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1.
Environ Sci Pollut Res Int ; 28(30): 40474-40495, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-2148922

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease represents the causative agent with a potentially fatal risk which is having great global human health concern. Earlier studies suggested that air pollutants and meteorological factors were considered as the risk factors for acute respiratory infection, which carries harmful pathogens and affects the immunity. The study intended to explore the correlation between air pollutants, meteorological factors, and the daily reported infected cases caused by novel coronavirus in India. The daily positive infected cases, concentrations of air pollutants, and meteorological factors in 288 districts were collected from January 30, 2020, to April 23, 2020, in India. Spearman's correlation and generalized additive model (GAM) were applied to investigate the correlations of four air pollutants (PM2.5, PM10, NO2, and SO2) and eight meteorological factors (Temp, DTR, RH, AH, AP, RF, WS, and WD) with COVID-19-infected cases. The study indicated that a 10 µg/m3 increase during (Lag0-14) in PM2.5, PM10, and NO2 resulted in 2.21% (95%CI: 1.13 to 3.29), 2.67% (95% CI: 0.33 to 5.01), and 4.56 (95% CI: 2.22 to 6.90) increase in daily counts of Coronavirus Disease 2019 (COVID 19)-infected cases respectively. However, only 1 unit increase in meteorological factor levels in case of daily mean temperature and DTR during (Lag0-14) associated with 3.78% (95%CI: 1.81 to 5.75) and 1.82% (95% CI: -1.74 to 5.38) rise of COVID-19-infected cases respectively. In addition, SO2 and relative humidity were negatively associated with COVID-19-infected cases at Lag0-14 with decrease of 7.23% (95% CI: -10.99 to -3.47) and 1.11% (95% CI: -3.45 to 1.23) for SO2 and for relative humidity respectively. The study recommended that there are significant correlations between air pollutants and meteorological factors with COVID-19-infected cases, which substantially explain the effect of national lockdown and suggested positive implications for control and prevention of the spread of SARS-CoV-2 disease.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollution/analysis , China , Communicable Disease Control , Humans , India/epidemiology , Meteorological Concepts , Particulate Matter/analysis , Risk Factors , SARS-CoV-2
2.
J Cancer Res Ther ; 18(6): 1629-1634, 2022.
Article in English | MEDLINE | ID: covidwho-2144197

ABSTRACT

Aim: The pandemic by novel coronavirus disease 2019 (COVID-19) is the biggest threat to global health care. Routine care of cancer patients is affected the most. Our institute, situated in Mumbai, declared as the hotspot of COVID-19 in India, continued to cater to the needs of cancer patients. We did an observational study to review the experience of managing uro-oncology patients and who underwent either open, endoscopic, or robot-assisted surgery for urological malignancy. Materials and Methods: During the peak of COVID-19 pandemic from March 21, 2020, to June 21, 2020, all the uro-oncology cases managed in our tertiary care hospital were analyzed. Teleconsultation was started for follow-up patients. All patients requiring surgery underwent reverse transcription-polymerase chain reaction for COVID-19. Institutional protocol was formulated based on existing international guidelines for patient management. Adequate personal protection and hydroxychloroquine prophylaxis were provided to health-care professionals. Results: During the study period, 417 outpatient consultations were made. Forty-nine patients underwent surgery for different urological malignancies. Majority of the surgeries were robot-assisted surgeries (59.2%, 29 patients), followed by endoscopic procedures (28.5%, 14 patients) and few open procedures (10.2%, five patients). Most of our patients were elderly males (mean, 62.5 years). With a median follow-up of 55 days (interquartile range, 32-77), there was no report of COVID-19 infection in any patient or health-care provider. Conclusions: We can continue treating needy cancer patients with minimal risk by taking all precautions. Our initial experience of managing uro-oncology cases during this pandemic is encouraging. Robotic surgeries can be safely performed.


