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Kulkarni PS, Padmapriyadarsini C, Vekemans J, Bavdekar A, Gupta M, Kulkarni P, Garg B, Gogtay NJ, Tambe M, Lalwani S, Singh K, Munshi R, Meshram S, Selvavinayagam T, Pandey K, Bhimarasetty DM, Ramakrishnan S, Bhamare C, Dharmadhikari A, Budhawant C, Bonhomme CJ, Thakar M, Kurle SN, Kelly EJ, Gautam M, Gupta N, Panda S, Bhargava B, Poonawalla CS, Shaligram U, Kapse D, Gunale B. Seropersistence of SII-ChAdOx1 nCoV-19 (COVID-19 vaccine): 6-month follow-up of a randomized, controlled, observer-blind, phase 2/3 immuno-bridging study in Indian adults. Hum Vaccin Immunother 2024; 20:2304974. [PMID: 38512394 PMCID: PMC10962622 DOI: 10.1080/21645515.2024.2304974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/10/2024] [Indexed: 03/23/2024] Open
Abstract
AZD1222 (ChAdOx1 nCoV-19) is a replication-deficient adenoviral vectored coronavirus disease-19 (COVID-19) vaccine that is manufactured as SII-ChAdOx1 nCoV-19 by the Serum Institute of India Pvt Ltd following technology transfer from Oxford University/AstraZeneca. The non-inferiority of SII-ChAdOx1 nCoV-19 with AZD1222 was previously demonstrated in an observer-blind, phase 2/3 immuno-bridging study (trial registration: CTRI/2020/08/027170). In this analysis of immunogenicity and safety data 6 months post first vaccination (Day 180), 1,601 participants were randomized 3:1 to SII-ChAdOx1 nCoV-19 or AZD1222 (immunogenicity/reactogenicity cohort n = 401) and 3:1 to SII-ChAdOx1 nCoV-19 or placebo (safety cohort n = 1,200). Immunogenicity was measured by anti-severe acute respiratory syndrome coronavirus 2 spike (anti-S) binding immunoglobulin G and neutralizing antibody (nAb) titers. A decline in anti-S titers was observed in both vaccine groups, albeit with a greater decline in SII-ChAdOx1 nCoV-19 vaccinees (geometric mean titer [GMT] ratio [95% confidence interval (CI) of SII-ChAdOx1 nCoV-19 to AZD1222]: 0.60 [0.41-0.87]). Consistent similar decreases in nAb titers were observed between vaccine groups (GMT ratio [95% CI]: 0.88 [0.44-1.73]). No cases of severe COVID-19 were reported following vaccination, while one case was observed in the placebo group. No causally related serious adverse events were reported through 180 days. No thromboembolic or autoimmune adverse events of special interest were reported. Collectively, these data illustrate that SII-ChAdOx1 nCoV-19 maintained a high level of immunogenicity 6 months post-vaccination. SII-ChAdOx1 nCoV-19 was safe and well tolerated.
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Affiliation(s)
| | | | - Johan Vekemans
- Formerly of: Clinical Development, Infection, Late-stage Development, Respiratory and Immunology (R&I), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Madhu Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Praveen Kulkarni
- Department of Community Medicine, JSS Academy of Higher Education and Research, Mysore, India
| | - B.S. Garg
- Department of Community Medicine and Dr Sushila Nayar School of Public Health, Mahatma Gandhi Institute of Medical Sciences, Wardha, India
| | - Nithya J. Gogtay
- Department of Clinical Pharmacology, Seth G S Medical College & KEM Hospital, Mumbai, India
| | - Muralidhar Tambe
- Department of Community Medicine, B J Government Medical College and Sassoon General Hospitals, Pune, India
| | - Sanjay Lalwani
- Department of Pediatrics, Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - Kiranjit Singh
- Jehangir Clinical Development Centre Pvt Ltd, Pune, India
| | - Renuka Munshi
- Department of Clinical Pharmacology, TN Medical College & BYL Nair Hospital, Mumbai, India
| | - Sushant Meshram
- Department of Pulmonary Medicine, Government Medical College, Nagpur, India
| | | | - Krishna Pandey
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - S.R. Ramakrishnan
- Department of Clinical Research, Sri Ramchandra Institute of Higher Education and Research, Chennai, India
| | | | | | | | - Cyrille J. Bonhomme
- Laboratory Services, Vaccines Sciences Lab, Clinical Research, PPD, Part of Thermo Fisher Scientific, Richmond, VA, USA
| | | | | | - Elizabeth J. Kelly
- Formerly of: Translational Medicine, Vaccines and Immune Therapies, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA
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Selvaraju S, Velayutham B, Rao R, Rade K, Thiruvengadam K, Asthana S, Balachandar R, Bangar SD, Bansal AK, Bhat J, Chopra V, Das D, Dutta S, Devi KR, Dwivedi GR, Kalliath A, Laxmaiah A, Madhukar M, Mahapatra A, Mohanty SS, Rangaraju C, Turuk J, Menon PA, Krishnan R, Singh M, Sekar K, Robinson A, Turuk A, Krishnan NN, Srinivasan N, Rexy C, Suresh M, Hanna LE, Choudhury AH, Parmar M, Ramachandran R, Kumar N, Joshi RP, Narasimhaiah S, Chandrasekaran P, Khan AM, Panda S, Bhargava B. Prevalence and factors associated with tuberculosis infection in India. J Infect Public Health 2023; 16:2058-2065. [PMID: 37948837 DOI: 10.1016/j.jiph.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The risk of tuberculosis (TB) disease is higher in individuals with TB infection. In a TB endemic country like India, it is essential to understand the current burden of TB infection at the population level. The objective of the present analysis is to estimate the prevalence of TB infection in India and to explore the factors associated with TB infection. METHODS Individuals aged > 15 years in the recently completed National TB prevalence survey in India who were tested for TB infection by QuantiFERON-TB Gold Plus (QFT-Plus) assay were considered for this sub-analysis. TB infection was defined as positive by QFT-Plus (value >0.35 IU/ml). The estimates for prevalence, prevalence ratio (PR) and adjusted risk ratio (aRR) estimates with 95% confidence intervals (CIs) were calculated. RESULTS Of the 16864 individuals analysed, the prevalence of TB infection was 22.6% (95% CI:19.4 -25.8). Factors more likely to be associated with TB infection include age > 30 years (aRR:1.49;95% CI:1.29-1.73), being male (aRR:1.26; 95%CI: 1.18-1.34), residing in urban location (aRR:1.58; 95%CI: 1.03-2.43) and past history of TB (aRR:1.49; 95%CI: 1.26-1.76). CONCLUSION About one fourth (22.6%) of the individuals were infected with TB in India. Individuals aged > 30 years, males, residing in urban location, and those with past history of TB were more likely to have TB infection. Targeted interventions for prevention of TB and close monitoring are essential to reduce the burden of TB in India.
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Affiliation(s)
- Sriram Selvaraju
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | | | | | | | | | - Smita Asthana
- ICMR - National Institute of Cancer Prevention and Research, Noida, India
| | | | | | - Avi Kumar Bansal
- ICMR - National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India
| | - Jyothi Bhat
- ICMR - National Institute of Research in Tribal Health, Jabalpur, India
| | | | - Dasarathi Das
- ICMR - Regional Medical Research Centre, Bhubaneswar, India
| | - Shantha Dutta
- ICMR - National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | | | | | - Avula Laxmaiah
- ICMR - National Institute of Nutrition, Hyderabad, India
| | - Major Madhukar
- ICMR - Rajendra Memorial Research Institute of Medical Sciences, Patna, India
| | | | - Suman Sundar Mohanty
- ICMR - National Institute for Implementation Research on Non-Communicable Diseases, Jodhpur, India
| | | | | | | | | | - Manjula Singh
- Indian Council of Medical Research, New Delhi, India
| | - Krithikaa Sekar
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Aby Robinson
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Alka Turuk
- Indian Council of Medical Research, New Delhi, India
| | | | | | - Catherine Rexy
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - M Suresh
- ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | | | | | | | | | | | | | | | | | - A M Khan
- ICMR - National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, India; Indian Council of Medical Research, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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3
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Patil SB, Tamirat M, Khazhidinov K, Ardizzoni E, Atger M, Austin A, Baudin E, Bekhit M, Bektasov S, Berikova E, Bonnet M, Caboclo R, Chaudhry M, Chavan V, Cloez S, Coit J, Coutisson S, Dakenova Z, De Jong BC, Delifer C, Demaisons S, Do JM, Dos Santos Tozzi D, Ducher V, Ferlazzo G, Gouillou M, Khan U, Kunda M, Lachenal N, LaHood AN, Lecca L, Mazmanian M, McIlleron H, Moreau M, Moschioni M, Nahid P, Osso E, Oyewusi L, Panda S, Pâquet A, Thuong Huu P, Pichon L, Rich ML, Rupasinghe P, Salahuddin N, Sanchez Garavito E, Seung KJ, Velásquez GE, Vallet M, Varaine F, Yuya-Septoh FJ, Mitnick CD, Guglielmetti L. Evaluating newly approved drugs in combination regimens for multidrug-resistant tuberculosis with fluoroquinolone resistance (endTB-Q): study protocol for a multi-country randomized controlled trial. Trials 2023; 24:773. [PMID: 38037119 PMCID: PMC10688049 DOI: 10.1186/s13063-023-07701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Treatment for fluoroquinolone-resistant multidrug-resistant/rifampicin-resistant tuberculosis (pre-XDR TB) often lasts longer than treatment for less resistant strains, yields worse efficacy results, and causes substantial toxicity. The newer anti-tuberculosis drugs, bedaquiline and delamanid, and repurposed drugs clofazimine and linezolid, show great promise for combination in shorter, less-toxic, and effective regimens. To date, there has been no randomized, internally and concurrently controlled trial of a shorter, all-oral regimen comprising these newer and repurposed drugs sufficiently powered to produce results for pre-XDR TB patients. METHODS endTB-Q is a phase III, multi-country, randomized, controlled, parallel, open-label clinical trial evaluating the efficacy and safety of a treatment strategy for patients with pre-XDR TB. Study participants are randomized 2:1 to experimental or control arms, respectively. The experimental arm contains bedaquiline, linezolid, clofazimine, and delamanid. The control comprises the contemporaneous WHO standard of care for pre-XDR TB. Experimental arm duration is determined by a composite of smear microscopy and chest radiographic imaging at baseline and re-evaluated at 6 months using sputum culture results: participants with less extensive disease receive 6 months and participants with more extensive disease receive 9 months of treatment. Randomization is stratified by country and by participant extent-of-TB-disease phenotype defined according to screening/baseline characteristics. Study participation lasts up to 104 weeks post randomization. The primary objective is to assess whether the efficacy of experimental regimens at 73 weeks is non-inferior to that of the control. A sample size of 324 participants across 2 arms affords at least 80% power to show the non-inferiority, with a one-sided alpha of 0.025 and a non-inferiority margin of 12%, against the control in both modified intention-to-treat and per-protocol populations. DISCUSSION This internally controlled study of shortened treatment for pre-XDR TB will provide urgently needed data and evidence for clinical and policy decision-making around the treatment of pre-XDR TB with a four-drug, all-oral, shortened regimen. TRIAL REGISTRATION ClinicalTrials.Gov NCT03896685. Registered on 1 April 2018; the record was last updated for study protocol version 4.3 on 17 March 2023.
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Affiliation(s)
- S B Patil
- Indian Council of Medical Research (ICMR) - National AIDS Research Institute, Pune, India
| | | | | | - E Ardizzoni
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - M Atger
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - A Austin
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
| | | | - M Bekhit
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - E Berikova
- Partners In Health, Astana, Kazakhstan
- National Scientific Center of Phthisiopulmonology, Almaty, Kazakhstan
| | - M Bonnet
- Université de Montpellier, IRD, INSERM, Montpellier, TransVIHMI, France
| | - R Caboclo
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - M Chaudhry
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - V Chavan
- Médecins Sans Frontières, Mumbai, India
| | - S Cloez
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - J Coit
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - S Coutisson
- Médecins Sans Frontières, Geneva, Switzerland
| | - Z Dakenova
- City Center of Phthisiopulmonology, Astana, Kazakhstan
| | - B C De Jong
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - C Delifer
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - S Demaisons
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - J M Do
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - V Ducher
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - G Ferlazzo
- Médecins Sans Frontières, Geneva, Switzerland
| | | | - U Khan
- Interactive Research and Development (IRD) Global, Singapore, Singapore
| | - M Kunda
- Partners In Health, Maseru, Lesotho
| | - N Lachenal
- Médecins Sans Frontières, Geneva, Switzerland
| | - A N LaHood
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - L Lecca
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Socios En Salud-Sucursal Peru, Lima, Peru
| | - M Mazmanian
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
- Assistance Publique Hôpitaux de Paris (APHP), Unité de Recherche Clinique, Hôpital Pitié-Salpêtrière, Paris, France
- Santé Arménie French-Armenian Research Center, Yerevan, Armenia
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - M Moreau
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - P Nahid
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
| | - E Osso
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | | | - S Panda
- Indian Council of Medical Research Headquarters, New Delhi, India
- Indian Journal of Medical Research, New Delhi, India
| | - A Pâquet
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - L Pichon
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - M L Rich
- Partners In Health, Boston, MA, USA
- Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA
| | - P Rupasinghe
- Institute of Tropical Medicine (ITM), Antwerp, Belgium
| | - N Salahuddin
- Indus Hospital & Health Network, Karachi, Pakistan
| | | | | | - G E Velásquez
- UCSF Center for Tuberculosis, University of California, , San Francisco, San Francisco, CA, USA
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - M Vallet
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | - F Varaine
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France
| | | | - C D Mitnick
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Partners In Health, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | - L Guglielmetti
- Medical Department, Médecins Sans Frontières, 14-34 Avenue Jean Jaurès, 75019, Paris, France.
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie Et Des Maladies Infectieuses, Paris, France.
- Assistance Publique Hôpitaux de Paris (APHP), Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié Salpêtrière, Centre National De Référence Des Mycobactéries Et De La Résistance Des Mycobactéries Aux Antituberculeux, Paris, France.
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Panda S, Nath A, Thakar A, Kumar R, Seenu V, Sikka K, Singh CA, Kumar R. In-vivo lymphoscintigraphy of sinonasal tumors identifies retropharyngeal node and level I as predominant sentinel nodes. Rev Esp Med Nucl Imagen Mol 2023; 42:374-379. [PMID: 37399973 DOI: 10.1016/j.remnie.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To evaluate by in- vivo lymphoscintigraphy and SPECT-CT imaging, the lymphatic drainage patterns of para-nasal sinus(PNS) tumors. To confirm or refute the belief of the retropharyngeal lymph node (RPLN) being the significant draining lymph node for such tumors. METHODS Prospective cohort study conducted on previously untreated PNS tumors with no clinico-radiological evidence of lymph node metastasis. Lymphoscintigraphy undertaken by nasal endoscopic assisted peritumoral injection of 99mTc Sulfur colloid. Injections were classified as anterior or posterior as per a vertical line along the maxillary sinus ostium. RESULTS 17 patients were included. Lymphoscintigraphy successfully identified 17 sentinel nodes in 15 patients and was unsuccessful (lymphoscintigraphy failure) in 2 patients. Predominant sites of sentinel lymphatic drainage were noted to be the RPLN (n = 8; 47%), and Level I (n = 7; 42%). Occasional drainage was identified at the peri-parotid node(n = 1) and at Level II (n = 1). Contralateral drainage was noted in 2 patients (level I-1 and RPLN-1). Anterior injections drained predominantly to Level I (6/8) and RPLN (2/8), while posterior injections drained predominantly to the RPLN ( 6/7). The relative risk of RPLN being identified as the sentinel node was significantly higher for posteriorly placed injections than for anteriorly placed injections (RR- 3.43; 95% CI-1.0-11.8, p = 0.05). CONCLUSION The RPLN is noted as a frequent draining node for sino-nasal tumours and merits routine attention in all sino-nasal tumors. The radio-colloid SPECT-CT technique described here offers an excellent in-vivo technique to further explore and validate the lymphatic drainage pathways of these tumours.
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Affiliation(s)
- S Panda
- Department of Otorhinolaryngology, Head, Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A Nath
- Department of Plastic Surgery, Himalayan Institute of Medical Sciences, Dehradun, India
| | - A Thakar
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - R Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - V Seenu
- Department of Surgical Discipline, All India Institute of Medical Sciences, New Delhi, India
| | - K Sikka
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - C A Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - R Kumar
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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Mukherjee A, Kumar G, Panda S. Response to: Prognostic factors for COVID-19 infected inpatients with chronic diseases. QJM 2023; 116:887-888. [PMID: 37335860 DOI: 10.1093/qjmed/hcad128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Indexed: 06/21/2023] Open
Affiliation(s)
- A Mukherjee
- Indian Council of Medical Research, New Delhi 110029, India
| | - G Kumar
- Indian Council of Medical Research, New Delhi 110029, India
| | - S Panda
- Indian Council of Medical Research, New Delhi 110029, India
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Turuk A, Kumar G, Mukherjee A, Jayashree M, Patel SM, Bhardwaj P, Bingi TC, Baruah TD, Sharma LK, Menon GR, Sahu D, Panda S, Rao VV, Bhargava B. Evaluation of a Hospitalized Pediatric COVID-19 Cohort from Indian National Clinical Registry of COVID-19. Indian J Pediatr 2023; 90:1000-1007. [PMID: 36795272 PMCID: PMC9933031 DOI: 10.1007/s12098-022-04449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/11/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To evaluate the factors associated with mortality of a multicentric cohort of hospitalized COVID-19 patients, 0-18 y old, from 42 centers across India. METHODS The National Clinical Registry for COVID-19 (NCRC) is an on-going prospective data collection platform enrolling COVID-19 patients diagnosed by real-time PCR or rapid antigen test. The data are collected in prestructured e-capture forms. The sociodemographic, clinical, laboratory, and hospital outcome data from 1st September 2020 to 20th February 2022 were analyzed. RESULTS Of the 1244 enrolled hospitalized COVID-19 patients aged 0-18 y, 98 and 124 were infants and neonates, respectively. Only 68.6% children were symptomatic at admission, with fever being the most common symptom. Diarrhea, rash, and neurological symptoms were also noted. At least 1 comorbidity was present in 260 (21%) children. The in-hospital mortality rate was 6.2% (n = 67), the highest in infants (12.5%). Altered sensorium (aOR: 6.8, CI: 1.9, 24.6), WHO ordinal scale ≥ 4 at admission (aOR: 19.6, CI: 8.0, 47.8), and malignancy (aOR: 8.9, 95% CI: 2.4, 32.3) were associated with higher odds of death. Malnutrition did not affect the outcome. Mortality rates were similar across the three waves of the pandemic, though a significant shift towards the under-five group was observed in the third wave. CONCLUSION This multicentric cohort of admitted Indian children showed that the COVID-19 was milder in children than adults, and the pattern was consistent across all waves of the pandemic.
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Affiliation(s)
- Alka Turuk
- Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, New Delhi, India
| | - Gunjan Kumar
- Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, New Delhi, India
| | - Aparna Mukherjee
- Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, New Delhi, India.
| | - Muralidharan Jayashree
- Department of Pediatrics, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sweety M Patel
- Department of Pediatrics, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India
| | - Pankaj Bhardwaj
- Department of Community Medicine, All Indian Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Thrilok Chander Bingi
- Department of Internal Medicine, Gandhi Medical College, Secunderabad, Telangana, India
| | - Tridip Dutta Baruah
- Department of Surgery, All Indian Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Lokesh Kumar Sharma
- Bio-Medical Informatics, Indian Council of Medical Research, New Delhi, India
| | - Geetha R Menon
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Damodar Sahu
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - Vishnu Vardhan Rao
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
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7
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Satija A, Anand T, Mukherjee A, Velamuri PS, Singh KJ, Das M, Josten K, Keche AY, Nagarkar NM, Gupta P, Himanshu D, Mistry SN, Patel JD, Rao P, Rohatgi S, Ghosh S, Hazra A, Kindo AJ, Annamalai R, Rudramurthy SM, Singh MP, Shameem M, Fatima N, Khambholja JR, Parikh S, Madkaikar M, Pradhan VD, Bhargava A, Mehata R, Arora RD, Tigga R, Banerjee G, Sonkar V, Malhotra HS, Kumar N, Patil R, Raut CG, Bhattacharyya K, Arthur P, Somu L, Srikanth P, Shah PB, Panda NK, Sharma D, Hasan W, Ahmed A, Bathla M, Solanki S, Doshi H, Kanani Y, Patel N, Shah Z, Tembhurne AK, Rajguru C, Sankhe LR, Chavan SS, Yadav RM, Panda S. Satellite Epidemic of Covid-19 Associated Mucormycosis in India: A Multi-Site Observational Study. Mycopathologia 2023; 188:745-753. [PMID: 37490256 DOI: 10.1007/s11046-023-00770-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/17/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Sudden upsurge in cases of COVID-19 Associated Mucormycosis (CAM) following the second wave of the COVID-19 pandemic was recorded in India. This study describes the clinical characteristics, management and outcomes of CAM cases, and factors associated with mortality. METHODS Microbiologically confirmed CAM cases were enrolled from April 2021 to September 2021 from ten diverse geographical locations in India. Data were collected using a structured questionnaire and entered into a web portal designed specifically for this investigation. Bivariate analyses and logistic regression were conducted using R version 4.0.2. RESULTS A total of 336 CAM patients were enrolled; the majority were male (n = 232, 69.1%), literate (n = 261, 77.7%), and employed (n = 224, 66.7%). The commonest presenting symptoms in our cohort of patients were oro-facial and ophthalmological in nature. The median (Interquartile Range; IQR) interval between COVID diagnosis and admission due to mucormycosis was 31 (18, 47) days, whereas the median duration of symptoms of CAM before hospitalization was 10 (5, 20) days. All CAM cases received antifungal treatment, and debridement (either surgical or endoscopic or both) was carried out in the majority of them (326, 97.02%). Twenty-three (6.9%) of the enrolled CAM cases expired. The odds of death in CAM patients increased with an increase in HbA1c level (aOR: 1.34, 95%CI: 1.05, 1.72) following adjustment for age, gender, education and employment status. CONCLUSION A longer vigil of around 4-6 weeks post-COVID-19 diagnosis is suggested for earlier diagnosis of CAM. Better glycemic control may avert mortality in admitted CAM cases.
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Affiliation(s)
| | - Tanu Anand
- Indian Council of Medical Research, New Delhi, India
| | | | | | | | | | - Kripa Josten
- Indian Council of Medical Research, New Delhi, India
| | | | | | | | - D Himanshu
- King George's Medical University, Lucknow, India
| | - Sejal N Mistry
- Pandit Deendayal Upadhyay Medical College, Rajkot, India
| | - Jimy D Patel
- Pandit Deendayal Upadhyay Medical College, Rajkot, India
| | - Prajwal Rao
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India
| | - Shalesh Rohatgi
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India
| | - Soumitra Ghosh
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | - Avijit Hazra
- Institute of Post Graduate Medical Education and Research, Kolkata, India
| | | | - Radha Annamalai
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | | | - Mini P Singh
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Mohammad Shameem
- Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, India
| | - Nazish Fatima
- Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, India
| | | | | | | | | | | | - Rupa Mehata
- All India Institute of Medical Sciences, Raipur, India
| | | | - Richa Tigga
- All India Institute of Medical Sciences, Raipur, India
| | | | - Vijay Sonkar
- King George's Medical University, Lucknow, India
| | | | - Neeraj Kumar
- King George's Medical University, Lucknow, India
| | - Rajashri Patil
- Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India
| | | | | | - Preetam Arthur
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - L Somu
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Padma Srikanth
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Pankaj B Shah
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Naresh K Panda
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipti Sharma
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Wasil Hasan
- Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, India
| | - Aftab Ahmed
- Jawaharlal Nehru Medical College Aligarh Muslim University, Aligarh, India
| | | | | | | | - Yash Kanani
- Smt. NHL Municipal Medical College, Ahmedabad, India
| | | | | | | | - Chhaya Rajguru
- Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India
| | - Lalitkumar R Sankhe
- Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India
| | - Shrinivas S Chavan
- Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, India
| | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India.
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8
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Kumar G, Bhalla A, Mukherjee A, Turuk A, Talukdar A, Mukherjee S, Bhardwaj P, Menon GR, Sahu D, Misra P, Sharma LK, Mohindra R, S S, Suri V, Das H, Sarkar D, Ghosh S, Ghosh P, Dutta M, Chakraborty S, Kumar D, Gupta MK, Goel AD, Baruah TD, Kannauje PK, Shukla AK, Khambholja JR, Patel A, Shah N, Bhuniya S, Panigrahi MK, Mohapatra PR, Pathak A, Sharma A, John M, Kaur K, Nongpiur V, Pala S, Shivnitwar SK, Krishna BR, Dulhani N, Gupta B, Gupta J, Bhandari S, Agrawal A, Aggarwal HK, Jain D, Shah AD, Naik P, Panchal M, Anderpa M, Kikon N, Humtsoe CN, Sharma N, Vohra R, Patnaik L, Sahoo JP, Joshi R, Kokane A, Ray Y, Rajvansh K, Purohit HM, Shah NM, Madharia A, Dube S, Shrivastava N, Kataria S, Shameem M, Fatima N, Ghosh S, Hazra A, D H, Salgar VB, Algur S, M L KY, M PK, Panda S, Vishnu Vardhana Rao M, Bhargava B. Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19. BMJ Glob Health 2023; 8:e012245. [PMID: 37816536 PMCID: PMC10565174 DOI: 10.1136/bmjgh-2023-012245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/20/2023] [Indexed: 10/12/2023] Open
Abstract
INTRODUCTION The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities. METHODS Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020-October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting. RESULTS Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30-60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6-7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03). CONCLUSION Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.
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Affiliation(s)
- Gunjan Kumar
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Ashish Bhalla
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aparna Mukherjee
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Alka Turuk
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | | | | | | | - Geetha R Menon
- National Institute of Medical Statistics, New Delhi, India
| | - Damodar Sahu
- National Institute of Medical Statistics, New Delhi, India
| | | | | | - Ritin Mohindra
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Samita S
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Suri
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Himadri Das
- Medical College and Hospital Kolkata, Kolkata, India
| | | | | | - Priyanka Ghosh
- College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Moumita Dutta
- College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | | | - Deepak Kumar
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | | | | | | | | | | | | | - Sourin Bhuniya
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | | | | | | | | - Mary John
- Christian Medical College and Hospital, Ludhiana, India
| | | | | | | | | | | | | | | | | | | | | | - H K Aggarwal
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Deepak Jain
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Arti D Shah
- SBKS Medical Institute and Research Centre, Vadodara, India
| | - Parshwa Naik
- SBKS Medical Institute and Research Centre, Vadodara, India
| | | | | | - Nyanthung Kikon
- Department of Health and Family Welfare, Government of Nagaland, Kohima, India
| | | | - Nikita Sharma
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Rajaat Vohra
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - Rajnish Joshi
- All India Institute of Medical Sciences, Bhopal, India
| | - Arun Kokane
- All India Institute of Medical Sciences, Bhopal, India
| | - Yogiraj Ray
- Institute of Postgraduate Medical Education and Research, Kolkata, India
| | | | | | - Nehal M Shah
- Smt NHL Municipal Medical College, Ahmedabad, India
| | | | | | | | | | | | | | - Saumitra Ghosh
- Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Himanshu D
- King George Medical University, Lucknow, India
| | | | - Santosh Algur
- Gulbarga Institute of Medical Sciences, Gulbarga, India
| | - Kala Yadhav M L
- Shri Atal Bihari Vajpayee Medical College and Research Institution, Bengaluru, India
| | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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9
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Kajal K, Singla K, Puri GD, Bhalla A, Mukherjee A, Kumar G, Turuk A, Premkumar M, Mahajan V, Naik NB, Bingi TC, Bhardwaj P, John M, Menon GR, Sahu D, Panda S, Rao VV. Analysis of Predictors and Outcomes of COVID-19 Patients Requiring ICU Admission from COVID-19 Registry, India. Indian J Crit Care Med 2023; 27:552-562. [PMID: 37636849 PMCID: PMC10452770 DOI: 10.5005/jp-journals-10071-24496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/03/2023] [Indexed: 08/29/2023] Open
Abstract
Background Patients admitted to intensive care units (ICUs) with severe coronavirus disease (COVID-19) are associated with high mortality. The present retrospective, multicenter study describes the predictors and outcomes of COVID-19 patients requiring ICU admission from COVID-19 Registry of Indian Council of Medical Research (ICMR), India. Materials and methods Prospectively collected data from participating institutions were entered into the electronic National Clinical Registry of COVID-19. We enrolled patients aged >18 years with COVID-19 pneumonia requiring ICU admission between March 2020 and August 2021. Exclusion criteria were negative in RT-PCR report, death within 24 hours of ICU admission, or incomplete data. Their demographic and laboratory variables, ICU severity indices, treatment strategies, and outcomes were analyzed. Results A total of 5,865 patients were enrolled. Overall mortality was 43.2%. Non-survivors were older (58.2 ± 15.4 vs 53.6 ± 14.7 years; p = 0.001), had multiple comorbidities (33.2% vs 29.5%, p = 0.001), had higher median D-dimer (1.56 vs 1.37, p = 0.015), higher CT severity index (16.8 ± 5.2 vs 13.5 ± 5.47, p = 0.001) and longer median hospital stay (10 vs 8 days, p = 0.001) and ICU stay (5 vs 4 days, p = 0.001), compared with survivors.On multivariate analysis, high CRP (HR 1.008, 95% CI: 1.006-1.010, p = 0.001) and high D-dimer (HR 1.089, 95% CI: 1.065-1.113, p < 0.001) were associated with invasive mechanical ventilation while older age (HR 1.19, CI: 1.001-1.038, p = 0.039) and high D-dimer (HR-1.121, CI: 1.072-1.172, p = 0.001) were independently associated with mortality and while the use of prophylactic low molecular weight heparin (LMWH) (HR 0.647, CI: 0.527-0.794, p = 0.001) lowered mortality. Conclusion Among 5,865 COVID-19 patients admitted to ICU, mortality was 43.5%. High CRP and D-dimers were independently associated with the need for invasive mechanical ventilation while older age and high D-dimer were associated with higher mortality. The use of prophylactic LMWH independently reduced mortality. How to cite this article Kajal K, Singla K, Puri GD, Bhalla A, Mukherjee A, Kumar G, et al. Analysis of Predictors and Outcomes of COVID-19 Patients Requiring ICU Admission from COVID-19 Registry, India. Indian J Crit Care Med 2023;27(8):552-562.
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Affiliation(s)
- Kamal Kajal
- Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Karan Singla
- Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Goverdhan Dutt Puri
- Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aparna Mukherjee
- Department of Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, Delhi, India
| | - Gunjan Kumar
- Department of Clinical Studies, Trials and Projection Unit, Indian Council of Medical Research, Delhi, India
| | - Alka Turuk
- National Clinical Registry for COVID-19, Indian Council of Medical Research, Delhi, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Varun Mahajan
- Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen B Naik
- Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Pankaj Bhardwaj
- Community Medicine and Family Medicine, All Indian Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mary John
- Department of Medicine, Christian Medical College & Hospital, Ludhiana, Punjab, India
| | - Geetha R Menon
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Damodar Sahu
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Samiran Panda
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Vishnu Vardhan Rao
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
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Grover A, Venkatesh U, Kishore J, Chakma T, Thomas B, Menon G, Periyasamy M, Kulkarni R, Prusty RK, Venkateswaran C, Mishra B, Balu V, Viray M, Mathew G, Ketharam A, Balachandar R, Singh P, Jakhar K, Devi R, Saha K, Barde P, Moral R, Singh R, John D, Yadav J, Kohli S, Aggarwal S, Rao V, Panda S. Factors associated with stigma and manifestations experienced by Indian health care workers involved in COVID-19 management in India: A qualitative study. Glob Ment Health (Camb) 2023; 10:e46. [PMID: 37854432 PMCID: PMC10579676 DOI: 10.1017/gmh.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/02/2023] [Accepted: 07/20/2023] [Indexed: 10/20/2023] Open
Abstract
Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers.
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Affiliation(s)
- Ashoo Grover
- Division of Non-Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
| | - U Venkatesh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Jugal Kishore
- Department of Community Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Tapas Chakma
- Division of Non-Communicable Diseases, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Beena Thomas
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Geetha Menon
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Murugesan Periyasamy
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ragini Kulkarni
- Department of Operational Research, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Ranjan K Prusty
- Department of Biostatistics, ICMR-National Institute for Research in Reproductive Health, Mumbai, India
| | - Chitra Venkateswaran
- Department of Psychiatry, Believers Church Medical College, Tiruvalla, Kerala, India
| | - Bijaya Mishra
- Department of Clinical Research, ICMR-Regional Medical Research Centre, Bhubaneswar, India
| | - Vinoth Balu
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Maribon Viray
- Department of Psychology, Department of Counselling Psychology Martin, Luther Christian University, Shillong, Meghalaya, India
| | - Geetu Mathew
- ICMR- Regional Occupational Health Centre -South, National Institute of Occupational Health, Bangalore, India
| | - Asha Ketharam
- Division of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Rakesh Balachandar
- Division of Clinical Epidemiology, ICMR-National Institute of Occupational Health, Ahmedabad, India
| | - Prashant Singh
- Division of Preventive Oncology and Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India
| | - Kiran Jakhar
- Department of Psychaitry, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Rekha Devi
- ICMR-Regional Medical Research Centre, N. E. Region, Dibrugarh, India
| | - Kalyan Saha
- Social Sciences and Ethnomedicine, ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Barde
- Division of Virology and Zoonotic Diseases, ICMR-National Institute of Research In Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Rony Moral
- Department of Social and Behavioural Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Ravinder Singh
- Division of Non-Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
| | - Denny John
- Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Simran Kohli
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases, ICMR, New Delhi, India
| | - Vishnu Rao
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Samiran Panda
- Division of Epidemiology and Communicable Diseases, ICMR, New Delhi, India
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Rao A, Mamulwar M, Panda S, Pachuau HZ, Vanlalvenzuali H, Lalruatsanga, Roy T, Lalnuntlangi N. Finding a way forward with the community: qualitative inquiry in the generalized HIV epidemic in Mizoram, India. Front Public Health 2023; 11:1217628. [PMID: 37554736 PMCID: PMC10405924 DOI: 10.3389/fpubh.2023.1217628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Introduction Mizoram, the northeastern State of India bordering Myanmar, is presently witnessing a burgeoning generalized HIV epidemic along with the highest State-level HIV prevalence among female sex workers (FSWs, 24.7%) and people who inject drugs (PWID,19.8%) in the country. The present study was conducted against such background to understand the current situation of HIV prevention and care services in Mizoram, and capture community voices as well as concerns so that the way forward could be informed appropriately. Methods The study period was October through December 2020 (in the midst of COVID-restrictions) in the districts of Aizawl, Mamit, Kolasib, Lunglei, and Champhai where HIV prevalence crossed 1% among ante-natal clinic (ANC) attending women. Contrastingly, the national average HIV prevalence among ANC attendees is 0.24%, which formed the basis for selecting the aforementioned five high burden districts for this current inquiry. In-depth-interviews were conducted with community members and youth leaders, vulnerable and general population groups as well as HIV-program officials. Interviews were recorded, transcribed, translated and later coded for analysis following thematic approach. Results The emerging issues were grouped in three thematic layers; (1) HIV vulnerability, (2) challenges pertaining to prevention and care services, and (3) program elements and future roadmap. Discrimination at the community level, unfriendly behavior of some of the HIV-service staff, occasional interruption in supplies of anti-retroviral treatment and sterile syringes and needles were voiced as deterrents to accessing HIV prevention and care services by the participants. Community engagement, based on restorative approach rather than retribution and ensuring enhanced performance of the district AIDS program control units emerged as necessary programmatic elements. Conclusion This inquiry highlighted macro-social and structural forces contributing to stigma and discrimination toward people at risk of HIV. It is urgent that HIV-services are re-aligned through de-centralized district level innovations and creation of safer spaces at the physical, societal and familial level. These, even during the time of stress such as a pandemic, would help health services to remain resilient. HIV outreach, sensitization of the community leaders and health-care professionals through strategic communication and ownership of the communities in these endeavors appeared paramount.
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Affiliation(s)
- Amrita Rao
- Indian Council of Medical Research-National AIDS Research Institute (ICMR-NARI), Pune, Maharashtra, India
| | - Megha Mamulwar
- Indian Council of Medical Research-National AIDS Research Institute (ICMR-NARI), Pune, Maharashtra, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | | | - H. Vanlalvenzuali
- ICMR-NARI Sustained & Timely AIDS Response: A Community Engagement in Mizoram (STAR) Project, Pune, Maharashtra, India
| | - Lalruatsanga
- ICMR-NARI Sustained & Timely AIDS Response: A Community Engagement in Mizoram (STAR) Project, Pune, Maharashtra, India
| | - Tarun Roy
- ICMR-NARI Sustained & Timely AIDS Response: A Community Engagement in Mizoram (STAR) Project, Pune, Maharashtra, India
| | - Nunui Lalnuntlangi
- ICMR-NARI Sustained & Timely AIDS Response: A Community Engagement in Mizoram (STAR) Project, Pune, Maharashtra, India
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Stephen A, Nair S, Joshi A, Aggarwal S, Adhikari T, Diwan V, Devi KR, Mishra BK, Yadav GK, Sahu D, Gulati BK, Sharma S, Yadav J, Ovung S, Duggal C, Sharma M, Bangar SD, Rebecca PB, Rani S, Selvaraj P, Xavier GG, Peter V, Watson B, Kannan T, Asmathulla KSMD, Bhattacharya D, Turuk J, Palo SK, Kanungo S, Behera AK, Pandey AK, Zaman K, Misra B, Kumar N, Behera S, Singh R, Narain K, Kant R, Sahay S, Tiwari R, Thomas BE, Karikalan N, Panda S, Vardhana Rao MV, Ujagare D, Chinchore S. Gender differences in COVID-19 knowledge, risk perception, and public stigma among the general community: Findings from a nationwide cross-sectional study in India. Int J Disaster Risk Reduct 2023; 93:103776. [PMID: 37303828 PMCID: PMC10229202 DOI: 10.1016/j.ijdrr.2023.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 04/10/2023] [Accepted: 05/30/2023] [Indexed: 06/13/2023]
Abstract
Introduction Individual and community characteristics predictive of knowledge, perception, and attitude on COVID-19, specifically on gender, have not been adequately explored. Objective To examine the gender differences in COVID-19 knowledge, self-risk perception and public stigma among the general community and to understand other socio-demographic factors which were predictive of them. Method A nationally representative cross-sectional multi-centric survey was conducted among adult individuals(≥18 yrs) from the community member (N = 1978) from six states and one union territory of India between August 2020 to February 2021. The participants were selected using systematic random sampling. The data were collected telephonically using pilot-tested structured questionnaires and were analyzed using STATA. Gender-segregated multivariable analysis was conducted to identify statistically significant predictors (p < 0.05) of COVID-19-related knowledge, risk perception, and public stigma in the community. Results Study identified significant differences between males and females in their self-risk perception (22.0% & 18.2% respectively) and stigmatizing attitude (55.3% & 47.1% respectively). Highly educated males and females had higher odds of having COVID-19 knowledge (aOR: 16.83: p < 0.05) than illiterates. Highly educated women had higher odds of having self-risk perception (aOR: 2.6; p < 0.05) but lower public stigma [aOR: 0.57; p < 0.05]. Male rural residents had lower odds of having self-risk perception and knowledge [aOR: 0.55; p < 0.05 & aOR: 0.72; p < 0.05] and female rural residents had higher odds of having public stigma [aOR: 1.36; p < 0.05]. Conclusion Our study findings suggest the importance of considering thegender differentials and their background, education status and residential status in designing effective interventions to improve knowledge and reduce risk perception and stigma in the community about COVID-19.
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Affiliation(s)
- A Stephen
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Saritha Nair
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Aparna Joshi
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Sumit Aggarwal
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Vishal Diwan
- Division of Environmental Monitoring & Exposure Assessment (Water & Soil), ICMR- National Institute for Research in Environmental Health, Bhopal, India
| | - Kangjam Rekha Devi
- Divison of Enteric Disease, ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Bijaya Kumar Mishra
- Department of Medical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Bal Kishan Gulati
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Saurabh Sharma
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Senthanro Ovung
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Moina Sharma
- Department of Environmental Health & Epidemiology, ICMR- National Institute for Research in Environmental Health, Bhopal, India
| | - Sampada Dipak Bangar
- Divisions of Epidemiology and Statistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Pricilla B Rebecca
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - S Rani
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Pradeep Selvaraj
- Office of District Non-Communicable Disease, Directorate of Public Health and Preventive Medicine, Chennai, India
| | | | - Vanessa Peter
- Informational & Resource Centre for the Deprived Urban Communities, Chennai, India
| | - Basilea Watson
- Electronic Data Processing Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - T Kannan
- Electronic Data Processing Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
- Epidemiology and Statistics Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - K S M D Asmathulla
- Integrated People Development Project Trust, Krishnagiri, Tamil Nadu, India
| | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Microbiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
- Department of Epidemiology, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ajit Kumar Behera
- Department of Clinical, ICMR-Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Kamran Zaman
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - BrijRanjan Misra
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | | | - Rajeev Singh
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
| | - Kanwar Narain
- ICMR-Regional Medical Research Centre, NE Region, Dibrugarh, Assam, India
| | - Rajni Kant
- ICMR-Regional Medical Research Centre, Gorakhpur, Uttar Pradesh, India
- Research Management, Policy, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Seema Sahay
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | | | - Beena Elizabeth Thomas
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - N Karikalan
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | - Samiran Panda
- Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - M Vishnu Vardhana Rao
- ICMR-National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, India
| | - Dhammsagar Ujagare
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Sneha Chinchore
- Social &Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
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Aggarwal S, Gupta P, Mahajan N, Balaji S, Singh KJ, Bhargava B, Panda S. Implementation of drone based delivery of medical supplies in North-East India: experiences, challenges and adopted strategies. Front Public Health 2023; 11:1128886. [PMID: 37333530 PMCID: PMC10275566 DOI: 10.3389/fpubh.2023.1128886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
Timely delivery of medical supplies is essential in the healthcare sector, which is hampered by factors such as poor transportation network, traffic and adverse environmental conditions. Alternatively, drone operations can leapfrog the last mile logistic solutions in hard-to-reach terrains. The present paper elucidates the implementation process of drone-based delivery of medical supplies, operational challenges and innovations adopted by scientists in Manipur and Nagaland. Three districts, Bishnupur, Imphal West and Churachandpur from Manipur and two districts, Mokokchung and Tuensang from Nagaland, were selected for the study. Regulatory and ethical approvals and coordination with state health and administrative authorities were accorded. Implementation and operational challenges faced by the research team were recorded elaborately in the field diaries and assessed qualitatively. The experiences encountered by the team for case-to-case based permission and coordination with the central and state aviation authorities, district administration and health authorities were observed. The drone-related technical and logistic challenges were identified as the deployment of suitable drones, payload capacity, time management for operations, and transportation of drones. The officials adopted mitigation strategies to overcome field-based challenges. Drone-based deliveries of medical supplies are proving to be time efficient, however, overcoming operational challenges could provide an effective long-term deployment strategy.
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Affiliation(s)
- Sumit Aggarwal
- Indian Council of Medical Research (ICMR), New Delhi, India
| | - Prakamya Gupta
- Indian Council of Medical Research (ICMR), New Delhi, India
| | - Nupur Mahajan
- Indian Council of Medical Research (ICMR), New Delhi, India
| | | | | | - Balram Bhargava
- Indian Council of Medical Research (ICMR), New Delhi, India
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research (ICMR), New Delhi, India
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Jayaprakasam M, Chatterjee N, Chanda MM, Shahabuddin SM, Singhai M, Tiwari S, Panda S. Human anthrax in India in recent times: A systematic review & risk mapping. One Health 2023; 16:100564. [PMID: 37363236 PMCID: PMC10288098 DOI: 10.1016/j.onehlt.2023.100564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 06/28/2023] Open
Abstract
The disease anthrax occurs generally in herbivores and the causative organism (Bacillus anthracis) infects humans who come in contact with infected animals or their products. The persistence of anthrax spores for decades and its lethality contribute to its biowarfare potential. We conducted this systematic review along with risk mapping to investigate the spatio-temporal distribution, clinico-epidemiological, socio-behavioural and programmatic issues pertaining to anthrax in India over the last two decades. Peer reviewed quantitative and qualitative studies and grey literature comprising weekly reports of the 'Integrated Disease Surveillance Program' (IDSP), were accessed for extracting data. IDSP data were used for geo-referencing of the villages of anthrax cases; Pseudo-absence was generated to fit a Bayesian Additive Regression Trees (BART) model to develop anthrax risk map. The case fatality rate of cutaneous anthrax ranged from 2% to 38%, while the gastrointestinal and inhalational types were 100% fatal. Our synthesis revealed that human anthrax outbreaks in India were clustered around the eastern coastal regions. The states of Odisha, West Bengal, Andhra Pradesh and Jharkhand reported maximum number of outbreaks. Odisha reported a maximum number of 439 human anthrax cases since 2009, of which Koraput district contributed to 200 cases (46%). While handling or consumption of infected animal product were proximal drivers of these events, poverty, lack of awareness, traditional beliefs and local practices served as facilitatory factors. Other structural determinants were wild life-livestock interface, historical forest loss, soil pH, soil-water balance, organic carbon content, temperature, rainfall and humidity. The programmatic issues identified through this review were lack of active surveillance, non-availability of diagnostic facility at the periphery, delayed reporting, absence of routine livestock vaccination and lack of adequate veterinary services. Interventions based on One-health approach in the country merit immediate policy and program attention; high risk zones for anthrax identified during present investigation, should be prioritized.
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Affiliation(s)
| | - Nabendu Chatterjee
- Division of Basic Medical Sciences, Indian Council of Medical Research, New Delhi, India
| | - Mohammed Mudassar Chanda
- ICAR - National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI), Bangalore, India
| | | | - Monil Singhai
- Center for Arboviral and Zoonotic Diseases (CAZD), National Center for Disease Control, New Delhi, India
| | - Simmi Tiwari
- Division of Zoonotic Diseases Program, National Centre for Disease Control, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Kamal R, Singh M, Roy S, Adhikari T, Gupta AK, Singh H, Rao VV, Panda S, Khan AM, Bhargava B. A comparison of the quality of images of chest X-ray between handheld portable digital X-ray & routinely used digital X-ray machine. Indian J Med Res 2023; 157:374889. [PMID: 37102518 DOI: 10.4103/ijmr.ijmr_845_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Background & objectives Chest X-ray (CXR) is an important screening tool for pulmonary tuberculosis (TB). Accessibility to CXR facilities in difficult-to-reach and underserved populations is a challenge. This can potentially be overcome by deploying digital X-ray machines that are portable. However, these portable X-ray machines need to be validated before their deployment in the field. Here, we compare the image quality of CXR taken by a newly developed handheld X-ray machine with routinely used reference digital X-ray machine through the conduct of a feasibility study. Methods A total of 100 participants with suspected pulmonary TB were recruited from the outpatient departments of a medical college and a community health centre in Agra. Each participant underwent CXR twice, once with each machine. Both sets of de-identified images were independently read by two radiologists, who were blinded to the type of X-ray machine used. The primary outcome was agreement between image qualities produced by these two machines. Results The intra-observer (radiologist) agreements regarding the status of the 15 CXR parameters ranged between 74 per cent and 100 per cent, with an unweighted mean of 87.2 per cent (95% confidence interval: 71.5-100). The median Cohen's kappa values for intra-observer agreement were 0.62 and 0.67 for radiologists 1 and 2, respectively. In addition, on comparison of the overall median score of quality of the image, the handheld machine images had a higher score for image quality. Interpretation & conclusions The current study shows that a handheld X-ray machine, which is easy to use and can potentially be carried to any area, produces X-ray images with quality that is comparable to digital X-ray machines routinely used in health facilities.
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Affiliation(s)
- Raj Kamal
- Clinical Division, ICMR-National Jalma Institute for Leprosy & Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | | | - Sudipto Roy
- Clinical Studies and Trials Unit, New Delhi, India
| | - Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | | | - Hari Singh
- S. N. Medical College, Agra, Uttar Pradesh, India
| | | | - Samiran Panda
- Dr. A. S. Paintal Distinguished Scientist Chair, Indian Council of Medical Research, New Delhi, India
| | - A M Khan
- ICMR-National Jalma Institute for Leprosy & Other Mycobacterial Diseases, Agra, Uttar Pradesh, India
| | - Balram Bhargava
- Cardio-Thoracic Centre, All India Institute of Medical Sciences, New Delhi, India
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Shete A, Deshpande S, Sawant J, Warthe N, Thakar M, Madkaikar M, Pradhan V, Rao P, Rohatgi S, Mukherjee A, Anand T, Satija A, Sharma Velamuri P, Das M, Deasi N, Kumar Tembhurne A, Yadav R, Pawaskar S, Rajguru C, Sankhe LR, Chavan SS, Panda S. Higher proinflammatory responses possibly contributing to suppressed cytotoxicity in patients with COVID-19 associated mucormycosis. Immunobiology 2023; 228:152384. [PMID: 37071959 PMCID: PMC10089671 DOI: 10.1016/j.imbio.2023.152384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/27/2023] [Accepted: 04/09/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION COVID-19 Associated Mucormycosis (CAM), an opportunistic fungal infection, surged during the second wave of SARS Cov-2 pandemic. Since immune responses play an important role in controlling this infection in immunocompetent hosts, it is required to understand immune perturbations associated with this condition for devising immunotherapeutic strategies for its control. We conducted a study to determine different immune parameters altered in CAM cases as compared to COVID-19 patients without CAM. METHODOLOGY Cytokine levels in serum samples of CAM cases (n = 29) and COVID-19 patients without CAM (n = 20) were determined using luminex assay. Flow cytometric assays were carried out in 20 CAM cases and 10 controls for determination of frequency of NK cells, DCs, phagocytes, T cells and their functionalities. The cytokine levels were analyzed for their association with each other as well as with T cell functionality. The immune parameters were also analyzed with respect to the known risk factors such as diabetes mellitus and steroid treatment. RESULTS Significant reduction in frequencies of total and CD56 + CD16 + NK cells (cytotoxic subset) was noted in CAM cases. Degranulation responses indicative of cytotoxicity of T cell were significantly hampered in CAM cases as compared to the controls. Conversely, phagocytic functions showed no difference in CAM cases versus their controls except for migratory potential which was found to be enhanced in CAM cases. Levels of proinflammatory cytokines such as IFN-γ, IL-2, TNF-α, IL-17, IL-1β, IL-18 and MCP-1 were significantly elevated in cases as compared to the control with IFN-γ and IL-18 levels correlating negatively with CD4 T cell cytotoxicity. Steroid administration was associated with higher frequency of CD56 + CD16- NK cells (cytokine producing subset) and higher MCP-1 levels. Whereas diabetic participants had higher phagocytic and chemotactic potential and had higher levels of IL-6, IL-17 and MCP-1. CONCLUSION CAM cases differed from the controls in terms of higher titers of proinflammatory cytokines, reduced frequency of total and cytotoxic CD56 + CD16 + NK cell. They also had reduced T cell cytotoxicity correlating inversely with IFN-γ and IL-18 levels, possibly indicating induction of negative feedback mechanisms while diabetes mellitus or steroid administration did not affect the responses negatively.
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Affiliation(s)
- Ashwini Shete
- ICMR-National AIDS Research Institute (ICMR-NARI), Pune, India.
| | | | - Jyoti Sawant
- ICMR-National AIDS Research Institute (ICMR-NARI), Pune, India
| | - Nidhi Warthe
- ICMR-National AIDS Research Institute (ICMR-NARI), Pune, India
| | - Madhuri Thakar
- ICMR-National AIDS Research Institute (ICMR-NARI), Pune, India
| | - Manisha Madkaikar
- ICMR - National Institute of Immunohematology (ICMR-NIIH), Mumbai, India
| | - Vandana Pradhan
- ICMR - National Institute of Immunohematology (ICMR-NIIH), Mumbai, India
| | - Prajwal Rao
- Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Shalesh Rohatgi
- Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | | | - Tanu Anand
- Indian Council of Medical Research, New Delhi, India
| | | | | | | | - Nidhi Deasi
- ICMR - National Institute of Immunohematology (ICMR-NIIH), Mumbai, India
| | | | - Reetika Yadav
- ICMR - National Institute of Immunohematology (ICMR-NIIH), Mumbai, India
| | - Swapnal Pawaskar
- ICMR - National Institute of Immunohematology (ICMR-NIIH), Mumbai, India
| | - Chhaya Rajguru
- Grant Government Medical College and J J group of Hospitals, Mumbai, India
| | | | - Shrinivas S Chavan
- Grant Government Medical College and J J group of Hospitals, Mumbai, India
| | - Samiran Panda
- ICMR-National AIDS Research Institute (ICMR-NARI), Pune, India; Indian Council of Medical Research, New Delhi, India.
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Panda S. Tuberculosis: National survey in India & elimination challenges reflected through global learning. Indian J Med Res 2023; 157:111-113. [PMID: 37006027 DOI: 10.4103/ijmr.ijmr_541_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Affiliation(s)
- Samiran Panda
- Editor-In-Chief, Indian J Med Res; ICMR-Dr. A. S. Paintal Distinguished Scientist Chair; Indian Council of Medical Research, New Delhi 110 029, India
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Panda S, Panda S, Mohanty N, Giacomello M, Colletti L, Corradini C, Greco Lucchina A, Goker F, Mortellaro C, Del Fabbro M, Panda S. Clinical and histopathological profile of oral cancer: a quadrennial analysis of Regional Cancer Centre of Odisha, India. Eur Rev Med Pharmacol Sci 2023; 27:71-76. [PMID: 37129337 DOI: 10.26355/eurrev_202304_31323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To contribute toward the identification of population-based clinical and histopathological profile of oral squamous cell carcinoma (OSCC), this study was undertaken at the Regional Cancer Centre of Odisha (AHRCC), India. PATIENTS AND METHODS This retrospective study included all patients diagnosed with OSCC registered at AHRCC, Odisha from 1st January 2015 to 31st December 2018. Demographic, clinical, and pathological data of each patient were retrieved from patient records. Patients with incomplete records were excluded. No postoperative treatment details were collected. RESULTS The study included 851 cases of OSCC with the mean age of the population found to be 53.8±14.2 years. Male to female ratio was found to be 2.18:1. Gingivobuccal complex was the most common site of OSCC. While 679 patients were reported to undergo incision biopsy only 172 patients underwent excision biopsy in four years. Well differentiation (n=782) is the most common histological grading. The median clinical size of the tumour was 4 cm. Upon analyzing histological parameters in excision specimens lymphovascular and perineural invasion were seen in 38 and 26 cases, respectively. Cervical lymph node metastasis was seen in 42 cases out of 172 excision specimens (24%). 63.23% of cases presented with a depth of invasion between 5 to 10 mm. CONCLUSIONS This is the largest comprehensive data from the regional cancer center of Odisha population which highlights the demographic, clinical, and histopathological data reported to date.
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Affiliation(s)
- S Panda
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences, Siksha'O'Anusandhan Deemed to be University, Bhubaneswar, Odisha, India.
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Khijmatgar S, Panda S, Biagi R, Rovati M, Colletti L, Goker F, Greco Lucchina A, Mortellaro C, Del Fabbro M. Optical coherence tomography application for assessing variation in bone mineral content: a preclinical study. Eur Rev Med Pharmacol Sci 2023; 27:61-70. [PMID: 37129336 DOI: 10.26355/eurrev_202304_31322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Optical Coherence Tomography (OCT) is a non-invasive imaging technique that produces cross-sectional images through biological tissues, allowing three-dimensional reconstruction and analysis. Aim was to evaluate if OCT may discriminate among tissues with different bone density and composition, by measuring the depth of light penetration in porcine and rat bone samples. MATERIALS AND METHODS Two carpal bone samples (2 cm length) were harvested from the porcine forelimb and fixed overnight in 3.7% buffered formal saline. Following fixation, one sample was decalcified in a 1:1 mixture of 8% hydrochloric acid and 8% formic acid solution for three days, with solution changes each day. Samples were imaged using an OCT microscope. Furthermore, the calvaria, ulnar, alveolar and basal bone of the mandible of 6 male and 6 female rats were cleared of overlying soft tissues and scanned under OCT. The light penetration depth in each sample was measured using the software Image J, and Scattering Attenuation Microscopy. RESULTS In the mineralized bone the average depth (µm) and standard deviation (SD) of light penetration were 790.1±18.05 and 410.4±21.7 for periosteal and endosteal surface, respectively, and 507.3±21.03 for cross-section surfaces, while it was 858.4±32.03 for periosteal surface, 1150±26.9 for endosteal, and 627.3±31.8 for cross-section bone surfaces in demineralized porcine bone. There was a significant difference (p<0.001) in depth of light penetration between normal and de-mineralized bone for all regions evaluated. No systematic significant difference in light penetration depth between-gender was found at any site evaluated, while there were variations between sites (p<0.001). The OCT detected differences in bone mineral and porosity among gender (p<0.0001) CONCLUSIONS: This study suggests that OCT may represent a valuable technique to estimate local variations in bone mineral content.
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Affiliation(s)
- S Khijmatgar
- Queen Mary University of London, London, United Kingdom.
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Papageorgiou M, Biver E, Mareschal J, Phillips N, Hemmer A, Biolley E, Schwab N, Manoogian E, Gonzalez Rodriguez E, Aeberli D, Hans D, Pot C, Naef F, Rodondi N, Panda S, Ferrari S, Collet TH. The Effects Of Time-Restricted Eating (Tre) And Weight Loss On Bone Metabolism And Health: An Exploratory Analysis In A 6-Month Randomised Controlled Trial. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023]
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D’Souza S, Mane A, Patil L, Shaikh A, Thakar M, Saxena V, Fotooh Abadi L, Godbole S, Kulkarni S, Gangakhedkar R, Shastry P, Panda S. HIV-1 exploits Hes-1 expression during pre-existing HPV-16 infection for cancer progression. Virusdisease 2023; 34:29-38. [PMID: 37009256 PMCID: PMC10050651 DOI: 10.1007/s13337-023-00809-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 01/02/2023] [Indexed: 02/10/2023] Open
Abstract
High Risk Human Papilloma Viruses (HR-HPV) persistently infect women with Human Immunodeficiency Virus-1 (HIV-1). HPV-16 escapes immune surveillance in HIV-1 positive women receiving combined antiretroviral therapy (cART). HIV-1 Tat and HPV E6/E7 proteins exploit Notch signaling. Notch-1, a developmentally conserved protein, influences cell fate from birth to death. Notch-1 and its downstream targets, Hes-1 and Hey-1 contribute to invasive and aggressive cancers. Cervical cancer cells utilize Notch-1 and hyper-express CXCR4, a co-receptor of HIV-1. Accumulating evidence shows that HIV-1 affects cell cycle progression in pre-existing HPV infection. Additionally, Tat binds Notch-1 receptor for activation and influences cell proliferation. Oncogenic viruses may interfere or converge together to favor tumor growth. The molecular dialogue during HIV-1/HPV-16+ co-infections in the context of Notch-1 signaling has not been explored thus far. This in vitro study was designed with cell lines (HPV-ve C33A and HPV-16+ CaSki) which were transfected with plasmids (pLEGFPN1 encoding HIV-1 Tat and pNL4-3 encoding HIV-1 [full HIV-1 genome]). HIV-1 Tat and HIV-1 inhibited Notch-1expression, with differential effects on EGFR. Notch-1 inhibition nullified Cyclin D expression with p21 induction and increased G2-M cell population in CaSki cells. On the contrary, HIV-1 infection shuts down p21 expression through interaction of Notch-1 downstream genes Hes-1-EGFR and Cyclin D for G2-M arrest, DDR response and cancer progression. This work lays foundations for future research and interventions, and therefore is necessary. Our results describe for the first time how HIV-1 Tat cancers have an aggressive nature due to the interplay between Notch-1 and EGFR signaling. Notch-1 inhibitor, DAPT used in organ cancer treatment may help rescue HIV-1 induced cancers. Graphical abstract The illustration shows how HIV interacts with HPV-16 to induce Notch 1 suppression for cancer progression (Created with BioRender.com). Supplementary Information The online version contains supplementary material available at 10.1007/s13337-023-00809-y.
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Affiliation(s)
- Serena D’Souza
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Arati Mane
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Linata Patil
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Aazam Shaikh
- National Centre for Cell Science (NCCS), Pune, India
| | - Madhuri Thakar
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Vandana Saxena
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Leila Fotooh Abadi
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Sheela Godbole
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Smita Kulkarni
- Indian Council of Medical Research (ICMR)-National AIDS Research Institute (NARI), Pune, India
| | - Raman Gangakhedkar
- Indian Council of Medical Research (ICMR) Headquarters, New Delhi, India
| | - Padma Shastry
- National Centre for Cell Science (NCCS), Pune, India
| | - Samiran Panda
- Indian Council of Medical Research (ICMR) Headquarters, New Delhi, India
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Kulkarni PS, Kadam A, Godbole S, Bhatt V, Raut A, Kohli S, Tripathi S, Kulkarni P, Ludam R, Prabhu M, Bavdekar A, Gogtay NJ, Meshram S, Kadhiravan T, Kar S, Narayana DA, Samuel C, Kulkarni G, Gaidhane A, Sathyapalan D, Raut S, Hadda V, Bhalla HL, Bhamare C, Dharmadhikari A, Plested JS, Cloney-Clarke S, Zhu M, Pryor M, Hamilton S, Thakar M, Shete A, Gautam M, Gupta N, Panda S, Shaligram U, Poonawalla CS, Bhargava B, Gunale B, Kapse D, Kakrani AL, Tripathy SP, Tilak AV, Dhamne AA, Mirza SB, Athavale PV, Bhowmik M, Ratnakar PJ, Gupta S, Deotale V, Jain J, Kalantri A, Jain V, Goyal N, Arya A, Rongsen-Chandola T, Dasgupta S, Periera P, A V, Kawade A, Gondhali A, Kudyar P, Singh A, Yadav R, Alexander A, Gunasekaran V, Dineshbabu S, Samantaray P, Ravish H, Kamra D, Gaidhane S, Zahiruddin QS, Moni M, Kumar A, Dravid A, Mohan A, Suri T, Patel TK, Kishore S, Choche R, Ghatage D, Salvi S. Safety and immunogenicity of SII-NVX-CoV2373 (COVID-19 vaccine) in adults in a phase 2/3, observer-blind, randomised, controlled study. Lancet Reg Health Southeast Asia 2023; 10:100139. [PMID: 36647543 PMCID: PMC9833646 DOI: 10.1016/j.lansea.2022.100139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023]
Abstract
Background NVX-CoV2373, a Covid-19 vaccine was developed in the USA with ∼90% efficacy. The same vaccine is manufactured in India after technology transfer (called as SII-NVX-CoV2373), was evaluated in this phase 2/3 immuno-bridging study. Methods This was an observer-blind, randomised, phase 2/3 study in 1600 adults. In phase 2, 200 participants were randomized 3:1 to SII-NVX-CoV2373 or placebo. In phase 3, 1400 participants were randomized 3:1 to SII-NVX-CoV2373 or NVX-CoV2373 (940 safety cohort and 460 immunogenicity cohort). Two doses of study products (SII-NVX-CoV2373, NVX-CoV2373 or placebo) were given 3 weeks apart. Primary objectives were to demonstrate non-inferiority of SII-NVX-CoV2373 to NVX-CoV2373 in terms of geometric mean ELISA units (GMEU) ratio of anti-S IgG antibodies 14 days after the second dose (day 36) and to determine the incidence of causally related serious adverse events (SAEs) through 180 days after the first dose. Anti-S IgG response was assessed using an Enzyme-Linked Immunosorbent Assay (ELISA) and neutralizing antibodies (nAb) were assessed by a microneutralization assay using wild type SARS CoV-2 in participants from the immunogenicity cohort at baseline, day 22, day 36 and day 180. Cell mediated immune (CMI) response was assessed in a subset of 28 participants from immunogenicity cohort by ELISpot assay at baseline, day 36 and day 180. The total follow-up was for 6 months. Trial registration: CTRI/2021/02/031554. Findings Total 1596 participants (200 in Phase 2 and 1396 in Phase 3) received the first dose. SII-NVX-CoV2373 was found non-inferior to NVX-CoV2373 (anti-S IgG antibodies GMEU ratio 0.91; 95% CI: 0.79, 1.06). At day 36, there was more than 58-fold rise in anti-S IgG and nAb titers compared to baseline in both the groups. On day 180 visit, these antibody titers declined to levels slightly lower than those after the first dose (13-22 fold-rise above baseline). Incidence of unsolicited and solicited AEs was similar between the SII-NVX-CoV2373 and NVX-CoV2373 groups. No adverse event of special interest (AESI) was reported. No causally related SAE was reported. Interpretation SII-NVX-CoV2373 induced a non-inferior immune response compared to NVX-CoV2373 and has acceptable safety profile. Funding SIIPL, Indian Council of Medical Research, Novavax.
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Affiliation(s)
- Prasad S. Kulkarni
- Serum Institute of India Pvt Ltd, Pune, India,Corresponding author: Serum Institute of India Pvt Ltd, Poonawalla Biotechnology Park SEZ, Manjari (Bk), Pune, 412307, India
| | - Abhijit Kadam
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Sheela Godbole
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Varsha Bhatt
- Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, India
| | - Abhishek Raut
- Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha, India
| | - Sunil Kohli
- Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | | | | | - Rakhi Ludam
- Institution of Medical Science and SUM Hospital, Bhubaneswar, India
| | - Madhav Prabhu
- KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belgavi, India
| | | | | | | | - Tamilarasu Kadhiravan
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sonali Kar
- Kalinga Institute of Medical Sciences, Bhubaneswar, India
| | | | | | | | - Abhay Gaidhane
- Acharya Vinoba Bhave Rural Hospital and Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha, India
| | | | | | - Vijay Hadda
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Mingzhu Zhu
- Clinical Immunology Laboratory, Novavax, Gaithersburg, MD, USA
| | - Melinda Pryor
- 360biolabs, 85 Commercial Road, Melbourne, Victoria, Australia
| | | | - Madhuri Thakar
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | - Ashwini Shete
- Indian Council of Medical Research-National AIDS Research Institute, Pune, India
| | | | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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23
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Mukherjee A, Kumar G, Turuk A, Bhalla A, Bingi TC, Bhardwaj P, Baruah TD, Mukherjee S, Talukdar A, Ray Y, John M, Khambholja JR, Patel AH, Bhuniya S, Joshi R, Menon GR, Sahu D, Rao VV, Bhargava B, Panda S. Vaccination saves lives: a real-time study of patients with chronic diseases and severe COVID-19 infection. QJM 2023; 116:47-56. [PMID: 36053197 PMCID: PMC9494346 DOI: 10.1093/qjmed/hcac202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES This study aims to describe the demographic and clinical profile and ascertain the determinants of outcome among hospitalized coronavirus disease 2019 (COVID-19) adult patients enrolled in the National Clinical Registry for COVID-19 (NCRC). METHODS NCRC is an on-going data collection platform operational in 42 hospitals across India. Data of hospitalized COVID-19 patients enrolled in NCRC between 1st September 2020 to 26th October 2021 were examined. RESULTS Analysis of 29 509 hospitalized, adult COVID-19 patients [mean (SD) age: 51.1 (16.2) year; male: 18 752 (63.6%)] showed that 15 678 (53.1%) had at least one comorbidity. Among 25 715 (87.1%) symptomatic patients, fever was the commonest symptom (72.3%) followed by shortness of breath (48.9%) and dry cough (45.5%). In-hospital mortality was 14.5% (n = 3957). Adjusted odds of dying were significantly higher in age group ≥60 years, males, with diabetes, chronic kidney diseases, chronic liver disease, malignancy and tuberculosis, presenting with dyspnoea and neurological symptoms. WHO ordinal scale 4 or above at admission carried the highest odds of dying [5.6 (95% CI: 4.6-7.0)]. Patients receiving one [OR: 0.5 (95% CI: 0.4-0.7)] or two doses of anti-SARS CoV-2 vaccine [OR: 0.4 (95% CI: 0.3-0.7)] were protected from in-hospital mortality. CONCLUSIONS WHO ordinal scale at admission is the most important independent predictor for in-hospital death in COVID-19 patients. Anti-SARS-CoV2 vaccination provides significant protection against mortality.
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Affiliation(s)
| | | | - Alka Turuk
- Indian Council of Medical Research, New Delhi, India
| | - Ashish Bhalla
- Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | | | - Pankaj Bhardwaj
- All Indian Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | | | - Subhasis Mukherjee
- College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
| | | | - Yogiraj Ray
- Infectious Disease And Beliaghata Hospital, Kolkata, West Bengal, India
| | - Mary John
- Christian Medical College, Ludhiana, Punjab, India
| | | | | | - Sourin Bhuniya
- All India Institute Of Medical Sciences, Bhubaneswar, India
| | - Rajnish Joshi
- All India Institute Of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Geetha R Menon
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Damodar Sahu
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | - Vishnu Vardhan Rao
- National Institute of Medical Statistics, Indian Council of Medical Research, Delhi, India
| | | | | | - NCRC Study team
MishraPuspendraMCANational Institute of Medical Statistics, Indian Council of Medical Research, Delhi, IndiaPanchalYashminPGDISADNational Institute of Medical Statistics, Indian Council of Medical Research, Delhi, IndiaSharmaLokesh KumarPhDIndian Council of Medical Research, New Delhi, IndiaAgarwalAnupMBBSMedstar Health, Baltimore, Maryland, United States of AmericaPuriG DMDPostgraduate Institute of Medical Education & Research, Chandigarh, IndiaSuriVikasMDPostgraduate Institute of Medical Education & Research, Chandigarh, IndiaSinglaKaranMDPostgraduate Institute of Medical Education & Research, Chandigarh, IndiaMesipoguRajaraoMDGandhi Medical College, Telangana, IndiaAedulaVinaya SekharMDGandhi Medical College, Telangana, IndiaMohiuddinMohammed AyazMDGandhi Medical College, Telangana, IndiaKumarDeepakMDAll Indian Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaSaurabhSumanMDAll Indian Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaMisraSanjeevMChAll Indian Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaKannaujePankaj KumarMDAll Indian Institute of Medical Sciences, Raipur Chhattisgarh, IndiaKumarAjitMDAll Indian Institute of Medical Sciences, Raipur Chhattisgarh, IndiaShuklaArvindPhDAll Indian Institute of Medical Sciences, Raipur Chhattisgarh, IndiaPalAmitavaMDCollege of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, IndiaChakrabortyShreetamaMScCollege of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, IndiaDuttaMoumitaMScCollege of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, IndiaMondalTanushreeMDMedical College, Kolkata, West Bengal, IndiaChakravortySarmisthaMScMedical College, Kolkata, West Bengal, IndiaBhattacharjeeBoudhyanMDMedical College, Kolkata, West Bengal, IndiaPaulShekhar RanjanDTCDInfectious Disease And Beliaghata Hospital, Kolkata, West Bengal, IndiaMajumderDebojyotiMDInfectious Disease And Beliaghata Hospital, Kolkata, West Bengal, IndiaChatterjeeSubhrangaMBBSInfectious Disease And Beliaghata Hospital, Kolkata, West Bengal, IndiaAbrahamAbinMDChristian Medical College, Ludhiana, Punjab, IndiaVargheseDivyaMDChristian Medical College, Ludhiana, Punjab, IndiaThomasMariaMDChristian Medical College, Ludhiana, Punjab, IndiaShahNiteshMDCIMS Hospital, Ahmedabad, IndiaPatelMineshMDCIMS Hospital, Ahmedabad, IndiaMadanSurabhiMDCIMS Hospital, Ahmedabad, IndiaDesaiAnitaPhDNational Institute Of Mental Health And Neurosciences, Bangalore, Karnataka, IndiaM LKala YadhavMDBowring & Lady Curzon Medical College & Research Institute, Bangalore, Karnataka, IndiaRMadhumathiMDBowring & Lady Curzon Medical College & Research Institute, Bangalore, Karnataka, IndiaG SChetnaMDBowring & Lady Curzon Medical College & Research Institute, Bangalore, Karnataka, IndiaOjhaU KMDShaheed Nirmal Mahato Medical College, Dhanbad, Jharkahnd, IndiaJhaRavi RanjanShaheed Nirmal Mahato Medical College, Dhanbad, Jharkahnd, IndiaKumarAvinashMDShaheed Nirmal Mahato Medical College, Dhanbad, Jharkahnd, IndiaPathakAshishPhDRD Gardi Medical College, Ujjain, Madhya Pradesh, IndiaSharmaAshishMDRD Gardi Medical College, Ujjain, Madhya Pradesh, IndiaPurohitManjuMDRD Gardi Medical College, Ujjain, Madhya Pradesh, IndiaSarangiLisaMDHi Tech Medical College and Hospital, Bhubaneswar, IndiaRathMaheshMDHi Tech Medical College and Hospital, Bhubaneswar, IndiaShahArti DDNBDhiraj Hospital & Sumandeep Vidyapeeth, Vadodara, Ahmedabad, IndiaKumarLavleshMDDhiraj Hospital & Sumandeep Vidyapeeth, Vadodara, Ahmedabad, IndiaPatelPrinceeMBBSDhiraj Hospital & Sumandeep Vidyapeeth, Vadodara, Ahmedabad, IndiaDulhaniNaveenMDLate BRK Memorial Medical College, Jagdalpur, Chhattisgarh, IndiaDubeSimmiMDGandhi Medical College, Bhopal, Madhya Pradesh, IndiaShrivastavaJyotsnaMDGandhi Medical College, Bhopal, Madhya Pradesh, IndiaMittalArvindMDGandhi Medical College, Bhopal, Madhya Pradesh, IndiaPatnaikLipilekhaMDInstitute of Medical Sciences & SUM Hospital, Siksha ‘O’ Anusandhan deemed to be University, Bhubaneswar, IndiaSahooJagdish PrasadDMInstitute of Medical Sciences & SUM Hospital, Siksha ‘O’ Anusandhan deemed to be University, Bhubaneswar, IndiaSharmaSumitaInstitute of Medical Sciences & SUM Hospital, Siksha ‘O’ Anusandhan deemed to be University, Bhubaneswar, IndiaKatyalV KMD, FACCPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaKatyalAshimaMDPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaYadavNidhiMDPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaUpadhyayRashmiMDGovernment Institute of Medical Sciences, Noida, Uttar Pradesh, IndiaSrivastavaSaurabhMDGovernment Institute of Medical Sciences, Noida, Uttar Pradesh, IndiaSrivastavaAnuragMDGovernment Institute of Medical Sciences, Noida, Uttar Pradesh, IndiaSutharNilay NMDSmt. NHL, Municipal Medical College, Ahmedabad, Gujarat, IndiaShahNehal MMDSmt. NHL, Municipal Medical College, Ahmedabad, Gujarat, IndiaRajvanshKrutiMDSmt. NHL, Municipal Medical College, Ahmedabad, Gujarat, IndiaPurohitHemangMScSmt. NHL, Municipal Medical College, Ahmedabad, Gujarat, IndiaMohapatraPrasanta RaghabMDAll India Institute Of Medical Sciences, Bhubaneswar, IndiaPanigrahiManoj KumarMDAll India Institute Of Medical Sciences, Bhubaneswar, IndiaSaigalSaurabhMD, EDICAll India Institute Of Medical Sciences, Bhopal, Madhya Pradesh, IndiaKhuranaAlkeshMDAll India Institute Of Medical Sciences, Bhopal, Madhya Pradesh, IndiaPanchalManishaMDGMERS Medical College Himmatnagar, Gujarat, IndiaAnderpaMayankMDGMERS Medical College Himmatnagar, Gujarat, IndiaPatelDhruvMBBSGMERS Medical College Himmatnagar, Gujarat, IndiaSalgarVeereshMDGulbarga Institute of Medical Sciences, Kalburagi, Karnataka, IndiaAlgurSantoshMBBSGulbarga Institute of Medical Sciences, Kalburagi, Karnataka, IndiaChoudhuryRatnamalaMDSt. Johns Medical College, Bengaluru, Karnataka, IndiaRaoMangalaMDSt. Johns Medical College, Bengaluru, Karnataka, IndiaDNithyaMScSt. Johns Medical College, Bengaluru, Karnataka, IndiaGuptaBal KishanMDS.P.Medical College, Bikaner, Rajasthan, IndiaKumarBhuvaneshMDS.P.Medical College, Bikaner, Rajasthan, IndiaGuptaJigyasaMBBSS.P.Medical College, Bikaner, Rajasthan, IndiaBhandariSudhirMDSMS Medical College, Jaipur, Rajasthan, IndiaAgrawalAbhishekMDSMS Medical College, Jaipur, Rajasthan, IndiaShameemMohammadMD, FRCPJN Medical College Aligarh Muslim University, Aligarh, Uttar Pradesh, IndiaFatimaNazishMDJN Medical College Aligarh Muslim University, Aligarh, Uttar Pradesh, IndiaPalaStarMDNorth Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, IndiaNongpiurVijayDMNorth Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, IndiaChatterjiSoumyadipDMTata Medical Centre, Kolkata, West Bengal, IndiaMukherjeeSudiptaFNBTata Medical Centre, Kolkata, West Bengal, IndiaShivnitwarSachin KMDDr D Y Patil Medical college Hospital and Research centre, Pune, Maharashtra, IndiaTripathySrikanthMDDr D Y Patil Medical college Hospital and Research centre, Pune, Maharashtra, IndiaLokhandePrajaktaMPHDr D Y Patil Medical college Hospital and Research centre, Pune, Maharashtra, IndiaDanduHimanshuMDKing George Medical University, Lucknow, Uttar Pradesh, IndiaGuptaAmitMDKing George Medical University, Lucknow, Uttar Pradesh, IndiaKumarVivekMDKing George Medical University, Lucknow, Uttar Pradesh, IndiaSharmaNikitaMDMahatma Gandhi Medical College, Jaipur, Rajasthan, IndiaVohraRajatMDMahatma Gandhi Medical College, Jaipur, Rajasthan, IndiaPaliwalArchanaMDMahatma Gandhi Medical College, Jaipur, Rajasthan, IndiaKumarM PavanMDKakatiya Medical College, MGM Hospital Warangal, Telangana, IndiaRaoA BikshapathiMDKakatiya Medical College, MGM Hospital Warangal, Telangana, IndiaKikonNyanthungPGDPHMDepartment of Health & Family Welfare, Government of Nagaland, Nagaland, IndiaKikonRhondemoMScIHCommunity Health Initiative, Nagaland, IndiaManoharKMDNizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, IndiaRajuY SathyanarayanaMDNizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, IndiaMadhariaArunMSESI Hospital and Gayatri Hospital, Raipur, Chhattisgarh, IndiaChakravartyJayaMDInstitute of Medical sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, IndiaChaubeyManaswiMDInstitute of Medical sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, IndiaBandaruRajiv KumarMDESIC medical College, Sanathnagar, Hyderabad. IndiaMirzaMehdi AliDMESIC medical College, Sanathnagar, Hyderabad. IndiaKatariaSushilaMDMedanta-The Medicity, Gurugram, Haryana, IndiaSharmaPoojaMedanta-The Medicity, Gurugram, Haryana, IndiaGhoshSoumitraMDInstitute of Postgraduate Medical Education & Research, Kolkata, West BengalHazraAvijitMDInstitute of Postgraduate Medical Education & Research, Kolkata, West Bengal
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24
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Shidhaye P, Ghate M, Gurav S, Gupte MD, Panda S. Metabolic syndrome in people living with antiretroviral therapy: A cross-sectional investigation from Pune, India. Indian J Public Health 2023; 67:84-91. [PMID: 37039211 DOI: 10.4103/ijph.ijph_1060_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
Background Improved longevity of people living with HIV on highly active antiretroviral therapy and accelerated aging processes are considered contributory to Metabolic Syndrome. Objectives The current study investigated metabolic syndrome (MetS) in people living with HIV (PLH) who were receiving antiretroviral therapy (ART) under the ongoing National AIDS Control Program. Methods Clinic attendees (n = 3088) who were on ART for more than 6 months constituted the sampling frame, from which 378 study participants were randomly drawn and included in the analysis following the eligibility check. One hundred and fifty-nine clinic attendees, initiated on ART in ≤6 months, provided an opportunity to estimate the prevalence of MetS in them. Sixty-two PLH from this smaller group were enrolled. Results MetS was found among 19% (73/378; 95% confidence interval [CI] 15.5%-23.7%) PLH who were on ART >6 months compared with 24% (15/62; 95% CI 14.2%-36.7%) in those who were on ART for ≤6 months based on harmonization criteria for the Asian population; the confidence intervals overlapped and apparently observed difference was not statistically significant. Adjusted for age, body mass index (BMI), protease inhibitor (PI)-based ART regimen, duration of ART, insulin resistance (IR), reported family history of hypertension and residential setting, factors independently associated with MetS were PI containing ART regimen, IR, duration of ART intake and BMI. In the adjusted model, the odds of MetS were three times higher among PLH on PI containing ART regimen (95% CI of adjusted odds ratio; aOR 1.27-8.51) and those having IR (95% CI of aOR 1.48-5.07). The odds of MetS among PLH with BMI ≥23 kg/m2 was 4 (95% CI of aOR 2.08-6.81) times higher than those with lower BMI. Conclusions MetS in PLH requires the attention of health-care workers in India. Appropriate screening would help initiate early management.
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Affiliation(s)
- Pallavi Shidhaye
- Scientist C, Division of Clinical Sciences, CMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Manisha Ghate
- Scientist G, Division of Clinical Sciences, CMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Shraddha Gurav
- Technical Officer A, Division of Epidemiology and Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Mohan D Gupte
- ICMR-Chair in Epidemiology, Indian Council of Medical Research, New Delhi, India
| | - Samiran Panda
- ICMR-Dr. AS Paintal Distinguished Scientist Chair, Indian Council of Medical Research, New Delhi, India
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25
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Yadav PD, Kumar G, Mukherjee A, Nyayanit DA, Shete AM, Sahay RR, Kumar A, Majumdar T, Patil S, Pandit P, Joshi Y, Dudhmal M, Panda S, Sharma LK, Yadav Ml K, Shastri J, Gangwar M, Munivenkattapa A, Potdar V, Nagamani K, Goyal K, Gadepalli R, Thomas M, Shukla S, Nagraj P, Gupta V, Dalela G, Umar N, Patel SM. Delta variant SARS-CoV-2 infections in pediatric cases during the second wave in India. J Microbiol Immunol Infect 2022; 55:1060-1068. [PMID: 35843834 PMCID: PMC9250235 DOI: 10.1016/j.jmii.2022.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/26/2022] [Accepted: 06/16/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND During October 2020, Delta variant was detected for the first time in India and rampantly spread across the globe. It also led to second wave of pandemic in India which affected millions of people. However, there is limited information pertaining to the SARS-CoV-2 strain infecting the children in India. METHODS Here, we assessed the SARS-CoV-2 lineages circulating in the pediatric population of India during the second wave of the pandemic. Clinical and demographic details linked with the nasopharyngeal/oropharyngeal swabs (NPS/OPS) collected from SARS-CoV-2 cases (n = 583) aged 0-18 year and tested positive by real-time RT-PCR were retrieved from March to June 2021. RESULTS Symptoms were reported among 37.2% of patients and 14.8% reported to be hospitalized. The E gene CT value had significant statistical difference at the point of sample collection when compared to that observed in the sequencing laboratory. Out of these 512 sequences 372 were VOCs, 51 were VOIs. Most common lineages observed were Delta, followed by Kappa, Alpha and B.1.36, seen in 65.82%, 9.96%, 6.83% and 4.68%, respectively in the study population. CONCLUSION Overall, it was observed that Delta strain was the leading cause of SARS-CoV-2 infection in Indian children during the second wave of the pandemic. We emphasize on the need of continuous genomic surveillance in SARS-CoV-2 infection even amongst children.
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Affiliation(s)
- Pragya D. Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India,Corresponding author
| | - Gunjan Kumar
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Aparna Mukherjee
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Dimpal A. Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Anita M. Shete
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Rima R. Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Abhinendra Kumar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Triparna Majumdar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Savita Patil
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Priyanka Pandit
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Yash Joshi
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Manisha Dudhmal
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Lokesh Kumar Sharma
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, Ansari Nagar, New Delhi 110029, India
| | - Kala Yadav Ml
- Bowring and Lady Curzon Medical College, Bangalore 560001, Karnataka, India
| | - Jayanthi Shastri
- Kasturba Hospital of Infectious Diseases, Mumbai 400011, Maharashtra, India
| | - Mayank Gangwar
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Ashok Munivenkattapa
- Indian Council of Medical Research-National Institute of Virology, Bangalore 560029, India
| | - Varsha Potdar
- Indian Council of Medical Research-National Institute of Virology, Pune 411021, India
| | - K. Nagamani
- Gandhi Hospital, Secunderabad, Telangana 500003, India
| | - Kapil Goyal
- Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India
| | | | - Maria Thomas
- Christian Medical College, Ludhiana, Punjab 141008, India
| | - Suruchi Shukla
- King George Medical University, Lucknow 226003, Uttar Pradesh, India
| | - P. Nagraj
- Gandhi Medical College, Bhopal 462001, Madhya Pradesh, India
| | - Vivek Gupta
- Government Institute of Medical Sciences, Noida 201310, Uttar Pradesh, India
| | - Gaurav Dalela
- Sawai Man Singh Medical College, Jaipur 302004, Rajasthan, India
| | - Nawaz Umar
- Gulbarga Institute of Medical Sciences, Rajiv Gandhi University of Health Sciences, Gulbarga 585105, Karnataka, India
| | - Sweety M. Patel
- Smt. NHL Municipal Medical College, Ahmedabad 380006, Gujarat, India
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Anand T, Mukherjee A, Satija A, Velamuri PS, Singh KJ, Das M, Josten K, Yadav PD, Sahay RR, Keche AY, Nagarkar NM, Gupta P, Himanshu D, Mistry SN, Patel JD, Rao P, Rohatgi S, Ghosh S, Hazra A, Kindo AJ, Annamalai R, Rudramurthy SM, Singh MP, Shameem M, Fatima N, Khambholja JR, Parikh S, Madkaikar M, Pradhan VD, Kataria S, Sharma P, Panda S, Shete AM, Majumdar T, Abraham P, Bhargava A, Mehata R, Arora RD, Tigga R, Banerjee G, Sonkar V, Malhotra HS, Kumar N, Patil R, Raut CG, Bhattacharyya K, Arthur P, Somu L, Srikanth P, Panda NK, Sharma D, Hasan W, Ahmed A, Bathla M, Solanki S, Doshi H, Kanani Y, Patel N, Shah Z, Tembhurne AK, Rajguru C, Sankhe LR, Chavan SS, Yadav RM, Deswal V, Kumar K. A case control investigation of COVID-19 associated mucormycosis in India. BMC Infect Dis 2022; 22:856. [PMID: 36384482 PMCID: PMC9667849 DOI: 10.1186/s12879-022-07844-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Increased occurrence of mucormycosis during the second wave of COVID-19 pandemic in early 2021 in India prompted us to undertake a multi-site case–control investigation. The objectives were to examine the monthly trend of COVID-19 Associated Mucormycosis (CAM) cases among in-patients and to identify factors associated with development of CAM. Methods Eleven study sites were involved across India; archived records since 1st January 2021 till 30th September 2021 were used for trend analysis. The cases and controls were enrolled during 15th June 2021 to 30th September 2021. Data were collected using a semi-structured questionnaire. Among 1211 enrolled participants, 336 were CAM cases and 875 were COVID-19 positive non-mucormycosis controls. Results CAM-case admissions reached their peak in May 2021 like a satellite epidemic after a month of in-patient admission peak recorded due to COVID-19. The odds of developing CAM increased with the history of working in a dusty environment (adjusted odds ratio; aOR 3.24, 95% CI 1.34, 7.82), diabetes mellitus (aOR: 31.83, 95% CI 13.96, 72.63), longer duration of hospital stay (aOR: 1.06, 95% CI 1.02, 1.11) and use of methylprednisolone (aOR: 2.71, 95% CI 1.37, 5.37) following adjustment for age, gender, occupation, education, type of houses used for living, requirement of ventilatory support and route of steroid administration. Higher proportion of CAM cases required supplemental oxygen compared to the controls; use of non-rebreather mask (NRBM) was associated as a protective factor against mucormycosis compared to face masks (aOR: 0.18, 95% CI 0.08, 0.41). Genomic sequencing of archived respiratory samples revealed similar occurrences of Delta and Delta derivates of SARS-CoV-2 infection in both cases and controls. Conclusions Appropriate management of hyperglycemia, judicious use of steroids and use of NRBM during oxygen supplementation among COVID-19 patients have the potential to reduce the risk of occurrence of mucormycosis. Avoiding exposure to dusty environment would add to such prevention efforts. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07844-y.
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Mane A, Jain S, Jain A, Nema V, Kurle S, Saxena V, Pereira M, Sirsat A, Pathak G, Bhoi V, Bhavsar S, Panda S. Diagnostic performance of patient self-collected oral swab (tongue and cheek) in comparison with healthcare worker-collected nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 detection. APMIS 2022; 130:671-677. [PMID: 35927785 PMCID: PMC9912197 DOI: 10.1111/apm.13266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
Abstract
The present study was conducted to compare the performance of patient self-collected oral swab (OS) with healthcare worker (HCW)-collected nasopharyngeal swab (NPS) for SARS-CoV-2 detection by reverse transcription polymerase chain reaction (RT-PCR) in real-world setting. Paired OS and NPS were collected from 485 consecutive individuals presenting with symptoms of coronavirus disease-19 (COVID-19) or asymptomatic contacts of COVID-19 cases. Both specimens were processed for RT-PCR and cycle threshold (Ct) value for each test was obtained. Positive percent agreement (PPA), negative percent agreement (NPA), overall percent agreement (OPA) and kappa were calculated for OS RT-PCR compared with NPS RT-PCR as reference. A total of 116/485 (23.9%) participants were positive by NPS RT-PCR. OS had PPA of 71.6%, NPA of 98.8%, OPA of 92.4% and kappa of 0.771. Almost all participants (483/485, 99.6%) reported OS as a convenient and comfortable sample for SARS-CoV-2 testing over NPS. All participants with Ct values <25 and majority (90.8%) with Ct values <30 were detected by OS. To conclude, OS self-sampling was preferred in comparison with NPS due the ease and comfort during collection. The performance of OS RT-PCR for SARS-CoV-2 detection, however, was sub-optimal in comparison with NPS RT-PCR.
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Affiliation(s)
- Arati Mane
- ICMR‐National AIDS Research InstitutePuneIndia
| | | | | | - Vijay Nema
- ICMR‐National AIDS Research InstitutePuneIndia
| | | | | | | | - Atul Sirsat
- ICMR‐National AIDS Research InstitutePuneIndia
| | | | | | | | - Samiran Panda
- ICMR‐National AIDS Research InstitutePuneIndia,Division of Epidemiology and Communicable DiseasesIndian Council of Medical ResearchNew DelhiIndia
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Cherian JJ, Eerike M, Bagepally BS, Das S, Panda S. Efficacy and safety of baricitinib and tocilizumab in hospitalized patients with COVID-19: A comparison using systematic review and meta-analysis. Front Pharmacol 2022; 13:1004308. [PMID: 36330085 PMCID: PMC9624173 DOI: 10.3389/fphar.2022.1004308] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/20/2022] [Indexed: 08/24/2023] Open
Abstract
Objective: This review was performed to compare the efficacy and safety among hospitalized patients with COVID-19 who received baricitinib and those who received tocilizumab independently with placebo or the standard of care (SOC). Methods: Relevant databases were searched for randomized controlled trials which evaluated the effect of baricitinib or tocilizumab as compared to placebo or the SOC in hospitalized patients with COVID-19. The primary endpoint was the comparison of the 28-day mortality. Risk ratios (RR) and mean differences were compared and pooled for dichotomous and continuous variables, respectively. A two-staged exploratory network meta-analysis using a multivariate meta-analysis was also performed. All analyses were performed in Stata version 16.0. The GRADE approach was used to assess the quality of the generated evidence (PROSPERO ID: CRD42022323363). Results: Treatment with baricitinib [RR, 0.69 (95% CI, 0.50-0.94), p = 0.02, i2 = 64.86%] but not with tocilizumab [RR, 0.87 (95% CI, 0.71-1.07), p = 0.19, i2 = 24.41%] led to a significant improvement in the 28-day mortality as compared to that with the SOC. Treatment with baricitinib or tocilizumab, both independently led to a significant reduction in the duration of hospitalization [baricitinib: mean difference, -1.13 days (95% CI, -1.51 to -0.76), p < 0.001, i2 = 0.00%; tocilizumab: mean difference, -2.80 days (95% CI, -4.17 to -1.43), p < 0.001, i2 = 55.47%] and a significant improvement in the proportion of patients recovering clinically by day 28 [baricitinib: RR, 1.24 (95% CI, 1.03-1.48), p = 0.02, i2 = 27.20%; tocilizumab: RR, 1.41 (95% CI, 1.12-1.78), p < 0.001, i2 = 34.59%] as compared to those with the SOC. From the safety point of view, both these drugs showed similar results. There were fewer patients who experienced any serious adverse event following treatment with barictinib and tocilizumab as compared to those following treatment with the SOC [baricitinib: RR, 0.76 (95% CI, 0.62-0.92), p = 0.01, i2 = 12.63%; tocilizumab: RR, 0.85 (95% CI, 0.72-1.01), p = 0.07, i2 = 0.00%]. Conclusion: As baricitinib and tocilizumab are recommended interchangeably by various guidelines for the management of COVID-19, considering the better 28-day mortality data and other comparable efficacy and safety outcomes, baricitinib may be favored over tocilizumab considering its ease of administration, shorter half-life, and lower cost of treatment.
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Affiliation(s)
| | - Madhavi Eerike
- Department of Pharmacology, All India Institute of Medical Sciences, Bibinagar, India
| | | | - Saibal Das
- Indian Council of Medical Research – Centre for Ageing and Mental Health, Kolkata, India
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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29
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Kshatri JS, Giri S, Bhattacharya D, Palo SK, Praharaj I, Kanungo S, Turuk J, Ghosal J, Bhoi T, Pattnaik M, Singh H, Panda S, Pati S. Analysis of the COVID-19 testing parameters and progression of the pandemic at the district level: findings from the ICMR Hundred Million Test (HMT) database during the first wave in India. Int J Infect Dis 2022; 122:497-505. [PMID: 35752375 PMCID: PMC9217685 DOI: 10.1016/j.ijid.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND India had the second-highest number of COVID-19 cases globally. We evaluated the progression of the pandemic across the lockdowns and phased reopenings at the district level during the first wave (in India). METHODS For the analysis in this study, we used more than 100 million COVID-19 test results along with other parameters available in the Indian Council of Medical Research database from March 2020 to October 2020. The districts were stratified as high, moderate, and low caseload districts and data analysis was done for each phase of lockdown. FINDINGS Of the 110.5 million tests included in the analysis, 54.79 million tests were performed using molecular methods, 53.58 million by rapid antigen tests, and 2.13 million using the indigenous TruNat platform. The proportion of positive cases among symptomatic individuals (22.6%) was significantly higher than asymptomatic individuals (8.6%). The tests conducted and proportions of positivity were significantly higher in high caseload districts; 58% of these tests were conducted using molecular methods as opposed to only one-third in low caseload districts. INTERPRETATION Laboratory parameters, along with other demographic information, can help us better understand the spread of the pandemic in a country. This information can be crucial to formulating and implementing public health policies in future waves of the pandemic.
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Affiliation(s)
| | - Sidhartha Giri
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | | | - Ira Praharaj
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | - Jyoti Ghosal
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Trilochan Bhoi
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India,Corresponding author: Sanghamitra Pati, ICMR- Regional Medical Research Centre, Bhubaneswar, 751023, Odisha, India. Telephone: +91-674-2301322
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30
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Meena P, Panda S, Kar N. POS-125 Revisiting kidney injury in scrub typhus infection: A novel cause of infection-related glomerulonephritis. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.07.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Khan AA, Jain SK, Rai M, Panda S. Exploring SARS-CoV2 host-pathogen interactions and associated fungal infections cross-talk: Screening of targets and understanding pathogenesis. Comput Struct Biotechnol J 2022; 20:4351-4359. [PMID: 35965662 PMCID: PMC9364728 DOI: 10.1016/j.csbj.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/15/2022] Open
Abstract
The COVID-19 associated opportunistic fungal infections have posed major challenges in recent times. Global scientific efforts have identified several SARS-CoV2 host-pathogen interactions in a very short time span. However, information about the molecular basis of COVID-19 associated opportunistic fungal infections is not readily available. Previous studies have identified a number of host targets involved in these opportunistic fungal infections showing association with COVID-19 patients. We screened host targets involved in COVID-19-associated opportunistic fungal infections, in addition to host-pathogen interaction data of SARS-CoV2 from well-known and widely used biological databases. Venn diagram was prepared to screen common host targets involved in studied COVID-19-associated fungal infections. Moreover, an interaction network of studied disease targets was prepared with STRING to identify important targets on the basis of network biological parameters. The host-pathogen interaction (HPI) map of SARS-CoV2 was also prepared and screened to identify interactions of the virus with targets involved in studied fungal infections. Pathway enrichment analysis of host targets involved in studied opportunistic fungal infections and the subset of those involved in SARS-CoV2 HPI were performed separately. This data-based analysis screened six common targets involved in all studied fungal infections, among which CARD9 and CYP51A1 were involved in host-pathogen interactions with SARS-CoV2. Moreover, several signaling pathways such as integrin signaling were screened, which were associated with disease targets involved in SARS-CoV2 HPI. The results of this study indicate several host targets deserving detailed investigation to develop strategies for the management of SARS-CoV2-associated fungal infections.
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Affiliation(s)
- Abdul Arif Khan
- Division of Microbiology, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Sudhir K Jain
- School of Studies in Microbiology, Vikram University, Ujjain (MP), India
| | - Mahendra Rai
- Department of Microbiology, Nicolaus Copernicus University, Torun, Poland.,Department of Biotechnology, Sant Gadge Baba Amravati University, Amravati, Maharashtra, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi Pin-110029, India
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Aggarwal S, Mahajan N, Kohli S, Balaji S, Singh T, Menon GR, Rade K, Panda S. Assessment of Community Behavior and COVID-19 Transmission during Festivities in India: A Qualitative Synthesis through a Media Scanning Technique. Int J Environ Res Public Health 2022; 19:10157. [PMID: 36011792 PMCID: PMC9407907 DOI: 10.3390/ijerph191610157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
In India during the first wave of COVID-19 infection, the authorities were concerned about the advent of the festive season, which could lead to a surge in cases of SARS-CoV-2 infection. The present study attempted to assess the socio-behavioral aspects of COVID-appropriate behavior (CAB) at individual and community levels, and their impact on the transmission of COVID-19 during festivities in India. Media scanning was conducted to qualitatively assess CAB by analyzing 284 news reports from across India; quantitative data on COVID-19 daily cases from March 2020 to December 2020 were used to determine the trends of the adjusted test positivity (ATP) ratio for six cities. Peaks in ATP were observed in Chandigarh, Delhi-NCR in North India during and after Dussehra and Deepavali, and in Mumbai, in the west, after Navratri. Additionally, a surge in ATP was observed in Trivandrum after Onam and in Chennai around Deepavali in the south; meanwhile, in the eastern city of Kolkata, cases increased following Durga Puja. The major challenges were adherence to CAB viz. social distancing, hygiene, and compliance with the mask mandate. Microlevel CAB indicated relatively higher laxity in maintaining hand hygiene in all cities. Observations from the current study indicate that innovative community-driven initiatives during festivals in each geographical zone are key to the large-scale implementation of disease prevention measures.
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Affiliation(s)
- Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, V. Ramalingaswami Building, Ansari Nagar, New Delhi 110029, India
| | - Nupur Mahajan
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, V. Ramalingaswami Building, Ansari Nagar, New Delhi 110029, India
| | - Simran Kohli
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi 110029, India
| | - Sivaraman Balaji
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, V. Ramalingaswami Building, Ansari Nagar, New Delhi 110029, India
| | - Tanvi Singh
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi 110029, India
| | - Geetha R. Menon
- Indian Council of Medical Research-National Institute of Medical Statistics, New Delhi 110029, India
| | - Kiran Rade
- Central Tuberculosis Division, World Health Organization, New Delhi 110002, India
| | - Samiran Panda
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, V. Ramalingaswami Building, Ansari Nagar, New Delhi 110029, India
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33
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Deshpande GR, Yadav PD, Abraham P, Nyayanit DA, Sapkal GN, Shete AM, Gupta N, Vadrevu KM, Ella R, Panda S, Bhargava B. Booster dose of the inactivated COVID-19 vaccine BBV152 (Covaxin) enhances the neutralizing antibody response against Alpha, Beta, Delta and Omicron variants of concern. J Travel Med 2022; 29:6553803. [PMID: 35325176 DOI: 10.1093/jtm/taac039] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 11/14/2022]
Abstract
The neutralizing antibody responses were significantly elevated after 3rd dose of BBV152/Covaxin against the B.1 (19.11 fold) variant including Delta (16.51 fold), Beta (14.70 fold) and Omicron (18.53 fold) Variants of concern in comparison with two dose vaccine, providing assurance of a protective immune response of booster in recipients.
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Affiliation(s)
- Gururaj Rao Deshpande
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Gajanan N Sapkal
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, MCC 130/1 Sus Road, Pashan, Pune, Maharashtra 411021, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | | | - Raches Ella
- Bharat Biotech International Limited, Genome Valley, Hyderabad, Telangana, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
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Sapkal G, Kant R, Dwivedi G, Sahay RR, Yadav PD, Deshpande GR, Singh R, Nyayanit DA, Patil DY, Shete-Aich AM, Zaman K, Chaudhari AK, Gupta N, Panda S, Abraham P, Bhargava B. Immune responses against different variants of SARS-CoV-2 including Omicron following 6 months of administration of heterologous prime-boost COVID-19 vaccine. J Travel Med 2022; 29:6542352. [PMID: 35244698 PMCID: PMC8903478 DOI: 10.1093/jtm/taac033] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/17/2022] [Accepted: 01/18/2022] [Indexed: 12/03/2022]
Abstract
Comparative analysis at one- and six-months post-vaccination showed modest reduction in S1-RBD IgG antibody and NAb titers against B.1, Alpha, Beta and Delta variants in heterologous and homologous vaccine recipients groups. However, significant reduction in NAb titers against Omicron in vaccinees’ sera post-six months underlines need for cautious prospective follow-up.
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Affiliation(s)
- Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Rajni Kant
- Indian Council of Medical Research-Regional Medical Research Centre (RMRC), Gorakhpur, Uttar Pradesh, 273013, India
| | - Gaurav Dwivedi
- Indian Council of Medical Research-Regional Medical Research Centre (RMRC), Gorakhpur, Uttar Pradesh, 273013, India
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Gururaj R Deshpande
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Rajeev Singh
- Indian Council of Medical Research-Regional Medical Research Centre (RMRC), Gorakhpur, Uttar Pradesh, 273013, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Anita M Shete-Aich
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Kamran Zaman
- Indian Council of Medical Research-Regional Medical Research Centre (RMRC), Gorakhpur, Uttar Pradesh, 273013, India
| | - Anil K Chaudhari
- Chief Medical Officer, Community Health Centre, Siddarthnagar, Uttar Pradesh, 272207, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
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Chaudhuri T, Nandakumar D, Datta SS, Husain Z, Sukumaran RK, Yadav IS, Krishnan S, Panda S. Information-sharing experiences of professionals looking after children with cancer: a qualitative exploration from a specialist paediatric oncology unit in India. Ecancermedicalscience 2022; 16:1399. [PMID: 35919241 PMCID: PMC9300413 DOI: 10.3332/ecancer.2022.1399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Childhood cancer often involves a long-term engagement of children and their parents with health services. During this journey, communications between professionals, parents and young people can be stressful for all the stakeholders. This study explores the communication preferences in paediatric oncology. Objectives The objective of the present exploratory qualitative study was to understand the views of professionals regarding information exchange during cancer treatment of children and complement these findings with clinic-based ethnographic observation of real-life consultations. Methods Using qualitative methods, in-depth interviews were conducted with paediatric oncology professionals. The interviews had been audio-recorded and transcribed verbatim. Alongside in-depth interviews, real-life interactions between parents, professionals and children were observed. Data were analysed using a thematic analysis framework as suggested by Braun and Clark. Results Paediatric oncology professionals (n = 14) were interviewed from diverse professional backgrounds that included consultant paediatric oncologists, junior specialist trainees in paediatric oncology, paediatric oncology nurses, social workers, survivor counsellor and psychologists looking after children with cancer. Additionally, clinic-based ethnographic observations (n = 10) of interactions between professionals, parents and young people were also conducted. The following themes emerged from the interviews: a) Information needs of children were very different from adolescents. Children were more worried about ‘here and now’; b) adolescents were, on the other hand, mostly worried about the ‘impact of cancer on their broader life, friendships and academics’; c) parents were curious about the outcome, costs and effectiveness of treatment, and different patterns emerged for mothers and fathers; d) information needs were dynamic and different at the start of the treatment, during treatment, at remission or end of life; e) the journey of the clinicians themselves impacted information-sharing practices; and f) direct observation of consultations highlighted the importance of priming parents before delivery of information, having multiple family members during the conversation and managing intense emotions expressed during the session. Conclusion Paediatric oncology professionals need to be sensitive about the dynamic nature of information needs while interacting with children and parents of children with cancer. The above findings may help tailor the discussions that professionals ought to have with families with a child with cancer. The results may contribute to the understanding as well as to developing training courses on communications in paediatric oncology for low- and middle-income countries.
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Affiliation(s)
- Trishna Chaudhuri
- Humanities & Social Sciences, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal 721302, India
| | - Devi Nandakumar
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Major Arterial Road, New Town, Kolkata 700160, India
| | - Soumitra Shankar Datta
- Department of Palliative Care and Psycho-oncology, Tata Medical Center, Major Arterial Road, New Town, Kolkata 700160, India
- MRC Clinical Trials Unit, Institute of Clinical Trials & Methodology, University College London, 90 High Holborn, London WC1V 6LJ, UK
- https://orcid.org/0000-0003-1674-5093
| | - Zakir Husain
- Department of Economics, Presidency University, College Street, College Square, Kolkata 700073, India
| | - Reghu K Sukumaran
- Department of Paediatric Haemato-oncology, Tata Medical Center, Major Arterial Road, New Town, Kolkata 700160, India
| | - Inder Sekhar Yadav
- Humanities & Social Sciences, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal 721302, India
| | - Sekhar Krishnan
- Department of Paediatric Haemato-oncology, Tata Medical Center, Major Arterial Road, New Town, Kolkata 700160, India
- https://orcid.org/0000-0002-6769-3847
| | - Samiran Panda
- National AIDS Research Institute - Indian Council of Medical Research, Plot No 73, G'-Block, MIDC Rd, MIDC, Bhosari, Pune, Maharashtra 411026, India
- Epidemiology & Communicable Diseases Division and Scientist - G, Indian Council of Medical Research Headquarter, New Delhi 110029, India
- https://orcid.org/0000-0002-5077-6275
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Patil A, Patil S, Rao A, Gadhe S, Kurle S, Panda S. Exploring the Evolutionary History and Phylodynamics of Human Immunodeficiency Virus Type 1 Outbreak From Unnao, India Using Phylogenetic Approach. Front Microbiol 2022; 13:848250. [PMID: 35663884 PMCID: PMC9158528 DOI: 10.3389/fmicb.2022.848250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
Certain rural and semiurban settings in the Unnao district, Uttar Pradesh, India observed an unprecedented increase in the detection of HIV cases during July 2017. Subsequent investigations through health camps and a follow-up case-control study attributed the outbreak to the unsafe injection exposures during treatment. In this study, we have undertaken a secondary analysis to understand the phylogenetic aspects of the outbreak-associated HIV-1 sequences along with the origin and phylodynamics of these sequences. The initial phylogenetic analysis indicated separate monophyletic grouping and there was no mixing of outbreak-associated sequences with sequences from other parts of India. Transmission network analysis using distance-based and non-distance-based methods revealed the existence of transmission clusters within the monophyletic Unnao clade. The median time to the most recent common ancestor (tMRCA) for sequences from Unnao using the pol gene region was observed to be 2011.87 [95% highest posterior density (HPD): 2010.09–2013.53], while the estimates using envelope (env) gene region sequences traced the tMRCA to 2010.33 (95% HPD: 2007.76–2012.99). Phylodynamics estimates demonstrated that the pace of this local epidemic has slowed down in recent times before the time of sampling, but was certainly on an upward track since its inception till 2014.
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Affiliation(s)
- Ajit Patil
- HIV Drug Resistance Laboratory, Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Pune, India
| | - Sandip Patil
- Division of Clinical Sciences, Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Pune, India
| | - Amrita Rao
- Division of Clinical Sciences, Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Pune, India
| | - Sharda Gadhe
- HIV Drug Resistance Laboratory, Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Pune, India
| | - Swarali Kurle
- HIV Drug Resistance Laboratory, Indian Council of Medical Research (ICMR)-National AIDS Research Institute, Pune, India
- *Correspondence: Swarali Kurle
| | - Samiran Panda
- Indian Council of Medical Research Headquarter, New Delhi, India
- Samiran Panda ;
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Mandal S, Parchani K, Arinaminpathy N, Sarkar S, Bhargava B, Panda S. 'Imperfect but useful': pandemic response in the Global South can benefit from greater use of mathematical modelling. BMJ Glob Health 2022; 7:bmjgh-2022-008710. [PMID: 35545289 PMCID: PMC9096499 DOI: 10.1136/bmjgh-2022-008710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/19/2022] [Indexed: 11/04/2022] Open
Abstract
Mathematical modelling has been a helpful resource for planning public health responses to COVID-19. However, there is a need to improve the accessibility of models built within country contexts in the Global South. Immediately following the overwhelming 'second wave' of COVID-19 in India, we developed a user-friendly, web-based modelling simulator in partnership with the public health experts and health administrators for subnational planning. The purpose was to help policy-makers and programme officials at the state and district levels, to construct model-based scenarios for a possible third wave. Here, we describe our experiences of developing and deploying the simulator and propose the following recommendations for future such initiatives: early preparation will be the key for pandemic management planning, including establishment of networks with potential simulator users. Ideally, this preparedness should be conducted during 'peace time', and coordinated by agencies such as WHO. Second, flexible modelling frameworks will be needed, to respond rapidly to future emergencies as the precise nature of any pandemic is impossible to predict. Modelling resources will, therefore, need to be rapidly adaptable to respond as soon as a novel pathogen emerges. Third, limitations of modelling must be communicated clearly and consistently to end users. Finally, systematic mechanisms are required for monitoring the use of models in decision making, which will help in providing modelling support to those local authorities who may benefit most from it. Overall, these lessons from India can be relevant for other countries in the South-Asian-Region, to incorporate modelling resources into their pandemic preparedness planning.
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Affiliation(s)
- Sandip Mandal
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Kanchan Parchani
- MRC Centre for Global Infectious Disease Analysis, and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College, London, UK
| | - Nimalan Arinaminpathy
- MRC Centre for Global Infectious Disease Analysis, and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College, London, UK
| | - Swarup Sarkar
- School of Public Health and Community Medicine, University of Gothenburg, Goteborg, Sweden
| | | | - Samiran Panda
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Mane A, Jain S, Jain A, Pereira M, Sirsat A, Pathak G, Bhoi V, Bhavsar S, Panda S. Diagnostic performance of oral swab specimen for SARS-CoV-2 detection with rapid point-of-care lateral flow antigen test. Sci Rep 2022; 12:7355. [PMID: 35513547 PMCID: PMC9069956 DOI: 10.1038/s41598-022-11284-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/19/2022] [Indexed: 12/12/2022] Open
Abstract
We evaluated the performance of oral swab specimen both health-care worker (HCW) collected and self-collected for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) detection with rapid antigen test (RAT) as compared to reverse transcriptase polymerase chain reaction (RT-PCR). Of the 529 participants enrolled, 121 (22.8%) were RT-PCR positive. Among the RT-PCR positives, 62 (51.2%) were RAT positive using oral swab. When compared with RT-PCR, RAT with oral swab had sensitivity and specificity of 63.3 and 96.8% respectively among symptomatic individuals. No statistically significant difference was observed in RAT positivity with HCW collection and self-collection, p = 0.606. Ct values were significantly lower in RT-PCR and RAT positive samples (ORF gene: 18.85 ± 4.36; E gene: 18.72 ± 4.84) as compared to RT-PCR positive and RAT negative samples (ORF gene: 26.98 ± 7.09; E gene: 26.97 ± 7.07), p < 0.0001. Our study demonstrated moderate sensitivity of RAT with oral swab in symptomatic individuals. Oral swab was the preferred sampling by almost all participants in terms of convenience and comfort as compared to nasopharyngeal swab. Oral swabs have utility for SARS-CoV-2 antigen detection among symptomatic individuals residing in remote rural areas and can serve as an initial screening tool during COVID-19 spikes when cases rise exponentially and laboratory capacities for RT-PCR testing become overwhelmed.
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Affiliation(s)
- Arati Mane
- Division of Microbiology, ICMR-National AIDS Research Institute, 73, G block, MIDC, Bhosari, Pune, Maharashtra, India.
| | - Shilpa Jain
- Old Bhosari Hospital, Bhosari, Pune, Maharashtra, India
| | - Ankita Jain
- Old Bhosari Hospital, Bhosari, Pune, Maharashtra, India
| | - Michael Pereira
- Division of Microbiology, ICMR-National AIDS Research Institute, 73, G block, MIDC, Bhosari, Pune, Maharashtra, India
| | - Atul Sirsat
- Division of Microbiology, ICMR-National AIDS Research Institute, 73, G block, MIDC, Bhosari, Pune, Maharashtra, India
| | - Gaurav Pathak
- Division of Microbiology, ICMR-National AIDS Research Institute, 73, G block, MIDC, Bhosari, Pune, Maharashtra, India
| | - Vikalp Bhoi
- Old Bhosari Hospital, Bhosari, Pune, Maharashtra, India
| | | | - Samiran Panda
- Division of Microbiology, ICMR-National AIDS Research Institute, 73, G block, MIDC, Bhosari, Pune, Maharashtra, India.,Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
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Yadav PD, Mohandas S, Shete AM, Nyayanit DA, Gupta N, Patil DY, Sapkal GN, Potdar V, Kadam M, Kumar A, Kumar S, Suryavanshi D, Mote CS, Abraham P, Panda S, Bhargava B. SARS-CoV-2 Kappa Variant Shows Pathogenicity in a Syrian Hamster Model. Vector Borne Zoonotic Dis 2022; 22:289-296. [PMID: 35580212 DOI: 10.1089/vbz.2021.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives: The emergence of SARS-CoV-2 lineage B.1.617 variants in India has been associated with a surge in the number of daily infections. We investigated the pathogenic potential of Kappa (B.1.617.1) variant in Syrian golden hamsters. Methods: Two groups of Syrian golden hamsters (18 each) were inoculated intranasally with SARS-CoV-2 isolates, B.1 (D614G) and Kappa variant, respectively. The animals were monitored daily for the clinical signs and body weight. Throat swab, nasal wash, and organ samples (lungs, nasal turbinate, trachea) were collected and screened using SARS-CoV-2-specific RT-qPCR. Histopathologic evaluation of the lung samples was performed. Results: The hamsters infected with the Kappa variant demonstrated increased body weight loss compared to the B.1 lineage isolate. The highest viral RNA load was observed in the nasal turbinate and lung specimens of animals infected with both variants. A significantly higher sgRNA load was observed in the nasal swabs (7 DPI), trachea (3 DPI), and lungs (3 DPI) of hamsters infected with the Kappa variant. Neutralizing antibody response generated in the B.1 lineage-infected hamster sera were comparable against both B.1 and Kappa variant in contrast to Kappa variant-infected hamsters, which showed lower titers against B.1 lineage isolate. Gross and microscopic evaluation of the lung specimens showed severe lung lesions in hamsters infected with Kappa variant compared to B.1. Conclusions: The study demonstrates pathogenicity of Kappa variant in hamsters evident with reduced body weight, high viral RNA load in lungs, and pronounced lung lesions. Both Kappa variant- and B.1-infected hamsters produced neutralizing antibodies against both variants studied.
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Affiliation(s)
- Pragya D Yadav
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Sreelekshmy Mohandas
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Anita M Shete
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Dimpal A Nyayanit
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Deepak Y Patil
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Gajanan N Sapkal
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Varsha Potdar
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Manoj Kadam
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Abhimanyu Kumar
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Sanjay Kumar
- Department of Neurosurgery, