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1.
Curr Psychol ; : 1-10, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-2035354

ABSTRACT

The main goal of this study was to examine the psychometric properties of the COVID Stress Scales (CSS) in the Palestinian context and the factorial structure of the instrument. The CSS, a newly emerging internationally standardized measure of stress related to being exposed to or contracting COVID-19, was translated and validated for a Palestinian context to ensure that it can be used to measure COVID-19 stress. The sample of the study consisted of 860 Palestinian adults living in the West Bank of Palestine. Participants' age ranged from 20 to 48 years old (M = 34.7, SD =13.46). They were all recruited from online advertisements, e-mail campaigns, blogs, social media, and SMS campaigns. The CSS was found to be valid in the Arabic language within a Palestinian context. The confirmatory factor analysis yielded six factors: (1) Fears about the dangerousness of COVID-19, (2) fears about the personal social, and economic consequences of COVID-19, fears of disruption in the supply chain, fears of looting or rioting, (3) COVID-19-xenophobia, fears that foreigners are sources of COVID-19, (4) fears about sources of COVID-19-related contamination,(5) traumatic stress symptoms related to COVID-19, and (6) COVID-19-related checking which is consisting with the ordinal structure the scale. The CSS demonstrated a high level of validity and reliability in a Palestinian context and therefore can be considered for future studies as the COVID-19 pandemic persists. Further investigations using the Arabic Language of CSS may have far-reaching implications for measuring and combating the stress of COVID-19 at a personal and societal level for uniquely at-risk populations such as in the occupied territories of Palestine.

2.
Am J Med Case Rep ; 8(10): 350-357, 2020.
Article in English | MEDLINE | ID: covidwho-1989679

ABSTRACT

COVID-19 is a pandemic that started in Wuhan city, Hubei province in China in December 2019 and is associated with high morbidity and mortality. It is characterized by a heightened inflammatory and prothrombotic state that are known to cause various cardiovascular manifestations such as thromboembolism, acute coronary syndrome and stroke. We here present a 72-year-old woman with multiple cardiovascular risk factors and COVI 19 pneumonia who presented with acute ischemic stroke. She was also noted to have ST segment elevation myocardial infarction (STEMI) on the electrocardiogram however the imaging and clinical presentation was consistent with apical takotsubo cardiomyopathy. We here discuss the various pathophysiologic mechanisms by which COVID-19 can result in acute stroke. The patient likely developed takotsubo cardiomyopathy because of stroke and acute COVID-19 induced sympathetic stimulation and catecholamine surge. To the best of our knowledge this is the first case of apical variant of takotsubo cardiomyopathy in a COVID-19 report.

3.
Am J Med Case Rep ; 8(10): 337-340, 2020.
Article in English | MEDLINE | ID: covidwho-1989678

ABSTRACT

Coronavirus Disease-2019 (COVID-19) is currently a public health emergency and has been listed by the World Health Organization (WHO) as a pandemic. It has commonly been associated with pulmonary manifestations and there is a growing body of evidence of multisystem involvement of the virus. As evidenced by various case reports and cohort studies, COVID-19-associated coagulopathy has been a common manifestation amongst the critically ill and has been associated with increased mortality. The presence of venous thromboembolic events in patients who are critically ill due to COVID-19 has prompted the adoption of anticoagulation regimens aimed at preventing thromboembolic phenomena. Coagulation abnormalities have also been implicated in the progression and the severity of COVID-19 related acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). There is strong evidence that D-dimer levels help predict which patients are at risk of thromboembolic events, progression to ARDS, DIC, immune dysregulation and mortality. We will review the utility of D-dimer as screening tool and in the risk stratification of COVID-19 patients prone to developing thromboembolic events, DIC, immune dysregulation and death. To date, the studies that have been published show the presence of elevated D-dimer levels in both the adult and pediatric populations and the measured level correlates with disease severity. Studies have also shown the relative increase of D-dimer levels in non-survivors compared to survivors. The elevation of D-dimer levels has shown to guide clinical decision making, namely the initiation of therapeutic anticoagulation and mortality benefit in patients with severe COVID-19 pneumonia compared to severe non COVID-19 pneumonia. Although the current body of literature suggested the use of D-dimer as a risk stratification tool and as a test to augment clinical judgement regarding the initiation of anticoagulation, randomized control trials are needed to fully understand the relationship between COVID-19 infection and the efficacy of D-dimer assays in clinical decision making.

