Management Of COVID-19 Infection Research Articles

Management of COVID-19 infection in antenatal, laboring, post-partum women and their newborns: a narrative review

Management of COVID-19 infection in antenatal, laboring, post-partum women and their newborns: a narrative review

Assessing Healthcare Provider's Skills in the Management of COVID-19 Infection at Busia County Referral Hospital, Kenya

Context: The zoonotic coronavirus of 2019 (COVID-19) was caused by an enveloped Ribonucleic Acid (RNA) virus from the Coronaviridae family in the Sarbecovirus subgenus and Severe Acute Respiratory Syndrome – Coronavirus – 2 (SARS-Cov-2) organism. The index case was believed to have originated and transmitted from animals (bats) to humans in November 2019 at the Wuhan live market in China, and subsequently, transmissions were among the human race through direct and indirect contact with respiratory droplets from an infected person(s) to the vulnerable person(s), while talking, sneezing, or coughing. World Health Organization (WHO) declared it a pandemic on March 11, 2020, while in Kenya, it was on March 20, 2020, and by June 11, 2021, Busia County had 3,982 infected individuals, with a positivity rate of 3.9%, 157 being health care providers across all cadres were infected and two deaths reported. Busia County Referral Hospital contributed 30% of the total infected healthcare providers across the seven sub-counties due to non-adherence to standard and transmission-based precautions as guided by the World Health Organization.
 Aim: The study assesses the healthcare provider's skills in managing COVID-19 infection at Busia County Referral Hospital in Kenya.
 Methods: The study utilized a descriptive cross-sectional study design, using a semi-structured questionnaire to collect qualitative and quantitative data from 153 study subjects stratified per cadre. The data collection tool was adapted from the facility readiness assessment questionnaire for COVID-19 (Centre for Disease Control and Prevention) and the risk assessment and management of exposure questionnaire of healthcare workers in the context of COVID-19 (World Health Organization).
 Results: The study reveals that respondents who had worked for shorter duration (1 to 3 years) and were taken through shorter training sessions (1 to 2 days) had higher odds 2.3 and 2.1 (p = 0.03) and p=0.04), respectively to demonstrate good skills in the management of COVID-19, which was statistically significant. Furthermore, knowledge of five moments of hand hygiene had p=0.007, with a higher odds ratio on availability of essential commodities such as gloves 2.5 odds, surgical face masks 3.8 odds, thermos-gun 3.8 odds, designated focal person at triage 6.1 odds and screening checklist 3.2 odds with p-value ≤ 0.05 enhanced good skills required to curb the pandemic.
 Conclusion: Frequent shorter periods of training of the health care providers and the availability of essential commodities for managing COVID-19 enhanced good skills to curb the pandemic infection. Knowledge of the five moments of hand hygiene influences good skills to prevent the spread of COVID-19 infection. The study recommended regular drills on appropriate use of personal protective equipment and adherence to five moments of hand hygiene by healthcare providers as key skills in managing COVID-19 infection. It further recommends establishing and disseminating policy on an essential list of health products and technologies required to manage COVID-19. In addition, the study recommends a further in-depth study on the impact of the mitigation strategies put in place to manage the pandemic.

Occupational stressors and coping mechanisms among obstetrical nursing staff during the COVID-19 pandemic: a qualitative study

BackgroundDue to heightened occupational stress throughout the COVID-19 pandemic, hospital nurses have experienced high rates of depression, anxiety, and burnout. Nurses in obstetrical departments faced unique challenges, such as the management of COVID-19 infection in pregnancy with limited evidence-based protocols and the unknown risks of the virus on pregnancy and fetal development. Despite evidence that obstetrical nurses have experienced high levels of job stress and a decrease in job satisfaction during the COVID-19 pandemic, there is less known about the working conditions resulting in these changes.Using the Job Demands-Resources (JD-R) model, this study aims to offer insight into the COVID-19 working environment of obstetrical nurses and shed light on their COVID-19 working experiences.MethodsThe study was conducted using a qualitative approach, with data collection occurring through semi-structured interviews from December 2021 to June 2022. A total of 20 obstetrical nurses recruited from the obstetrical departments of a tertiary hospital located in Ontario, Canada, participated in the study.Interviews were audio-recorded, transcribed verbatim, and coded using NVivo. Data was analyzed using a theoretical thematic approach based on the JD-R model.ResultsFour themes were identified: (1) Job stressors, (2) Consequences of working during COVID-19, (3) Personal resources, and (4) Constructive feedback surrounding job resources. The findings show that obstetrical nurses faced several unique job stressors during the COVID-19 pandemic but were often left feeling inadequately supported and undervalued by hospital upper management. However, participants offered several suggestions on how they believe support could have been improved and shared insight on resources they personally used to cope with job stress during the pandemic. A model was created to demonstrate the clear linkage between the four main themes.ConclusionsThis qualitative study can help inform hospital management and public policy on how to better support and meet the needs of nurses working in obstetrical care during pandemics. Moreover, applying the JD-R model offers both a novel and comprehensive look at how the COVID-19 hospital work environment has influenced obstetrical nurses' well-being and performance.

