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Background:SARS- CoV-2 has radically influenced the health care workers, especially Obstetricians who are at high-risk COVID-19 transmission due to the nature of their specialty as a result of exposure to infectious particles, hence they have to be judg emental in taking up pregnant females. As the Obstetrical population has to go through a unique challenge during this pandemic, the aim of the study was to know the incidence of SARS- CoV-2 positivity rate in pregnant women admitted to hospital for delivery. Furthermore, infected patients may be asymptomatic on admission and may easily transmit the disease during delivery. Methods:The study protocol was approved by the Institutional Review Board and Ethics Committee. It was conducted between Sep- tember and November 2020 at Deccan College of Medical Sciences, includes 75 pregnant women who were screened for SARS -CoV-2 positivity upon admission to the hospital for delivery. Detection of SARS-CoV-2 in Nasopharyngeal and oropharyngeal samples was performed by Real-Time Reverse Transcriptase PCR (RT-PCR) method, targeting Screening Envelope (E) gene and Confirmatory gene RNA dependent RNA polymerase gene (RdRp). Results:Out of 75 women;two (2) women had mild symptoms of fever and shortness of breath on admission respectively, on testing tested positive for SARS-CoV-2. Of the other 73 women admitted without symptoms screened for SARS-CoV-2, two (2) were found to be positive for SARS-CoV-2. Although this prevalence has limited generaliza- bility to geographical regions with lower rates of infection, it underscores the risk of Covid-19 among asymptomatic obstetrical patients. [Formula presented] Conclusions:Health care professionals have to be meticulous about taking precautionary potential steps regarding COVID-19 status of the patient to determine hospital isolation practices and control measures which also includes judicious use of Personal protective equipment. Access to such clinical data from the laboratory provides an important opportunity to pro- tect mothers, babies, and health care teams during these challenging times.
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Background:A prospective study was conducted by Department of Molecular diagnostic laboratory, Deccan College of Medical Sciences to assess the importance of interpretation of a COVID-19 test result. This study strongly encourages us to manage patients with a high pre-clinical likelihood and typical clinical and radiological features as affected by COVID - 19, independently of the result of real-time RT-PCR, especially if performed on specimens collected from the upper air- ways. Acquisition of lower respiratory tract samples should be considered in the event of one or more negative RT -PCR assays. Methods:Out of 500 cases, 400 suspicious of COVID-19 affected patients were subjected to HRCT, simultaneously after admission their Nasopharyngeal and Oro-pharyngeal swabs for RT- PCR Assays. Laboratory diagnosis through RT-PCR testing alone lacks adequate sensitivity and specificity to be recommended as the only valid criterion to confirm COVID - 19 diagnosis. The leading role played by CT scan and repeat RT-PCR assay in the identification and management of espe- cially false-negative patients with COVID-19-has been highlighted in this study. Results: 24 cases were found to positive after retested by RT-PCR. Real-time RT-PCR has intrinsic limitations that might significantly affect its accuracy in the diagnosis of COVID-19. False-negative results may depend on several pre-analytical and analytical vulnerabilities, during specimen collection, transport, execution of test outside of the diagnostic window, PCR Inhibitors, use of non-validated assays. Moreover, the development of recombinant forms of SARS-CoV-2 may ad- versely affect the diagnostic accuracy of nucleic acid-based assays. Conclusions:If Covid-19 is suspected HRCT scan should be performed at hospital admission, together with or even be- fore or repeat sample, as this has been shown to correctly lead the clinical management yet from the earliest stage of the disease and to provide the highest detection rate after a very short time from symptoms onset. Hence, accurate diagnosis of SARS-CoV-2 holds the key in containing COVID-19 pandemic.
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BACKGROUND: Published reports on tocilizumab in COVID-19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues. METHODS: This open-label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti-IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID-19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response. RESULTS: Twenty-one patients fulfilled pre-defined response criteria. Lower levels of IL-6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response. CONCLUSIONS: Objective clinical response rate overcame the pre-defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials.