Refractory Atrial Flutter, the Only Presentation of covid-19 Infection in a Neonate: a case report and review of literature (preprint)

Background The accurate incidence of different cardiovascular consequences of COVID-19 in pediatric population have been inadequately defined due to ongoing genotype changes in the virus. Although COVID-19 is known to increase inflammatory markers associated with atrial arrhythmias, the contemporary literature has poorly described new onset arrhythmias as a complication in previously healthy neonate with COVID-19 Case presentation Twenty-day-old female term neonate, born by caesarean section with immediate cry developed labored breathing, cyanosis and tachycardia after having close contact with a confirmed case of covid-19. She developed atrial flutter, which was refractory to cardioversion and drugs namely Amiodarone, Flecainide and Propranolol. The neonate was treated with IVIG. This is the first reported case of atrial flutter in neonatal period secondary to COVID-19. Conclusion Since the starting of SARS –COV2 pandemic all attentions and concerns has been mainly on respiratory manifestations and complications. The cardiovascular complications and treatment are neglected. This case reports tachyarrhythmia (Atrial Flutter) as unusual presentation of MISC in neonatal population and show role of IvIg in treatment of refractory arrhythmias.

A machine learning-based approach to determine infection status in recipients of BBV152 whole virion inactivated SARS-CoV-2 vaccine for serological surveys (preprint)

Data science has been an invaluable part of the COVID-19 pandemic response with multiple applications, ranging from tracking viral evolution to understanding the effectiveness of interventions. Asymptomatic breakthrough infections have been a major problem during the ongoing surge of Delta variant globally. Serological discrimination of vaccine response from infection has so far been limited to Spike protein vaccines used in the higher-income regions. Here, we show for the first time how statistical and machine learning (ML) approaches can discriminate SARS-CoV-2 infection from immune response to an inactivated whole virion vaccine (BBV152, Covaxin, India), thereby permitting real-world vaccine effectiveness assessments from cohort-based serosurveys in Asia and Africa where such vaccines are commonly used. Briefly, we accessed serial data on Anti-S and Anti-NC antibody concentration values, along with age, sex, number of doses, and number of days since the last vaccine dose for 1823 Covaxin recipients. An ensemble ML model, incorporating a consensus clustering approach alongside the support vector machine (SVM) model, was built on 1063 samples where reliable qualifying data existed, and then applied to the entire dataset. Of 1448 self-reported negative subjects, 724 were classified as infected. Since the vaccine contains wild-type virus and the antibodies induced will neutralize wild type much better than Delta variant, we determined the relative ability of a random subset of such samples to neutralize Delta versus wild type strain. In 100 of 156 samples, where ML prediction differed from self-reported uninfected status, Delta variant, was neutralized more effectively than the wild type, which cannot happen without infection. The fraction rose to 71.8% (28 of 39) in subjects predicted to be infected during the surge, which is concordant with the percentage of sequences classified as Delta (75.6%-80.2%) over the same period.

SARS-CoV-2 seroprevalence in the city of Hyderabad, India in early 2021 (preprint)

BackgroundCOVID-19 emerged as a global pandemic in 2020, rapidly spreading to most parts of the world. The proportion of infected individuals in a population can be reliably estimated via sero-surveillance, making it a valuable tool for planning control measures. We conducted a serosurvey study to investigate SARS-CoV-2 seroprevalence in the urban population of Hyderabad at the end of the first wave of infections. MethodsThe cross-sectional survey conducted in January 2021 included males and females aged 10 years and above, selected by multi-stage random sampling. 9363 samples were collected from 30 wards distributed over 6 zones of Hyderabad and tested for antibodies against SARS-CoV-2 nucleocapsid antigen. ResultsOverall seropositivity was 54.2%, ranging from 50-60% in most wards. Highest exposure appeared to be among 30-39y and 50-59y olds, with women showing greater seropositivity. Seropositivity increased with family size, with only marginal differences among people with varying levels of education. Seroprevalence was significantly lower among smokers. Only 11% of the survey subjects reported any COVID-19 symptoms, while 17% had appeared for Covid testing. ConclusionOver half the citys population was infected within a year of onset of the pandemic. However, [~]46% people were still susceptible, contributing to subsequent waves of infection. Highlights National level serosurveys under-estimate localised prevalence in dense urban areas SARS-CoV-2 seroprevalence in Hyderabad city was 54.2% after the first wave A large proportion of the population remains at risk over a year into the pandemic

Insights from a Pan India Sero-Epidemiological survey (Phenome-India Cohort) for SARS-CoV2 (preprint)

