), EDSS pretreatment (p=0.005), annual relapse rate post-treatment. When it came to the number of relapses after treatment, there was a high statistically significant difference between the two groups (p=0.016), with group 1 (RTX group) having zero relapses. There was a statistically significant decrease comparing EDDS scores pre-and post-treatment regarding the RTX group (p=0.003). Adverse events were Infusion rate reaction (5.3%) and pneumonic COVID (9.5%) of patients. Conclusion: RTX is more helpful and less harmful for NMO-SD patients than AZA.

20.
NeuroQuantology ; 20(8):8231-8242, 2022.
Article in English | EMBASE | ID: covidwho-2033469

ABSTRACT

Introduction: Healthcare Workers (HCWs) are repeatedly exposed to SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus 2) or the COVID-19 virus. This study aimed to identify factors associated with SARS-CoV-2 re-infection among HCWs in a tertiary care centre. Methods: We conducted a case–control study. Cases were defined as those with a second positive reverse transcription-polymerase chain reaction (RT-PCR) report after a symptom free period of atleast 30 days after previous positive RT-PCR report and controls were those with a single covid-19 episode (RTPCR positive) during Aug-2020 to Jul-2021. All HCWs (second positive report) were included as cases and matched controls (age, gender) recruited in 1:2 ratio. They were interviewed using a google form and clarifications (if any) were obtained on phone. Analyses were performed using logistic regression models. Results: A total of 53 cases and 110 controls were included. Age>50 (AOR-1.63 95%CI-1.06-5.59), Men (AOR-4.13 95% CI-1.70–10.05), Nurses (AOR-11.24 95% CI-1.05–119.63), not using N95(AOR-2.89 95% CI-1.02–5.05), Diabetic (AOR-3.51 95%CI-2.01-8.73) and inadequate use of personal protective equipment or PPE (AOR 4.82 95% CI 1.18–19.65) were identified as risk factors. Conversely, graduate (AOR 0.06 95% CI 0.01–0.53) and postgraduate (AOR-0.05 95% CI-0.005–0.7) education, feeling scared or nervous (AOR-0.45 95% CI-0.22–0.91), not always wearing any gloves, caps and goggles/face shields (AOR 0.10 95% CI-0.02–0.41), hand hygiene (AOR-0.42 95% CI-0.1-0.94) and consistent use of N95 masks or double masking (AOR-0.27 95% CI-0.09–0.80) even outside the workplace were protective factors. Conclusion: Study highlights protection provided by high-performance filtering masks or double masking among HCWs. These modifiable risk factors should be considered while designing, implementing, and monitoring COVID-19 biosafety protocols.

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