Subject(s)
COVID-19 , Neoplasms , Robotic Surgical Procedures , Male , Humans , Aged , Robotic Surgical Procedures/adverse effects , COVID-19/epidemiology , Pandemics , India/epidemiology , Neoplasms/surgery
3.
Indian J Public Health ; 66(Supplement): S71-S75, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2144166

ABSTRACT

Background: Persons with type 2 diabetes mellitus (T2DM) are at high-risk for COVID-19 infection and are a priority group for vaccination. Objectives: The objective of this study is to estimate the seroconversion and determine the side effects after COVID-19 vaccination among persons with T2DM in urban, rural, and tribal areas in Kerala. Methods: A cross-sectional study was conducted in urban, rural, and tribal field practice areas of a medical college in Central Kerala, among 396 persons with T2DM. The participants were selected by simple random sampling from the 200-250 diabetic patients visiting each health center. Qualitative and quantitative estimation of antibodies were done by WANTAI Ab enzyme-linked immunosorbent assay kit and Abbott SARS COV-2 IgG Quantitative assay, respectively. Results: The mean age of the respondents was 59.40 ± 12.25 years. A majority (65.5%) had received both doses of vaccine. About half (51.5%) experienced side effects after vaccination. Antibodies (IgG or IgM) were detected in 93.2% (95% confidence interval [CI] 90.2, 95.5) of participants. Those with a duration of diabetes ≥5 years, with a single dose of vaccine, were five times (adjusted odds ratio [aOR] - 5.23,95% CI 1.86, 14.66) and four times (aOR - 4.11, 95% CI 1.66, 10.13) more likely, respectively, to be seronegative. Those who took medication for diabetes were protected against a no antibody (aOR - 0.05, 95% CI 0.02, 0.148) response. The median antibody titer in a subset (150) of participants was 365.2 (90-1587) AU/ml. Past COVID infection was an independent determinant of high IgG titers (aOR - 4.95, 95% CI 1.50, 16.36). Conclusion: Reinforcing the importance of vaccination particularly among those with longer duration of diabetes is imperative.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Humans , Middle Aged , Aged , Diabetes Mellitus, Type 2/epidemiology , India/epidemiology , Seroconversion , Cross-Sectional Studies , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Vaccination , Immunoglobulin G
4.
Indian J Public Health ; 66(Supplement): S36-S40, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2144164

ABSTRACT

Background: The incidence of breakthrough infection with the emergence of new variants of concern of SARS-CoV-2 is posing a threat, and it is pertinent to understand the role of vaccines in protecting the elderly and people with comorbidities. Objective: The present study was undertaken to understand the natural history of SARS-CoV-2 infection in a closed cohort of the elderly population in an old-age home who have received two doses of COVID-19 vaccination. The study has also undertaken genomic sequencing to identify SARS-CoV-2 variants of concern from an academic perspective. Materials and Methods: A prospective observational study was conducted from March to August 2021 among residents of 11 old-age homes in Kerala who were vaccinated with 2 doses of the COVID-19 vaccine, from 2 weeks following vaccination. Samples with a threshold cycle value of <25 were subjected to targeted sequencing of the spike protein receptor-binding domain coding region. Results: Among the 479 vaccinated individuals, 86 (17.95%) turned positive during the follow-up period. The mean duration of symptoms was 3-5 days, and no hospitalization was required. A phylogenetic analysis of the nucleotide sequences from the samples indicated B.1.617.2 lineage representing the Delta strain. Conclusion: The evidence supports maximizing the vaccine coverage among vulnerable groups to prevent hospitalization and death rate on the verge of the emergence of new variants of SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Aged , Humans , Infant, Newborn , SARS-CoV-2/genetics , COVID-19 Vaccines , Phylogeny , India/epidemiology
5.
Indian J Public Health ; 66(Supplement): S66-S70, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2144163