Management of COVID-19 Infection in a Small Bowel Transplant Recipient: A Case Report

The COVID-19 pandemic has caused millions of people to become infected worldwide. Some patients may have disease progression and may need treatment with an anti-COVID-19 agent, hospitalization, and even intensive care. The risk factors for disease progression include old age, diabetes mellitus, pulmonary disease, cardiac disease, immunodeficiency, and immunosuppressant treatment. Therefore, managing COVID-19 infection in transplant patients under immunosuppressant treatments needs specific consideration, especially the side effects of anti-COVID-19 agents and the interaction between immunosuppressants and anti-COVID-19 agents. In this report, we present the case of a small bowel transplant patient who had a COVID-19 infection. The patient was initially treated for paxlovid, and she developed bloody stools and dizziness. The treatment was then changed to molnupiravir without discontinuation of tacrolimus. The patient recovered smoothly after a 5-day treatment with molnupiravir. Here, we discuss the management experience of such patients and review the relevant literature.

Utilization of chest imaging in COVID 19 pandemic

Introduction and Aim: Coronavirus disease (COVID-19) is a viral infection that can lead to severe respiratory disease. Radiological examinations mainly computed tomography (CT) and Chest x-ray (CXR) play a role in diagnosis, follow-up, and management of COVID-19 infection. The purpose of this study was to look into the extent of using chest imaging in COVID-19 infection, as well to see if chest imaging in COVID-19 infections is justified and guided by clinical recommendation in Mosul, Iraq. Materials and Methods: This cross-sectional study involved 245 people (93 males and 152 females), infected previously with COVID-19 infection in Mosul, Iraq. The participants were asked to self-complete an anonymous questionnaire. Data obtained was subjected to statistical analysis. Results: The 245 participants had an average age of 25.7 ±8.44 years. The study sample included 57 (23.2%) with low education and 188 (76.7%) with moderate to high education. Among the radiological examinations undergone by these participants, chest X-ray (CXR) was the most common followed by chest computed tomography scan (CT scan). The CXR and the CT scan were done during the patient's illness either for diagnosis or follow-up of the disease. Non-clinically recommended examinations were reported by 64% and 20% of patients who undertook CXR and CT scan respectively, during COVID-19 illness. Higher education status was associated with a tendency to do non-recommended CXR examination during COVID-19 infection. Conclusion: CXR and CT imaging are the most commonly used radiological examinations in the diagnosis and follow-up in COVID-19 infection. However, a non-clinically recommended utilization of these examinations was noted in Mosul, Iraq during the pandemic. Therefore, educating people of this region about the limitation of non-justified uses of imaging is essential for healthy maintenance of individuals, environment, and resources.

Experiences of Nurses with COVID-19 Infection Management in General Hospitals and Long-term Care Hospitals

The purpose of this study was to understand and describe the experiences of nurses in general and long-term care hospitals in infection management related to COVID-19. The participants were 10 nurses working at general and long-term care hospitals located in G province. Data were collected through interviews with three focus groups conducted from June to July 2021. All interviews were audiotaped and transcribed verbatim. The collected data were analyzed using qualitative content analysis. As a result, 62 codes, 9 subcategories, and 4 categories were extracted. The four themes were as follows: (1) the sudden emergence of COVID-19 and the unending uncertainty, (2) various efforts to prevent and manage COVID-19, (3) facilitators and barriers in managing COVID-19, and (4) suggestions for strengthening infection management. Based on the results, an educational program to enhance the infection management competency of nurses should be developed and applied considering the characteristics of general and long-term hospitals. Moreover, practical policies such as preparing a network for infection management should be prepared.