4.
MMWR Morb Mortal Wkly Rep ; 70(14): 519-522, 2021 04 09.
Article in English | MEDLINE | ID: covidwho-1384037

ABSTRACT

CDC's National Vital Statistics System (NVSS) collects and reports annual mortality statistics using data from U.S. death certificates. Because of the time needed to investigate certain causes of death and to process and review data, final annual mortality data for a given year are typically released 11 months after the end of the calendar year. Daily totals reported by CDC COVID-19 case surveillance are timely but can underestimate numbers of deaths because of incomplete or delayed reporting. As a result of improvements in timeliness and the pressing need for updated, quality data during the global COVID-19 pandemic, NVSS expanded provisional data releases to produce near real-time U.S. mortality data.* This report presents an overview of provisional U.S. mortality data for 2020, including the first ranking of leading causes of death. In 2020, approximately 3,358,814 deaths† occurred in the United States. From 2019 to 2020, the estimated age-adjusted death rate increased by 15.9%, from 715.2 to 828.7 deaths per 100,000 population. COVID-19 was reported as the underlying cause of death or a contributing cause of death for an estimated 377,883 (11.3%) of those deaths (91.5 deaths per 100,000). The highest age-adjusted death rates by age, race/ethnicity, and sex occurred among adults aged ≥85 years, non-Hispanic Black or African American (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, and males. COVID-19 death rates were highest among adults aged ≥85 years, AI/AN and Hispanic persons, and males. COVID-19 was the third leading cause of death in 2020, after heart disease and cancer. Provisional death estimates provide an early indication of shifts in mortality trends and can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic.


Subject(s)
COVID-19/mortality , Mortality/trends , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/ethnology , Cause of Death/trends , Child , Child, Preschool , Female , Health Status Disparities , Humans , Infant , Male , Middle Aged , Mortality/ethnology , United States/epidemiology , Vital Statistics , Young Adult
5.
Anaesthesist ; 70(Suppl 1): 19-29, 2021 12.
Article in English | MEDLINE | ID: covidwho-1958962

ABSTRACT

Since December 2019 a novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) has rapidly spread around the world resulting in an acute respiratory illness pandemic. The immense challenges for clinicians and hospitals as well as the strain on many healthcare systems has been unprecedented.The majority of patients present with mild symptoms of coronavirus disease 2019 (COVID-19); however, 5-8% become critically ill and require intensive care treatment. Acute hypoxemic respiratory failure with severe dyspnea and an increased respiratory rate (>30/min) usually leads to intensive care unit (ICU) admission. At this point bilateral pulmonary infiltrates are typically seen. Patients often develop a severe acute respiratory distress syndrome (ARDS).So far, remdesivir and dexamethasone have shown clinical effectiveness in severe COVID-19 in hospitalized patients. The main goal of supportive treatment is to ascertain adequate oxygenation. Invasive mechanical ventilation and repeated prone positioning are key elements in treating severely hypoxemic COVID-19 patients.Strict adherence to basic infection control measures (including hand hygiene) and correct use of personal protection equipment (PPE) are essential in the care of patients. Procedures that lead to formation of aerosols should be carried out with utmost precaution and preparation.


Subject(s)
COVID-19 , Critical Illness , Humans , SARS-CoV-2
6.
J Policy Pract Intellect Disabil ; 17(3): 256-269, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1949684

ABSTRACT

The current COVID-19 pandemic is a pressing world crisis and people with intellectual disabilities (IDs) are vulnerable due to disparity in healthcare provision and physical and mental health multimorbidity. While most people will develop mild symptoms upon contracting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), some will develop serious complications. The aim of this study is to present guidelines for the care and treatment of people with IDs during the COVID-19 pandemic for both community teams providing care to people with IDs and inpatient psychiatric settings. The guidelines cover specific issues associated with hospital passports, individual COVID-19 care plans, the important role of families and carers, capacity to make decisions, issues associated with social distancing, ceiling of care/treatment escalation plans, mental health and challenging behavior, and caring for someone suspected of contracting or who has contracted SARS-CoV-2 within community or inpatient psychiatric settings. We have proposed that the included conditions recommended by Public Health England to categorize someone as high risk of severe illness due to COVID-19 should also include mental health and challenging behavior. There are specific issues associated with providing care to people with IDs and appropriate action must be taken by care providers to ensure that disparity of healthcare is addressed during the COVID-19 pandemic. We recognize that our guidance is focused upon healthcare delivery in England and invite others to augment our guidance for use in other jurisdictions.