ABSTRACT

Background: The age group of 5-17 years belongs to the vulnerable segment of the population for COVID-19 infection in India. Seroprevalence in this population can therefore allow inferences to be made about the extent of infection. Objectives: The objective of this study was to assess the seroprevalence and to determine the factors associated with COVID-19 antibody among children aged 5-17 years in an urban and rural area of Kochi, Kerala. Methods: A community-based cross-sectional study was undertaken in the urban and rural field practice areas of the community medicine department in a medical college, Kochi. A semi-structured questionnaire was used to collect information about sociodemographic data, history related to COVID-19, and the severe acute respiratory syndrome coronavirus 2 antibody test result. Blood samples were collected and tested for the presence of COVID-19 antibodies using the Wantai test kit after attaining informed assent from the parent/guardian. Results: The seroprevalence of the COVID-19 antibody was 48.3% among participants. The seroprevalence of COVID-19 antibody was higher among children of mothers with skilled/unskilled occupation, residents of rural area, above poverty line category, those with a history of COVID-19, and those who had a history of contact with COVID-19-positive patients. Conclusion: Half of the study population were COVID antibody positive, and the rest were at risk of infection. Therefore, adherence to COVID-19 guidelines is essential to control further spread of infection among children.


Subject(s)
COVID-19 , Child , Female , Humans , Child, Preschool , Adolescent , Seroepidemiologic Studies , Cross-Sectional Studies , India/epidemiology , Antibodies, Viral
6.
Indian J Public Health ; 66(Supplement): S76-S79, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2144161

ABSTRACT

Background: The emergence of COVID-19 and its consequences is causing widespread fears, anxiety, and worries. To overcome the transmission of COVID-19, people resorted to compulsive behaviors. Objectives: The objectives of this study were to assess the prevalence of obsessive-compulsive symptoms (OCSs) due to COVID-19 pandemic, the prevalence of level of fear due to COVID-19 pandemic, and to assess the factors associated with OCSs due to COVID-19 pandemic among the undergraduate medical students of in tertiary unit in Southern India. Methods: The cross-sectional study was conducted in 250 undergraduate medical students (both MBBS and BDS, from 1st to 4th year) in the institute. Students who had consented in the study were included as study participants. The Yale-Brown Obsessive-Compulsive Scale and Fear of COVID-19 Scale (FCV-19 S) were used in assessing OCSs and the level of fear due to COVID-19. Chi-square test and multiple logistic regression were used to compute the factors associated with OCS. Results: The mean age of the respondents was 21 ± 1.313 years. The prevalence of OCS in undergraduate medical students was 36 (14.4%), and the level of FCV-19 was 107 (42.8%). Male students (17.8%, 44.2%) had higher OCSs and levels of fear as compared to female students (13.6%, 42.4%). Students with FCV-19 were three (adjusted odds ratio-3.418, 95% confidence interval-1.596, 7.319) times more likely to manifest OCSs while factors such as age, gender, and course were not significantly associated with OCS. Conclusion: Psychological counseling for undergraduate students should be pivotal, especially during pandemics and outbreaks.


Subject(s)
COVID-19 , Obsessive-Compulsive Disorder , Students, Medical , Humans , Male , Female , Young Adult , Adult , Prevalence , Pandemics , Tertiary Healthcare , Obsessive-Compulsive Disorder/epidemiology , Obsessive-Compulsive Disorder/diagnosis , Obsessive-Compulsive Disorder/psychology , Cross-Sectional Studies , India/epidemiology , Fear
7.
Ann Afr Med ; 21(4): 383-389, 2022.
Article in English | MEDLINE | ID: covidwho-2144097

