Confirmed COVID-19 Patients Research Articles

Dermatological Manifestations of COVID-19 in Patients Reporting to a Tertiary Care Hospital in Rawalpindi, Pakistan.

IntroductionThe clinicopathological description of dermatological manifestations of COVID-19 leaves much to be desired. There is a need to determine their association with disease severity, outcome, and other clinical variables.ObjectivesThe objectives of this study are to record and histopathologically examine the cutaneous manifestations of COVID-19 and correlate these to age, disease severity, and mortality.MethodsAll confirmed COVID-19 patients admitted to a single tertiary healthcare hospital in Rawalpindi, Pakistan, were included. Their diseases were classified as mild, moderate, severe, and critical. The recent onset skin eruptions in these patients were recorded via photographs along with relevant clinical data. The photographs were independently reviewed by a group of three dermatologists without knowledge of the clinical information. The skin manifestations were divided into disease-specific and nonspecific categories using an already defined algorithm. Histopathological examination of skin manifestations was conducted.ResultsA total of 23% (n=47) had “new” skin manifestations. Specific skin findings were seen in 21.6% (n=44), which consisted of ecchymosis/purpura in 50% (n=22), maculopapular exanthem in 18% (n=8), livedo reticularis in 16.2% (n=7), ischemia/gangrene in 16.2% (n=7), perniosis in 15.9 % (n=7), vesiculo-bullous rash in 9% (n=4) and urticaria in 4% (n=1). Non-specific findings were seen in 6% (n=13) and included bedsores, dermatitis passivata, dryness, herpes labialis, oral ulcerations, and nasogastric tube-induced ulcerations. There was a significant association (p=0.03) between disease severity and specific skin lesions. Ischemia/gangrene was significantly associated with COVID-19 disease severity and mortality. Vesiculobullous lesions were associated with higher mortality, though not with disease severity. Livedo reticularis had a higher-than-expected count in critical disease, albeit statistically insignificant. The association of maculopapular exanthem and ecchymosis/purpura with severe/critical disease was statistically insignificant. Urticaria was significantly associated with low disease severity. Mean age with specific manifestations was 56.86 ± 15.81 and with nonspecific/without any manifestations was 42.58 ± 16.96, a highly significant difference, with p-value < 0.001. Old age (>60 years) was significantly associated with ecchymosis (p=0.038), maculopapular exanthem (p=0.021), and vesiculo-bullous rash (p=0.029). Histopathology varied according to the type of skin lesion.ConclusionsDermatological manifestations coexist in many patients and tend to appear more in severe cases of COVID-19 among the older age group and only minimally in mild/moderate cases. Their presence could help set prognostic criteria of COVID-19 disease in the future.

The correlation of anti-heart antibodies levels with clinical manifestations and outcomes in patients with COVID-19

PurposeTo evaluate the blood level of anti-heart antibodies (AHA) and its correlation with clinical outcomes in patients with severe and moderate COVID-19.MethodsThe study included 34 patients (11 females and 23 males, mean age 58.3±17.6 years, from 20 to 87 years) who underwent treatment for moderate and severe COVID-19 at the Sechenov University hospital in April-June 2020. The diagnosis was confirmed by 50% using nasopharyngeal smears. In other cases, the diagnosis of COVID-19 was based on the following criteria: contact with a serologically confirmed COVID-19 patient, persistent fever of at least 38 degrees Celsius, typical CT findings of viral pneumonia, typical changes in blood tests in the absence of evidence for other diseases. Besides standard medical examination the AHA blood levels by immunoassay were observed, including antinuclear antibodies (ANA), antiendothelial cell antibodies (AECA), anti-cardiomyocyte antibodies (AbC), anti-smooth muscle antibodies (ASMA) and cardiac conducting tissue antibodies (CCTA). Median hospital length of stay was 14 [13; 18] days.ResultsAHA levels were increased in 25 (73.5%) patients. The patients were divided into the five groups: 1.Patients with previous chronic myocarditis who had already been receiving immunosuppressive therapy at the admission (n=4). Moderate titer increase was noted only in one patient. 2.Patients with severe COVID-19 and high inflammatory activity, in whom the degree of AHA increase matched the general disease activity. 3. Patients with severe COVID-19 and high inflammatory activity without AHA increase. 4. Patients with moderate COVID-19, in whom high AHA titers may reflect chronic latent myocarditis not associated with SARS-Cov2. 5. Patients with moderate COVID-19 and nearly normal / normal AHA titers. Significant correlation (p<0.05) of AHA levels with cardiovascular manifestations (r=0.459) was found. AbC levels correlated significantly with pneumonia severity (r=0.472), respiratory failure (r=0.387), need for invasive ventilation (r=0.469), chest pain (r=0.374), low QRS voltage (r=0.415) and high levels of CRP (r=0.360) and LDH (r=0.360). ASMA levels were found to correlate significantly with atrial fibrillation (r=0.414, p<0.05). ANA and AbC levels correlated significantly with pericardial effusion (r=0.721 and r=0.745 respectively, p<0.05). The lethality rate was 8.8%. AbC and ASMA levels correlated significantly with lethality (r=0.363, and r=0.426 respectively, p<0.05) and were prognostically important.ConclusionElevated titres of AHA were found in 73.5% of patients. AHA correlated with lethality, in most cases reflecting the overall activity and severity of the disease and may be considered within the systemic immune and inflammatory response in COVID-19. At the same time, the correlation with signs of myocardial injury and pericardial effusion, confirms the direct role of AHA in the inflammatory heart disease (myopericarditis).FUNDunding AcknowledgementType of funding sources: None.

Coronavirus disease 2019 and peripheral blood eosinophil counts: a retrospective study

PurposeEosinopenia has been described in COVID-19. With this study, we aim to study the peripheral blood eosinophil counts in COVID-19 patients and to investigate whether there is an association between the peripheral blood eosinophil counts and disease severity of COVID-19.MethodsWe revised the electronical medical records of confirmed COVID-19 patients with polymerase chain reaction (PCR) assays in the Groene Hart Ziekenhuis, Gouda, The Netherlands. We divided patients in mild, moderate and severe groups based on clinical severity of COVID-19. Clinical severity was based on the therapy needed and the outcome of patients. We compared clinical characteristics, laboratory results and outcome between the three groups.ResultsOf the 230 patients included in this study, the mild, moderate and severe groups consisted of 16.5%, 45.7% and 37.8% of the included patients, respectively. The mean age was 68 years (IQR 57–78). 63% of patients were male. A significant decrease in the peripheral eosinophil counts was found corresponding to the increase of COVID-19 severity. In the mild, moderate and severe groups, the percentage of patients with eosinopenia was 73.7%, 86.7% and 94.3%, respectively (p value 0.002).ConclusionEosinopenia is significantly more frequent present in patients with a severe COVID-19.

Evaluation of professional practice in the context of Covid-19

An evaluation of professional practices was carried out in a cancer centre in the wake of the management of the health crisis linked to the severe acute respiratory syndrome coronavirus 2 pandemic. Hospital teams questioned the relevance of the measures adopted, internally and during home care, to manage suspected or confirmed Covid-19 patients and prevent contagion for all.

COVID-19 screening using breath-borne volatile organic compounds

Rapid screening of COVID-19 is key to controlling the pandemic. However, current nucleic acid amplification involves lengthy procedures in addition to the discomfort of taking throat/nasal swabs. Here we describe potential breath-borne volatile organic compound (VOC) biomarkers together with machine learning that can be used for point-of-care screening of COVID-19. Using a commercial gas chromatograph-ion mobility spectrometer, higher levels of propanol were detected in the exhaled breath of COVID-19 patients (N = 74) and non-COVID-19 respiratory infections (RI) (N = 30) than those of non-COVID-19 controls (NC)/health care workers (HCW) (N = 87), and backgrounds (N = 87). In contrast, breath-borne acetone was found to be significantly lower for COVID-19 patients than other subjects. Twelve key endogenous VOC species using supervised machine learning models (support vector machines, gradient boosting machines (GBMs), and Random Forests) were shown to exhibit strong capabilities in discriminating COVID-19 from (HCW + NC) and RI with a precision ranging from 91% to 100%. GBM and Random Forests models can also discriminate RI patients from healthy subjects with a precision of 100%. In addition, the developed models using breath-borne VOCs could also detect a confirmed COVID-19 patient but with a false negative throat swab polymerase chain reaction test. It takes 10 min to allow an entire breath test to finish, including analysis of the 12 key VOC species. The developed technology provides a novel concept for non-invasive rapid point-of-care-test screening for COVID-19 in various scenarios.

ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN DEPRESI PADA ORANG TERKONFIRMASI COVIND-19 DI KABUPATEN PEKALONGAN

&lt;strong&gt;&lt;span lang="EN-ID"&gt;Background&lt;/span&gt;&lt;span&gt; :&lt;/span&gt;&lt;/strong&gt;&lt;span&gt; Coronavirus Disease (Covid-19) has become a global pandemic since its emergence in 2019. Data released &lt;/span&gt;&lt;span lang="EN-ID"&gt;from COVID Task Force &lt;/span&gt;&lt;span&gt;Pekalongan Regency (6/9/2020), the number of patients who were confirmed positive was 115 patients and 22 patients were under treatment. The number of COVID-19 cases that continues to increase will certainly have several impacts on the community, including people who are confirmed to be COVID-19. Patients who are confirmed positive for COVID-19 tend to experience depression. Depression in individuals is influenced by several factors including biological, psychological and social factors.&lt;/span&gt;&lt;strong&gt;&lt;span&gt;Objec&lt;/span&gt;&lt;span lang="EN-ID"&gt;tive&lt;/span&gt;&lt;span&gt; :&lt;/span&gt;&lt;/strong&gt;&lt;span&gt; This study aims to analyze factors associated with depression &lt;/span&gt;&lt;span lang="EN-ID"&gt;among&lt;/span&gt;&lt;span&gt; people with COVID-19&lt;/span&gt;&lt;span lang="EN-ID"&gt; confirmed&lt;/span&gt;&lt;span&gt; in Pekalongan Regency.&lt;/span&gt;&lt;strong&gt;&lt;span&gt;Met&lt;/span&gt;&lt;span lang="EN-ID"&gt;hod&lt;/span&gt;&lt;span&gt; :&lt;/span&gt;&lt;/strong&gt;&lt;span&gt; Th&lt;/span&gt;&lt;span lang="EN-ID"&gt;is&lt;/span&gt;&lt;span lang="EN-ID"&gt;was&lt;/span&gt;&lt;span&gt; a descriptive correlational research with a cross sectional approach. The population in this study were confirmed COVID-19 patients who were treated in Pekalongan Regency with the sample technique used was total sampling. The instrument used in this study consisted of 4 parts, namely the demographic questionnaire, the Major Depression Inventory (MDI) questionnaire, the Mishel Uncertainty Illness Scale (MUIS) questionnaire, the Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. The analysis used is univariate analysis, bivariate with chi square test.&lt;/span&gt;&lt;strong&gt;&lt;span lang="EN-ID"&gt;Results&lt;/span&gt;&lt;span&gt; :&lt;/span&gt;&lt;/strong&gt;&lt;span&gt;Illness uncertainty was significantly associated with depression among people confirmed eith COVID-19 (p-value &amp;lt; 0.05).&lt;/span&gt;&lt;strong&gt;&lt;span lang="EN-ID"&gt;Conclusion and reccommendation&lt;/span&gt;&lt;span&gt; :&lt;/span&gt;&lt;/strong&gt;&lt;span&gt;The results of the study &lt;/span&gt;&lt;span lang="EN-ID"&gt;were&lt;/span&gt;&lt;span&gt; expected to be a database for formulating strategies in preventing post-COVID-19 depression. Health workers &lt;/span&gt;&lt;span lang="EN-ID"&gt;were &lt;/span&gt;&lt;span&gt;expected to be able to reduce &lt;/span&gt;&lt;span lang="EN-ID"&gt;illness&lt;/span&gt;&lt;span&gt; uncertainty in patients and social &lt;/span&gt;&lt;span lang="EN-ID"&gt;support&lt;/span&gt;&lt;span&gt; can prevent depression in COVID-19 patients.&lt;/span&gt;

Study on Psycho-social Problems among COVID-19 Patients in Tirunelveli District, Tamil Nadu, India

Background: COVID-19 crisis leads to significant changes in routine life, loss of employment, financial crisis, living in isolation, and death of loved ones etc. that can create worry and stress among the people infected with COVID-19. The aim of the study is to estimate the burden of psycho-social problems among COVID-19 patients admitted in a tertiary care institute. A hospital-based cross-sectional study carried out among stable 450 RT-PCR confirmed COVID-19 patients admitted in the COVID ward of Tertiary Care Institute, Tirunelveli, Tamil Nadu, India between August and September 2020. Materials and Methods: Participants with self-reported pre-existing mental illnesses were excluded. Psycho-social issues of the participants were studied through telephonic conversation using a predesigned questionnaire including DASS 21 scale. Chi-square test was used to test the association between categorical variables. Variables significant in univariate analysis were included for multivariate analysis. P-value &lt; 0.05 was considered to be statistically significant. Results: Based on DASS21 Scoring, 89 (20%) had depression, 190 (42%) were anxious and 53 (12%) were under stress. Patients aged more than 60 years, literate, with risk factors like diabetes mellitus and hypertension were more likely to have one or more psychological conditions. Conclusion: There is an increased prevalence of psychological morbidities among COVID-19 patients. It warrants the need for a combined action from health care professionals in the early identification of these psychological issues to prevent long term mental health issues among survivors.

An evaluative model for assessing pandemic resilience at the neighborhood level: The case of Tehran.

The spread of the COVID-19 virus, which has caused abundant mortalities in human settlements, has drawn the attention of urban planners and policy-makers to the necessity of improving resilience to future pandemics. In this study, a set of indicators related to pandemic resilience were identified and used to develop a composite multi-dimensional pandemic resilience index for Tehran's neighborhoods. The physical, infrastructural, socio-economic, and environmental dimensions of pandemic resilience were defined considering the conditions of 351 neighborhoods through the exploratory factor analysis method. Accordingly, the pandemic resilience (PR) score of the neighborhoods was calculated. Furthermore, the Pearson correlation analysis was used to validate the PR scores by examining the correlation between the neighborhood PR scores and the number of confirmed cases. For this purpose, we used a sample consisting of 43,000 confirmed COVID-19 patients in the first five months of its spread. The test shows a statistically significant negative correlation between neighborhoods’ resilience score and the cumulative number of confirmed patients in the neighborhoods (r= -.456, P<0.001). This study also tries to develop a new model to better understand health determinants of pandemic resilience. The proposed model can inform planners and policymakers to take appropriate measures to create more pandemic-resilient urban neighborhoods.

Nasopharyngeal and serological anti SARS-CoV-2 IgG/IgA responses in COVID-19 patients

BackgroundThe systemic antibody responses to SARS-CoV-2 in COVID-19 patients has been extensively studied. However, less is known about the mucosal responses in the upper airways, the site of initial SARS-CoV-2 replication. MethodsThe IgG and IgA antibody responses were analysed in plasma and nasopharyngeal swabs from the first four confirmed COVID-19 patients in France. Two were pauci-symptomatic while two developed severe disease. We characterized their antibody profiles by using an in-house ELISA to detect antibodies directed against SARS-CoV-2 Nucleoprotein and Spike. ResultsAnti-N IgG and IgA antibodies were detected in the NPS of severe patients only. The levels of antibodies in the plasma markedly differed amongst the patients. The most distinctive features are a strong anti-N IgG response in the severe patient who recovered, and a high anti-N IgA response specifically detected in the fatal case of COVID-19. ConclusionsAnti-N IgG and IgA antibodies are detected in NPS only for severe patients, with levels related to serological antibodies. The severe patients showed different antibody profiles in the plasma, notably regarding the IgA and IgG response to the N antigen, that may reflect different disease outcome. By contrast, pauci-symptomatic patients did not exhibit any mucosal antibodies in NSP, which is associated with a low or absent serological response against both N and S.

STRATEGY IN ANTICIPATING THE HOSPITAL’S FINANCIAL CONDITION DURING THE COVID-19 PANDEMIC: A SYSTEMATIC REVIEW

As of June 9, 2021, the number of confirmed COVID-19 patients was 174 million, and the death toll was 3.76 million. In the current pandemic situation, the function of hospitals as a place for treatment and health rehabilitation services meeting hospital service standards is very much needed. However, with the emergence of COVID-19 causing the financial stability of the hospital has been undermined. The purpose of this systematic review is to discuss strategies in predicting the financial status of hospitals in various countries to face the pandemic. Included study within periods 2020, type of research articles published in the field of public health and hospitals related to the COVID-19 pandemic National and international research articles relating to hospital financial strategies. The search, using a multi-method strategy and downloaded it into Mendeley. Strategies that can be taken include change of leadership style, social media strategy, funding allocation system, rejuvenating income, SWOT analysis, and health policy. The management approach to establishing a stable financial condition is to reduce unnecessary costs and improve planning and execution. These things must be evaluated immediately so that decisions can be taken immediately to prevent the financial deficit that will continue to occur.

Spectrum of hospitalized NeuroCOVID diagnoses from a tertiary care neurology centre in Eastern India

PurposeTo describe the spectrum of hospitalized NeuroCOVID on admission in a tertiary neurology centre in Kolkata, the largest and most populated metropolitan city in Eastern India. MethodWe retrospectively studied confirmed COVID-19 patients admitted with a neurological condition from 1st May 2020 to 30th January 2021. Neurological diagnoses and their temporal relationship to respiratory features along with clinicodemographic profile for such patients was ascertained. Result228 patients were diagnosed with NeuroCOVID at our centre. Of the 162 included population (median age was 59 (50–70) and 62.3% (101) were male) and 73.5% were diagnosed with NeuroCovid before any respiratory or febrile features. 46 patients (28.8%) had a pre/co-existing neurological illness, and 103 (63.6%) had systemic comorbidities. No significant difference was observed when comparing demographics and comorbidities of NeuroCOVID patients presenting with and without fever and respiratory features. Moreover, no individual NeuroCOVID diagnosis was more prone to present with respiratory or febrile features. Diabetes mellitus was the only comorbidity which was significantly higher in the ischemic stroke group, all other comorbidities and characteristics were evenly distributed between stroke and non-stroke NeuroCOVID patients and encephalopathy non encephalopathy NeuroCOVID patients. ConclusionStroke and encephalopathy are the most prevalent parainfectious neurological conditions occurring with COVID-19 in the Indian population. This study demonstrates seemingly low-risk individuals (i.e. people without pre-existing systemic and neurological comorbidities) may develop neurological conditions. Moreover, NeuroCOVID may manifest independent of respiratory features and fever.

Chest Radiography Findings of COVID-19 Patients: Differences between the Intubated and Non-intubated Groups.

ObjectivesWe sought to identify the chest radiography differences at presentation between two groups of hospitalized confirmed COVID-19 patients; intubated group compared to non-intubated group.MethodsWe retrospectively collected the data of confirmed hospitalized COVID-19 patients at the Royal Hospital, Muscat, Oman, from March to April 2020. Radiographic and clinical data were collected from the hospital and radiology information systems and compared between two groups based on intubation status.ResultsTwenty-six patients confirmed to have COVID-19 by reverse-transcriptase polymerase chain reaction test were included in the study; 15/26 were non-intubated, and 11/26 were intubated. Overall, 88.5% were males in the intubated group. Respiratory symptoms were the most common presentation (84.6%) followed by fever (76.9%), with no statistical difference between the two groups. There was a statistically significant difference in having diabetes mellitus (p = 0.020) in which 8/11 and 4/15 were recorded to have diabetes mellitus in the intubated and non-intubated groups, respectively. Other comorbidities showed no statistically significant difference. The radiographic analysis redemonstrates the peripheral lower zone distribution but no statistically significant difference among the two groups. There were no differences between the intubated and non-intubated chest radiography in laterality involvement, central and peripheral distribution, and lesions type. However, upper zones involvement was more noted in the intubated group with 10/11 (90.9%) compared to 7/15 (46.7%) in non-intubated cases (p = 0.036). There were higher numbers of zone involvement in intubated cases than non-intubated cases: 9/11 (81.8%) of intubated patients had 10–12 areas of involvement on chest radiographs compared to 3/15 (20.0%) in the non-intubated group. Half of the cases were discharged home; 3/11 from the intubated group and 10/15 from the non-intubated group. Five patients died from the intubated group (5/11) versus 3/15 from the non-intubated group. Five patients are still hospitalized (three from the intubated group and two from the non-intubated group).ConclusionsThe radiographic findings among intubated and non-intubated hospitalized COVID-19 patients demonstrate differences in the number of zones involved. More upper zone involvement was noted in the intubated group. Male sex and diabetes mellitus carried a poorer prognosis and were more associated with the intubated group.

Comparative Analysis of COVID-19 Outbreak and Changes in Neurosurgical Emergency Patients.

ObjectiveCOVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. MethodsThe overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. ResultsBased on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. ConclusionDue to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

Clinical Spectrum of Neurological Complaints in COVID-19: Experiences from a COVID-19 Referral Hospital in Indonesia

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in confirmed COVID-19 patients in Indonesia is still lacking&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.&lt;/p&gt;

Assessment of COVID severity by measuring D-dimer and Serum Ferritin level in selected Tertiary Care Hospitals of Dhaka city

Aim: This study was aimed to evaluate the association between serumD-dimer, serum Ferritin with disease severity in patents havingCOVID-19. Methods:Total 80 confirmed COVID-19 patients were enrolled in this cross sectional study. Samples were assessed by positive SARSCoV- 2 by RT-PCR testing and were collected from two tertiary Hospitals(IbnSina Medical College Hospital and Ibrahim Cardiac Hospital and Research Institute).We also performed CT findings of COVID patients with or without pulmonary involvement. COVIDpositive patients were divided into two groups (Group 1 and Group2) according to lungs involvement confirmed by CT-scan. In this analysis, several variables such as gender, age, D-dimer and serum ferritin were taken. Results: The Mean of D-dimer in Group-1 subjects was 4.26±3.60mg/L and in Group-2, this was 0.59±1.08mg/L. So D-dimer level was significantly raised in COVIDpneumonic patient (P value = &lt;0.001). The mean of ferritin(554.65±515.841)ng/ml for pneumonic patient was also highly significant than the mean(133.70±109.22)ng/ml of COVID without pneumonia. Conclusion:D-dimer and S. ferritin were elevated in patients with COVID-19. These two reliable biomarkers are correlate with the disease severity and useful for better management of COVIDpositive patients. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.166-170

Neurological Manifestations of Covid-19 Hospitalized Patients In the state of Punjab, India

Introduction: COVID 19 often presents with flu-like symptoms. Elderly patients with systemic comorbidities are more likely to have severe COVID 19 infections and deaths. Severe neurological complications are frequently reported in severely and critically ill patients. In COVID-19, both central and peripheral nervous systems can be affected. The study aims to overview the spectrum, characteristics, and outcomes of neurologic manifestations associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: A total of 1000 confirmed CoVID-19 patients were enrolled for the study. Demographic features and initial clinical manifestations were noted, and patients were followed during the hospital stay to develop any new neurological signs and symptoms. For analytical purposes, neurological presentations were grouped into the central nervous system, peripheral nervous system, and musculoskeletal system manifestations. Appropriate laboratory testing was employed as required on a case-to-case basis. Results: The mean age was 44.6 ± 14.3 years. 625 (62.5%) patients were male, while 375 (37.5%) were female. The neurological illness was a primary manifestation in 119 (11.9%) cases. These included encephalopathy (n=78), ischemic stroke (n=28), Guillain- Barre syndrome, (n=3), facial nerve palsy (n=4), and encephalitis (n=6). The most common neurological symptoms were headache 313 (31.3%) and hyposmia 52 (5.2%), followed by encephalopathy 78 (7.8%). More serious complications like seizures 18 (1.8%) and stroke 28 (2.8%) were also seen. Conclusion: CoVID-19 can present with a neurological illness, and we should remain vigilant to the possibility of neurological presentation of COVID-19 that can be thrombo-embolic, inflammatory, or immune-mediated. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.155-161

Detection of COVID-19 from Chest X-ray Images Using Deep Convolutional Neural Networks.

The COVID-19 global pandemic has wreaked havoc on every aspect of our lives. More specifically, healthcare systems were greatly stretched to their limits and beyond. Advances in artificial intelligence have enabled the implementation of sophisticated applications that can meet clinical accuracy requirements. In this study, customized and pre-trained deep learning models based on convolutional neural networks were used to detect pneumonia caused by COVID-19 respiratory complications. Chest X-ray images from 368 confirmed COVID-19 patients were collected locally. In addition, data from three publicly available datasets were used. The performance was evaluated in four ways. First, the public dataset was used for training and testing. Second, data from the local and public sources were combined and used to train and test the models. Third, the public dataset was used to train the model and the local data were used for testing only. This approach adds greater credibility to the detection models and tests their ability to generalize to new data without overfitting the model to specific samples. Fourth, the combined data were used for training and the local dataset was used for testing. The results show a high detection accuracy of 98.7% with the combined dataset, and most models handled new data with an insignificant drop in accuracy.

Covid-19 Patient Mortality Risk Classification Using Bayesian Binary Logistic Regression

At the end of 2019 the world was shocked by a new disease caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). The disease is called Covid-19 (Coronavirus Disease). The mortality rate due to disease is increasing every day. In Indonesia as of April 2021, confirmed Covid-19 patients who died reached 42,530 patients, seeing the high mortality rate of Covid-19 patients so it needs to be studied further so that the risk of death of these Covid-19 patients can be minimized. This research utilizing binary logistic regression with Bayesian method parameter estimation. In this study, the predictor variables used were in the form of categories that each category in the predictor variables was assumed to have the same risk of death risk of Covid-19 patients. The results of this study indicate that the number of comorbids has a significant effect on the risk of death of Covid-19 patients, the more the number of comorbids suffered by the patient, the higher the risk of death of the patient. The accuracy of this method in classifying data is 84.68%.

Prevalence of anti-SARS-CoV-2 IgG antibodies in a group of patients, a control group, and healthcare workers of Thrace area in Greece, by the use of two distinct methods.

The aim of this study was to assess the clinical performance of different automated immunoassays available in Europe to detect anti-SARS-CoV-2 antibodies; an ELISA assay and a CLIA. The second goal was to estimate the seroprevalence of SARS-CoV-2 antibodies among healthcare workers in Evros area during the first pandemic wave of COVID-19. The study included serum samples from 101 patients with confirmed COVID-19 by RT-PCR and 208 negative patients. Furthermore, it included 1036 healthcare workers (HWs) of the Evros Region, Northern Greece. The measurement of anti-SARS-CoV-2 antibodies was performed using the Abbott SARS-CoV-2 IgG and anti-SARS-CoV-2 ELISA IgG assay (Epitope Diagnostics, USA). Of 101 confirmed COVID-19 patients, 82 were hospitalized and 19 were outpatients. Hospitalized patients had higher IgG levels in comparison to outpatients (6.46±2.2 vs. 3.52±1.52, p<0.001). Of 208 non-COVID-19 patients only 1 was positive in both ELISA and CLIA assay. SARS-CoV-2-IgG antibodies were detected in 6 HWs out of 1036 (0.58%) with mean S/CO-value of anti-SARS-CoV-2 IgG 3.12±1.3 (confidence interval 0.95), which was lower than in COVID-19 patients (3.12 vs. 5.9; p=0.016). The clinical evaluation of two immunoassays showed remarkably high true positivity rates in the confirmed COVID-19 patients. Sensitivities obtained with CLIA and ELISA methods were 99.02% vs. 97.09% and specificities 99.52% vs 99.05% respectively. We found an acceptable accordance between CLIA and ELISA assays in the confirmed COVID-19 patients. In all subjects included in this study in the past medical history, the information that was obtained included details about the presence of autoimmune diseases.

Correlation between Chest CT Score and Outcome of COVID-19 Patients: Experience from A COVID Hospital of Chattogram, Bangladesh

Background: Studies elsewhere in the world observed that, chest Computed Tomography (CT) scoring could help to stratify patient’s risk and predict short-term outcome of patients with COVID-19 pneumonia. But report from Bangladesh in this regard is in short supply. This study was aimed to investigate the relationship between the percentage of lung involvement as defined by CT scan score and outcome of COVID-19 patients admitted in a COVID dedicated hospital of Bangladesh.&#x0D; Materials and methods: This prospective observational study included 103 RTPCR confirmed COVID19 patients admitted in Chittagong Medical College Hospital (CMCH). All patients had a non-contrast HRCT scan done at presentation. Severity of CT score was categorized as Mild: score 7 or less, Moderate: score 8–17 and severe: score 18 or more. Outcome data in terms of oxygen requirement, length of hospital stay and in-hospital mortality were collected.&#x0D; Results: The mean age was 53.12 ± 12.69 years (58.3% males, 41.7% females). CT severity score was found to be positively correlated with clinical category of COVID-19. The oxygen requirements and length of hospital stay were increasing with the increase in scan severity. Multivariate analysis revealed that CT severity score was the only significant predictor for death (Odds ratio: 1.228; 95% CI:1.019-1.48).&#x0D; Conclusions: Our data suggest that chest CT scoring system can aid in predicting COVID-19 disease outcome and significantly correlates with oxygen requirements in a sample of Bangladeshi COVID-19 patients.&#x0D; JCMCTA 2021 ; 32 (1) : 78-82