Second Wave Of Pandemic Research Articles

COVID-19 Elderly Patients Treated for Proximal Femoral Fractures during the Second Wave of Pandemic in Italy and Iran: A Comparison between Two Countries.

Background and objevtive: The worldwide spread of SARS-CoV-2 has affected the various regions of the world differently. Italy and Iran have experienced a different adaptation to coexistence with the pandemic. Above all, fractures of the femur represent a large part of the necessary care for elderly patients. The aim of this study was to compare the treatment in Italy and Iran of COVID-19-positive patients suffering from proximal femur fractures in terms of characteristics, comorbidities, outcomes and complications. Materials and Methods: Medical records of COVID-19-positive patients with proximal femoral fractures treated at IRCCS Istituto Ortopedico Galeazzi in Milan (Italy) and at Salamat Farda and Parsa hospitals in the province of Tehran (Iran), in the time frame from 1 October 2020 to 16 January 2021, were analyzed and compared. Results: Records from 37 Italian patients and 33 Iranian patients were analyzed. The Italian group (mean age: 83.89 ± 1.60 years) was statistically older than the Iranian group (mean age: 75.18 ± 1.62 years) (p value = 0.0003). The mean number of transfusions for each patient in Italy was higher than the Iranian mean number (p value = 0.0062). The length of hospital stay in Italy was longer than in Iran (p value < 0.0001). Furthermore, laboratory values were different in the post-operative value of WBC and admission and post-operative values of CRP. Conclusions: The present study shows that differences were found between COVID-19-positive patients with proximal femoral fractures in these two countries. Further studies are required to validate these results and to better explain the reasons behind these differences.

Mitigating the risk of COVID-19 in a large community oncology clinic and its impact on the patient experience.

e18631 Background: Cancer patients have a high risk of severe illness from COVID-19 infection, and the William Osler Health System oncology clinic (WOHS-OC) is in Brampton, ON, Canada, a COVID-19 hotspot with high community COVID-19 prevalence. As such, heightened symptom screening prior to entering the WOHS-OC, asymptomatic COVID-19 testing pre-chemotherapy, staff personal protective equipment (PPE) use, enhanced cleaning, and clinic capacity limits (including implementation of virtual visits) were employed in the outpatient WOHS-OC. This study examined patient's perspectives regarding the implemented containment and mitigation strategies in the WOHS-OC during the second wave of the COVID-19 pandemic. Methods: Consenting patients in the WOHS-OC from Dec 01 2020 to Feb 01 2021 were provided a written questionnaire regarding their care during the second wave of the COVID-19 pandemic. Questions about satisfaction with COVID-19 protocols were rated on an analogue scale from 1-5, with 1 being the worst and 5 being the best possible satisfaction. Patient demographics (age, sex, type of cancer, and treatment type) were obtained through electronic medical records. Patients also consented to a second survey should they contract COVID-19 regarding, symptoms and risk factors for contracting the virus. Results: Fifty-six patients with various solid and hematological malignancies consented to the study; median age 59.5, male (30%), type of treatment; chemotherapy (55%), immunotherapy (9%), targeted therapy (23%), biologic therapy (14%), endocrine therapy (11%). Patients felt safe coming to the oncology clinic (95% of respondents), and 100% of patients were screened for symptoms on entry. Prior to cancer treatment, 49% of participants were contacted to do a screening COVID-19 swab. In 57% of patients, at least one clinic visit was changed to virtual (telephone or video). Communication during virtual visits was felt to be adequate with 89% of patients rating communication 4 or 5. Rating of virtual visits compared to in-person visits was widely distributed (57% rated virtual 4 or 5 compared to in person). Infection control practices were rated highly (4 or 5; physical distancing 83%, enhanced cleaning 93%, staff screening 89%, and staff PPE 96%). No patients that consented to the survey contracted COVID-19 during the study period. Conclusions: COVID-19 mitigation strategies in the WOHS-OC made patients feel safe during the second wave of the pandemic. Additionally, despite high levels of community transmission, no patients responding to the survey tested positive for COVID-19 during the study period. Patients were satisfied with communication during virtual visits, however there was a wide distribution of follow-up preferences. Future interventions should be aimed at standardizing pre- treatment COVID-19 testing and delineating areas of virtual care that patients identify as needing improvement.

Maternal Deaths from COVID-19 in Brazil: Increase during the Second Wave of the Pandemic.

To compare death rates by COVID-19 between pregnant or postpartum and nonpregnant women during the first and second waves of the Brazilian pandemic. In the present population-based evaluation data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe, in the Portuguese acronym), we included women with c (ARDS) by COVID-19: 47,768 in 2020 (4,853 obstetric versus 42,915 nonobstetric) and 66,689 in 2021 (5,208 obstetric versus 61,481 nonobstetric) and estimated the frequency of in-hospital death. We identified 377 maternal deaths in 2020 (first wave) and 804 in 2021 (second wave). The death rate increased 2.0-fold for the obstetric (7.7 to 15.4%) and 1.6-fold for the nonobstetric groups (13.9 to 22.9%) from 2020 to 2021 (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.47-0.58 in 2020 and OR: 0.61; 95%CI: 0.56-0.66 in 2021; p < 0.05). In women with comorbidities, the death rate increased 1.7-fold (13.3 to 23.3%) and 1.4-fold (22.8 to 31.4%) in the obstetric and nonobstetric groups, respectively (OR: 0.52; 95%CI: 0.44-0.61 in 2020 to OR: 0.66; 95%CI: 0.59-0.73 in 2021; p < 0.05). In women without comorbidities, the mortality rate was higher for nonobstetric (2.4 times; 6.6 to 15.7%) than for obstetric women (1.8 times; 5.5 to 10.1%; OR: 0.81; 95%CI: 0.69-0.95 in 2020 and OR: 0.60; 95%CI: 0.58-0.68 in 2021; p < 0.05). There was an increase in maternal deaths from COVID-19 in 2021 compared with 2020, especially in patients with comorbidities. Death rates were even higher in nonpregnant women, with or without comorbidities.

Examining Anxiety, Sleep Quality, and Physical Activity as Predictors of Depression among University Students from Saudi Arabia during the Second Wave of the COVID-19 Pandemic.

Conducted during the second wave of the pandemic, this cross-sectional study examined the link between sleep quality, physical activity, exposure, and the impact of COVID-19 as predictors of mental health in Saudi undergraduate students. A convenience sample of 207 participants were recruited, 89% of whom were females and 94% were single. The measures included questionnaires on the level of exposure and the perceived impact of COVID-19, a physical activity measure, GAD-7, PHQ-9, and PSQI. The results indicated that approximately 43% of participants exhibited moderate anxiety, and 50% were at risk of depression. Overall, 63.93% of students exposed to strict quarantine for at least 14 days (n = 39) exhibited a high risk of developing depression (χ2(1) = 6.49, p < 0.05, ϕ = 0.18). A higher risk of depression was also found in students whose loved ones lost their jobs (χ2(1) = 4.24, p < 0.05, ϕ = 0.14). Moreover, there was also a strong association between depression and anxiety (β = 0.33, p < 0.01), sleep quality (β = 0.32, p < 0.01), and the perceived negative impact of COVID-19 on socio-economic status (β = 0.26, p < 0.05), explaining 66.67% of depression variance. Our study highlights the socio-economic impact of this pandemic and the overwhelming prevalence of depression.

