COVID-19 Positive Patients Research Articles

Pneumothorax in Acute Neurologically Ill COVID-19 Positive Patients: A Brief Report.

Pneumothorax is reported as a complication of coronavirus disease-2019 (COVID-19). The present report describes the incidence, clinical characteristics, and outcomes of pneumothorax in acute neurologically ill COVID-19 positive patients admitted to the COVID-19 neuro-intensive care unit (CNICU). In this retrospective study, pneumothorax was identified by reviewing chest radiographs of acute neurologically ill patients with and without associated COVID-19 admitted to the CNICU and non-COVID-19 NICU, respectively, from July to November 2020. The clinico-epidemiological characteristics of acute neurologically ill COVID-19 positive patients with pneumothorax are described. The incidence of pneumothorax was 17% (8/47) in acute neurologically ill COVID-19 positive patients in the CNICU and 14.6% (6/41) in patients who received mechanical ventilation (MV). In contrast, the incidence of pneumothorax in acute neurologically ill non-COVID-19 patients admitted to the NICU was 3.7% (7/188) and 0.69% (1/143) in patients receiving MV. In our study, the incidence of pneumothorax was higher in patients with concomitant neurological and COVID-19 diseases than in acute neurologically ill non-COVID-19 patients managed during the same period in the ICUs.

Vliv pandemie covidu-19 na akutní pankreatitidu v České republice – pilotní data studie PANACOTA (PANcreatitis Acuta in COvid Time Analysis)

Summary: Introduction: The COVID-19 pandemic had a significant impact on health care. Previous studies point to a possible negative impact of COVID-19 infection on the development and severity of acute pancreatitis. The aim of this study is to analyze the impact of the COVID-19 pandemic on the epidemiology, treatment and prognosis of acute pancreatitis at the population level. Methods: Using data from the National Registry of Reimbursed Health Services (NRRHS) parameters of hospital admissions for acute pancreatitis, the provided health care and treatment outcomes in the pandemic period (2020 and 2021) with previous years (2010–2019) were compared. Results: The incidence during the pandemic was not significantly different from the previous period: 67 vs. 63 per 100,000 population. Hospitalizations for acute pancreatitis in each month of 2020 and 2021 did not correlate with the number of COVID-19 positive patients. The overall mortality rates for acute pancreatitis before and during the pandemic were almost identical – at 3.8% and 3.9%, respectively. There was a trend towards a decrease in the number of surgical procedures, a gradual decrease in ERCPs and an increase in endoscopic drainages throughout the 2010–2021 period. The crude mortality rate of patients hospitalized for COVID-19 and concomitant acute pancreatitis was 14.2% and these patients were operated in 4.7%. Conclusions: Based on pilot population data, the COVID-19 pandemic did not have an impact on the incidence of acute pancreatitis in the Czech Republic. A more severe course and prognosis of the disease was associated with near-term COVID-19 positivity. More frequent indication of surgical and other interventions for acute pancreatitis in COVID-19 positive individuals may have been related to the disruption of standard quality and availability of care. Key words: acute pancreatitis – COVID-19 – epidemiology – endoscopic drainage – surgery – complications

Medical events in SARS-Cov-2 infected psychiatric inpatients with and without pre-existing co-morbid medical conditions

SARS-CoV-2 (COVID-19) infection can be associated with significant medical complications. This risk could be even higher in psychiatric patients due to an increased risk of medical co-morbidity. In addition, psychiatric patients are also vulnerable to acquiring SARS-CoV2 infection due to homelessness, living in crowded areas, and poor adherence to recommended preventive measures. This retrospective study aims to compare two groups of patients, namely COVID-19 positive inpatient psychiatric patients with and without preexisting medical comorbidity on specific clinical and socio-demographic features and more importantly how many patients in the two groups subsequently developed medical complications. All COVID-19 positive psychiatric patients who were admitted to acute psychiatric inpatient units over a one-year period during the peri-pandemic phase were included for this study. Data was collected from the electronic medical records of 174 patients admitted to the inpatient psychiatric facility between January and December 2020.Among the COVID-19 positive patients, twenty individuals out of eighty-nine in the WC (with pre-existing medical comorbidity) group and two individuals out of eighty-five in the WOC (without pre-existing medical comorbidity) group developed COVID-related pneumonia. Ten WC patients and two WOC patients required supplemental oxygen, while only one patient in the WC group developed critical illness and required ventilatory support. The WC group had longer stay in both psychiatric and medical units compared to the WOC group. Consistent with existing literature that patients with comorbid medical condition are higher risk of COVID-19 complications, this study replicates the finding that in psychiatric inpatients pre-existing comorbid medical conditions create a higher risk of experiencing COVID-19 related medical complications. More interestingly, however that increased risk of developing new medical complications was not significantly different from the published rates observed in the general population which is surprising given how vulnerable psychiatric patients are, both medical, psychiatrically and psychosocially. In fact, in some ways and for reasons as yet unclear, the medical complication rate was slightly better in the WC compared to published data in the general population groups.

151 How Do Mortality Rates From COVID-19 Differ Between Vaccinated and Unvaccinated People in a Tertiary Centre of Bangladesh

Abstract Aim To find out the difference in mortality rates between vaccinated and unvaccinated COVID-19 positive patients who admitted in a tertiary center (Ward Vs Intensive care) of Bangladesh. Method Retrospective analysis of data over 6 weeks (February- March 2021). 100 confirmed COVID-19 positive patients were included- 50 from ICU (Intensive Care Unit) and 50 from ward irrespective of age, gender, vaccination status and comorbidities. Results 75% of all confirmed COVID 19 positive patients were vaccinated. Mortality among vaccinated people was less compared to unvaccinated 41.3% Vs 52%. Interestingly pregnancy was found to be the most significant risk factor in child-bearing age female group- 86.7% of pregnant and peripartum female required ICU admission and mortality was 40% although none of them had any co-morbidities. Again, mortality among vaccinated was significantly less (35.7%) compared to 100% mortality among unvaccinated. Mortality rate among ICU admitted patients was significantly high- 72% Vs 16%. 83% of patients who died in ICU were vaccinated (90% had 2 doses, 10% had 3 doses). 87.5% who died in ward were unvaccinated. Among the survivors from ICU - 93% were vaccinated (Vs 7% unvaccinated). Overall, pre-existing comorbidities increased mortality by 18.1% (59% Vs 40.9%). Conclusions Vaccination against COVID-19 reduces mortality irrespective of co-morbidities or disease severity. Recovery rate was significantly increased in vaccinated ICU admitted patients. Pregnancy was found to be the most important risk factor for ICU admission and mortality in otherwise healthy child-bearing age females and mortality was 100% (limited data availability) in unvaccinated. These results require further revalidation on larger population.

Clinical Outcomes of Patients with Chronic Myeloid Leukemia and COVID-19 Infection-A Single Center Survey.

Background: Previous research has shown different effects of hematological malignancies on the outcome of patients with COVID-19 infection depending on the type of disease and the treatment received. This research was aimed at examining the clinical outcome of COVID-19 infection in positive patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. Methods: We collected retrospective information on chronic myeloid leukemia patients who were treated and monitored in our institution during the pandemic period. Within this cohort, we recorded COVID-19 positive symptomatic patients and analyzed their basic characteristics, symptoms, severity, and outcome. Results: In the study cohort when COVID-19 was diagnosed, 86.7% of patients were on first-generation tyrosine kinase inhibitors therapy-imatinib. At the time of infection, 70% of patients were in molecular remission, 23.4% in complete cytogenetic remission, and 3.3% in complete hematological response. Most patients had symptomatic disease. Within the analyzed group, 56.7% of patients had asymptomatic/mild COVID-19 infection, 23.3% of patients had moderate symptoms which did not require hospitalization, and 20% of patients had severe/critical symptoms that required admission to the intensive care unit. More than half of the patients interrupted treatment with tyrosine kinase inhibitors temporarily during COVID-19. There were no deaths due to COVID-19 infection. Conclusions: In compliance with other larger clinical studies, analysis of the clinical outcome of COVID-19 infection in patients with chronic myeloid leukemia on tyrosine kinase inhibitors therapy in this study showed that they do not have an increased risk for COVID-19 infection and that they have a mild course of the disease with recovery.

