ABSTRACT
Study ObjectivesStudies have found Obstructive Sleep Apnea (OSA) as a risk factor for increased risk for COVID19 Acute respiratory Distress Syndrome (ARDS); but most of the studies were done in already known patients of OSA. This study was done to find prevalence of OSA in patients with COVID-19 related acute respiratory distress syndrome. MethodologyA hospital based longitudinal study was conducted among COVID 19 Intensive Care Unit (ICU) survivors. All consecutive COVID19 with moderate to severe ARDS were evaluated for OSA by Level I Polysomnography (PSG) after 4-6 weeks of discharge. Prevalence of OSA and PSG variables {Total sleep time, Sleep efficiency, sleep stage percentage, Apnea Hypopnea Index (AHI), T90, nadir oxygen} was estimated. ResultsOut of 103 patients discharged from ICU during study period (October 2020 to 15 December 2020), 67 underwent Level I PSG. Mean Age was 52.6{+/-}10.9 years and mean Body Mass Index was 27.5 {+/-} 6.2 Kg/m2. Total sleep time was 343.2 {+/-} 86 minutes, sleep efficiency was 75.9{+/-}14.2%. OSA (AHI [≥]5) was seen in 65/67 patients and 49 patients had moderate to severe OSA (i.e. AHI [≥] 15). ConclusionModerate-severe OSA was highly prevalent (73%) in COVID19 moderate to severe ARDS survivors. Role of OSA in pathophysiology of COVID19 ARDS needs further evaluation. HighlightsO_LIThis study was done to find prevalence of OSA in patients with COVID-19 related Acute respiratory distress syndrome C_LIO_LIModerate-severe OSA is highly prevalent (73%) in COVID19 ARDS survivors. C_LIO_LITo the best of our knowledge, it is first study in which level I PSG was done in COVID19 survivors. C_LI
ABSTRACT
IntroductionOSA has been postulated to be associated with mortality in COVID19, but studies are lacking thereof. This study was done to estimate prevalence of OSA in patients with COVID-19 using various screening questionnaires and to assess effect of OSA on outcome of disease. MethodologyIn this prospective observational study, consecutive patients with RTPCR confirmed COVID 19 patients were screened for OSA by different questionnaires (STOPBANG, Berlin Questionnaire, NoSAS and Epworth Scale). Association between OSA and outcome (mortality) and requirement for respiratory support was assessed. ResultsIn study of 213 patients; screening questionnaires for OSA {STOPBANG, Berlin Questionnaire (BQ), NoSAS} were more likely to be positive in patients who died compared to patients who survived. On binary logistic yregression analysis, age[≥]55 and STOPBANG score [≥]5 were found to have small positive but independent effect on mortality even after adjusting for other variables. Proportion of patients who were classified as high risk for OSA by various OSA screening tools significantly increased with increasing respiratory support (p<0.001 for STOPBANG, BQ, ESS and p=0.004 for NoSAS). ConclusionThis is one of the first prospective studies of sequentially hospitalized patients with confirmed COVID 19 status who were screened for possible OSA. This study shows that OSA could be an independent risk factor for poor outcome in patients with COVID19.
ABSTRACT
The Government of India in network with the State Governments has implemented the epidemic curtailment strategies inclusive of case-isolation, quarantine and lockdown in response to ongoing novel coronavirus (COVID-19) outbreak. In this manuscript we attempt to estimate the effect of these steps across ten Indian states using crowd-sourced data. The chosen transmission parameters are -reproduction number (R0), doubling time and growth rate during the early epidemic phase (15 days into lockdown) and 30 days into lockdown (23rd April 2020) through maximum likelihood approach. The overall analysis shows the decreasing trends in reproductive numbers and growth rate (with few exceptions) and incremental doubling time. The curtailment strategies employed by the Indian government seems to be effective in reducing the transmission parameters of the COVID-19 epidemic. The effective reproductive numbers are still higher above the threshold of 1, the resultant absolute numbers tend to augment as a function of time. The curtailment strategy thus may take into account these findings while formulating further course of actions.
ABSTRACT
India was certified polio free on 27 March 2014. Supplementary immunizationactivities, in the form of national immunization days, is one of the core strategiesfor eradication, where oral polio vaccine is administered to children aged under5 years throughout the country. Oral polio vaccine is heat sensitive and requiresmaintenance of a stringent cold chain. Therefore, vaccine carriers with ice packsare used in the Pulse Polio Immunization (PPI) programme. This study assessedwhether the cold chain is maintained during National Immunization Day in Beeddistrict. A cross-sectional study was conducted at six randomly selected booths, oneeach from six primary health centres in Georai block of Beed district in Maharashtra.Electronic data loggers, configured to measure half-hourly temperatures, werekept in vaccine carriers throughout the day of PPI. The vaccine carrier temperaturewas below 8 °C at all six booths; minimum temperature recorded was –9.5 °C,while the maximum was 4.5 °C. The vaccine vial monitor did not reach discardpoint in any booth. A vaccine carrier with four ice packs very effectively maintainsthe cold chain required for oral polio vaccine