MO495: A Comparative Study of Patient Mortality During First and Second Waves of Covid-19 Pandemic in Dialysis Patients and Kidney Transplant Recipients

Abstract BACKGROUND AND AIMS Patients on kidney replacement therapy (KRT) are at a particularly high risk of mortality from COVID-19. In this study, we investigated COVID-19 mortality in KRT patients in the first and second waves of the pandemic and potential reasons for any difference in mortality between the two waves. METHOD Data from the European Renal Association COVID-19 Database (ERACODA) of KRT patients who presented between 1 March 2020 and 28 February 2021 with COVID-19 were analyzed. The cut-off for dividing the first and second waves was set for 1 August 2020. The primary study outcome was 28-day mortality. Multivariable Cox proportional-hazards regression analysis was used to examine the relationship between the pandemic waves and mortality with follow-up time starting at the date of presentation. Dialysis patients and kidney transplant recipients were analyzed separately. RESULTS Among 3004 dialysis patients (1253 in the first and 1751 in the second wave), the 28-day mortality was 24.3% in the first wave and 19.6% in the second wave (P = .002). Compared with the first wave, in the second wave, identification of patients with limited to no symptoms was higher (14.3% versus 24.8%; P &amp;lt; .001), hospitalization was lower (71.3% versus 44.3%; P &amp;lt; .001), but in-hospital mortality was similar (30.4% versus 30.7%; P = .92) (Fig. 1). Crude hazard ratio (HR) for 28-day mortality in the second wave was 0.77 (95% CI: 0.66, 0.89). However, in a fully adjusted model, when correcting for differences in patient and disease characteristics, including the reason for COVID-19 screening and disease severity, the HR for mortality in the second wave was 0.93 [95% confidence interval (95% CI): 0.79–1.10]. When follow-up was chosen to start at the date of first symptoms to account for possible lead-time bias, crude HR for 28-day mortality in the second wave was 0.90 (95% CI: 0.75–1.07) and the fully adjusted HR was 0.98 (95% CI: 0.81–1.18). Among 1035 kidney transplant recipients (475 in the first and 560 in the second wave), results were essentially similar except that patients in the second wave were younger (55.6 years versus 58.2 years; P = .002), and crude HR for 28-day mortality from the date of first symptoms was 0.66 (95% CI: 0.47–0.93), whereas the fully adjusted HR was 1.02 (95% CI: 0.70–1.49). CONCLUSION Among patients on KRT with COVID-19, 28-day mortality rates were lower in the second wave compared with the first wave. However, a greater proportion of patients with minimal symptoms, lead-time bias in dialysis patients, and younger age in kidney transplant recipients possibly explain the lower mortality during the second wave. Any improvement in patient management during the second wave may not be the main reason for lower mortality.

Pandemic Situation in Pakistan: Recoveries and Mortalities Rate of COVID-19 during First and Second Waves of Pandemic in Pakistan - Data from Feb to Dec 2020

The novel coronavirus disease COVID-19 outbreak has caused significant global issues and challenged healthcare systems across the globe and in Pakistan as well. This infectious disease is found to be a pandemic and has massively impacted countries across the world. The disease is still rapidly spreading and has caused many deaths in Pakistan, according to the world health organization; early in the year of 2020, Pakistan was ranked among the top 10 countries in the world reporting the highest number of new cases of COVID-19 per day during the first wave of the outbreak. The second wave of COVID-19 was relatively high on the first wave of disease in the current scenario of the pandemic. In the all over Pakistan, the real-time PCR is being applied for the qualitative detection of COVID-19 in the human nasopharyngeal swab specimen. From Feb to Dec.2020, in Pakistan there were a total of 416,499 cases registered across the country there have been (2%) deaths, with (85.2%) total recoveries. Sindh and Punjab were the most affected provinces; however, Balochistan, KPK, and other regions of Pakistan were less affected comparatively. This short communication is carried out to shed light on the coronavirus outbreak in the country; it will help to highlight the recoveries and mortalities rate of first and second waves of the disease.

Psychological Health and Sleep Quality of Medical Graduates During the Second Wave of COVID-19 Pandemic in Post-epidemic Era.