RWD67 Association of COVID-19 With Venous Thrombosis and Arterial Thrombosis

Management of COVID-19 infection is evolving with the understanding of the disease. There is well-established literature pointing towards the increased coagulation risk associated with COVID-19. This study compares the relative coagulation risk between the COVID-19 and influenza patients. This study aims to analyze the risk of venous thrombosis and arterial thrombosis because of COVID-19 as compared with influenza.

Outcomes and Management of Sars-CoV2 Omicron Variant in Recipients of Hematopoietic Cell Transplantation (HCT) and CAR-T Therapy

HCT or CAR-T therapy recipients who develop COVID-19 have decreased overall survival (68% Sharma et al. Lancet Haematol. 2021), likely due to disease-inherent and therapy-related immunodeficiency. The development of specific COVID therapies and vaccination during the pandemic has changed the prevention and management of COVID-19 infection. Nevertheless, with the appearance of new SARS-CoV2 variants and omicron, in particular, questions about the severity of disease in high-risk patients are yet to be defined. Methods We included retrospectively 218 adult HCT/CAR-T recipients diagnosed with presumed COVID-19 omicron variant at Memorial Sloan Kettering Cancer Center (MSK), New York, between December 2021 and February 2022. Data were analyzed using SPSS version 26 (IBM, Armonk, NY). Results Among 218 patients, 107 received an autologous HCT, 92 allogeneic HCT, and 19 CAR-T. The median age was 58 years (range, 21 to 87), and 56% were male. The median time from HCT/CAR-T to SARS-CoV2 infection was 44 months (range, 0.1 to 272 months), and 27 patients (12%) acquired SARS-CoV2 within the first 100 days post-HCT/CAR-T. The primary hematologic diagnoses were plasma cell (37%), myeloid (37%), and lymphoid (26%) malignancies. Myeloablative conditioning was performed in 90 patients (41%). In the alloHCT recipients, 17 donors (18%) were matched related, 51 (55%) matched unrelated, 19 (21%) umbilical cord blood, and 5 (6%) haploidentical. 31% patients had 2 or more comorbidities and 9% received IVIG for hypogammaglobulinemia within the prior month. Of note, 40% of the patients were on active cancer therapy (maintenance or treatment) at the time of COVID-19 infection, and 47% of the alloHCT recipients were on GVHD immunosuppressive treatment. Characteristics of COVID-19 omicron variant infection are shown in Table1. Specific COVID-19 treatment was administered in 111 patients (51%) and included MoAbs in 63 patients (56.7%), sotrovimab being the most frequently used (n=55, 87 %), remdesivir (n= 23, 21%), and other antivirals (n= 15, 14%). Risk factors for admission were presence of > 3 comorbidities (HR, 6.2; 95% CI 2.3-16.3, p= 0.000), progression of disease (POD) (HR, 3.8; 95% CI 1.6-8.9, p= 0.002,) and CAR-T therapy (HR 4.5; 95% CI 1.4-14.1p= 0.008). Regarding vaccination status, 84% (n= 183) of the cohort was vaccinated with mRNA Covid-19 vaccines, with 42% of patients having 1 booster before COVID19 infection. Interestingly, only 15/35 (42%) of the booster patients with measured serologic response showed SARS-CoV-19 Antibodies value> 2500 BAU/I. Nineteen patients showed low titer COVID-19 antibodies (<2500 BAU/I) testing after COVID-19 infection: 3 patients died (2 for POD, 1 for COVID), 3 were not vaccinated, 1 patient had to be revaccinated after HCT, and 6 patients were administered tixagevimab/cilgavimab for future prophylaxis. Persistent/Long COVID were present in 8 (3.5%) patients, showing fatigue and URI symptoms 5/8 (62%) had a previous admission for COVID-19 infection and 5/8 (62%) had a negative spike antibody titer before infection. The median duration of viral shedding (positive SARS-CoV-2 PCR) was 11 weeks (range, 3.2 to 19.1 weeks). After a median follow up of 4 months (range, 0 to 8 months), 21 patients (9.6%) had recurrent COVID infection, and two of them died. The overall mortality rate was 10% in all patients (22/218 patients), with 2.5% (6/22) attributable to COVID. Other causes of death were progressive disease (n=13), sepsis (n=1), and hepatic VOD (n=1). Comparing our omicron cohort with the initial 77 HCT & CAR-T patients infected with first wave COVID-19 in March 2020 at our institution, overall survival at 30 days was 94% vs 78% (p=0.010) (Figure 1). Conclusions In our cohort, mortality attributable to the COVID-19 omicron variant was low (2.5%), and only 19% required admission. Risk factors for admission were presence of 3 or more comorbidities, POD at time of COVID infection, and CAR-T therapy. Altogether our date confirms enhanced overall survival (94%) in HCT, and CART recipients infected with the omicron variant of SARS-CoV2 as compared to prior waves of the COVID-19 pandemic. Access to SARS-COV-2 specific treatments and the higher incidence of vaccination in this cohort appear to be key factors to successfully managing patients in order to reduce COVID-19 mortality. Pre-exposure prophylaxis became available later and is also likely important. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Use of convalescent plasma in pregnant women with early stage COVID-19 infection in a tertiary care hospital in Dubai, February to March 2021: a case series study