BackgroundIndia has been amongst the most affected nations during the SARS-CoV2 pandemic, with sparse data on country-wide spread of asymptomatic infections and antibody persistence. This longitudinal cohort study was aimed to evaluate SARS-CoV2 sero-positivity rate as a marker of infection and evaluate temporal persistence of antibodies with neutralization capability and to infer possible risk factors for infection. MethodsCouncil of Scientific and Industrial Research, India (CSIR) with its more than 40 laboratories and centers in urban and semi-urban settings spread across the country piloted the pan country surveillance. 10427 adult individuals working in CSIR laboratories and their family members based on voluntary participation were assessed for antibody presence and stability was analyzed over 6 months utilizing qualitative Elecsys SARS CoV2 specific antibody kit and GENScript cPass SARS-CoV2 Neutralization Antibody Detection Kit. Along with demographic information, possible risk factors were evaluated through self to be filled online forms with data acquired on blood group type, occupation type, addiction and habits including smoking and alcohol, diet preferences, medical history and transport type utilized. Symptom history and information on possible contact and compliance with COVID 19 universal precautions was also obtained. Findings1058 individuals (10{middle dot}14%) had antibodies against SARS-CoV2. A follow-up on 346 sero-positive individuals after three months revealed stable to higher antibody levels against SARS-CoV2 but declining plasma activity for neutralizing SARS-CoV2 receptor binding domain and ACE2 interaction. A repeat sampling of 35 individuals, at six months, revealed declining antibody levels while the neutralizing activity remained stable compared to three months. Majority of sero-positive individuals (75%) did not recall even one of nine symptoms since March 2020. Fever was the most common symptom with one-fourth reporting loss of taste or smell. Significantly associated risks for sero-positivity (Odds Ratio, 95% CI, p value) were observed with usage of public transport (1{middle dot}79, 1{middle dot}43 - 2{middle dot}24, 2{middle dot}81561E-06), occupational responsibilities such as security, housekeeping personnel etc. (2{middle dot}23, 1{middle dot}92 - 2{middle dot}59, 6{middle dot}43969E-26), non-smokers (1{middle dot}52, 1{middle dot}16 - 1{middle dot}99, 0{middle dot}02) and non-vegetarianism (1{middle dot}67, 1{middle dot}41 - 1{middle dot}99, 3{middle dot}03821E-08). An iterative regression analysis was confirmatory and led to only modest changes to estimates. Predilections for sero-positivity was noted with specific ABO blood groups -O was associated with a lower risk. InterpretationIn a first-of-its-kind study from India, we report the sero-positivity in a country-wide cohort and identify variable susceptible associations for contacting infection. Serology and Neutralizing Antibody response provides much-sought-for general insights on the immune response to the virus among Indians and will be an important resource for designing vaccination strategies. FundingCouncil of Scientific and Industrial Research, India (CSIR)

Media news on vaccines and vaccination: The content profile, sentiment and trend of the online mass media during 2015–2020 in India

Background The immunization coverage progress in India is relatively slower than anticipated. The rising internet and media penetration and online news contents are likely to shape the public vaccine sentiments and attitude. The measles-rubella immunization campaign in India experienced challenges in some states due to the social media and messaging. This study studied the profile and vaccine sentiments of the online media news in India. Methods We retrieved the online news on immunization and vaccines published in English during November 2015 to May 2020. The news were analysed for contents and categorised as positive, negative and neutral sentiments. Results Out of 2626 news retrieved, 1788 eligible ones were analysed. The news focused on immunization program in 59.1% and vaccine hesitancy in 7.7% items. While 42.5% news originated from national level, 33.2% were from six states. Measles-rubella was the leading vaccine in the news (23.2%) followed by coronavirus (12.8%), poliomyelitis (10.4%) and rotavirus (5.1%) vaccines. While 71.4% news conveyed positive sentiment, 23.8% and 4.7% had negative and neutral sentiments, respectively. The negative sentiments focused on adverse events, vaccine hesitancy and resistance. The news volume and negative sentiments were largely linked to the measles-rubella vaccination campaign phases in India. Conclusions Negative vaccine news constitute a sizable proportion of the online news and can influence the public vaccine sentiment and attitude. The experiences of public response towards measles-rubella, pentavalent and human papillomavirus vaccines suggest necessity of comprehensive media mapping and tracking to guide appropriately to sustain the public vaccine confidence and improve coverage.

Evaluation of Traditional Ayurvedic Preparation for Prevention and Management of the Novel Coronavirus (SARS-CoV-2) Using Molecular Docking Approach (preprint)

Since the emergence of novel Coronavirus (SARS-CoV-2) infection in Wuhan, China in December 2019, it has now spread to over 205 countries. The ever-growing list of globally spread corona virus-19 disease (COVID19) patients has demonstrated the high transmission rate among human population. Although 12 new drugs are being tried for management of COVID19, currently there are no FDA approved drugs or vaccines to prevent and treat the infection of the SARS-CoV-2. Considering the current state of affairs, there is an urgent unmet medical need to identify novel and effective approaches for prevention and treatment of COVID19 by re-evaluating the knowledge of traditional medicines and repurposing of drugs. Here, we used molecular docking approach to explore the beneficial roles of an array of phytochemicals and active pharmacological agents present in the Indian herbs (Tulsi, Haldi, Giloy, Black pepper, Ginger, Clove, Cardamom, lemon, and Ashwagandha) which are widely used in the preparation of Ayurvedic medicines in the form of Kadha to control various respiratory disorders such as cough, cold and flu. The evaluation was made based on the docking scores calculated by AutoDock Vina. Our study has identified an array of phytochemicals present in these herbs which have significant docking scores and potential to inhibit different stages of SARS-CoV-2 infection as well as other Coronavirus target proteins. Molecular docking also indicated that, the phytochemicals present in these herbs possess significant anti-inflammatory property. Overall our study provides scientific justification in terms of binding of active ingredients present in different plants used in Kadha preparation with viral proteins and target proteins for prevention and treatment of the COVID19. This preparation can boost individual’s immunity and inhibit the viral severity by interfering at different stages of virus multiplication in the infected person.