7.
J Matern Fetal Neonatal Med ; 35(16): 3040-3043, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1908604

ABSTRACT

BACKGROUND: Management of acute respiratory distress syndrome (ARDS) in pregnant women infected with new severe acute respiratory syndrome Corona virus 2 (SARS-CoV2) is a challenging clinical task. CASE: A 30- year-old woman (gravid 3, parity 2) presented at her 21 and 2/7 weeks gestation (pre pregnancy BMI: 36.1 kg/m2), with ARDS caused by SARS-CoV2 infection. She received lopinavir/ritonavir and azithromycin as well as early methyl prednisolone therapy. Given the persistent hypoxemia despite oxygen therapy via non rebreather face mask (FiO2:80%), convalescent plasma transfusion was administered that led to a mild clinical improvement as well as decrease in inflammatory markers. Growth of her fetus assessed by obstetric sonography was normal during hospital stay. CONCLUSION: Judicious corticosteroid therapy along with convalescent plasma transfusion to suppress viremia and cytokine storm can lead to favorable outcome in the pregnant women with ARDS caused by SARS-CoV2 infection without superimposed bacterial infection.


Subject(s)
COVID-19 , Pregnancy Complications, Infectious , Respiratory Distress Syndrome , Adrenal Cortex Hormones , Adult , Blood Component Transfusion , COVID-19/complications , COVID-19/therapy , Female , Humans , Immunization, Passive , Plasma , Pregnancy , Pregnancy Complications, Infectious/therapy , SARS-CoV-2
8.
Nurs Res ; 70(3): 165-172, 2021.
Article in English | MEDLINE | ID: covidwho-1901299

ABSTRACT

BACKGROUND: The global COVID-19 pandemic has brought numerous challenges for conducting the human subjects research needed to advance science and improve health. OBJECTIVES: The purpose of this article is to discuss how a college of nursing at a large public university in the southeast United States has responded to the challenges of conducting research during the novel COVID-19 pandemic. METHODS: Seven faculty researchers at the University of South Carolina College of Nursing share their experiences in overcoming the unique challenges of conducting research because of the COVID-19 pandemic. Strategies to overcome the challenges posed by COVID-19 are presented within the context of the research process, career implications, communication, and maintaining morale. RESULTS: Fears of COVID-19 and social distancing measures have hindered participant recruitment, enrollment, and involvement in ongoing studies. Increasing virtual technology use and enhancing safety precautions have assisted researchers to overcome barriers. Scholarly writing has increased for some faculty members whose studies have been stalled by the pandemic, yet others have seen a decline because of additional personal responsibilities. The careers of faculty members across all ranks have been uniquely affected by the pandemic. With most faculty working remotely, enhanced communication strategies at the university and college have supported the research enterprise. Morale has been adversely affected, but a variety of personal and collegial efforts have helped faculty cope and preserve a sense of normalcy during this devastating pandemic. DISCUSSION: Faculty and their ability to conduct the research needed to inform clinical and public health practice have been adversely affected by the COVID-19 pandemic. Despite the challenges of conducting research during this unprecedented crisis, faculty and institutions are taking novel steps to ensure the continuity of scientific progress for improving the health and well-being of patients and populations.


Subject(s)
COVID-19 , Fellowships and Scholarships/organization & administration , Nursing Research/organization & administration , Schools, Nursing/organization & administration , Humans , Southeastern United States/epidemiology
9.
Curr Psychol ; 41(6): 3349-3362, 2022.
Article in English | MEDLINE | ID: covidwho-1899337