BackgroundThe use of COVID-19 convalescent plasma (CCP) for the treatment of SARS-CoV-2 infection in pregnancy is intriguing in view of its safety profile in pregnancy and historical precedence of the use of plasma for other viral illnesses. This study aimed to evaluate the use of CCP in pregnant women with early COVID-19 infection.MethodsThis is a retrospective case series study. We have included seven pregnant women admitted with early COVID-19 infection to a tertiary care hospital, Latifa Maternity Hospital in Dubai, United Arab Emirates between 12 February and 04 March 2021 and who consented to receive COVID-19 convalescent plasma as part of their treatment plan. Main outcomes measured were clinical and radiological features, laboratory tests, WHO clinical progression scale pre and post treatment, and maternal, fetal outcomes. COVID-19 clinical severity was classified according to the NIH guidelines for criteria of SARS-CoV-2. For the radiological features, a modified chest X-ray scoring system was used where each lung was divided into 6 zones (3 on each side upper, middle, and lower). Opacities were classified into reticular, ground glass, patchy and dense consolidations patterns.ResultsSeven pregnant women with early COVID-19 were enrolled in this study, their mean age was 28 years (SD 3.6). Four had comorbidities: 2 with diabetes, 1 with asthma, and 1 was obese. Five patients were admitted with a WHO clinical progression score of 4 (hospitalized; with no oxygen therapy) and 2 with a score of 5 (hospitalized; oxygen by mask/nasal prongs). Upon follow up on day 10, 6 patients had a WHO score of 1 or 2 (asymptomatic/mild symptoms) indicating clinical recovery. Adverse reactions were reported in 2 patients, one reported a mild skin rash, and another developed transfusion related circulatory overload. All patients were discharged alive.ConclusionCCP seems to be a promising modality of treating COVID-19 infected pregnant women. However, further studies are needed to ascertain the efficacy of CCP in preventing progressive disease in the management of COVID-19 infection in pregnant women.

Practices, knowledge, and attitudes of community pharmacists towards dispensing drugs during the COVID-19 pandemic: A cross sectional study from Jordan.

Pharmacists have an important role in providing correct information, education, and counseling to the public during the COVID-19 pandemic and other health crisis. In order to perform their duties in a correct manner, they must receive adequate and evidence-based information from official resources. The objectives of the study were to examine the practices of community pharmacists towards dispensing drugs during the COVI-19 pandemic and assess their knowledge concerning the safety and efficacy of these drugs in managing the COVID-19 infection. This was a web-based cross-sectional study conducted through the distribution of the questionnaire via the social media through a google form. The drugs examined were azithromycin, hydroxychloroquine, dexamethasone, and certain antiviral drugs. A total of 485 community pharmacists responded to the questionnaire. Pharmacists dispensed these medications based on the physician's orders, 420 (86.6%), according to the pharmacist´s recommendations 327 (67.4%), or upon patient´s request 278 (57.3%). Azithromycin was the most dispensed drug and two thirds of the pharmacists dispensed drugs more than 10 times. Community pharmacists did not possess adequate knowledge concerning the effectiveness and safety of the drugs in the management of COVID-19 infection. In the multivariate linear regression analysis; education, type of university, and the average number of daily customers were statistically significant, p values: 0.004, 0.002, and 0.016, respectively. Pharmacists did not have a positive attitude towards dispensing drugs based on their own recommendations. More than half of the pharmacists agreed that they thought it was a correct decision to give these drugs based on their own judgment. Community pharmacists should not receive information from non-official sources. Strict regulations and implementation of disciplinary actions against pharmacists that dispense prescription only drugs based on their medical judgment are necessary to stop this illegal behavior. A proactive role demonstrated by the pharmacists and based on scientific facts will reduce misconceptions and hazardous behavior of self-medication using prescription only drugs based on rumors and fictitious news.