ABSTRACT

Background: Mucormycosis is a life-threatening fungal disease in immunocompromised patients. There has been increase in the number of mucormycosis associated with COVID-19 patients in second wave. Now country battle with both COVID-19 and mucormycosis. An invasive mucormycosis infection has been a significant burden in India after COVID-19. It has been recently emerged a notifiable disease by the Rajasthan government. Our aim is to develop awareness regarding the importance of early detection and treatment of mucormycosis with COVID-19 and reduce the morbidity and mortality. Materials and Methods: This is a Prospective longitudinal study including 34 patients diagnosed with acute invasive fungal infection by contrast enhancement magnetic resonance imaging studies of paranasal, orbit and brain or nasal biopsy for KOH/culture. Diagnosis is made through routine blood tests, biopsy, and radiological imaging. The patients taken for the study were COVID-19 reverse transcription-polymerase chain reaction positive or recent post COVID-19 (within 15 days) or symptoms of COVID-19 with bilateral pneumonitis. The study was conducted with 34 patients admitted to the department of medicine with mucormycosis within a month may 2021. Results: A total of 34 patients with a mean age of 50.92 years old and male female ratio 24/10 (70.5/29.41) were included in this study. The most common comorbidity was diabetes mellitus (23 patients 67.64%). Nine patients were newly diagnosed or recent onset of diabetes with or after COVID-19 infection. Twenty-four (70.58%) patients were COVID-19 positive or recent (within 15 days) history of COVID-19 positive. Seven (20.58) patients had the history of steroid as a treatment during COVID-19 and 5 (14.70) patients was on oxygen inhalation. One (2.94%) patient was fully vaccinated, and 5 (14.70) patients had the history of steam inhalation. The most common involvement was naso-orbital mucormycosis found in 28 patients (82.35%) followed by nasal-and orbital 26 (76.47) and 18 (52.94), respectively. Naso-Orbito-Cerebral was seen in 16 (47.05) patients. The more common reported symptoms and signs were headache (76.47), facial numbness (64.70), Nasal discharge (52.94), and ophthalmoplegia (52.94). Cranial nerve involvement was seen in 10 patients (facial palsy in 8 patients and bulbar palsy in 2 patients). Total mortality was 7 (7/34 20.58%). Conclusion: COVID-19 infection associated with the wide range of invasive mucormycosis. Early diagnosis and Clinical suspicion of acute invasive fungal sinusitis among COVID-19 patients is essential for better outcomes and higher survival.


Résumé Contexte: La mucormycose est une maladie fongique mortelle chez les patients immunodéprimés. Il y a eu une augmentation du nombre de mucormycose associée aux patients Covid - 19 en deuxième vague. Maintenant, le pays se bat contre le Covid-19 et la mucormycose. Une infection invasive en mucormycose a été une charge significative en Inde après Covid - 19. Il a récemment émergé une maladie notifiable du gouvernement du Rajasthan. Notre objectif est de sensibiliser à l'importance de la détection et du traitement précoce de la mucormycose avec Covid-19 et de réduire la morbidité et la mortalité. Matériaux et méthodes: Il s'agit d'une étude longitudinale prospective comprenant 34 patients diagnostiqués avec une infection fongique invasive aiguë par un contraste d'imagerie magnétique des études d'imagerie par résonance magnétique de biopsie paranasale, en orbite et au cerveau ou nasale pour le KOH / la culture. Le diagnostic est posé par des tests sanguins de routine, une biopsie et une imagerie radiologique. Les patients pris pour l'étude ont été la réaction en chaîne de la transcription inverse de Covid-19, la réaction en chaîne de polymérase positive ou le post-COVID-19 récent (dans les 15 jours) ou les symptômes de Covid-19 avec une pneumonite bilatérale. L'étude a été menée avec 34 patients admis au Département de médecine avec mucormycose dans un mois en mai 2021. Résultats: Un total de 34 patients avec un âge moyen de 50,92 ans et un rapport féminine masculin 24/10 (70,5 / 29,41) ont été inclus dans cette étude. La comorbidité la plus courante était le diabète sucré (23 patients 67,64%). Neuf patients ont été récemment diagnostiqués ou un début récent du diabète avec ou après l'infection à Covid - 19. Vingt-quatre (70,58%) patients étaient des antécédents de Covid - 19 positifs ou récents (dans les 15 jours) de Covid - 19 positifs. Sept (20,58) patients avaient des antécédents de stéroïde comme traitement pendant les patients COVID-19 et 5 (14,70) étaient sous inhalation d'oxygène. Un patient (2,94%) a été entièrement vacciné et 5 (14,70) patients avaient des antécédents d'inhalation de vapeur. L'atteinte la plus courante était la mucormycose naso-orbitale trouvée chez 28 patients (82,35%), suivie respectivement par l'orbital nasal et orbital 26 (76,47) et 18 (52,94). Le naso - orbito-cervebral a été observé chez 16 (47,05) patients. Les symptômes et les signes rapportés les plus courants étaient des maux de tête (76,47), un engourdissement facial (64,70), une décharge nasale (52,94) et une ophtalmoplégie (52,94). Une atteinte du nerf crânien a été observée chez 10 patients (paralysie faciale chez 8 patients et paralysie bulbaire chez 2 patients). La mortalité totale était de 7 (7/34 20,58%). Conclusion: Infection Covid - 19 associée à la large gamme de mucormycose invasive. Le diagnostic précoce et la suspicion clinique de sinusite fongique invasive aiguë chez les patients COVID-19 sont essentiels pour de meilleurs résultats et une survie plus élevée. Mots-clés: Covid - 19, fongique, invasive, nasal, rhinocéros orbital cerebral.


Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Humans , Male , Female , Middle Aged , Mucormycosis/complications , Mucormycosis/epidemiology , Mucormycosis/diagnosis , COVID-19/complications , COVID-19/epidemiology , Prospective Studies , Longitudinal Studies , Orbital Diseases/epidemiology , Orbital Diseases/complications , Orbital Diseases/microbiology , India/epidemiology
8.
Twin Res Hum Genet ; 25(3): 156-164, 2022 06.
Article in English | MEDLINE | ID: covidwho-2133125

ABSTRACT

Nature and nurture have always been a prerogative of evolutionary biologists. The environment's role in shaping an organism's phenotype has always intrigued us. Since the inception of humankind, twinning has existed with an unsettled parley on the contribution of nature (i.e. genetics) versus nurture (i.e. environment), which can influence the phenotypes. The study of twins measures the genetic contribution and that of the environmental influence for a particular trait, acting as a catalyst, fine-tuning the phenotypic trajectories. This is further evident because a number of human diseases show a spectrum of clinical manifestations with the same underlying molecular aberration. As of now, there is no definite way to conclude just from the genomic data the severity of a disease or even to predict who will get affected. This greatly justifies initiating a twin registry for a country as diverse and populated as India. There is an unmet need to set up a nationwide database to carefully curate the information on twins, serving as a valuable biorepository to study their overall susceptibility to disease. Establishing a twin registry is of paramount importance to harness the wealth of human information related to the biomedical, anthropological, cultural, social and economic significance.


Subject(s)
Diseases in Twins , Twins , Diseases in Twins/epidemiology , Diseases in Twins/genetics , Humans , India/epidemiology , Registries , Twins/genetics , Workforce
9.
Indian J Pediatr ; 89(12): 1222-1228, 2022 12.
Article in English | MEDLINE | ID: covidwho-2129321

ABSTRACT

OBJECTIVE: To describe COVID-19 in children and the differences between the two waves. METHODS: The electronic medical records of children younger than 16 y of age with laboratory-confirmed COVID-19 infection between June 1st 2020 and May 31st 2021 at Christian Medical College, Vellore were retrospectively reviewed. Demographic, clinical, and laboratory data were collected on a predesigned case record form and analyzed. RESULTS: A total of 988 children were diagnosed with confirmed COVID-19 during the study period. Of these, there were 585 children diagnosed during the 1st wave (June 2020-Feb 2021) and 403 children during the 2nd wave (March 2021-May 2021). It was found that loose stools and rash were significantly more frequent during the 1st wave and fever, cough, coryza, heart rate and temperature were significantly more during the 2nd wave. There was no significant difference between the two groups in terms of requirement of oxygen therapy, need for ICU admission, duration of ICU stay or hospital stay, or severity of illness. Mortality was significantly higher during the 2nd wave (0.3% vs. 2%). CONCLUSION: The COVID-19 pandemic among children during the 1st and 2nd waves were similar in severity, though there was a higher mortality during the 2nd wave.


