Multisystem Inflammatory Syndrome in Children

Multisystem inflammatory syndrome in children (MIS-C) is an uncommon but emerging syndrome related to SARS-CoV-2 infection. While the presentation of MIS-C is generally delayed after exposure to the virus that causes coronavirus 2019, both MIS-C and Kawasaki disease (KD) share similar clinical features. Multisystem inflammatory syndrome in children poses a diagnostic and therapeutic challenge given the lack of definitive diagnostic tests and a paucity of evidence regarding treatment modalities. We review the clinical presentation, diagnostic evaluations, and management of MIS-C and compare its clinical features to those of KD.

COVID-19 case fatality and Alzheimer's disease

Objective: Our objective was to determine whether AD increases COVID-19 case fatality rate (CFR). Background: Previous studies have identified dementia as a risk factor for death from coronavirus disease 2019 (COVID-19). However, it is unclear whether Alzheimer's disease (AD) is an independent risk factor for COVID-19 mortality. Design/Methods: In a retrospective cohort study, we identified 387,841 COVID-19 patientes through TriNetX, and performed a multivariable logistic regression to determine the odds ratio of dying from COVID-19 between patients with and without AD. We accounted for differences between cohorts in three ways. First, we included age, gender, race, ethnicity, and 30 comorbidities from the Elixhauser comorbidity index in our regression. Second, we matched each AD COVID-19 case to control COVID-19 cases with the same age, gender, race, and Elixhauser Comorbidity Index, and then performed conditional logistic regression to account for residual confounding. Third, we performed propensity score matching followed by conditional logistic regression. We extended this analysis to vascular dementia, dementia with Lewy bodies (DLB) and frontotemporal dementia (FTD). Results: We found that AD patients had higher odds of dying from COVID-19 compared to patients without AD (Odds Ratio(OR): 1.20, 95% confidence interval(CI): 1.09-1.32, p<0.001). This result is corroborated by conditional logistic regression analyses with exact-matching and propensity score matching. Interestingly, we did not observe increased mortality from COVID-19 among patients with vascular dementia (OR: 0.99, 95% CI: 0.88-1.10, p=0.83), DLB or FTD. Conclusions: AD increases CFR associated with COVID-19, though vascular dementia does not. These data are relevant to the evolving global COVID-19 pandemic and future pandemics.

Assessment of Air Quality Index in major cities of India-Lessons from Lockdown

An unexpected closure episode of most of the public movement and industrial activities during the initial spreading duration of COVID-19 has significantly resulted in drastic reduction of environmental pollution in the urban areas globally. Being an active bio-aerosol with pandemic effect, COVID-19 presents a never-before scenario for the meteorologists and environmental engineers to look for systematic analysis of the overlap of air quality modelling with modifications in the atmospheric science. The long-term monitoring of pollution records help in defining unique indices for categorizing the severity of the existing pollution and thus helps in developing strategies for improving environmental quality. In this study, we present the observations in major air quality parameters in selected major cities of India using air quality index (AQI) before and after the announcement of a nationwide lockdown that extended nearly for many months. The results indicate a major sustaining type of decline in the average AQI values for major Type-1 and Type-2 cities due to the reduction in public movement and industrial activities, whereas the reduction AQI values for Type-3 and Type-4 cities were observed to be fluctuating due to the continued small-scale industrial activities and low level of awareness about ban on public gathering programmes. © 2020 Published under licence by IOP Publishing Ltd.