Oral and nasal rinse in the management of COVID-19 infection

Oral and nasal rinse in the management of COVID-19 infection

A Deep Learning Approach for the Morphological Recognition of Reactive Lymphocytes in Patients with COVID-19 Infection.

Laboratory medicine plays a fundamental role in the detection, diagnosis and management of COVID-19 infection. Recent observations of the morphology of cells circulating in blood found the presence of particular reactive lymphocytes (COVID-19 RL) in some of the infected patients and demonstrated that it was an indicator of a better prognosis of the disease. Visual morphological analysis is time consuming, requires smear review by expert clinical pathologists, and is prone to subjectivity. This paper presents a convolutional neural network system designed for automatic recognition of COVID-19 RL. It is based on the Xception71 structure and is trained using images of blood cells from real infected patients. An experimental study is carried out with a group of 92 individuals. The input for the system is a set of images selected by the clinical pathologist from the blood smear of a patient. The output is the prediction whether the patient belongs to the group associated with better prognosis of the disease. A threshold is obtained for the classification system to predict that the smear belongs to this group. With this threshold, the experimental test shows excellent performance metrics: 98.3% sensitivity and precision, 97.1% specificity, and 97.8% accuracy. The system does not require costly calculations and can potentially be integrated into clinical practice to assist clinical pathologists in a more objective smear review for early prognosis.

The Effects of Sex Hormones and some Respiratory Diseases on the Severity of Corona Virus Infection

Sex hormones and chronic respiratory diseases play a role in the pathogenesis and the management of Covid-19 infection. Present research tries to shed light on the role of sex hormones, bronchial asthma and lung cancer on the severity of Covid-19 infection and the resulting mortality rate. This study included a follow-up of the health status of 85 patients infected with Covid-19, and all the patients previously diagnosed had hereditary respiratory diseases (bronchial asthma (64) and lung cancer (21)). The serum level of progesterone and testosterone and the stages of lung cancer development were measured in the laboratories of Diwaniyah Teaching Hospital. After conducting medical examinations, computed tomography and x-rays, the severity of Covid-19 infection was classified according to the WHO to moderate, severe and critical infection. The current results showed that most of the hospitalized cases were males (65%) with a death rate (18%), so bronchial asthma was associated with the death rate in males (70% of dead males), followed by postmenopausal (POM) women (66.7% of the dead woman), while pre-menopausal (PRM) women had the highest cure rate (100%). The results of the study showed that the rise in the mean of progesterone in PRM (13.55 ng/ml) was associated with moderate symptoms of Covid-19, while the increased testosterone in males and POM (1018 ng/dL and 67.3 ng/dL, respectively) was associated with an increase in the severity of the infection. In conclusion, asthma and high testosterone directly affected the increase in the severity of Covid-19 and the high mortality rate among the Corona sufferers. While advanced lung cancer had a clear role in that, at the same time, progesterone appeared as a protective factor in young women. Keywords: Covid-19, bronchial asthma, lung cancer, testosterone, progesterone

Hydroxychloroquine and Azithromycin Combination in the Management of COVID-19 Infection: Safety and Effectiveness Challenges.