Subject(s)
COVID-19 , Child , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Retrospective Studies , Tertiary Care Centers , India/epidemiology
10.
JMIR Public Health Surveill ; 7(8): e29957, 2021 Aug 30.
Article in English | MEDLINE | ID: covidwho-2141339

ABSTRACT

BACKGROUND: Association between human mobility and disease transmission has been established for COVID-19, but quantifying the levels of mobility over large geographical areas is difficult. Google has released Community Mobility Reports (CMRs) containing data about the movement of people, collated from mobile devices. OBJECTIVE: The aim of this study is to explore the use of CMRs to assess the role of mobility in spreading COVID-19 infection in India. METHODS: In this ecological study, we analyzed CMRs to determine human mobility between March and October 2020. The data were compared for the phases before the lockdown (between March 14 and 25, 2020), during lockdown (March 25-June 7, 2020), and after the lockdown (June 8-October 15, 2020) with the reference periods (ie, January 3-February 6, 2020). Another data set depicting the burden of COVID-19 as per various disease severity indicators was derived from a crowdsourced API. The relationship between the two data sets was investigated using the Kendall tau correlation to depict the correlation between mobility and disease severity. RESULTS: At the national level, mobility decreased from -38% to -77% for all areas but residential (which showed an increase of 24.6%) during the lockdown compared to the reference period. At the beginning of the unlock phase, the state of Sikkim (minimum cases: 7) with a -60% reduction in mobility depicted more mobility compared to -82% in Maharashtra (maximum cases: 1.59 million). Residential mobility was negatively correlated (-0.05 to -0.91) with all other measures of mobility. The magnitude of the correlations for intramobility indicators was comparatively low for the lockdown phase (correlation ≥0.5 for 12 indicators) compared to the other phases (correlation ≥0.5 for 45 and 18 indicators in the prelockdown and unlock phases, respectively). A high correlation coefficient between epidemiological and mobility indicators was observed for the lockdown and unlock phases compared to the prelockdown phase. CONCLUSIONS: Mobile-based open-source mobility data can be used to assess the effectiveness of social distancing in mitigating disease spread. CMR data depicted an association between mobility and disease severity, and we suggest using this technique to supplement future COVID-19 surveillance.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Cell Phone , Geographic Information Systems , Pandemics , Travel/statistics & numerical data , Humans , India/epidemiology
11.
Neurol India ; 70(5): 2116-2120, 2022.
Article in English | MEDLINE | ID: covidwho-2117631

ABSTRACT

Background: India, with a total population of 1,309,053,980, has 0.29 psychiatrists, 0.00 child psychiatrists, and 0.80 mental health nurses per 100,000 population. The mental health expenditure per person is just 4 INR as per Mental Health ATLAS 2017 (World Health Organization). The treatment gap for mental disorders still remains very high. These raise issues to our mental health status post coronavirus disease 2019 (COVID-19). Higher levels of anxiety, stress, and depression after the stay-at-home order post COVID-19 could lead to further psychological trauma besides mental health. A younger age, the female gender, and the caregiver status have a greater degree of stressfulness because of the pandemic. Objective: To assess the mental health status of the general population post COVID-19 in India. Material and Methods: An online survey was conducted using Depression Anxiety Stress Scale (DASS) 21 in the month of July, 2020. Results: The results of the online survey using DASS 21 conducted in the month of July, 2020, in India support the mental distress in the general population too. Conclusions: Systematic and regular surveys need to be conducted to allow for monitoring of the mental health impact of COVID-19 from time to time and prepare ourselves so as to prevent the second wave of mental health crises post the COVID-19 pandemic.