Relationship of D-Dimer, Pt, Aptt, and Albumin with severity and mortality rate in Covid-19 positive patients

COVID-19 is a global health problem that is divided into mild, moderate, and severe degrees of severity and a high mortality rate. The coagulopathy system has value in COVID-19 patients. This study aims to determine the relationship and predictive value of d-dimer, PT, aPTT, and albumin with severity and mortality in COVID-19 positive patients. The type of research used is retrospective with a cross-sectional approach. The research data were taken using a simple random sampling technique from the Medical Record Installation of Husada Utama Hospital, Surabaya in August-September 2021. Bivariate relationship data analysis used the Chi-Square test followed by a multivariate logistic regression test with cut-off values ??of D-dimer, PT, aPTT, and albumin each 0.5 g/mL, 14.0 sec. 36.0 seconds and 3.5 g/dL. The results of the chi-square test (? < 0.05) showed the sig value of D-Dimer, PT, aPTT albumin with a severity level of 0.000; 0.000; 0.001; 0.001 while the value of Sig. with a mortality of 0.000; 0.047; 0.239; 0.022. The results of the multivariate logistic regression test with the degree of severity obtained the value of Sig. 0.000; 0.000; 0.021; 0.000 with a [PR] value of 16.7; 4.4; 2.7; 14.4. The results of the multivariate logistic regression test with mortality obtained the value of Sig. 0.000; 0.020; 0.273 with a [PR] value of 26.9; 2.8;1.6. There is a relationship between D-Dimer, PT, aPTT, and albumin with severity and mortality and can be used as a predictor of severity and mortality in COVID-19 patients.

Continued Infarction Growth and Penumbral Consumption After Reperfusion in Vaccine-Naïve Patients With COVID-19: A Case-Control Study.

Background: Neurologic sequelae of SARS-CoV-2 include potentially malignant cerebrovascular events arising from complex hemodynamic, hematologic, and inflammatory processes occurring in concert. Objective: This study concerns the hypothesis that, despite angiographic reperfusion, COVID-19 promotes continued consumption of at-risk tissue volumes after acute ischemic stroke (AIS) unlike what is seen with COVID-negative individuals, yielding critical insights into prognostication and monitoring paradigms in vaccine-naïve patients experiencing AIS. Methods: This retrospective study compared 100 consecutively presenting patients with COVID-19 and AIS between March 2020 and April 2021 with a contemporaneous cohort of 282 patients with AIS who did not have COVID-19. Reperfusion classes were dichotomized into positive (extended thrombolysis in cerebral ischemia [eTICI] score = 2c-3) and negative (eTICI score < 2c) groups. All patients underwent endovascular therapy following initial CT perfusion imaging (CTP) to document infarction core and total hypoperfusion volumes. Results: Ten COVID-positive (mean age ± SD, 67 ± 6 years; seven men, three women) and 144 COVID-negative patients (mean age, 71 ± 10 years; 76 men, 68 women) undergoing endovascular reperfusion with antecedent CTP and follow-up imaging comprised the final dataset. Initial infarction core and total hypoperfusion volumes were 1.5 ± 18 mL and 85 ± 100 mL in COVID-negative patients and 30.5 ± 34 mL and 117 ± 80.5 mL in COVID-positive patients, respectively. Final infarction volumes were significantly larger in patients with COVID-19, with median volumes of 77.8 mL versus 18.2 mL among control patients (p = .01), as were normalized measures of infarction growth relative to baseline infarction volume (p = .05). In adjusted logistic parametric regression models, COVID positivity emerged as a significant predictor for continued infarct growth (OR, 5.1 [95% CI, 1.0-25.95]; p = .05). Conclusion: These findings support the potentially aggressive clinical course of cerebrovascular events in patients with COVID-19, suggesting greater infarction growth and ongoing consumption of at-risk tissues, even following angiographic reperfusion. Clinical Impact: SARS-CoV-2 infection may promote continued infarction progression, despite angiographic reperfusion, in vaccine-naïve patients with large-vessel occlusion AIS. The findings carry potential implications for prognostication, treatment selection, and surveillance for infarction growth among revascularized patients in future waves of infection by novel viral strains.

ThTP8.9 The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies

Abstract Anecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP-appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. This is an interesting finding which, if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.

