Management Of Coronavirus Disease-19 Research Articles

Curbing COVID-19: the quest continues in time

The menace of Coronavirus Disease-19 (COVID-19) has made life more and more challenging throughout the world. Amidst these difficult times, doctors have proved their exceptional worth. They have performed their duties with notable dedication, diligence, resilience, and compassion. Here we share our experiences from the State of Rajasthan in Northern India. We were benefitted by very early lockdown by the Government, preventive strategies of containment, and the most effective contact tracing program. The creation of hundreds of surveillance teams and rapid response teams (RRT) was instrumental for the containment program. This was coupled with outstanding medical care exemplified by Sawai Man Singh Medical College Hospital (SMSMCH) at Jaipur, the capital city of Rajasthan. The mortality rate-limiting to 1.98% in Rajasthan has been an outcome of the amalgamation of brisk administrative action, government support, and visionary action and the best of health care facilities. Our COVID-19 management program strategy was based on the advanced treatment guidelines from the Indian Council of Medical Research, New Delhi, India, and the Ministry of Health and Family Welfare, Government of India.
 
 References
 
 Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791-796. https://doi.org/10.1002/jmv.25770.
 Covid-19 data for Rajasthan, India. Available from: https://www.covid19india.org/state/RJ. [Accessed on 17 July 2020].
 Clinical Management Protocol: Covid-19. Version 5, 03/07/20. Available from: http://www.rajswasthya.nic.in/PDF/COVID%20-19/FOR%20HOSPITALS/03.07.2020.pdf. [Accessed on 17 July 2020]
 Brown BL, McCullough J. Treatment for emerging viruses: Convalescent plasma and COVID-19. Transfus Apher Sci. 2020;59(3):102790. https://doi.org/10.1016/j.transci.2020.102790.
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Public Health Approach of Ayurveda and Yoga for COVID-19 Prophylaxis.

Public Health Approach of Ayurveda and Yoga for COVID-19 Prophylaxis.

COVID 19 and Acute Kidney Injury.

Coronavirus disease 19 (COVID-19) is caused by severe acute respiratory syndrome-corona virus (SARS-CoV-2), a beta coronavirus, mainly involves the respiratory tract, and the clinical features simulate to a severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) of the past. The genome of the SARS-CoV-2, isolated from a cluster-patient with a typical pneumonia after visiting Wuhan, had 89% nucleotide identitical with bat SARS-like-CoVZXC21 and 82% with that of human SARS-CoV. It enters the respiratory tract through angiotensin converting enzyme-2 (ACE2) receptors on alveoli. It may induce lung injury through direct cytopathic effect, involving effector T cells or causing sepsis and inducing cytokine storm. With a similar mechanism, it can cause acute kidney injury (AKI). The overall incidence of AKI is 5.1%, and AKI is an independent risk factor for mortality. The hazard ratio of death increases with the increasing severity of AKI. Management of COVID-19 with AKI is primarily supportive care, and at present, there are no evidence based effective antivirals for the treatment.

Challenges in the management of corona virus in pregnancy in low resource countries

Background: Coronavirus disease-19 (COVID-19) is a potentially lethal infection caused by severe acute respiratory syndrome. Pregnancy is a state of partial immune suppression, which makes pregnant women more vulnerable to viral infections. COVID-19 pandemic presents many challenges in when it coexists with pregnancy in resource-poor countries with background ignorance and deficient health infrastructure. Materials and Methods: A literature search for studies on COVID-19 was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 85 articles were identified. Twenty-five articles were considered suitable for review. Results: An extensive review of management of COVID-19 in pregnancy and challenges confronting its management in resource-poor countries was presented. These challenges included poor health infrastructure, poor testing capacity, and nonadherence or impracticable preventive measures including physical distancing, hand hygiene, inadequate personal protective equipment, and stigmatization. Specific challenges related to pregnancy were availability of blood and blood products, labor management, operative deliveries, and postdelivery management. Conclusions: Current evidence suggests that its pathogenesis, clinical manifestations, and management are influenced by pregnancy. The outcomes of pregnancy and COVID-19 are negatively influenced by similar problems of ignorance, poverty, and deficient health infrastructure. COVID-19, therefore, has the potential for worsening maternal mortality in low-resource nations.

Challenges in the management of corona virus in pregnancy in low resource countries

Background: Coronavirus disease-19 (COVID-19) is a potentially lethal infection caused by severe acute respiratory syndrome. Pregnancy is a state of partial immune suppression, which makes pregnant women more vulnerable to viral infections. COVID-19 pandemic presents many challenges in when it coexists with pregnancy in resource-poor countries with background ignorance and deficient health infrastructure. Materials and Methods: A literature search for studies on COVID-19 was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 85 articles were identified. Twenty-five articles were considered suitable for review. Results: An extensive review of management of COVID-19 in pregnancy and challenges confronting its management in resource-poor countries was presented. These challenges included poor health infrastructure, poor testing capacity, and nonadherence or impracticable preventive measures including physical distancing, hand hygiene, inadequate personal protective equipment, and stigmatization. Specific challenges related to pregnancy were availability of blood and blood products, labor management, operative deliveries, and postdelivery management. Conclusions: Current evidence suggests that its pathogenesis, clinical manifestations, and management are influenced by pregnancy. The outcomes of pregnancy and COVID-19 are negatively influenced by similar problems of ignorance, poverty, and deficient health infrastructure. COVID-19, therefore, has the potential for worsening maternal mortality in low-resource nations.

Potential treatment of COVID-19

Following the first reported cases of pneumonia of unknown etiology at the end of 2019 in Wuhan city, Hubei province, China, the causative agent was demonstrated to be a new coronavirus that has not been defined in humans before. The World Health Organization (WHO) named this virus as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease caused by the virus as coronavirus disease-19 (COVID-19). The disease spread rapidly to other countries through human-to-human transmission, and WHO declared a pandemic on March 11, 2020. As of April 2020, the number of individuals infected with SARS-CoV-2 and COVID-19 related deaths continue to increase rapidly worldwide. The main reason for the increase in the rate of infection is person-to-person transmission, while the main reason for the increase in mortality rate is the lack of a proven medical treatment specific to COVID-19 and the severe course of the disease in the elderly with low immunity. While a vast majority of individuals infected with SARS-CoV-2 are asymptomatic or recover after displaying mild symptoms, hospitalization is required in 14% of cases and severe disease requiring intensive care admission is seen in 5% of the infected individuals. WHO and national guidelines do not make clear recommendations regarding treatments for symptomatic patients. Currently, there is no vaccine or specific antiviral treatment for COVID-19, however supportive care, isolation and protective measures and experimental drugs/treatments are being used for the management of COVID-19. Medical treatments being used for COVID-19, aim to prevent the entry of the virus into the cell, to inhibit or reduce its replication, and to suppress the increased inflammatory response. In addition, “convalescent” plasma, which includes antibodies of patients who were completely recovered from the infection, is among the treatment options.

A learning experience of pandemic COVID-19 management at our medical institute.

Background:Coronavirus disease-19 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is a novel disease.Objectives:Our healthcare sector is at the epicentre of this unprecedented global pandemic challenge and we are not fully aware of it's management. Here we have discussed our learning experience in managing and tackling the COVID-19 pandemic at our institute which will set an example for other hospitals as well as instill confidence in our primary care physicians who are the frontline warriors.Methods and Results:For combating COVID-19, dedicated teams for its management including logistic support was streamlined. Our capacity was built up for 200 isolation beds including 40 ventilator equipped beds and 645 defined quarantine rooms, to be implemented in phased manner. Till date more than 200 COVID-19 patients have been admitted here. Fever and cough were common presentations. Mortality was high in patients with advanced age or who had multiple co-morbid conditions. Efficient training and infection prevention control have resulted in a satisfactory outcome.Conclusion:In the wake of this pandemic all hospital setup, with collective responsibility should follow a specified protocol so that our hospital is not converted to the hotspot. COVID-19 has imposed a new challenge where not only patients have to be managed but our health care workers also need to be protected. Telemedicine and our primary care physicians will play a crucial role. Here at a medical institute, medical teaching, and learning atmosphere has to be created amidst the pandemic apprehension for our budding medicos.