ABSTRACT

During the COVID-19 pandemic in early 2020, domestic violence, interpersonal conflicts, and cyberbullying have risen sharply in China. We speculate that the perceived threat of COVID-19 is related to a general, non-target-specific aggressive tendency during the pandemic. We surveyed 1556 Chinese people in April 2020 (757 people in Hubei Province, the pandemic epicenter in China, and 799 in other regions of China where the pandemic is relatively not severe). A multiple-group structural equation modeling analysis found significant total effects between perceived threat of COVID-19 and aggressive tendencies during the pandemic in both regional groups, and the effect between them was mainly achieved through the mediating roles of sense of control and powerlessness during the pandemic. For all participants, negative coping strategies significantly aggravated the association between perceived threat of COVID-19 and aggressive tendencies during the pandemic, but the buffers were different across regions of outbreak severity. For participants in other regions where the pandemic is relatively not severe, positive coping strategies could mitigate the association between perceived threat of COVID-19 and aggressions. However, for participants in Hubei Province, the epicenter of China's pandemic, higher life satisfaction was more effective in buffering. These findings extend the possible consequences of the perceived COVID-19 threat and suggest that improving the life satisfaction of residents in areas with severe outbreaks is more effective in mitigating the adverse effects of COVID-19. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01792-7.

10.
J Am Coll Clin Pharm ; 3(8): 1458-1463, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1898811

ABSTRACT

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has significantly affected health care systems around the world. In many hospitals and health care facilities, services and health care workers have been reorganized and restructured to meet the demands of the pandemic. The impact of the pandemic on hospital-based clinical pharmacists and their ability to deliver pharmaceutical care is currently unknown. Objective: This study aimed to explore the impact of the COVID-19 pandemic on hospital-based clinical pharmacists working in Malaysia and the implications on how clinical pharmacy is perceived as a health care service. Methods: A qualitative study was designed to meet the research objectives. Nineteen hospital-based clinical pharmacists consented and participated in one-on-one, semi-structured interviews. The interviews were transcribed and analyzed using an iterative thematic analysis approach. Results: The experiences and views of the participants were reported. Three main themes were developed: "Reassignment and other changes in clinical pharmacist roles," "Adapting clinical pharmacy services to COVID-19," and "The need for clinical pharmacists in the ward." The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment. Despite this, clinical pharmacists continued to support patient care in hospitals through the use of technology. The withdrawal of clinical pharmacy services, however, raises concern that the role of clinical pharmacists is still poorly recognized. Conclusion: Clinical pharmacists in hospitals continue to support patient care despite the disruption caused by the COVID-19 pandemic. Greater support and recognition of their role is required in order to empower and enhance their ability to deliver pharmaceutical care.

11.
J Am Coll Emerg Physicians Open ; 1(4): 578-591, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1898681

ABSTRACT

Objective: All respiratory care represents some risk of becoming an aerosol-generating procedure (AGP) during COVID-19 patient management. Personal protective equipment (PPE) and environmental control/engineering is advised. High velocity nasal insufflation (HVNI) and high flow nasal cannula (HFNC) deliver high flow oxygen (HFO) therapy, established as a competent means of supporting oxygenation for acute respiratory distress patients, including that precipitated by COVID-19. Although unlikely to present a disproportionate particle dispersal risk, AGP from HFO continues to be a concern. Previously, we published a preliminary model. Here, we present a subsequent highresolution simulation (higher complexity/reliability) to provide a more accurate and precise particle characterization on the effect of surgical masks on patients during HVNI, low-flow oxygen therapy (LFO2), and tidal breathing. Methods: This in silico modeling study of HVNI, LFO2, and tidal breathing presents ANSYS fluent computational fluid dynamics simulations that evaluate the effect of Type I surgical mask use over patient face on particle/droplet behavior. Results: This in silico modeling simulation study of HVNI (40 L min-1) with a simulated surgical mask suggests 88.8% capture of exhaled particulate mass in the mask, compared to 77.4% in LFO2 (6 L min-1) capture, with particle distribution escaping to the room (> 1 m from face) lower for HVNI+Mask versus LFO2+Mask (8.23% vs 17.2%). The overwhelming proportion of particulate escape was associated with mask-fit designed model gaps. Particle dispersion was associated with lower velocity. Conclusions: These simulations suggest employing a surgical mask over the HVNI interface may be useful in reduction of particulate mass distribution associated with AGPs.