SP9.15 Rates of COVID-19 infection and mortality following elective surgery at a tertiary NHS Trust in relation to operative caseload

Abstract Aims Elective surgery globally has been halted by COVID-19 due to apparent significant mortality rates with changes in planned surgery pathways. This audit examines COVID-19 infection and mortality rates at key intervals throughout the UK COVID-19 pandemic in relation to operative elective caseload at an NHS Trust. Methods Prospective cohort of elective surgical patients at a tertiary NHS Trust between March 2020-March 2022, examining three time periods. Period 1: 1st UK Lockdown (April-July 2020). Period 2: 2nd-3rd UK Lockdowns (November 2020-March 2021). Period 3: Omicron wave (December 2021-February 2022). Post-operative PCR positive COVID-19 infection rates within 30-days, proportion fully “double-jabbed” vaccinated, 90-day mortality and any COVID-19 related deaths are reported. Audit registration 20-190C. Results Between March 2020-2022, of 50,247 operations, 518 (1.03%) developed COVID-19 infection of which 62 (11.97%) died giving an overall COVID-19 death rate of 0.12%. Between Periods 1 and 3, despite a 53% increase in operations per week (294 to 450) the proportion of COVID-19 infected patients remained similar (1.12% and 1.14%). Between Periods 2-3, despite an almost 6-fold increase in fully vaccinated patients (9.80% to 57.74%), the proportion of vaccinated COVID-19 positive patients increased (4.20% to 55.38%). However, the overall proportion of COVID-19 infections decreased (2.53% to 1.14%) as well as the mortality of those infected (15.97% to 9.23%). Conclusions Overall COVID-19 infection and mortality rates are low. These have been maintained despite increases in operative caseload, suggesting further sustained elective surgery can re-commence. This may relate to an increase in fully vaccinated patients undergoing surgery.

The impact of COVID on bacterial sepsis.

To identify the predictors of morbidity and mortality in matched COVID-19 positive and negative patients who were septic with Gram positive or Gram negative infections. We conducted a retrospective review, from March to October 2020, of matched septic patients at five Hackensack Meridian Health hospitals who had bacteremia with Staphylococcus aureus, Klebsiella pneumoniae or Escherichia coli with and without COVID-19. We extracted patient demographics, comorbidities and clinical outcomes data using ICD-10 codes. Bacterial isolates were compared by whole genome sequencing analysis. Multivariate logistic regression was used to analyze independent predictors of morbidity and mortality. A total of 208 patients were grouped by positive bloodstream infection (BSI) with COVID-19 (n = 104) and without COVID-19 (n = 104). Most patients were over age 50 (90% vs. 89%) and Caucasian (78% vs. 86%). Inpatient mortality was higher in patients with COVID-19 for both GP (35% vs. 8%, p < 0.05) and GN (28% vs. 10%, p < 0.05) BSIs. Patients with Gram positive (GP) BSIs had a significant increase in mortality risk (OR 4.5, CI 1.4-14.5, p < 0.05) in contrast to those with Gram negative (GN) infections (OR 0.4, CI 0.4-4.0, p = 0.4). Concurrent COVID-19 infection is associated with a significant increase in morbidity and mortality in patients with GP and GN BSIs. Patients with S. aureus BSIs with COVID-19 are more likely to develop shock and respiratory failure and have higher rates and odds of mortality than those without COVID-19. These findings provide an essential insight into the care of these patients, especially those co-infected with Staphylococcus aureus.

