Wave Of Coronavirus Disease 2019 Research Articles

The health-related quality of life of patients with musculoskeletal disorders after the COVID-19 pandemic.

PurposeTo verify changes in the health-related quality of life (HRQOL) of patients with musculoskeletal disorders after the coronavirus disease 2019 (COVID-19) pandemic and to assess the relationship between the patients’ change in several activities of daily living and in the HRQOL to discover factors related to the deterioration in HRQOL.MethodsA multi-centre cross-sectional questionnaire survey was administered between November 1, 2020, and December 31, 2020, in Japan. The participants included those who visited the orthopaedics clinic within the survey period and had experienced the first and second waves of COVID-19 in Japan and the first stay-at-home order issued by the government. Patients’ HRQOL at the two different time points (pre-outbreak and post-second wave of COVID-19) was assessed with the EuroQoL-5 dimensions 5-level (EQ-5D).ResultsThe survey was completed by 1254 patients (average age: 52.5 ± 21.9 years; 644 women). Among them, 431 patients (34.3%) reported a decrease in the EQ-5D index after the pandemic. The largest decrease was in the pain domain followed by the mobility domain. Multivariate logistic regression analysis revealed that the patients with decreased regular exercise habits were significantly related to deterioration in HRQOL compared with those with stable regular exercise (adjusted odds ratio = 1.76, p < 0.001) independently from age, sex, and change of symptoms.ConclusionsUp to 35% of patients with musculoskeletal disorders reported deterioration of HRQOL after the COVID-19 pandemic. Pain and mobility rather than anxiety were the two leading factors of the HRQOL decrease. The decrease in regular exercise was related to the HRQOL decrease.

Longitudinal validation of an electronic health record delirium prediction model applied at admission in COVID-19 patients

ObjectiveTo validate a previously published machine learning model of delirium risk in hospitalized patients with coronavirus disease 2019 (COVID-19). MethodUsing data from six hospitals across two academic medical networks covering care occurring after initial model development, we calculated the predicted risk of delirium using a previously developed risk model applied to diagnostic, medication, laboratory, and other clinical features available in the electronic health record (EHR) at time of hospital admission. We evaluated the accuracy of these predictions against subsequent delirium diagnoses during that admission. ResultsOf the 5102 patients in this cohort, 716 (14%) developed delirium. The model's risk predictions produced a c-index of 0.75 (95% CI, 0.73–0.77) with 27.7% of cases occurring in the top decile of predicted risk scores. Model calibration was diminished compared to the initial COVID-19 wave. ConclusionThis EHR delirium risk prediction model, developed during the initial surge of COVID-19 patients, produced consistent discrimination over subsequent larger waves; however, with changing cohort composition and delirium occurrence rates, model calibration decreased. These results underscore the importance of calibration, and the challenge of developing risk models for clinical contexts where standard of care and clinical populations may shift.

Ensemble learning based classifier to predict depression caused due to pandemic

Pandemic caused due to Corona Virus Disease 2019 (COVID-19) affected each and every person life throughout the world. First wave of COVID-19 followed by second wave made situation more panic. Government declared Lockdown imposed strict prohibition on social gathering, unnecessary outing, travelling, and education. During home quarantine, people shared opinion, expressed views, feelings on social media. Home isolation and quarantine affected mental health of people which may lead to depression. Hence in this research article depression is predicted by implementing Neural Network based model. At first level this model implements text classification of COVID-19 based Tweets. Neural network model accuracy is 86.85%. In next level, using same tweet dataset as input, Ensemble learning based model is constructed. This model uses one of the boosting techniques known as Adaboost. Model is executed by varying Train-test-validation ratio. It is observed that accuracy of the model is improved. The model showed accuracy of 99.33 % successfully in every execution. Obtained results are compared with previous work in same area.

COVID-19 Mechanisms in the Human Body-What We Know So Far.