12.
J Am Coll Emerg Physicians Open ; 1(4): 569-577, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1898677

ABSTRACT

Background: The SARS-CoV-2 (COVID-19) virus has wide community spread. The aim of this study was to describe patient characteristics and to identify factors associated with COVID-19 among emergency department (ED) patients under investigation for COVID-19 who were admitted to the hospital. Methods: This was a retrospective observational study from 8 EDs within a 9-hospital health system. Patients with COVID-19 testing around the time of hospital admission were included. The primary outcome measure was COVID-19 test result. Patient characteristics were described and a multivariable logistic regression model was used to identify factors associated with a positive COVID-19 test. Results: During the study period from March 1, 2020 to April 8, 2020, 2182 admitted patients had a test resulted for COVID-19. Of these patients, 786 (36%) had a positive test result. For COVID-19-positive patients, 63 (8.1%) died during hospitalization. COVID-19-positive patients had lower pulse oximetry (0.91 [95% confidence interval, CI], [0.88-0.94]), higher temperatures (1.36 [1.26-1.47]), and lower leukocyte counts than negative patients (0.78 [0.75-0.82]). Chronic lung disease (odds ratio [OR] 0.68, [0.52-0.90]) and histories of alcohol (0.64 [0.42-0.99]) or substance abuse (0.39 [0.25-0.62]) were less likely to be associated with a positive COVID-19 result. Conclusion: We observed a high percentage of positive results among an admitted ED cohort under investigation for COVID-19. Patient factors may be useful in early differentiation of patients with COVID-19 from similarly presenting respiratory illnesses although no single factor will serve this purpose.

13.
J Am Coll Emerg Physicians Open ; 1(4): 375-378, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-1898670

ABSTRACT

COVID-19 is proving to be a devastating pandemic with both tragic economic and health consequences worldwide. Point-of-care ultrasound (POCUS) of the lungs has been thrust into the forefront of resources that could be used in the management of COVID-19 acute care patients. However, relatively little attention has been paid to POCUS utility in assessing the heart in COVID-19 patients. Anecdotal reports suggest encounters of likely COVID-19 induced pericardial effusions and myocardial electrical dysfunction. This article presents 2 cases of generally healthy patients who were noted to have classic COVID-19 bilateral pneumonia findings on lung ultrasound and incidentally discovered to have unsuspected left ventricular dysfunction likely resulting from myocarditis. POCUS videos are presented as illustrations of this potentially overlooked complication.

14.
Minerva Med ; 113(2): 281-290, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1847990

ABSTRACT

BACKGROUND: The efficacy and safety of continuous positive airway pressure and respiratory physiotherapy outside the Intensive Care Unit during a pandemic. METHODS: In this cohort study performed in February-May 2020 in a large teaching hospital in Milan, COVID-19 patients with adult respiratory distress syndrome receiving continuous positive airway pressure (positive end-expiratory pressure =10 cm H2O, FiO2=0.6, daily treatment duration: 4×3h-cycles) and respiratory physiotherapy including pronation outside the Intensive Care Unit were followed-up. RESULTS: Of 90 acute respiratory distress syndrome (ARDS) patients treated with continuous positive airway pressure (45/90, 50% pronated at least once) outside the Intensive Care Unit and with a median (interquartile) follow-up of 37 (11-46) days, 45 (50%) were discharged at home, 28 (31%) were still hospitalized, and 17 (19%) died. Continuous positive airway pressure failure was recorded for 35 (39%) patients. Patient mobilization was associated with reduced failure rates (P=0.033). No safety issues were observed. CONCLUSIONS: Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the Intensive Care Unit setting during the pandemic.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Adult , COVID-19/complications , COVID-19/therapy , Cohort Studies , Continuous Positive Airway Pressure , Humans , Intensive Care Units , Pronation , Respiratory Distress Syndrome/therapy
15.
J Ayurveda Integr Med ; 13(1): 100424, 2022.
Article in English | MEDLINE | ID: covidwho-1838955

ABSTRACT

For centuries, traditional medicines of Ayurveda have been in use to manage infectious and non-infectious diseases. The key embodiment of traditional medicines is the holistic system of approach in the management of human diseases. SARS-CoV-2 (COVID-19) infection is an ongoing pandemic, which has emerged as the major health threat worldwide and is causing significant stress, morbidity and mortality. Studies from the individuals with SARS-CoV-2 infection have shown significant immune dysregulation and cytokine overproduction. Neutrophilia and neutrophil to lymphocyte ratio has been correlated to poor outcome due to the disease. Neutrophils, component of innate immune system, upon stimulation expel DNA along with histones and granular proteins to form extracellular traps (NETs). Although, these DNA lattices possess beneficial activity in trapping and eliminating pathogens, NETs may also cause adverse effects by inducing immunothrombosis and tissue damage in diseases including Type 2 Diabetes and atherosclerosis. Tissues of SARS-CoV-2 infected subjects showed microthrombi with neutrophil-platelet infiltration and serum showed elevated NETs components, suggesting large involvement and uncontrolled activation of neutrophils leading to pathogenesis and associated organ damage. Hence, traditional Ayurvedic herbs exhibiting anti-inflammatory and antioxidant properties may act in a manner that might prove beneficial in targeting over-functioning of neutrophils and there by promoting normal immune homeostasis. In the present manuscript, we have reviewed and discussed pathological importance of NETs formation in SARS-CoV-2 infections and discuss how various Ayurvedic herbs can be explored to modulate neutrophil function and inhibit NETs formation in the context of a) anti-microbial activity to enhance neutrophil function, b) immunomodulatory effects to maintain neutrophil mediated immune homeostasis and c) to inhibit NETs mediated thrombosis.

16.
J Ayurveda Integr Med ; 13(1): 100397, 2022.
Article in English | MEDLINE | ID: covidwho-1838952

ABSTRACT

BACKGROUND: The corona virus disease 2019 (COVID-19), an acute respiratory disease, caused by a novel corona virus (SARS-CoV-2, previously known as 2019-nCoV), obtained worldwide attention. In this review, we explored the potential siddha strategies for COVID -19 infections. OBJECTIVES: To evaluate the additional benefits of siddha drugs Vasantha kusumakaram mathirai, Thippili rasayanam, Adathodai manapagu and Kabasura kudineer compared to the allopathic standard treatment of care alone in COVID-19 asymptomatic, mild - moderate cases. MATERIALS AND METHODS: The present study was an open label Two arm - randomized controlled interventional clinical study. The Group I patients were assigned to Siddha add on treatment whereas Group II subjects were assigned with standard treatment alone. The sample size was 100 for each group. RESULT: The average number of days taken for reduction of symptoms showed significant results (P < 0.001) in Siddha add on compared with standard treatment. The real - time polymerase chain reaction (RT-PCR) investigation turned negative for 78.33% in Siddha add on and 33.33% in standard treatment after 11-14 days. Similarly, CT chest, covid pattern lung involvement percentage showed highly significant reduction (P < 0.0001) in Siddha add on treatment. In addition, Neutrophil Lymphocyte Ratio (NLR) ratio, showed significant reduction (P < 0.01) when analyzed by Wilcoxon signed rank test, and Renal, Liver parameters were within the normal limits in Siddha add on Group for 25 samples in post treatment. CONCLUSION: Finally, it was concluded that Siddha add on Group showed accelerated recovery for COVID - 19 patients compared to standard Group. The synergistic effect of Siddha add on with standard treatment gave more promising results in the current study of COVID -19.

17.
PLoS One ; 16(4): e0250815, 2021.
Article in English | MEDLINE | ID: covidwho-1833533

ABSTRACT

BACKGROUND: COVID-19 is a respiratory infectious disease caused by SARS-CoV-2, and cardiovascular damage is commonly observed in affected patients. We sought to investigate the effect of SARS-CoV-2 infection on cardiac injury and hypertension during the current coronavirus pandemic. STUDY DESIGN AND METHODS: The clinical data of 366 hospitalized COVID-19-confirmed patients were analyzed. The clinical signs and laboratory findings were extracted from electronic medical records. Two independent, experienced clinicians reviewed and analyzed the data. RESULTS: Cardiac injury was found in 11.19% (30/268) of enrolled patients. 93.33% (28/30) of cardiac injury cases were in the severe group. The laboratory findings indicated that white blood cells, neutrophils, procalcitonin, C-reactive protein, lactate, and lactic dehydrogenase were positively associated with cardiac injury marker. Compared with healthy controls, the 190 patients without prior hypertension have higher AngⅡ level, of which 16 (8.42%) patients had a rise in blood pressure to the diagnostic criteria of hypertension during hospitalization, with a significantly increased level of the cTnI, procalcitonin, angiotensin-II (AngⅡ) than those normal blood pressure ones. Multivariate analysis indicated that elevated age, cTnI, the history of hypertension, and diabetes were independent predictors for illness severity. The predictive model, based on the four parameters and gender, has a good ability to identify the clinical severity of COVID-19 in hospitalized patients (area under the curve: 0.932, sensitivity: 98.67%, specificity: 75.68%). CONCLUSION: Hypertension, sometimes accompanied by elevated cTnI, may occur in COVID-19 patients and become a sequela. Enhancing Ang II signaling, driven by SARS-CoV-2 infection, might play an important role in the renin-angiotensin system, and consequently lead to the development of hypertension in COVID-19.