The impact of COVID-19 infection on heart transplant function

BackgroundHeart transplant recipients are a subset of immunocompromised patients at particularly high risk of morbidity and mortality from COVID-19. Acute effects of the viral infection have been well-described in the literature but the chronic effects persisting after recovery from infection have not. The aim of this study is to determine the impact of COVID-19 on heart transplant function both during and after recovery from acute infection.MethodsWe retrospectively analyzed the data of 32 heart transplant recipients at the University of Texas Medical Branch (UTMB). Echocardiograms of patients with documented COVID-19 infection were analyzed at three time points including pre-infection, peri-infection, and post-infection. Echocardiograms of patients without history of infection were analyzed as control. Left Ventricular Ejection Fraction (LVEF) and presence or absence of valvular insufficiency were collected from echocardiograms to assess systolic and valvular function.Results2 out of 10 COVID-19 positive heart transplant recipients had decreases in LVEF below 20% during the peri-infection period, and one of these patients passed away from complications of infection. Despite this, mean LVEF was not significantly different at peri-infection (p = .3, 95% CI − 11.5 to 27.6) or post-infection (p = .6, 95% CI − 3.6 to 5.8) time points when compared to pre-infection. A statistically significant increase in valvular dysfunction was found among COVID-19 positive patients without documented history of valvular dysfunction on pre-infection echocardiograms (p = .01, 95% CI 19.3% to 96.4%). COVID-19 negative heart transplant recipients did not experience statistically significant changes in LVEF 1, 2, or 3 years after baseline echocardiogram.ConclusionCOVID-19 may induce myocardial dysfunction resulting in decreased systolic function and valvular dysfunction among heart transplant recipients. Severity of systolic dysfunction may be a useful prognostic indicator among this patient population. More research must be conducted to fully elucidate the effects of COVID-19 infection on heart transplant recipients.

MAKNA KOMUNIKASI ANTARA PERAWAT DAN PASIEN PADA MASA ISOLASI PANDEMI COVID-19

This research is motivated by the many cases of people exposed to Covid-19 who have to carry out isolation. With an increase in positive Covid-19 patients with a very fast risk of transmission, so in this study how to communicate patients and nurses in interpreting them during isolation during a pandemic. This study uses a qualitative approach with phenomenology theory which has the basic assumption that humans actively interpret the experiences they feel by giving meaning to something they have experienced. Data collection techniques used are observation, in-depth interviews and literature study. There were 6 informants in this study including Covid-19 patients and nurses and 3 informants from hospitals, the Health Service and the Covid-19 Task Force. The results of the study showed that the motives of patients and nurses during the isolation period had motives to help heal Covid-19 patients and for patients to have motives to cure Covid-19 by isolating in hospitals, and motives because this is how patients and nurses can become part of Covid -19. Initially, patients with Covid-19 experienced transmission from those infected with Covid-19. In the process of isolation to divert fear. Experiences felt by patients and nurses get positive and negative experiences during isolation. This is the experience experienced by the informant who hopes that the Covid-19 pandemic will end quickly because they are tired enough to face this pandemic and it is hoped that a pandemic like this will not happen again. keywords: phenomenology, isolation, covid-19, experience

Intravenous thrombolysis and endovascular therapy for acute ischemic stroke in COVID-19: a systematic review and meta-analysis.

The impact of COVID-19 on clinical outcomes in acute ischemic stroke patients receiving reperfusion therapy remains unclear. We therefore aimed to synthesize the available evidence to investigate the safety and short-term efficacy of reperfusion therapy in this patient population. We searched the electronic databases MEDLINE, Embase and Cochrane Library Reviews for randomized controlled trials and observational studies that investigated the use of intravenous thrombolysis, endovascular therapy, or a combination of both in acute ischemic stroke patients with laboratory-confirmed COVID-19, compared to controls. Our primary safety outcomes included any intracerebral hemorrhage (ICH), symptomatic ICH and all-cause in-hospital mortality. Short-term favorable functional outcomes were assessed at discharge and at 3 months. We calculated pooled risk ratios (RR) and 95% confidence intervals (CI) using DerSimonian and Laird random-effects model. Heterogeneity was evaluated using Cochran's Q test and I2 statistics. We included 11 studies with a total of 477 COVID-19 positive and 8,092 COVID-19 negative ischemic stroke patients who underwent reperfusion therapy. COVID-19 positive patients exhibited a significantly higher risk of experiencing any ICH (RR 1.54, 95% CI 1.16-2.05, p < 0.001), while the nominally increased risk of symptomatic ICH in these patients did not reach statistical significance (RR 2.04, 95% CI 0.97-4.31; p = 0.06). COVID-19 positive stroke patients also had a significantly higher in-hospital mortality compared to COVID-19 negative stroke patients (RR 2.78, 95% CI 2.15-3.59, p < 0.001). Moreover, COVID-19 positive stroke patients were less likely to achieve a favorable functional outcome at discharge (RR 0.66, 95% CI 0.51-0.86, p < 0.001) compared to COVID-19 negative patients, but this difference was not observed at 3-month follow-up (RR 0.64, 95% CI 0.14-2.91, p = 0.56). COVID-19 appears to have an adverse impact on acute ischemic stroke patients who undergo reperfusion therapy, leading to an elevated risk of any ICH, higher mortality and lower likelihood of favorable functional outcome. PROSPERO, identifier CRD42022309785.

