COVID-19 associated pulmonary cavitary lesions - A single center observational study

Introduction: Cavitary lesions are rarely associated with COVID-19 and have been very rarely reported. We conducted a retrospective analysis of the COVID-19 patients admitted in our center in South India and attempted to study the distribution and etiology of cavitary lesions in COVID-19. Material(s) and Method(s): All inpatients in pulmonology department over a period of 14 months who were diagnosed to have COVID-19 and were found to have cavity on thoracic imaging were included in the study. patient with pre existing cavity were excluded. Patient demographics, comorbid conditions, treatment details, length of hospital stay, and outcomes were examined. The details of the cavitary lesions including their number, the time of detection and lobe of involvement, and the etiology of the cavity were described. Result(s): 602 patients with COVID-19 were admitted during the study period. A total of 9 patients were included in this report with an incidence of cavitation in hospitalised COVID-19 patients being 1.5%. 55.5% patients had evidence of Aspergillus infection confirmed by serology or isolation of Aspergillus from respiratory specimen. Two (22.2%) patients had tuberculosis. The mortality rate of COVID-19 patients with Aspergillus lesions was 44.4%. Majority were detected to have cavity in the third week of illness. Left lower lobe was the most common involved site. Result(s): The incidence of cavitary lesions in patients hospitalised with COVID-19 was 1.5% in this study most common etiology of these cavities was fungal followed by TB. These patients had a very high mortality rate of around 45% in this study. Early identification and treatment may improve clinical outcomes in these patients.

Online Sequential Extreme learning machine-based hybrid model for forecasting of COVID-19 cases in India

COVID-19 has posed high stress on government and people with its disruptive effects on every sector of the nation. Accurate and reliable forecasting models are of great need to handle this unprecedented situation. A hybrid model, which is a combination of, cuckoo search optimization algorithm, variational mode decomposition and online sequential extreme learning machine has been proposed in this work for multistep forecasting of COVID-19 cases. The model showed reasonable accuracy of 1.363%, 1.596% and 1.933% for one, three and five days ahead forecasting. The model gave superior results when compared with partial autocorrelation function (PACF) for selection of number of input parameters. The robustness of the proposed model has been evident in comparison with other similar state of the art techniques discussed in the literature. © 2022 IEEE.

Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 in Children- a Comparative Study between First and Second Wave

BACKGROUND AND AIM: The clinical spectrum and management of Multi-system Inflammatory Syndrome in Children (MIS-C) is evolving with each wave of COVID-19. This study aims to compare the clinical spectrum and immunomodulatory management of children with MIS-C between first and second wave in a tertiary care hospital in south India. METHOD(S): This prospective observational comparative study included children satisfying CDC MIS-C criteria admitted during 1st and 2nd wave of COVID 19 (total period from September 2019 to January 2022). We compared the clinical presentation, severity of illness, inflammatory biomarker profile, immunomodulatory therapy, need for inotropic support, duration of stay and outcome. RESULT(S): Study population included 27 during 1st wave and 75 during 2nd wave. Median age (IQR) of patients was 4.4years (3.15, 7.95) and 5.6 years (3.25, 8.8) during 1st and 2nd wave respectively. Males preponderance was seen in both waves (69% VS 65%). Clinical presentation was similar in both waves. 37% patients presented with shock during 1st wave while 36% in 2nd wave. Gastrointestinal symptoms were predominant (78% VS 82%) followed by cardiac manifestations (44% VS 45%), while a higher incidence of coronary artery dilatation was seen in 2nd wave (35% VS 26%). Comparison of immunomodulatory therapy is depicted in table 1. IVIG and pulse Methylprednisolone requirement was more during 2nd wave. 3 patients during 2nd wave needed additional immunomodulatory therapy with Anakinra (table 1). No patient required 2nd dose of IVIG. There was no mortality. CONCLUSION(S): Clinical presentation was similar in both waves. Requirement of immunomodulatory therapy was more during 2nd wave.

Immunomodulatory Therapy in Multisystem Inflammatory Syndrome Associated with Sars-Cov-2 in Children

BACKGROUND AND AIM: The clinical spectrum and management of Multi-system Inflammatory Syndrome in Children (MIS-C) is evolving with each wave of COVID-19 and emerging literature. This study aims to describe the clinico-pathological spectrum and immunomodulatory management of MIS-C in a tertiary care hospital in south India. METHOD(S): This prospective observational study included children satisfying CDC MIS-C criteria admitted from September 2019 to January 2022. We studied the characteristics of patients receiving immunomodulatory therapy with respect to need for inotropic support, duration of stay, mortality, escalation of immunomodulation, time to defervescence and persistence of coronary abnormalities at 2 weeks. RESULT(S): 102 children were included with median (IQR) age of 5.5 (3.2-8.5) years with male: female ratio of 1.84. Gastrointestinal symptoms were seen in 85 (84%), cardiac manifestations in 48 (47%) and coronary artery dilatation was seen in 33 (32%). Methylprednisolone and intravenous immunoglobulin were used as first line therapy in 31 (30.4%), and 25 (24.5%) patients, respectively. 46 (45.1%) children received both IVIG and IV Methylprednisolone. 30 (29%) presented with shock and 28 (27%) required inotropic support. Defervescence at 48hrs was observed in 30 (96%) in steroids alone group, 18 (72%) in IVIG group and 26 (57%) in IVIG+steroid group. 4 needed additional immunomodulatory therapy with Anakinra (table 1). None of them required 2nd dose of IVIG. There was no mortality. At 2 weeks follow-up coronary artery dilatation persisted in 9 children. CONCLUSION(S): Immunomodulator therapy was based on severity at presentation and all combinations of therapy were effective.