Recently, a COVID-19 virus variant spread rapidly in Guangzhou, China, causing public panic. This study aimed to understand the psychological and sleep-related consequences of the secondary outbreak of the pandemic on medical students. In this cross-sectional survey-based study, participants anonymously completed structured questionnaires online from June 8–22, 2021. We collected participants' demographic and general information. Anxiety, depression, and sleep quality were measured using the Zung Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Protective factors were assessed using the Coping Style Questionnaire (CSQ). Uni- and multivariate logistic regression analyses were performed examining factors associated with mental health and sleep quality problems. During the second wave of the pandemic in local outbreak areas in Guangzhou, China, more than one-third of medical students' mental health and sleep quality were affected. The prevalence of anxiety, depression, and poor sleep quality were 27.54%, 27.58%, and 18.19%, respectively. Students belonging to the Class of 2019, aged over 29 years, those with siblings, and those whose hometowns were in other provinces were more prone to the three health problems. Factors associated with an increased risk of mental health problems were vaccination status (adjusted odds ratio 1.603–1.839) and diet status (adjusted odds ratio 1.62–1.929). Positive coping styles served as protective factors (p < 0.05). We discovered that completed vaccination status, good diet, and positive coping styles were related to good mental health and sleep quality.

Being Nice or Being Scared? Personality Traits, Beliefs and Threat of COVID-19 as Predictors of Non-Normative Health Behaviors during Second Wave of Pandemic

Being Nice or Being Scared? Personality Traits, Beliefs and Threat of COVID-19 as Predictors of Non-Normative Health Behaviors during Second Wave of Pandemic

Hesitancy and Acceptance of COVID-19 Vaccination Amidst the Second Wave of Pandemic in India: A General Population Study.

Hesitancy and Acceptance of COVID-19 Vaccination Amidst the Second Wave of Pandemic in India: A General Population Study.

Emergency department visits due to hand trauma and subsequent emergency hand surgery in three Finnish hospitals during the first and second waves of COVID-19 pandemic.

The rate of acute hand trauma visits to emergency departments (ED) and surgeries decreased during the COVID-19 lockdown. Our aim was to analyze the influence of national lockdown during the first wave and the regional restrictions during the second wave on the rate of visits to the ED and urgent hand surgeries in Finland. Material for this retrospective study was gathered from three Finnish hospitals All ED visits and urgent or emergency surgeries from January 2017 to December 2020 were included. Incidences per 100 000 persons with 95% confidence intervals (CI) were calculated and compared by incidence rate ratios (IRR). The incidence of hand injury was lower after the beginning of the lockdown in March 2020 (IRR 0.70 CI 0.63-0.78). After lockdown ended in May, the monthly incidences of ED visits returned to the reference level. During the lockdown, the incidence of fractures and dislocations was 42% lower in March (IRR 0.58 CI 0.50-0.68) and 33% lower in April 2020 (IRR 0.67 CI 0.57-0.80). The incidence of fracture repair surgeries was 43% lower in March 2020 (IRR 0.57 CI 0.35-0.93) and 41% lower in July 2020 (IRR 0.59 CI 0.36-0.98). Incidence of replantation was 49% higher in March 2020 (IRR 1.49 CI 0.53-4.20) and 200% higher in July 2020 (IRR 3.00 CI 0.68-13.2) but these increases had high uncertainty. The rate of ED visits due to hand injuries decreased while the rate of emergency hand operations remained unchanged during the national COVID-19 lockdown in spring. After the lockdown, the incidences returned to reference level and were unaffected by regional restrictions during the second wave of pandemic.

Coping with Stress During the Second Wave of the COVID-19 Pandemic by Polish University Students: Strategies, Structure, and Relation to Psychological Well-Being.