Patients' characteristics and 30-day mortality for those undergoing elective surgeries during the COVID-19 pandemic in Bangladesh.

The COVID-19 pandemic has significantly impacted the surgical practice throughout the world, including elective surgical care. This study investigated the characteristics of patients undergoing elective surgery, the prevalence of COVID-19 infection, the surgical procedures performed, and 30-day mortality in general and pediatric surgical settings in selected tertiary-level hospitals in Bangladesh from November 2020 to August 2021. This serial cross-sectional study included 264 patients scheduled for elective surgeries during the study period. All patients underwent COVID-19 real-time polymerase chain reaction (RT-PCR) testing within 24 hours before surgery. Data on age, sex, common comorbidities, surgical procedures, and 30-day mortality were collected and analyzed. Furthermore, comparisons were made between COVID-19 positive and negative patients. The prevalence of COVID-19 infection among patients was 10.6%. Older age, a history of major surgery within the last three months, hypertension, and diabetes mellitus were significantly associated with COVID-19 infection. All COVID-19-negative patients underwent surgery, while only 46.4% of COVID-19-positive patients underwent surgery. The most common surgical procedures were related to the digestive system, breast, and urinary system. Only one patient (0.4%) died within 30 days after surgery among the COVID-19-negative patients, whereas two patients (7.1%) died among the COVID-19-positive patients: one before surgery and one after surgery. This study provides valuable insights into the characteristics, burden of COVID-19 infection, and 30-day mortality of patients undergoing elective surgery in tertiary care centers in Bangladesh during the pandemic.

Metabolic Associated Fatty Liver Disease (MAFLD) and COVID-19 Infection: An Independent Predictor of Poor Disease Outcome?

Background and Objectives: Early reports on COVID-19 infection suggested that the SARS-CoV-2 virus solely attacks respiratory tract cells. As the pandemic spread, it became clear that the infection is multiorganic. Metabolic associated fatty liver disease (MAFLD) is a chronic liver disease strongly associated with insulin resistance and diabetes. The aim of this study was to assess a possible interplay between MAFLD and COVID-19 infection and its implication in COVID-19 outcome. Materials and Methods: A retrospective observational study, including 130 COVID-19 positive patients was conducted. MAFLD diagnosis was made based on the International Consensus criteria. Patients were divided into two groups, group A (MAFLD) and group B (nonMAFLD). Anthropometric and laboratory analysis were obtained. COVID-19 severity was assessed using the NEWS2 score. Disease outcome was threefold and regarded as discharged, patients who required mechanical ventilation (MV), and deceased patients. Results: MAFLD prevalence was 42%, 67% of patients were discharged, and 19% needed MV. Mortality rate was 14%. MAFLD patients were significantly younger (p < 0.001), and had higher body mass index (p < 0.05), respiratory rate (p < 0.05) and systolic blood pressure (p < 0.05) than nonMAFLD patients. Regarding metabolic syndrome and inflammatory markers: group A had significantly higher glycemia at admission (p = 0.008), lower HDL-c (p < 0.01), higher triglycerides (p < 0.01), CRP (p < 0.001), IL-6 (p < 0.05) and ferritin (p < 0.05) than group B. MAFLD was associated with more prevalent type 2 diabetes (p = 0.035) and hypertension (p < 0.05). MAFLD patients had a more severe disease course (NEWS2 score, 6.5 ± 0.5 vs. 3 ± 1.0, p < 0.05). MAFLD presence was associated with lower patient discharge (p < 0.01) and increased need for MV (p = 0.024). Multiple regression analysis showed that BMI (p = 0.045), IL-6 (p = 0.03), and MAFLD (p < 0.05) are significant independent risk factors for a poor COVID-19 outcome. Conclusions: The prevalence of MAFLD is relatively high. MAFLD patients had a more severe COVID-19 clinical course and worse disease outcome. Our results imply that early patient stratification and risk assessment are mandatory in order to avoid poor outcomes.