More than one and a half years have elapsed since the commencement of the coronavirus disease 2019 (COVID-19) pandemic, and the world is struggling to contain it. Being caused by a previously unknown virus, in the initial period, there had been an extreme paucity of knowledge about the disease mechanisms, which hampered preventive and therapeutic measures against COVID-19. In an endeavor to understand the pathogenic mechanisms, extensive experimental studies have been conducted across the globe involving cell culture-based experiments, human tissue organoids, and animal models, targeted to various aspects of the disease, viz., viral properties, tissue tropism and organ-specific pathogenesis, involvement of physiological systems, and the human immune response against the infection. The vastly accumulated scientific knowledge on all aspects of COVID-19 has currently changed the scenario from great despair to hope. Even though spectacular progress has been made in all of these aspects, multiple knowledge gaps are remaining that need to be addressed in future studies. Moreover, multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have emerged across the globe since the onset of the first COVID-19 wave, with seemingly greater transmissibility/virulence and immune escape capabilities than the wild-type strain. In this review, we narrate the progress made since the commencement of the pandemic regarding the knowledge on COVID-19 mechanisms in the human body, including virus–host interactions, pulmonary and other systemic manifestations, immunological dysregulations, complications, host-specific vulnerability, and long-term health consequences in the survivors. Additionally, we provide a brief review of the current evidence explaining molecular mechanisms imparting greater transmissibility and virulence and immune escape capabilities to the emerging SARS-CoV-2 variants.

Sleep disturbance and anxiety symptom among public during the second wave of COVID-19 in Beijing: A web-based cross-sectional survey

PurposeThe global coronavirus disease 2019 (COVID-19) epidemic has significantly impacted people's lives. This study aimed to examine the influence of the unexpected second wave of COVID-19 on sleep quality and anxiety of Chinese residents in Beijing in June 2020, compared with the initial outbreak at the beginning of 2020, and to investigate the associated factors. MethodsUsing a web-based cross-sectional survey, we collected data from 1,511 participants. assessed with demographic information, sleep quality and anxiety symptoms. The participants were asked to compare their recent sleep and sleep during the first outbreak. The Zung's Self-rating Anxiety Scale (SAS) was used to assess their current insomnia severity. Multivariable logistic regression models were used to analyze the association between COVID-19 epidemic and risk of sleep disturbance and anxiety symptom. ResultsThe overall prevalence of sleep disturbance and anxiety symptoms were 50.8% and 15.3% respectively. People had significantly shorter sleep duration during the second wave of COVID-19(7.3 ± 1.3) h than the first outbreak (7.5 ± 1.4)h (p < 0.001). During the second outbreak, people were less concerned about infection and more concerned about financial stress and occupational inferference. Beijing residents did not have significant differences in sleep disturbance and anxiety compared with other regions, nor were occupations and nucleic acid testing associated risk factors. Home quarantine, health administrators, history of insomnia and anxiety-depression were significantly associated with sleep disturbance. Female gender, home quarantine, history of insomnia and anxiety-depression were significantly associated with anxiety. ConclusionHigh prevalence of sleep disturbance and depression symptom was common during the second wave of COVID-19 crisis in Beijing. Home quarantine and previous history of insomnia and anxiety-depressive risk factors were associated with sleep disturbance and anxiety. Female gender was impacting predictor of anxiety. We need continuous assessment of the sleep quality and anxiety symptoms of this epidemic.

Differences in age distribution in first and second waves of COVID-19 in eastern Uttar Pradesh, India

Comparison of first and second waves of Coronavirus disease (COVID-19) showed varied differences including the peak and time distribution. Contrary to published reports of comparing two waves in India wherein the younger age group was affected more in the second wave in India; a secondary data analysis of around 0.5 million real-time reverse transcription-polymerase chain reaction tests conducted in COVID-19 diagnostic laboratory in eastern Uttar Pradesh, India showed an increase in positivity rate in older age groups in the second wave. The positivity rate among symptomatic cases was found to be three times higher in second wave compare to the first wave. Higher positivity rates were seen across older age groups, with a shift of 11 years in the mean age of positivity in the second wave compared to the first.

Effect of the COVID-19 pandemic in stroke code activations in the region of Madrid: A retrospective study.

Acute sstroke is the most common time-dependent disease attended in the emergency medical service (EMS) of Madrid (SUMMA 112). Community of Madrid has been one of the most affected regions in Spain by the coronavirus disease 2019 (COVID-19) pandemic. A significant reduction in acute sstroke hospital admissions has been reported during the COVID-19 pandemic compared to the same period 1 year before. As international clinical practice guidelines support those patients with suspected acute stroke should be accessed via EMS, it is important to know whether the pandemic has jeopardized urgent pre-hospital stroke care, the first medical contact for most patients. We aimed to examine the impact of the COVID-19 in stroke codes (SC) in our EMS among 3 periods of time: the COVID-19 period, the same period the year before, and the 2019-2020 seasonal influenza period.We compared the SC frequency among the periods with high cumulative infection rate (above the median of the series) of the first wave of COVID-19, seasonal influenza, and also with the same period of the year before.One thousand one hundred thirty SC were attended during the 3 periods. No significant reduction in SC was found during the COVID-19 pandemic. The reduction of hospital admissions might be attributable to patients attending the hospital by their means. The maximum SC workload seen during seasonal influenza has not been reached during the pandemic. We detected a nonsignificant deviation from the SC protocol, with a slight increase in hospitals’ transfers to hospitals without stroke units.

Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19\u2014a prospective multicenter cohort study

BackgroundIn a prospective healthcare worker (HCW) cohort, we assessed the risk of SARS-CoV-2 infection according to baseline serostatus.MethodsBaseline serologies were performed among HCW from 23 Swiss healthcare institutions between June and September 2020, before the second COVID-19 wave. Participants answered weekly electronic questionnaires covering information about nasopharyngeal swabs (PCR/rapid antigen tests) and symptoms compatible with coronavirus disease 2019 (COVID-19). Screening of symptomatic staff by nasopharyngeal swabs was routinely performed in participating facilities. We compared numbers of positive nasopharyngeal tests and occurrence of COVID-19 symptoms between HCW with and without anti-nucleocapsid antibodies.ResultsA total of 4812 HCW participated, wherein 144 (3%) were seropositive at baseline. We analyzed 107,807 questionnaires with a median follow-up of 7.9 months. Median number of answered questionnaires was similar (24 vs. 23 per person, P = 0.83) between those with and without positive baseline serology. Among 2712 HCW with ≥ 1 SARS-CoV-2 test during follow-up, 3/67 (4.5%) seropositive individuals reported a positive result (one of whom asymptomatic), compared to 547/2645 (20.7%) seronegative participants, 12 of whom asymptomatic (risk ratio [RR] 0.22; 95% confidence interval [CI] 0.07 to 0.66). Seropositive HCWs less frequently reported impaired olfaction/taste (6/144, 4.2% vs. 588/4674, 12.6%, RR 0.33, 95% CI 0.15–0.73), chills (19/144, 13.2% vs. 1040/4674, 22.3%, RR 0.59, 95% CI 0.39–0.90), and limb/muscle pain (28/144, 19.4% vs. 1335/4674, 28.6%, RR 0.68 95% CI 0.49–0.95). Impaired olfaction/taste and limb/muscle pain also discriminated best between positive and negative SARS-CoV-2 results.ConclusionsHaving SARS-CoV-2 anti-nucleocapsid antibodies provides almost 80% protection against SARS-CoV-2 re-infection for a period of at least 8 months.

Interventional cardiology in times of COVID-19: impact on a terciary centre

IntroductionCardiovascular diseases are the leading cause of death worldwide and the pandemic caused by coronavirus disease 2019 (COVID-19) has forced profound changes in the care of patients with cardiac conditions. In Portugal, an increase in mortality beyond that attributed solely to COVID-19 was observed. We aimed to realize how COVID-19 has changed the activity of our Interventional Cardiology Unit.MethodsWe retrospectively assessed all patients submitted to any interventional procedure in 2019 and 2020 in our hospital. A total of 7621 patients and 9163 procedures were evaluated. The mean weekly numbers of coronarography, angioplasty, right heart catheterization and structural heart intervention during 2019 were assessed and were compared with the first COVID-19 wave (comprising March and April 2020) and the second COVID-19 wave (including the time period from October to end of December 2020).ResultsMean age was 65.2±16.6 years with 72% being male. In the first COVID-19 wave there was a significant reduction in the mean weekly numbers of all procedures, with a 64% decline in coronarographies (30.9±29.3 vs 87.2±12.9, P<0.001), 48% in angiographies (15.7±10.9 vs 30.2±5.7, P=0.004), 51% in right heart catheterizations (5.3±5.9 vs 10.9±4.5, P=0.002) and 57% in structural heart interventions (1.1±1.9 vs 2.6±2, P=0.044). Although there was an evident recovery in activity (figure 1), comparing to 2019, the second wave also showed a significant lower number of procedures, with 24% fewer coronarographies (66.6±20.6 vs 87.2±12.9, P=0.003) and 13% fewer angiographies (26.4±7.6 vs 30.2±5.7, P=0.004). Contrariwise, in the second wave there was no difference in the number of right heart catheterizations (7.3±6.1 vs 10.9±4.5, P=0.055) or structural heart interventions (1.6±1.6 vs 2.6±2, P=0.106).ConclusionsIn our Interventional Cardiology Unit, COVID-19 led to a significant reduction of procedures in the first and second pandemic waves. The effect on the increase in morbidity and mortality has yet to be determined. Health authorities should focus attention in defining measures to amend the consequences of this documented activity reduction.Funding AcknowledgementType of funding sources: None. Figure 1

Effect of lockdown on digestive system cancer care amongst older patients during the first wave of COVID-19: The CADIGCOVAGE multicentre cohort study

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on cancer diagnosis and treatment. Most patients newly diagnosed with digestive system cancer are aged 65 and over. MethodsWe performed a retrospective, observational, multicentre cohort study based on prospectively collected electronic health records. All adults aged 65 or over and having been newly treated for a digestive system cancer between January 2018 until August 2020 were enroled. ResultsData on 7882 patients were analysed. The first COVID-19 lockdown period led to a 42.4% decrease in newly treated digestive system cancers, and the post-lockdown period was associated with a 17% decrease. The decrease in newly treated digestive system cancer did not differ as a function of age, sex, comorbidities, primary tumour site, and disease stage. The proportion of patients admitted to an emergency department increased during the lockdown period. We do not observe a higher 3-month mortality rate in 2020, relative to the corresponding calendar periods in 2018 and 2019. ConclusionTo avoid a decrease in newly treated cancers during future lockdown periods, access to healthcare will have to be modified. Although 3-month mortality did not increase in any of the patient subgroups, the 2020 cohort must be followed up for long-term mortality.

Re-positive testing, clinical evolution and clearance of infection: results from COVID-19 cases in isolation in Viet Nam.

ObjectiveAsymptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and test re-positivity after a negative test have raised concerns about the ability to effectively control the coronavirus disease 2019 (COVID-19) pandemic. We aimed to investigate the prevalence of COVID-19 asymptomatic and pre-symptomatic infections during the second wave of COVID-19 in Viet Nam, and to better understand the duration of SARS-CoV-2 infection and the dynamics between the evolution of clinical symptoms and SARS-CoV-2 test positivity among confirmed COVID-19 cases.MethodsWe conducted a cohort analysis on the first 50 confirmed cases during the second COVID-19 wave in Viet Nam using clinical, laboratory and epidemiological data collected from 9 March to 30 April 2020. Kaplan–Meier estimates were used to assess time to clearance of SARS-CoV-2 infection, and log-rank tests were used to explore factors related to time to SARS-CoV-2 infection clearance.ResultsMost cases (58%) had no typical signs or symptoms of COVID-19 at the time of diagnosis. Ten cases (20%) were re-positive for SARS-CoV-2 during infection. Eight cases (16%) experienced COVID-19 symptoms after testing negative for SARS-CoV-2. The median duration from symptom onset until clearance of infection was 14 days (range: 6–31); it was longer in re-positive and older patients and those with pre-existing conditions.ConclusionAsymptomatic and pre-symptomatic infections were common during the second wave of COVID-19 in Viet Nam. Re-positivity was frequent during hospitalization and led to a long duration of SARS-CoV-2 infection.

COVID-19: The Potential Difference in High Resolution Computed Tomography Findings between Vaccinated and Unvaccinated Cases among The Adult Egyptian Population

Background: As the world experiences successive waves of corona virus disease (COVID-19) pandemic, global efforts to develop and distribute an effective vaccine produced several promising options. The aim of our study was to assess the difference in pulmonary involvement between vaccinated and unvaccinated patients among Egyptians. Patients and methods: Our study involved 234 patients who were tested positive for COVID-19 and had classic symptoms. They were split into 2 groups: group 1 (131 unvaccinated patients), and group 2 (103 fully vaccinated patients). Patients underwent high resolution computed tomography (HRCT) of the chest. All scans were evaluated, and CT severity score (CT-SS) was calculated. Results: For group 1 the patients’ ages ranged from 19 to 84, mean = 44.5 years (+ 16.2 SD), 76 (58%) males and 55 (42%) females, while group 2 age ranged from 18 to 85, mean (+SD)= 42.2 years (+ 16.6), 59 (57.3%) males and 44 (42.7%) females”. The presence of ground glass opacities and white lung sign varied significantly between both groups (P=0.001 and 0.002 respectively). For other recorded signs no significant difference was detected. The mean computed tomography severity score (CT-SS) for group 1 was 11.25 (± 6.6 SD). While for group 2 it was 6.32 (± 4.33 SD). The difference between studied groups was highly significant (P<0.001). Conclusion: Our results showed that COVID vaccine could effectively reduce the extent and severity of lung involvement in vaccinated patients compared with unvaccinated patients. Further wide-ranging clinical studies are needed to support our results. © 2021, Ain Shams University Faculty of Medicine. All rights reserved.

"Salus Populi Suprema Lex": Considerations on the Initial Response of the United Kingdom to the SARS-CoV-2 Pandemic.

In several countries worldwide, the initial response to coronavirus disease 2019 (COVID-19) has been heavily criticized by general public, media, and healthcare professionals, as well as being an acrimonious topic in the political debate. The present article elaborates on some aspects of the United Kingdom (UK) primary reaction to SARS-CoV-2 pandemic; specifically, from February to July 2020. The fact that the UK showed the highest mortality rate in Western Europe following the first wave of COVID-19 certainly has many contributing causes; each deserves an accurate analysis. We focused on three specific points that have been insofar not fully discussed in the UK and not very well known outside the British border: clinical governance, access to hospital care or intensive care unit, and implementation of non-pharmaceutical interventions. The considerations herein presented on these fundamental matters will likely contribute to a wider and positive discussion on public health, in the context of an unprecedented crisis.

Effectiveness of the movement control measures during the third wave of COVID-19 in Malaysia.

OBJECTIVESStarting in March 2020, movement control measures were instituted across several phases in Malaysia to break the chain of transmission of coronavirus disease 2019 (COVID-19). In this study, we developed a susceptible-exposed-infected-recovered (SEIR) model to examine the effects of the various phases of movement control measures on disease transmissibility and the trend of cases during the third wave of the COVID-19 pandemic in Malaysia.METHODSThree SEIR models were developed using the R programming software ODIN interface based on COVID-19 case data from September 1, 2020, to March 29, 2021. The models were validated and subsequently used to provide forecasts of daily cases from October 14, 2020, to March 29, 2021, based on 3 phases of movement control measures.RESULTSWe found that the reproduction rate (R-value) of COVID-19 decreased by 59.1% from an initial high of 2.2 during the nationwide Recovery Movement Control Order (RMCO) to 0.9 during the Movement Control Order (MCO) and Conditional MCO (CMCO) phases. In addition, the observed cumulative and daily highest numbers of cases were much lower than the forecasted cumulative and daily highest numbers of cases (by 64.4-98.9% and 68.8-99.8%, respectively).CONCLUSIONSThe movement control measures progressively reduced the R-value during the COVID-19 pandemic. In addition, more stringent movement control measures such as the MCO and CMCO were effective for further lowering the R-value and case numbers during the third wave of the COVID-19 pandemic in Malaysia due to their higher stringency than the nationwide RMCO.

Effects of the COVID-19 pandemic in a preexisting longitudinal study of patients with recently diagnosed bipolar disorder: Indications for increases in manic symptoms.

BackgroundThe coronavirus disease 2019 (COVID‐19) pandemic interfered in the daily lives of people and is assumed to adversely affect mental health. However, the effects on mood (in)stability of bipolar disorder (BD) patients and the comparison to pre‐COVID‐19 symptom severity levels are unknown.MethodBetween April and September, 2020, symptoms and well‐being were assessed in the Bipolar Netherlands Cohort (BINCO) study of recently diagnosed patients with BD I and II. The questionnaire contained questions regarding manic and depressive symptoms (YMRS and ASRM, QIDS), worry (PSWQ), stress (PSS), loneliness, sleep, fear for COVID‐19, positive coping, and substance use. As manic, depressive and stress symptoms levels were assessed pre‐COVID‐19, their trajectories during the lockdown restrictions were estimated using mixed models.ResultsOf the 70 invited BD patients, 36 (51%) responded at least once (mean age of 36.7 years, 54% female, and 31% BD type 1) to the COVID‐19 assessments. There was a significant increase (X2 = 17.06; p = .004) in (hypo)manic symptoms from baseline during the first COVID‐19 wave, with a decrease thereafter. Fear of COVID‐19 (X2 = 18.01; p = .003) and positive coping (X2 = 12.44; p = .03) were the highest at the start of the pandemic and decreased thereafter. Other scales including depression and stress symptoms did not vary significantly over time.ConclusionWe found a meaningful increase in manic symptomatology from pre‐COVID‐19 into the initial phases of the pandemic in BD patients. These symptoms decreased along with fear of COVID‐19 and positive coping during the following months when lockdown measures were eased.

Bio-Politics and Calculative Technologies in COVID-19 Governance: Reflections From England.

Through the extensive use of public media, the government of England was heavily involved in encouraging and instructing people on how to manage their life during coronavirus disease 2019 (COVID-19). This model of health emergency governance replicates the practice of 'calculative technologies' and 'bio-politics' embedded in population management. Previous research on COVID-19 governance both in the United Kingdom and beyond provides varied revelations on broader 'technologies of government' and bio-politics by numerous governments. However, rarely have any studies explicitly and distinctively highlighted the unique 'calculative technologies' mobilised by governments within their bio-politically designed "technologies of government" to compel the populations to manage their lives under their COVID-19 guidance. The paper therefor examines how the UK government deployed "calculative technologies," as part of its strategies of health governance and governmentality during the first wave of COVID-19 in England. This study uses document analysis as its data collection method. Its review includes documents, press releases, social media disclosures and health guidance issued by the UK government from March to December, 2020. The data are analysed employing the Foucault's governmentality and bio-political scholarship. The paper's findings reveal the UK government's use of integrated calculative technologies of self-governance in the form of risk calculations and metrices/statistics (eg, death tolls, infection rates), performance management (eg, two metre social distancing, and hand washing for twenty seconds) and discipline and control (eg, fourteen days self-isolation), in addition to a more conventional top-down, managerial decision-making process adopted in the past. By these newly initiated "calculative technologies," the government has "bio-politically" governed the behaviours and lifestyles of vulnerable community members, health workers and general public at a distance, inculcating self-management and individualisation of responsibility. The newly adopted calculative technologies used by the UK government created a multi-faceted discourse of obligations, entitlements and scale of engagement, and facilitated directions about what people should do to protect themselves and others from the spread of the virus. Overall, the overtly and idiosyncratically used calculative technologies resemble a unique 'art of government' and produce a set of 'bio-political' interventions enforcing the populations to manage their own wellbeing and governing them at a distance during COVID-19.

Estimation of Mortality Rate of COVID-19 in India using SEIRD Model

In India, the number of infections is rapidly increased with a mounting death toll during the second wave of Coronavirus disease (COVID-19). To measure the severity of the said disease, the mortality rate plays an important role. In this research work, the mortality rate of COVID-19 is estimated by using the Susceptible-Exposed-Infected-Recovered-Dead (SEIRD) epidemiological model. As the disease contains a significant amount of uncertainty, a fundamental SEIRD model with minimal assumptions is employed. Further, a basic method is proposed to obtain time-dependent estimations of the parameters of the SEIRD model by using historical data. From our proposed model and with the predictive analysis, it is expected that the infection may go rise in the month of May-2021 and the mortality rate could go as high as 1.8%. Such high rates of mortality may be used as a measure to understand the severity of the situation.

Demographic profile and outcome of patients admitted to a COVID dedicated hospital in Bangladesh during the second wave.

In December 2019, with pneumonia-like clinical manifestations, a new severe acute respiratory syndrome coronavirus 2 emerged and quickly escalated into a pandemic. Since the first case detected in early March of last year, 8668 have died with an infection mortality rate of 1.52%, as of March 20, 2021. Bangladesh has been struck by the 2nd wave from mid-march 2021. As data on the second wave are sparse, the present study observed the demographic profile, symptoms, and outcomes of Coronavirus Disease 2019 (COVID-19) patients during this wave.The study was conducted at Sheikh Russel National Gastroliver Institute on 486 admitted cases during the 2nd wave of COVID-19 in Bangladesh (March 24–April 24, 2021) using a cross-sectional study design and a convenient sampling technique.Out of 486 cases, 306 (62.9%) were male, and 180 were female, with a mean age of 53.47 ± 13.86. The majority of patients (32.5%) were between the ages of 51 and 60. While fever and cough being the predominant symptoms (>70% cases), the most common co-morbidities were hypertension (41.4) and diabetes mellitus (39.4). Intensive care unit utilization rate was 25%, and a half of the patients had 51% to 70% tomographic lung involvement with an overall mortality rate of 19.3%. Older age, chronic renal disease, percentage of lung involvement, and intensive care unit necessity were important mortality determinants.The present study gives an insight into the demographic profiles and outcomes of admitted patients with COVID-19 during the second wave at a covid dedicated hospital in Bangladesh.

The impact of coronavirus disease 2019 (COVID-19) on older adults with an intellectual disability during the first wave of the pandemic in Ireland

Background: People with intellectual disability have increased risk of exposure to and adverse outcomes from coronavirus disease 2019 (COVID-19).They also face challenges to mental health and well-being from COVID-19-related social restrictions and service closures. Methods: Data from a supplemental COVID-19 survey from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) (n=710) was used to assess outcomes from the first infection wave of COVID-19 among adults with intellectual disability aged 40+ years in Ireland. Data was gathered on testing, for symptoms and outcomes; procedures to manage COVID-19; and both stress/anxiety and positive experiences during the pandemic. Demographic and health-related data from the main IDS-TILDA dataset was included in analyses. Results: High rates were identified of health conditions associated with poorer COVID-19 outcomes, including overweight/obesity (66.6%, n=365), high cholesterol (38.6%, n=274) and cardiovascular disease (33.7%, n=239). Over half (53.5%, n=380) reported emotional, nervous or psychiatric disorders. Almost two-thirds (62.4%, n=443) were tested for COVID-19, with 10% (n=71) reporting symptoms and 2.5% (n=11) testing positive. There were no instances of COVID-19 related mortality. Common symptoms included fatigue, fever, and cough. Some participants (7.8%, n=55) moved from their usual home, most often to isolate (n=31) or relocate to a family home (n=11). Three-quarters (78.7%) of those who were symptomatic or who tested positive had plans to manage self-isolation and two-thirds were able to comply with guidelines. Over half (55%, n=383) reported some COVID-19 related stress/anxiety; and a similar proportion reported positive aspects during this period (58%, n=381). Conclusions: Our data suggests that people with intellectual disability avoided the worst impacts of COVID-19 during the first infection wave in Ireland. Nevertheless, participants’ health profiles suggest that this population remains at high risk for adverse infection outcomes. Repeated measures are needed to track health and well-being outcomes across multiple infection waves.

Comparison of baseline characteristics, treatment and celinical outcomes of critically ill COVID-19 patients admitted in the first and second waves in Australia

Objective: To report longitudinal differences in baseline characteristics, treatment, and outcomes in patients with coronavirus disease 2019 (COVID-19) admitted to intensive care units (ICUs) between the first and second waves of COVID-19 in Australia.Design, setting and participants: SPRINT-SARI Australia is a multicentre, inception cohort study enrolling adult patients with COVID-19 admitted to participating ICUs. The first wave of COVID-19 was from 27 February to 30 June 2020, and the second wave was from 1 July to 22 October 2020.Results: A total of 461 patients were recruited in 53 ICUs across Australia; a higher number were admitted to the ICU during the second wave compared with the first: 255 (55.3%) versus 206 (44.7%). Patients admitted to the ICU in the second wave were younger (58.0 v 64.0 years; P = 0.001) and less commonly male (68.9% v 60.0%; P = 0.045), although Acute Physiology and Chronic Health Evaluation (APACHE) II scores were similar (14 v 14; P = 0.998). High flow oxygen use (75.2% v 43.4%; P < 0.001) and non-invasive ventilation (16.5% v 7.1%; P = 0.002) were more common in the second wave, as was steroid use (95.0% v 30.3%; P < 0.001). ICU length of stay was shorter (6.0 v 8.4 days; P = 0.003). In-hospital mortality was similar (12.2% v 14.6%; P = 0.452), but observed mortality decreased over time and patients were more likely to be discharged alive earlier in their ICU admission (hazard ratio, 1.43; 95% CI, 1.13–1.79; P = 0.002).Conclusion: During the second wave of COVID-19 in Australia, ICU length of stay and observed mortality decreased over time. Multiple factors were associated with this, including changes in clinical management, the adoption of new evidence-based treatments, and changes in patient demographic characteristics but not illness severity.