PurposeThe aim of the study was to establish a hierarchy of strategies and the structure of copIng with the stress of the COVID-19 pandemic by university students and the relationship between coping strategies and psychological well-being.Participants and MethodsAn exploratory study was conducted using a cross-sectional research design. The study involved 1330 university students, aged 18 to 30 years. The Brief COPE Scale, being the Polish adaptation by Juczyński and Ogińska-Bulik, and the short version of the Psychological General Well-Being Index (authors’ adaptation) were used.ResultsAcceptance, doing something else, active coping, and physical activity were the most commonly used strategies for coping with stress during the second wave of the pandemic. Substance use, denial, and behavioral disengagement were lowest in the hierarchy of coping strategies. Female and master’s students used a variety of strategies more than male and bachelor’s students. Coping strategies correlated significantly with psychological well-being. Four second-degree factors were distinguished, explaining 55.1% of the total variation: maladaptive coping, coping by support, by positive reappraisal, and by action. Stepwise regression analysis confirmed the importance of the second-degree factors as predictors of psychological well-being.ConclusionOur findings show that young adults studying at the university of physical Education in Poland used adaptive strategies to cope with stress during the second wave of the COVID-19 pandemic. Gender differences in coping with pandemic stress are similar to those found in previous studies. The structure of coping with pandemic stress is to some extent similar, but also partially dependent on various cultural factors.

Self-rated mental health, community belonging, life satisfaction and perceived change in mental health among adults during the second and third waves of the COVID-19 pandemic in Canada.

Findings from the 2020 Survey on COVID-19 and Mental Health (SCMH) suggested that the positive mental health of adults in Canada was lower during the second wave of the pandemic (fall 2020) than in 2019. With 2021 SCMH data from winter/spring 2021, we find in the current study that average life satisfaction and the prevalence of high self-rated mental health, high community belonging and perceptions of stable/improved mental health were even lower during the third wave of the pandemic as compared to the second wave in the overall adult population and in most sociodemographic groups.

Parallel evolution and differences in seroprevalence of SARS-CoV-2 antibody between patients with cancer and health care workers in a tertiary cancer centre during the first and second wave of COVID-19 pandemic: canSEROcov-II cross-sectional study

BackgroundPatients with cancer are a population at high risk of severe infection from SARS-CoV-2. Patients with cancer regularly attend specialised healthcare centres for management and treatment, where they are in contact with healthcare workers (HCWs). Numerous recommendations target both patients with cancer and HCWs to minimise the spread of SARS-CoV-2 during these interactions. ObjectiveTo investigate the parallel evolution of the COVID-19 epidemic in these 2 populations over time, we studied the seroprevalence of anti-SARS-CoV-2 antibodies after both the first and second waves of the pandemic, and in both cancer patients and HCWs from a single specialised anti-cancer centre. Factors associated with seropositivity were identified in both populations. MethodsWe conducted a cross-sectional study after the second wave of the COVID pandemic in France. All participants were invited to undergo serological testing for SARS-CoV-2 and complete a questionnaire collecting data about their working conditions (for HCWs) or medical management (for patients) during this period. Results after the second wave were compared to those of a previous study among 1011 patients with cancer and 663 HCWs performed in the same centre after the first wave, using the same evaluations. FindingsWe included 502 HCWs and 507 patients with cancer. Seroprevalence of anti-SARS-CoV-2 antibodies was higher after the second wave than after the first wave in both HCWs (15.1% versus 1.8%; p < 0.001), and patients (4.1% versus 1.7%; p = 0.038). By multivariate analysis, the factors found to be associated with seropositivity after the second wave for HCWs were: working in direct patient care (p = 0.050); having worked in a dedicated COVID-19 unit (p = 0.0036); contact with a person with COVID-19-positive in the workplace (p = 0.0118) or outside of the workplace (p = 0.0297). Among patients with cancer, only a contact with someone who tested positive for COVID-19 was found to be significantly associated with positive serology. The proportion of reported contacts with individuals with COVID-19-positive was significantly lower among patients with cancer than among HCWs (7.6% versus 40.7%, respectively; p < 0.0001) InterpretationBetween the first and second waves of the epidemic in France, the seroprevalence of anti-SARS-CoV-2 antibodies increased to a lesser extent among patients with cancer than among their HCWs, possibly due to better self-protection, notably social distancing. The risk factors for infection identified among HCWs plead in favour of numerous intra-hospital contaminations, especially for HCWs in contact with high-risk patients. This underlines the compelling need to pursue efforts to implement strict hygiene and personal protection measures (including vaccination) to protect HCWs and patients with cancer.