An Insight into ABO Blood Group and Susceptibility to COVID19 (SARS-CoV-2) in Darjeeling Hill Region, West Bengal, India

Introduction: Recent research studies have linked the relationship between ABO blood group and COVID19infection. The study aims to analyze the possibility of a correlation between the ABO blood group distribution and its possible impact on the infection and susceptibility to COVD19 virus in Darjeeling. &#x0D; Methods: A total sample of 234 COVID19 positive patients confirmed by the severe acute respiratory syndrome, corona virus test (RT-PCR) were collected from Darjeeling District Hospital, Darjeeling (COVID Cell Records). The patients were visited in their given address and were asked to fill up a questionnaire.&#x0D; Results: The 234 COVID-19-infected patients were of blood group, A (55.4%), B(20.9%), AB(11.8%), O (23.6%), 97.86% were Rh positive. A statistically significant association of severe acute respiratory syndrome coronavirus 2 infection was observed for blood group A (55.4% vs 34.34%; odds ratio=1.83, 95% confidence interval=1.41–2.37). The association of SARS Coronavirus 2 for blood group AB was (11.8% vs 9.6%; odds ratio=1.18, 95% confidence interval=0.78–1.78). However, there was no association of severe acute respiratory syndrome coronavirus 2 infection for, B (20.9% vs 22.66%; odds ratio=0.84, 95% confidence interval=0.60–1.16) and with O (23.6% vs 30.37%; odds ratio=0.513, 95% confidence interval=0.35–0.70).&#x0D; Discussion: This study reported blood group A to be most susceptible and blood group O least susceptible to severe acute respiratory syndrome coronavirus 2 infection which was found to be strikingly consistent with findings of the Meta-analysis of data from Wuhan, Shenzhen and NYP/CUIMC. Distributions of blood groups between New York City data from the NYP/CUIMC EHR system.

Application of Internet hospitals for first-visit patients with COVID-19 during the pandemic in China.

There has been controversy over whether to carry out online medical inquiries and electronic prescription for first-visit patients. While Internet hospitals have become crucial to ensure providing online diagnosis and prescription needs for first-visit COVID-positive patients. We describe the results and advantages of online medical treatment during the coronavirus disease 2019 (COVID-19) outbreak and analyse the results and advantages of online medical treatment. Data were collected from the patients who received online medical inquiry services through the COVID-19 Special Section of our Internet hospital. The user demographic characteristics, user behaviour, clinical symptoms and medical records were collected. Baseline data of offline outpatient patients were also collected. A total of 16 173 online medical inquiries were included. The daily online outpatient service volume reached a peak of 2446 person-times. The median age was 29.92 years (SD 15.59), ranging from 20-39 years (n = 8870, 54.84%). A total of 89.20% (n = 14 426/16 173) patients had epidemic-related symptoms. Moreover, 23.35% of the people were diagnosed as COVID-19-positive through antigen or nucleic acid testing. Furthermore, 86.61% (14 008/16 173) of the patients visited our hospital for the first time or had no offline physical outpatient service record within the past 3 months. The demand for medical inquiries was mainly for drug dispensing, followed by medication guidance and disease diagnosis. And 2.07% (334/16 173) of the patients needed to go to the offline hospital for further treatment. The service model of the COVID-19 Special Section based on Internet hospitals provided the public with the necessary medical support during the COVID-19 outbreak. It provides a reference for future pandemics or public health emergencies.

Characteristics and Outcomes of Tracheostomized Patients With and Without COVID-19.

