Epidemiological Characteristics of the COVID-19 Pandemic During the First and Second Waves in Chhattisgarh, Central India: A Comparative Analysis

A comprehensive profile of SARS-CoV-2 variants spreading during the COVID-19 pandemic: a genomic characterization study from Chhattisgarh State, India

SARS-CoV-2 has expressively changed its sequences during the COVID-19 pandemic situation by encompassing persistent evolutionary mutational changes resulting in the emergence of many clades and lineages. Evolution of these SARS-CoV-2 variants have significantly imparted fitness advantage to the virus, enhanced its transmissibility and severity of the disease. These new variants are a potential threat to the vaccine efficacy as well. It is therefore pertinent to monitor the evolution of these variants and their epidemiological and clinical impact, in a geographic setting. This study has thus looked into the geographic distribution and genetic diversity of SARS-CoV-2 variants and the evolutionary circulation of different clades in Chhattisgarh (CG) state from March 2020 to July 2023. A total of 3018 sequences were retrieved from the GISAID database, in which 558 were submitted by us. The demographic data revealed male preponderance of 56.45% versus 43.54% females, with the overall mean age of 36.5 years. SARS-CoV-2 sequences represented many variants viz., Delta (55%), Omicron (22%) and others (15%) with a small proportion of recombinant (5%), Kappa (2%), and Alpha (1%). The viral clades G was found predominant for a year from initial days of pandemic in March, 2020 to January, 2021 which then subsequently evoluted to subclade GK (Delta B.1.617.2) and remained in circulation in CG till November, 2021. From December 2021, the GRA (Omicron B.1.1.529) variant had replaced GK to become the dominant strain and continues to predominate in present time. GRA clade is however continuously encompassing new recombinant strains, having various non-synonymous mutations especially in spike protein. The non-synonymous mutation P314L in ORF1b, S84L in ORF8 and D614G in spike protein were found as the pan mutation carried over from clade G to GRA. The continuous evolution in SARS-CoV2 warrants periodical geographic genomic surveillance monitoring to timely detect any new variants having the potential of causing future outbreak.

Household Transmission of SARS-CoV-2 in the Third Wave of the Pandemic with Special Reference to Clinico-epidemiological Characteristics

Background

Coronavirus disease 2019 (COVID-19) pandemic began in India in 2020. Despite successful vaccination, cases again started increasing from mid-December 2021. Therefore, this study was undertaken to find out the clinico-epidemiological characteristics and effectiveness of vaccination in the household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in and around Pune.

Material and Methods

All samples received from December 15, 2021, till February 15, 2022, were included in the study. Samples received in viral transport medium (VTM) were extracted by the MagMAX RNA Extraction Kit, and reverse transcriptase-polymerase chain reaction (RT-PCR) was performed by the CoviPath Kit as per kit guidelines. Values of nucleocapsid (N) gene and open reading frame (ORF) less than 37 were considered positive. Clinico-epidemiological data were analyzed from the sample referral form (SRF).

Results

A total of 712 of 1032 household contacts of 271 families were positive. When geographical areas were compared, it was found that rural areas were affected more (63.76%) as compared to urban areas (36.24%). Males were more affected than females. The most commonly affected age group was 41-50 years (26.54%). Small families were found to have more household transmission. Mild symptoms were present in 97.89%. Among 271 infected individuals, seven were admitted to hospital, of which one patient died due to pneumonia. Two doses of vaccination were completed in 93.95%, and 3.79% had taken booster dose.

Conclusions

Data from this study showed that a high rate of transmission was observed in household contact despite two doses of vaccination. However, these vaccinated individuals had mild symptoms, maybe due to the effect of vaccination and infecting variant omicron.

The Local Heroes Project: a youth-led pan-India hyperlocal crisis relief model during the COVID-19 pandemic

Introduction

There was shortage of essential diagnostic and therapeutic supplies in public hospitals during the second wave of COVID-19 in India.

Materials and methods

The Local Heroes Project, a hyperlocal project initiated by the World Youth Heart Federation (WYHF). Pilot project was conducted in six cities, and a nationwide project was scaled up to 58 city groups with 438 volunteers. Three-step model of needs assessment, fundraising, and establishment of the supply chain was undertaken. A national team was formed consisting of representatives from multiple international organizations and stakeholders. Local Volunteers were recruited and empowered in each city to conduct donation drives. The Qualitative Comparative Analysis (QCA) model was used to assess the impact of the intervention.

Results

48.2% of the city groups completed needs assessment and 37.9% completed their donations. Factors such as team strength more than 4, local needs assessment, regular reporting during monthly meeting, receptive local administration, donation to more than 2 health centers and donation of supplies worth >= Rs 5,000 in each city (raw coverage 0.44, consistency 1) were more important contributors for success of the outcome. Supplies worth INR 2.45 million were donated.

Conclusion

Hyperlocal projects can effectively address essential supply shortages. A three-step model of needs assessment, fundraising, and supply chain establishment can be an effective approach. Community involvement and donations are crucial for the success and sustainability of such projects.

Prosthodontic Rehabilitation's Role in Alleviating Anxiety and Depression in Mucormycosis-Induced Maxillectomy Patients Post-COVID-19

BACKGROUND The aim of this study was to assess the influence of maxillofacial prosthodontic rehabilitation on anxiety/depression severity in patients with rhino-orbital cerebral mucormycosis (ROCM) after maxillectomy. MATERIAL AND METHODS Sixty post-mucormycotic patients treated with maxillectomy (33 males, 27 females) were divided into 5 groups based on maxillectomy types (unilateral/bilateral, subtotal/total) and treatment given (psychotherapy/obturator/implant/orbital/ocular prosthesis). Anxiety and depression symptoms were assessed using appearance anxiety inventory (AAI) and patient health questionnaire (PHQ9). Data were collected at 4 time intervals [T0 (before prosthesis), T1 (2 weeks after prosthesis), T2 (6 months) and T3 (1 year). Frequency distribution and mean values were determined for individual group/subgroups/total cohort. Differences between groups were determined using one-way ANOVA (single-factor/Friedman's) followed by post hoc correction (Bonferroni) and t test for unequal variance with probability P value being statistically significant at <0.05. RESULTS The mean scores for appearance anxiety were 29.13±4.72 (diagnostic for existing body dysmorphic disorder) at T0, which decreased to 16.88±3.02 at T3 for the total cohort. The differences for the gender-based cohort, its various groups, and respective subgroups were significant (P<0.05) at various time intervals. The mean scores in the total cohort for depression symptom severity were 16.81±4.89 (moderately severe) at T0, which increased to 18.5±4.94 at T1, followed by reduction at T2 (12.0±4.43; moderate) and T3 (7.38±3.37; mild). Gender differences for both variables were found to be statistically significant (P<0.05). CONCLUSIONS Comprehensive rehabilitation that included a diagnosis of psychological symptoms followed by psychotherapeutic/pharmacotherapeutic/prosthodontic intervention reduced the anxiety/depression symptom levels to normal at 1 year.

Vaccine Breakthrough Infections Among Healthcare Workers in a COVID-19-Designated Tertiary Care Government Hospital in Sikkim

Introduction Since the emergence of the coronavirus disease 2019 (COVID-19) virus at the beginning of 2020, the world has gone through various waves of pandemics. The health care workers (HCWs) or the COVID warriors as they were termed were the first line of defense against the virus. They were armed with personal protective equipment and prophylactic doses of the COVID-19 vaccine. Despite these precautions, some of the HCWs still contracted the disease and a few others succumbed to it. The objective of this study was to estimate the prevalence of COVID-19 infections and vaccine breakthrough infections (BTIs) in HCWs after receiving the COVID-19 vaccine during the second wave of the pandemic. Methods This was a cross-sectional, hospital-based study conducted over a period of four months from September 2021 to December 2021 on HCWs aged 18 years and above working at the COVID-19-designated tertiary care government hospital in Sikkim. A structured coded questionnaire with no patient identifiers was used to gather details on demographics, vaccination history, breakthrough infection, and other social details. HCWs who had received at least one dose of the COVID-19 vaccine at the time of initiation of the study and were >18 years of age were included in this study. Results A total of 678 HCWs were screened, out of which 229 (33%) participants tested positive for COVID-19 and the rest of the participants (455; 67%) tested negative. COVID-19 infections and vaccine BTIs (COVID-19 infection >14 days after the second vaccination) were recorded and 137 (20%) respondents had a post-vaccination COVID-19 infection out of which 115 (18.5%) were BTI. The majority of the participants were females and of the age group of 26-35 years. The correlation of COVID-19 infections with the dose gap between vaccination, gender, age, profession, department, area posted during COVID duty, cycles of duty performed, hospitalization due to infection, influenza vaccination, and comorbidity was analyzed. Conclusion COVID-19 vaccines are disease-modifying and they decrease the severity of BTIs in HCWs. Pandemics and outbreaks cannot be predicted; therefore, it becomes very important to have healthy frontline workers who are constantly exposed to infectious agents. Monitoring of health and surveillance of infectious diseases among the HCWs should be encouraged.

An Analysis of COVID-19 Mortality in Chhattisgarh: A Two-Year Study on Demographics, Trends, and Impacts

Background The COVID-19 pandemic, caused by the novel coronavirus, has had a profound impact on global health, significantly affecting demographics worldwide. As India's twelfth most affected state, Chhattisgarh has experienced substantial COVID-19-related fatalities. This study aims to analyze the temporal, geographical, and demographic distribution and trends in COVID-19 mortality reported by the Department of Health and Family Welfare, Chhattisgarh, spanning from the onset of the pandemic until March 2022 (two years). Methods Data about all COVID-19 deaths recorded between March 2020 and March 2022 were collected from the State Surveillance Unit, Department of Health and Family Welfare, Chhattisgarh, and subsequently compiled in a Microsoft Excel sheet (Microsoft, Redmond, Washinton) for analysis. Results A comprehensive dataset of 14,038 deaths was examined during the study period. Of these, 24.5% (3446), 72.2% (10141), and 3.3% (451) occurred in 2020, 2021, and 2022, respectively. The top five districts in Chhattisgarh with the highest COVID-19 mortality rates were identified as follows: 1) Raipur (23.5%), 2) Durg (13.4%), 3) Bilaspur (8.9%), 4) Raigarh (7.05%), and 5) Janjgir Champa (6.25%). The mean age of the deceased individuals was determined to be 55.44 years, with a standard deviation of 15.14 years. Furthermore, the impact of the pandemic was found to affect males compared to females in Chhattisgarh disproportionately. Conclusion Over the two-year study period, three distinct waves of COVID-19 were observed, with the second wave being the most devastating, particularly for the elderly population. Understanding the demographic characteristics and trends in COVID-19 mortality is crucial for implementing targeted public health measures and interventions to mitigate the impact of future infectious disease outbreaks.