Subject(s)
COVID-19 , Pandemics , Child , Humans , Female , SARS-CoV-2 , Depression/epidemiology , Depression/psychology , India/epidemiology , Surveys and Questionnaires
12.
BMC Infect Dis ; 22(1): 856, 2022 Nov 16.
Article in English | MEDLINE | ID: covidwho-2116356

ABSTRACT

BACKGROUND: Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case-control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. METHODS: Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. RESULTS: CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. CONCLUSIONS: Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , SARS-CoV-2 , India/epidemiology , Case-Control Studies
13.
Indian J Med Res ; 155(5&6): 546-553, 2022.
Article in English | MEDLINE | ID: covidwho-2110448

ABSTRACT

Background & objectives: High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome. Methods: Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality. Results: Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil-lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome. Interpretation & conclusions: Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected.


Subject(s)
COVID-19 , Neoplasms , Neutropenia , Humans , Aged , Middle Aged , Retrospective Studies , SARS-CoV-2 , India/epidemiology , Neoplasms/complications , Neoplasms/epidemiology , Neutropenia/complications
15.
Lancet ; 400(10363): 1581-1583, 2022 11 05.
Article in English | MEDLINE | ID: covidwho-2106184
16.
J Clin Virol ; 157: 105300, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2105314

ABSTRACT

BACKGROUND: Viral conjunctivitis (pink eye) can be highly contagious and is of public health importance. There remains significant debate whether SARS-CoV-2 can present as a primary conjunctivitis. The aim of this study was to identify pathogens associated with outpatient infectious conjunctivitis during the COVID-19 Delta surge. METHODS: This prospective study was conducted in the spring and summer months of 2021. 106 patients with acute conjunctivitis who presented to the Aravind Eye Center in Madurai, India were included. One anterior nasal swab and one conjunctival swab of each eye were obtained for each enrolled patient. Samples were subsequently processed for unbiased metagenomic RNA deep sequencing (RNA-seq). Outcomes included clinical findings and codetection of other pathogens with SARS-CoV-2 in patients with conjunctivitis. RESULTS: Among the 13 patients identified with human coronavirus RNA fragments in their swabs, 6 patients had SARS-CoV-2 infection, 5 patients had coinfections of SARS-CoV-2 and human adenovirus (HAdV), 1 patient had a coinfection with human coronavirus OC43 and HAdV, and 1 patient had a coinfection of Vittaforma corneae and SARS-CoV-2. 30% had bilateral disease and symptoms on presentation. Petechial hemorrhage was noted in 33% of patients with SARS-CoV-2 infection. No patients with SARS-CoV-2 or SARS-CoV-2 and HAdV infections had subepithelial infiltrates on presentation. All patients denied systemic symptoms. CONCLUSIONS: Among the patients presented with conjunctivitis associated with human coronavirus infection, over 50% of the patients had co-infections with other circulating pathogens, suggesting the public-health importance of broad pathogen testing and surveillance in the outpatient conjunctivitis population.


Subject(s)
COVID-19 , Coinfection , Conjunctivitis , Humans , SARS-CoV-2 , Coinfection/epidemiology , Outpatients , Prospective Studies , India/epidemiology , RNA
17.
Ir J Psychol Med ; 38(2): 140-144, 2021 06.
Article in English | MEDLINE | ID: covidwho-2096528

ABSTRACT

India is a de facto continent in the garb of a country. COVID-19 is an unprecedented global pandemic spanning continents. Being the second most populous country in the world, experts regard how India deals with the outbreak will have enormous impact on the world's ability to deal with it. The country has been in lockdown since March 25, 2020 until the current time of early May 2020, and despite several challenges, there has been early success. The major conflict now is the health benefits weighed up against the deleterious social and economic consequences of prolonged lockdown, that is, life versus livelihood. This unprecedented calamity could potentially cause or exacerbate various psychiatric disorders. It is recognized that lifestyle changes and limited screen time may help reduce mental health difficulties. Considering the physical barriers to consultation, development of telemedicine services is needed. This pandemic, like other previous pandemics, will pass, and until this happens, we must remain extremely vigilant.