To create a study evaluating the impact of COVID-19 on tracheostomized patients by comparing clinical outcomes and weaning parameters in COVID-19 positive and negative cohorts. A retrospective observational cohort study of 604 tracheostomized patients hospitalized in 16 ICUs in New York City between March 9, 2020, and September 8, 2021. Patients were stratified into two cohorts: 398 COVID-19 negative (COVID-ve) and 206 COVID-19 positive (COVID+ve) patients. Clinical characteristics, outcomes, and weaning parameters (first pressure support [PS], tracheostomy collar [TC], speech valve placement, and decannulation) were analyzed. COVID+ve had fewer comorbidities including coronary artery disease, congestive heart failure, malignancy, chronic kidney disease, liver disease, and HIV (p < 0.05). Higher Fio2 (53% vs 44%), positive end-expiratory pressure (PEEP) (7.15 vs 5.69), Pco2 (45.8 vs 38.2), and lower pH (7.41 vs 7.43) were observed at the time of tracheostomy in COVID+ve (p < 0.005). There was no statistical difference in post-tracheostomy complication rates. Longer time from intubation to tracheostomy (15.90 vs 13.60 d; p = 0.002), tracheostomy to first PS (2.87 vs 1.80 d; p = 0.005), and TC placement (11.07 vs 4.46 d; p < 0.001) were seen in COVID+ve. However, similar time to speech valve placement, decannulation, and significantly lower 1-year mortality (23.3% vs 36.7%; p = 0.001) with higher number of discharges to long-term acute care hospital (LTACH) (23.8% vs 13.6%; p = 0.015) were seen in COVID+ve. Patients with COVID-19 required higher Fio2 and PEEP ventilatory support at the time of tracheostomy, with no observed change in complication rates. Despite longer initial weaning period with PS or TC, similar time to speech valve placement or decannulation with significantly lower mortality and higher LTACH discharges suggest favorable outcome in COVID-19 positive patients. Higher ventilatory support requirements and prolonged weaning should not be a deterrent to pursuing a tracheostomy.

Phytochemical Characterization and Screening of the Anti-Pneumonia (Anti-COVID-19, Anti-Fungal, and Anti-Bacterial) Activities of Cuscuta Campestris Extract

Introduction: Although several vaccines are being approved, no effective antiviral has been developed for Covid-19 infectious. The present investigation was aimed to increase the essential oils of Cuscuta campestris using far-red light treatment and examine the potential of crude extracts of C. campestris against selected pneumonia pathogens and covid-19. Methods: Anti-Covid-19 activity was determined in human lung cell lines and Covid-19 positive patients. Results: Results demonstrated that the aqueous extract had the highest amount of anti-Covid-19, antibiotic and antioxidant activity. The far-red light treatment increased Scoparone, cineole, Benzofuran, 2, 3-dihydro, Cinnamic acid, and Benzo[h]quinoline, 2, 4-dimethyl, which are mainly effective components against Covid-19 inflammation and pneumonia microbes. CT scan and clinical laboratory tests in a clinical case study, a 30-year-old woman who presented with severe 2019-nCoV, demonstrated that inhalation of 30 mg extract nebulized/day for seven days resulted in an improvement in consolidation and ground-glass opacity in lungs on the seventh day of treatment. Conclusion: It is hoped that this study would be led to the introduction of some compounds that could be used to formulate new and more potent anti-Covid-19 antibiotics, or other drugs of natural origin in medicine.

Psychological impact of COVID-19 among undergraduate students in Jordan: A cross-sectional study.

Psychopathology could be brought on by an immune system disruption triggered by an infection. Psychiatric residual effects have been noted following prior coronavirus outbreaks. This study is a cross-sectional study that examined the psychopathological influence of the COVID-19 pandemic among survivor students compared to students who have never been diagnosed as positive COVID-19 patients (i.e., healthy students). Further, the study identified the relationship between sociodemographic profiles and mental health. To examine the significance of psychological health differences we used the DASS-21, to measure depression, anxiety, and stress scales. There were seven questions to assess each dimension within the psychological scales. The respondents were selected randomly via online sources and completed the online self-reporting questionnaire between August 23 and October 2, 2021. A total of 750 students completed the online questionnaire, with 677 participants (90.27% of those originally surveyed) included in the final analysis of this study. The mean score of the stress scale for healthy students (M = 16.88, SD = 12.3, N = 537) demonstrated a significantly lower mean compared to COVID-19 survival students (M = 21.7, SD = 11.01, N = 140), t(675) = -4.22, p < 0.001. The mean of the depression scale for healthy students (M = 16.18, SD = 11.94) demonstrated significantly lower mean compared to COVID-19 survival students (M = 20.91, SD = 11. 90), t(675) = -4.18, p < 0.001. The mean of the anxiety scale for healthy students (M = 12.50, SD = 10.72) demonstrated significantly lower mean compared to COVID-19 survival students (M = 19.43, SD = 11. 25), t(675) = -6.74, p < 0.001. University students who were infected with COVID-19 had a traumatic experience, and thus developed psychological symptoms greater than students with no history of this infection.