Pattern Analysis of COVID-19 Based On Geotagged Social Media Data with Sociodemographic Factors

The world has faced a catastrophic global crisis of COVID-19 caused by coronavirus and called for analyzing the affected areas in any country. The study helps to understand how the second wave affected different states in India concerning sociodemographic factors, such as population density, economy, and unemployment rate. During the lockdown, the sudden impact of staying at home has led to increased social media usage, where people expressed their opinions on multiple topics. Twitter provides timestamp and sometimes spatial information of the tweets generated. Using the geotagged Twitter dataset, a study in India is performed in this work considering the second wave of COVID-19, which occurred approximately from April to June 2021. It analyses the temporal and spatial patterns of the geotagged tweets generated from all the states during the period mentioned above. Also, topic modeling and sentiment analysis are performed to understand the concerns discussed by the people. We use different states' sociodemographic factors and machine learning algorithms to divide the population into high and low categories to understand the topic prevalence in different socioeconomic groups. This study reveals that the low socioeconomic groups have shared more concerns, urging the government to help fight the COVID-19 pandemic. © 2022 IEEE.

Impact of COVID-19 on the trend of leptospirosis: A retrospective study

Background and Objectives: With the prevalence of a large number of febrile diseases in the Asia-Pacific region, the presentation of fever poses a diagnostic dilemma for physicians during the COVID era. We noticed an alarming increase in the number of cases of leptospirosis during the pandemic. Hence, we conducted a study to compare the trend, complications, and outcomes of patients with leptospirosis before and during the COVID-19 pandemic. Subjects and Methods: A retrospective, hospital case record-based analytical study was conducted in a tertiary care center in Mangaluru. All patients who were admitted to our hospital from March to October 2019 (before the COVID pandemic) and from March to October 2020 (during the COVID pandemic) with a clinical and laboratory-confirmed diagnosis of leptospirosis were included in our study. Patient records were screened, and demographic, clinical, and laboratory information was collected. Statistical analysis was done using SPSS 16.0 (Statistical Package for the Social Sciences). Results: The incidence of leptospirosis was higher during the COVID pandemic (102 vs. 62). The mean age of leptospirosis patients in 2019 and 2020 was 45.18 and 45.19 years, respectively. Fewer patients with leptospirosis reported fever during the pandemic (69.6% vs. 94.2%). There was an increased incidence of complications such as hepatitis (84.3% vs. 31.9%), acute kidney injury (87.3% vs. 52.2%), acute respiratory distress syndrome (20.6% vs. 8.7%), and multiorgan dysfunction syndrome (68.6% vs. 33.3%) in 2020. The case fatality rate Was higher in 2020 (2 0. 6 %) when compared to 2019 (5. 8 %) Conclusions: There was an increase in Proportion of leptospirosiscases, complications and mortality during the COVID pandemic. This is a cause for concern. More studies are needed in the community to determine the reason for this increase. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

VIRTUAL LEARNING: A PANACEA IN THE PHASE OF COVID PANDEMIC AND PROSPECT OF EDUCATION

The petrifying and extreme impact of COVID-19 has shaken the world to its core. The COVID-19 pandemic has caused the biggest interruption in the history of education systems, affecting almost 1.6 billion learners in more than 190 countries on all continents. When most of the world is experiencing an e-learning boom as the aftermath of the COVID-19 crisis, the situation arose many challenges on the execution and effectiveness of online classes in the rural regions. The present study aims at exploring the views and opinions of students in the state of Karnataka in India who switched to online classes due to lockdown which was not their choice, rather the only option available. This study reflects the feasibility of virtual learning in the higher education system during the COVID pandemic, explores the different variables that positively and skeptically affects students in virtual learning, and inspects the impact of virtual learning on student's contentment. The paper employs a quantitative approach to analyze the perceptions of students on online learning. The results of the study indicate the aspects that encouraged students to support virtual learning and those aspects that need to be improved to ensure effective teaching-learning in the online scenario. Improving the quality of education provided, activities for engagement and maintaining of social relationships, and scope for participation in co-curricular activities will improve the student satisfaction score in online learning. This study indicated that at present the students are more satisfied with the physical classes. Even though the present crisis is alleviated, the scope of a blended teaching-learning method of online and offline classes might be continuing. Hence the findings of the present study will help instructors to improve the learning experience of their students.

How do the government and more than 1.3 billion people stand against the covid-19 pandemic in the world’s largest democratic country? a comprehensive reflection from india, in a public health perspective

Background-Coronavirus disease (COVID-19), which is caused by deadly novel corona virus has devastated the world causing a morbidity rate of more than 64 million and mortality rate of 1.5 million. India, being a Lower Middle-Income Country (LMIC) with a GNI per capita of nearly $2000, has proactively instituted various containment strategies. India has witnessed the effectiveness of primary prevention strategies in fighting various health problems in the years gone. The most worrying factor was about community spread of the pandemic, which would cause the spread of illness uncontrollable. Economic analysts had forecasted if appropriate strategy on containment of coronavirus is not initiated, the country would regress back to 20 years, in terms of economy and healthcare. This scoping review throws light into the efficacious preventive strategies adopted by India to fight COVID-19 pandemic and attempting to reduce mortality and morbidity rate, to flatten the illness curve. Methods-We used a wide range of scientific database and news reports to conduct an extensive review on India’s fight against COVID-19. Articles which has been published from January to November 2020 were reviewed and pooled the data to write this review. Conclusion-Containment strategies are the key for prevention of any contagious illness. COVID-19 being highly contagious, and infecting millions of populations, is successfully being controlled in India to reduce the cases. The Case Fatality Ratio (CFR) of COVID-19 is very low in India, compared to other countries.