Subject(s)
COVID-19 , Pandemics , Communicable Disease Control , Humans , India/epidemiology , Mental Health , SARS-CoV-2
19.
Int J Environ Res Public Health ; 19(21)2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2090144

ABSTRACT

CONTEXT: COVID-19 was declared 'a global pandemic' by the World Health Organization in March 2020. India's lockdown, one of the harshest in the world, came with additional challenges for women. This paper aims to assess the impact of COVID-19 pandemic-related pathways on the first thousand days of life in the Integrated Child Development Scheme and the public distribution ecosystem in India. DATA SOURCES: Using Cochrane guidelines, electronic databases, namely Google Scholar and PubMed-NCBI, were searched for evidence between 1 March 2020 and 1 May 2022. A total of 73 studies were identified in initial search; 20 met the inclusion criteria and, thus, were included in the research analysis. Primary studies were conducted throughout pan-India in rural, urban, and semi-urban areas to study the impact of COVID-19 pandemic-related pathways on the first 1000 days of life. The impact of social security, food insecurity, service delivery, nutrition of pregnant and nursing mothers (P&NMs), and infant and young child feeding (IYCF) varied between geographies and within geographies. Most of the primary studies were conducted at small scale, while only three studies were pan-Indian. The majority of studies were conducted on the mental health of P&NMs and pre-natal and post-natal service delivery disruption. The paucity of the available literature highlights the need to undertake research on the impact of the COVID-19 pandemic-related pathways on 1000 days of life in India and worldwide. The best implementation practices were observed where cross-sectional programs were carried out in relation to health services and social security for P&NMs and children.


Subject(s)
COVID-19 , Infant , Child , Pregnancy , Female , Humans , COVID-19/epidemiology , Pandemics , Public Health , Cross-Sectional Studies , Social Security , Ecosystem , Communicable Disease Control , India/epidemiology
20.
PLoS Comput Biol ; 18(10): e1010632, 2022 10.
Article in English | MEDLINE | ID: covidwho-2089314

ABSTRACT

Estimating the burden of COVID-19 in India is difficult because the extent to which cases and deaths have been undercounted is hard to assess. Here, we use a 9-component, age-stratified, contact-structured epidemiological compartmental model, which we call the INDSCI-SIM model, to analyse the first wave of COVID-19 spread in India. We use INDSCI-SIM, together with Bayesian methods, to obtain optimal fits to daily reported cases and deaths across the span of the first wave of the Indian pandemic, over the period Jan 30, 2020 to Feb 15, 2021. We account for lock-downs and other non-pharmaceutical interventions (NPIs), an overall increase in testing as a function of time, the under-counting of cases and deaths, and a range of age-specific infection-fatality ratios. We first use our model to describe data from all individual districts of the state of Karnataka, benchmarking our calculations using data from serological surveys. We then extend this approach to aggregated data for Karnataka state. We model the progress of the pandemic across the cities of Delhi, Mumbai, Pune, Bengaluru and Chennai, and then for India as a whole. We estimate that deaths were undercounted by a factor between 2 and 5 across the span of the first wave, converging on 2.2 as a representative multiplier that accounts for the urban-rural gradient. We also estimate an overall under-counting of cases by a factor of between 20 and 25 towards the end of the first wave. Our estimates of the infection fatality ratio (IFR) are in the range 0.05-0.15, broadly consistent with previous estimates but substantially lower than values that have been estimated for other LMIC countries. We find that approximately 35% of India had been infected overall by the end of the first wave, results broadly consistent with those from serosurveys. These results contribute to the understanding of the long-term trajectory of COVID-19 in India.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , India/epidemiology , Bayes Theorem , Communicable Disease Control , Pandemics
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