Subject(s)
COVID-19/complications , Heart Injuries/epidemiology , Hypertension/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/metabolism , COVID-19/physiopathology , Comorbidity , Disease Progression , Female , Heart Injuries/virology , Hospitalization , Humans , Hypertension/physiopathology , Hypertension/virology , Male , Medical Records , Middle Aged , Pandemics , Renin-Angiotensin System , SARS-CoV-2/pathogenicity
18.
Pacing Clin Electrophysiol ; 45(6): 807-810, 2022 06.
Article in English | MEDLINE | ID: covidwho-1832218

ABSTRACT

In the era of coronavirus disease 2019 (COVID-19), the management of cardiac implantable electronic devices infections with concomitant viral infection has not been completely defined yet. In this explorable context, we report the first experience of a Cardiac resynchronization therapy with defibrillator (CRT-D) implantation after transvenous lead extraction for endocarditis in a COVID-19 patient. We describe both the measures and procedures implemented to reduce the cross-infection in the operating room and our clinical practice to improving procedure effectiveness on patient care.


Subject(s)
COVID-19 , Cardiac Resynchronization Therapy , Defibrillators, Implantable , Endocarditis , Heart Diseases , Cardiac Resynchronization Therapy Devices , Device Removal/methods , Humans , Retrospective Studies , SARS-CoV-2 , Treatment Outcome
19.
Nat Rev Immunol ; 20(7): 442-447, 2020 07.
Article in English | MEDLINE | ID: covidwho-1830064

ABSTRACT

A male bias in mortality has emerged in the COVID-19 pandemic, which is consistent with the pathogenesis of other viral infections. Biological sex differences may manifest themselves in susceptibility to infection, early pathogenesis, innate viral control, adaptive immune responses or the balance of inflammation and tissue repair in the resolution of infection. We discuss available sex-disaggregated epidemiological data from the COVID-19 pandemic, introduce sex-differential features of immunity and highlight potential sex differences underlying COVID-19 severity. We propose that sex differences in immunopathogenesis will inform mechanisms of COVID-19, identify points for therapeutic intervention and improve vaccine design and increase vaccine efficacy.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Adaptive Immunity , Age Factors , Betacoronavirus/physiology , COVID-19 , Coronavirus Infections/immunology , Coronavirus Infections/pathology , Coronavirus Infections/physiopathology , Female , Humans , Interferons/immunology , Male , Pandemics , Pneumonia, Viral/immunology , Pneumonia, Viral/pathology , Pneumonia, Viral/physiopathology , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Sociological Factors
20.
J Diabetes Complications ; 34(9): 107637, 2020 09.
Article in English | MEDLINE | ID: covidwho-1828813

ABSTRACT

BACKGROUND: The novel coronavirus SARS-CoV-2 has taken the world by storm. Alongside COVID-19, diabetes is a long-standing global epidemic. The diabetes population has been reported to suffer adverse outcomes if infected by COVID-19. The aim was to summarise information and resources available on diabetes and COVID-19, highlighting special measures that individuals with diabetes need to follow. METHODS: A search using keywords "COVID-19" and "Diabetes" was performed using different sources, including PubMed and World Health Organization. RESULTS: COVID-19 may enhance complications in individuals with diabetes through an imbalance in angiotension-converting enzyme 2 (ACE2) activation pathways leading to an inflammatory response. ACE2 imbalance in the pancreas causes acute ß-cell dysfunction and a resultant hyperglycemic state. These individuals may be prone to worsened COVID-19 complications including vasculopathy, coagulopathy as well as psychological stress. Apart from general preventive measures, remaining hydrated, monitoring blood glucose regularly and monitoring ketone bodies in urine if on insulin is essential. All this while concurrently maintaining physical activity and a healthy diet. Different supporting entities are being set up to help this population. CONCLUSION: COVID-19 is a top priority. It is important to remember that a substantial proportion of the world's population is affected by other co-morbidities such as diabetes. These require special attention during this pandemic to avoid adding on to the burden of countries' healthcare systems.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Diabetes Mellitus/epidemiology , Diabetes Mellitus/therapy , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , COVID-19 , Humans , SARS-CoV-2
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