The treatment of COVID-19 disease remains a dilemma so far because there is no approved therapy for it. This study aimed to evaluate the use of hydroxychloroquine and azithromycin combination in treatment. This study was carried out to determine the safety and effectiveness of hydroxychloroquine and azithromycin combination in COVID 19 patients. This study included 90 adult COVID 19 patients. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocols, receiving a combination of hydroxychloroquine 400mg twice on day 1, then 200 mg twice daily in addition to azithromycin 500mg/day for 5 days. ECG findings, especially the QTc interval, were assessed before and after 5 days from the administration. All patients showed a statistically significant higher post-treatment QTc readings (433.6 ± 37.2) compared to baseline QTc (402.4 ± 31.3) at p<0.005 with a median QTc prolongation by 26 mSec and IQR (17.8-41.3), but without serious clinical complications. Only 5.6% of patients showed QTc more than 500 mSec and no torsade de points or cardiac arrest. Geriatric patients were at higher risk for QTc prolongation compared to patients aged less than 65 years but without a significant difference as regards the median max QTc difference p˂0.65. The expected therapeutic effectiveness was 82.5% for moderate patients compared to 26% for severe patients (P<0.005). In a modest safety profile, we support the evidence that HQ/AZ therapy can be used to treat Covid-19 infection with more effectiveness in moderate rather than severe cases, which might be a reflection of the time of administration in the disease course.

Comprehensive review on repurposing of approved medicine in the management of COVID-19 infection

Comprehensive review on repurposing of approved medicine in the management of COVID-19 infection

Impact of vitamin D level and supplementation on systemic lupus erythematosus patients during COVID-19 pandemic

Objectives In this study, we aimed to assess the impact of serum vitamin D level in systemic lupus erythematosus (SLE) patients with novel coronavirus-2019 (COVID-19) disease on severity of infection, duration of COVID-19 disease course, and fatigue development as a complication of both SLE and COVID-19.Patients and methods Between April 2020 and January 2021, a total of 38 patients (31 males, 7 females; mean age: 49.2±8.1 years; range, 38 to 65 years) who were previously diagnosed with SLE and on different lines of lupus management were included. The patients presented to chest outpatient clinic and emergency hospital with manifestations suggesting COVID-19 infection. Vitamin D levels were measured in serum by enzymelinked immunosorbent assay (ELISA). Vitamin D supplement was added to treatment protocols for COVID-19.Results Thirteen (34.2%) patients had normal baseline serum vitamin D levels (≥30 ng/mL), nine (23.7%) patients had vitamin D insufficiency (21 to 29 ng/mL), and 16 (42.1%) patients had vitamin D deficiency (≤20 ng/mL). Low vitamin D levels (insufficiency & deficiency) patients had long SLE disease duration (p=0.06). Also, there was a significant long time spent until recovery from COVID-19 infection in low vitamin D levels (insufficiency & deficiency) patient groups versus those with normal vitamin D (p=0.019). Low baseline vitamin D level patients mainly presented with severe COVID19 symptoms (p=0.04). Patients recovered from COVID-19 had normal vitamin D levels than those who died or were lost to follow-up (p=0.07). After recovery from COVID-19, fatigue was more common in SLE patients with low baseline vitamin D level.Conclusion Vitamin D seems to play a certain role in the management of COVID-19 infection in SLE patients. Patients with normal vitamin D levels have less severe symptoms, shorter time to recovery, improved COVID-19 outcomes, and less development of fatigue after COVID-19 infection.

Management of COVID-19 Infection in a Context of Countries with Limited Resources: Case of the University Hospital Center of Renaissance (UHCR) in N’Djamena, Chad

Introduction: The aim of this study was to describe the clinical characteristics of patients admitted for Covid-19 in the department of Covid-19 of the University Hospital Center of Renaissance (UHCR) of N’Djamena in Chad. The pandemic of the sickness of Covid-19 constitutes a real public health problem in the world since its appearance in December 2019.&#x0D; Materials and Methods: This was an observational, transversal and descriptive study carried out from 19 March 2020 to 19 November 2021. All patients diagnosed with Covid-19, confirmed at least either by RT-PCR or chest computed tomography (CT) were included. The healing was defined through the disappearance of clinical signs and two negative RT-PCRs at 72 hours intervals.&#x0D; Results: Our study included 825 patients of which 613 (74.34%) men (sex ratio 2.9). Age Medium for patients was 50 ± 4 years with extreme ranging from 19 to 84 years old. Six hundred and thirty-three (76.70%) patients came directly from their residences. Respectively 82 and 71 were transferred from the provincial hospital of Farcha (9.9%) and from a private health structure (8.7%). Three hundred and thirteen patients had at least a comorbidity especially arterial hypertension (n = 173; 21%); the diabetes (n = 156; 19.7%); chronic renal failure (n = 28; 3.5%); heart disease (n =27; 3.3%) and obesity (n= 14; 1.6%), HIV infection (n = 9; 1.09%). five hundred and seventy-two (61.12%) patients performed the CT and all the RT-PCR. Four hundred and ninety-two patients (59.60%) presented severe forms of the disease, 160 (19.40%) were critical and 124 (15.10%) were moderates. The hospital lethality was 16.24% (n = 134). The treatment consisted in the administration of Hydroxychloroquine-Azythromycin in 99.4% of cases (n = 813) and by covid-organics in 0.6% of cases (n = 5).&#x0D; Conclusion: The infected patients with Covid-19 were admitted with the advance stage of the disease. Lethality was associate with the presence of comorbidities. The sensitization of the population on the importance of vaccination, barrier measures and recourse to care are necessary.

Agreement between low-dose and ultra-low-dose chest CT for the diagnosis of viral pneumonia imaging patterns during the COVID-19 pandemic

BackgroundChest CT scan has an important role in the diagnosis and management of COVID-19 infection. A major concern in radiologic assessment of the patients is the radiation dose. Research has been done to evaluate low-dose chest CT in the diagnosis of pulmonary lesions with promising findings. We decided to determine diagnostic performance of ultra-low-dose chest CT in comparison to low-dose CT for viral pneumonia during the COVID-19 pandemic.Results167 patients underwent both low-dose and ultra-low-dose chest CT scans. Two radiologists blinded to the diagnosis independently examined ultra-low-dose chest CT scans for findings consistent with COVID-19 pneumonia. In case of any disagreement, a third senior radiologist made the final diagnosis. Agreement between two CT protocols regarding ground-glass opacity, consolidation, reticulation, and nodular infiltration were recorded. On low-dose chest CT, 44 patients had findings consistent with COVID-19 infection. Ultra-low-dose chest CT had sensitivity and specificity values of 100% and 98.4%, respectively for diagnosis of viral pneumonia. Two patients were falsely categorized to have pneumonia on ultra-low-dose CT scan. Positive predictive value and negative predictive value of ultra-low-dose CT scan were respectively 95.7% and 100%. There was good agreement between low-dose and ultra-low-dose methods (kappa = 0.97; P < 0.001). Perfect agreement between low-dose and ultra-low-dose scans was found regarding diagnosis of ground-glass opacity (kappa = 0.83, P < 0.001), consolidation (kappa = 0.88, P < 0.001), reticulation (kappa = 0.82, P < 0.001), and nodular infiltration (kappa = 0.87, P < 0.001).ConclusionUltra-low-dose chest CT scan is comparable to low-dose chest CT for detection of lung infiltration during the COVID-19 outbreak while maintaining less radiation dose. It can also be used instead of low-dose chest CT scan for patient triage in circumstances where rapid-abundant PCR tests are not available.

The Management of Covid-19 Infection in Pregnancy and Puerperium: From the World View to the Italian Reality

Coronavirus disease 2019 (Covid-19) is characterized by severe acute respiratory syndrome and is an emerging disease. Considering the changes in maternal physiological and immune function during pregnancy, pregnant women may be at increased risk of being infected with Covid-19 and developing more complicated clinical events. Vertical transmission of the Covid-19 virus is possible although to this day it is still considered a rare event. It is conceivable that most pregnant patients infected with the Covid-19 virus have mild or moderate flu symptoms. More serious symptoms, such as pneumonia, in fact, seem to be more common in the elderly population or in subjects suffering from chronic diseases. As a precaution, pregnant women are considered the most vulnerable and therefore isolation and limitation of contact are recommended. At the moment there are no data to indicate whether spontaneous delivery is preferable in case of coronavirus infection (suspected or confirmed) to a cesarean section. However, in case of breathing difficulties that require delivery as soon as possible, a cesarean section is recommended. There is no evidence that the virus can be transmitted through breast milk. Furthermore, breastfeeding is preferable and has numerous benefits for the newborn's immune system. Since pregnant people appear to have a high risk of becoming seriously ill if they have an infection, vaccination is particularly important. In addition, there is evidence that vaccinated people have a lower risk of baby problems, such as stillbirth.

Knowledge and attitude regarding prevention and management of Covid-19 infection among people of selected rural areas of Kalaburgi district

Knowledge and attitude regarding prevention and management of Covid-19 infection among people of selected rural areas of Kalaburgi district