Predictors of Severity and Mortality in Chronic Liver Disease Patients With COVID-19 During the Second Wave of the Pandemic in India.

BackgroundCoronavirus disease 2019 (COVID-19) infection in chronic liver disease patients is associated with poor outcomes. In this study, we aimed to evaluate the predictors of severity and mortality in this group of patients during the second wave of the COVID-19 pandemic in India. In addition, we compared cirrhotic patients with COVID-19 with cirrhotic patients from the pre-COVID-19 period.MethodologyThis was a single-center observational study. We included data from 50 patients with cirrhosis and COVID-19 retrospectively from the discharge/death files. A comparison group of 100 patients with cirrhosis from the pre-COVID period was also analyzed retrospectively.ResultsThe majority of patients had predominantly respiratory symptoms, with fever being the most common symptom (85%). The most common presentation was acute on chronic liver failure (ACLF). The most common form of decompensation was jaundice followed by hepatic encephalopathy. The overall mortality in cirrhotic patients with COVID-19 was double than that in cirrhotic patients from the pre-COVID-19 period. All patients with ACLF succumbed to multiorgan failure. Diabetes was the only comorbidity that was associated with severe infection. Higher creatinine on admission and high D-dimer levels correlated with severity. D-dimer was the only parameter that correlated with severity and mortality on multivariate analysis. None of the comorbidities predicted mortality. Among various composite scores, the Child-Turcotte-Pugh (CTP) score and CURB-65 correlated with mortality. On the area under the receiver operating characteristic analysis, a D-dimer level of >1.1 mg/L was associated with mortality.ConclusionsCOVID-19 infection in patients with cirrhosis is associated with poor outcomes. D-dimer levels of >1.1 mg/L on admission are a simple parameter to predict mortality. CTP and CURB-65 are composite scores that correlate with mortality in this group of patients.

Comparison of Demographic Profile and CT Findings in COVID-19 Pneumonia between First and Second Waves of COVID-19 Pandemic: A Retrospective Study

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic has affected the world in two waves. The human civilisation took a heavy toll in the two waves of pandemic in terms of human deaths, loss of livelihood and socioeconomic regression. Aim: To present the Computed Tomography (CT) thorax findings of COVID-19 pneumonia during peak three months of first and second waves of COVID-19 pandemic and compare the demographic profile, radiological patterns and CT severity scores to document if significant difference exists between the two waves. Materials and Methods: The present observational, retrospective and single-centric study included all Real-time Reverse Transcription-polymerase Chain Reaction (RT-PCR) tests proven COVID-19 patients who underwent CT scan during the peak three months of first (August to October 2020) and second (April to June 2021) waves of COVID-19 pandemic at TRIHMS, Naharlagun, Arunachal Pradesh, India. A total of 93 and 120 patients were included from the first and second waves, respectively. The demographic profile, radiological pattern based on the Radiological Society of North America (RSNA) consensus statement and CT severity index in COVID- 19 pneumonia were compared during the peak three months of first and second waves of the pandemic. Chi-squared and t-test were used for statistical analysis. Results: The patients affected during the second wave were younger compared to the first wave (mean age of 43 vs 49, p=0.001). The patients having moderate or severe COVID-19 pneumonia during the second wave were significantly younger compared to the first wave (mean age of 42 vs 55, p&lt;0.001). More females were affected with moderate or severe COVID-19 pneumonia during the second wave compared to the first wave (p=0.017). However, the overall sex difference in COVID-19 pneumonia (including mild category) was not significant with p-value of 0.127. There was same prevalence of radiological patterns in the two waves (p=0.981). The difference in the prevalence of CT severity score was not significant in the two waves (p=0.256). Conclusion: Similar radiological patterns were observed in the two waves of the pandemic. Younger patients were significantly more affected during the second wave of the pandemic.

Influence of the Second Wave of the COVID-19 Pandemic on the Management of Patients with ST-T Segment Elevation Myocardial Infarction.

The ongoing coronavirus disease 2019 (COVID-19) has caused a global health crisis. This prospective, observational, single-centre, cohort study investigated the influence of the second wave of the pandemic on the treatment of ST-segment elevation myocardial infarction (STEMI) patients admitted to the largest tertiary centre in Nicosia, Cyprus. We measured onset-to-door (O2D) time, door-to-balloon (D2B) time, onset-to-balloon (O2B) time, and 30-day mortality for 250 consecutive patients who presented directly or were transferred to Nicosia General Hospital from 1 January 2021, to 31 December 2021, during the second wave of the pandemic in Cyprus. We compared a control group of patients with similar clinical characteristics admitted before the COVID-19 outbreak. Median O2D time was increased from 89 min to 120 min (p-value=0.094). D2B time was not increased significantly (85.5 vs. 87 min, p-value=0.137). The total ischemic time (O2B time) was increased from 173.5 min to 232.5 min, respectively (173.5 vs. 232.5, p=0.001). During the pandemic, more patients presented with cardiogenic shock (3.94 vs. 13.6, p=0.001) and with cardiac arrest (9.85 vs. 17.2, p=0.035,) while there was an increase in 30-day mortality (4.43% vs. 8.8%, p-value=0.100). Patients with STEMI during the second wave of the COVID-19 pandemic seem to have presentation delays with increased total ischaemic times, presented more commonly in cardiogenic shock or cardiac arrest, increasing 30-day mortality.

Sleep Quality of Covid-19 Recovered Patients in India.

Objective:The second wave of the Covid-19 pandemic in India was widespread and caused psychological distress among the citizens. Hospitals were running at a premium, increasing deaths and trepidation stories were on air by media, this generated sleep disturbances for many. This study aimed to examine the sleep quality of Covid-19 recovered patients in India during the second wave of the pandemic.Methods:Patients who had recently recovered from Covid-19 were invited to participate in this cross-sectional study using various social media platforms. An online survey questionnaire, including socio-demographics, health-related information, Covid-19 related information, and the Pittsburgh Sleep Quality Index (PSQI), was administered in June 2021. Descriptive statistics were used to compare the scores among the mild, moderate, and severe groups. ANOVA was used to find the difference between the groups for global PSQI scores.Results:A total of 311 participants (261 mild, 45 moderate, and 5 severe) provided usable responses. The Global PSQI score for the overall study sample was 8.22 ± 3.79. In the severe group, scores were higher 16.8 ± 2.59, and statistically significant from mild or moderate groups. Sleep quality of Covid-19 recovered patients was found to be statistically significantly different based on their gender (P < .001), annual income (P < .001), employment status (P < .001), and marital status (P < .001).Conclusion:Females, employment in the private sector, annual income below rupees 11 lakh, and unmarried Covid-19 recovered patients reported poor sleep quality. As our findings indicate poor sleep quality among the Covid-19 recovered patients during the second wave in India, designing psychological interventions is recommended to support their wellbeing post-recovery.

COVID-19 infection in kidney transplant recipients during the first versus the second wave - Retrospective Observational study from a single center

Background: Kidney transplant recipients (KTRs) are deemed to be at a high risk of severe coronavirus disease (COVID-19). Herein, we describe the clinical, laboratory profiles, management, and outcomes of 26 KTRs who developed COVID-19 during the first and second waves of the pandemic from a tertiary care center in northern India. Methods: This retrospective observational study included KTRs detected with COVID-19 infection during the first wave (March–November 2020) and the second wave (March–July 2021). Their clinical and laboratory investigations, management aspects, and outcomes were compared, using data retrieved from clinical and telenephrology records, and the hospital information system. Results: Of the 23 KTRs, 20 were male (86%), 20 patients had fever (86%), and cough and breathlessness were seen in 19 (82%) and 12 (52%), respectively. Acute graft dysfunction was seen in 6 (26%) patients, and the need for renal replacement was seen in 4 (17%) patients. Supplemental oxygen by reservoir mask was utilized in 10 (43%) patients, high-flow nasal cannula in 3 (13%), noninvasive mechanical ventilation in 4 (17%), and invasive mechanical ventilation in 6 (26%) patients. All the KTRs with moderate and severe COVID illness and 6/7 nonsurvivors were infected during the second wave. Overall mortality in this group of patients was very high at 27%, and the mortality in the group on mechanical ventilation was 100%. Conclusions: The second wave of the COVID-19 pandemic was associated with greater severity of illness and high mortality in KTRs.

Factors affecting mortality in COVID-19 patients

Background: Coronavirus disease 2019 (COVID-19) has caused large number of deaths all over the world. Our study was conducted to investigate the factors affecting mortality in patients hospitalized with COVID-19 during second wave of pandemic in India. Material and methods: The data was collected retrospectively from the medical records of P. K. Trauma Care Centre, Mysuru where exclusively COVID-19 patients were admitted during second wave of COVID-19 pandemic in India. This study included total of 98 patients who expired due to COVID-19 during the period of March 2021 to October 2021. Demographic details, clinical presentation, treatment and laboratory data were extracted from medical records. We analysed the significance of the data using chi square test and other statistical tests. Results: A total of 948 cases were admitted during the said period and 98 patients expired. With statistical analysis following factors are found to be significantly associated with high mortality - age above 60 years, unvaccinated, low oxygen saturation at presentation to the hospital, high serum ferritin level, elevated neutrophil –lymphocyte ratio (NLR), elevated D-dimer level, presence of co-morbidities. Duration of symptoms with which the patients presents to the hospital is the least significant factor associated with the mortality. Conclusion: Elderly age group, lack of vaccination, low oxygen saturation at presentation to the hospital, presence of comorbidities like diabetes, hypertension and ischemic heart disease, elevated serum ferritin, D-dimer level and high NL ratio are associated significantly with high mortality in patients with COVID-19 infection. Vaccination, monitoring of oxygen saturation and proper management and control of comorbidities are the easily modifiable factors to reduce the mortality in COVID-19 patients.

Psoriasis-related treatment exposure and hospitalization or in-hospital mortality due to COVID-19 during the first and second wave of the pandemic: cohort study of 1 326 312 patients in France.

SummaryBackgroundData on treatment exposures for psoriasis and poor COVID‐19 outcomes are limited.ObjectivesTo assess the risk of hospitalization or in‐hospital mortality due to COVID‐19 by treatment exposure in patients with psoriasis.MethodsAll adults with psoriasis registered in the French national health‐insurance (Système National des Données de Santé, SNDS) database between 2008 and 2019 were eligible. Two study periods were considered: 15 February to 30 June 2020 and 1 October 2020 to 31 January 2021, the first and second waves of the COVID‐19 pandemic in France, respectively. Patients were classified according to their baseline treatment: biologics, nonbiologics, topicals or no treatment. The primary endpoint was hospitalization for COVID‐19 using Cox models with inverse probability of treatment weighting. The secondary endpoint was in‐hospital mortality due to COVID‐19.ResultsWe identified 1 326 312 patients with psoriasis (mean age 59 years; males, 48%). During the first study period, 3871 patients were hospitalized for COVID‐19 and 759 (20%) died; during the second period 3603 were hospitalized for COVID‐19 and 686 (19%) died. In the propensity score‐weighted Cox models, risk of hospitalization for COVID‐19 was associated with exposure to topicals or nonbiologics [hazard ratio (95% confidence interval): 1·11 (1·04–1·20) and 1·27 (1·09–1·48), respectively] during the first period, and with all exposure types, during the second period. None of the exposure types was associated with in‐hospital mortality due to COVID‐19.ConclusionsSystemic treatments for psoriasis (including biologics) were not associated with increased risk of in‐hospital mortality due to COVID‐19. These results support maintaining systemic treatment for psoriasis during the pandemic.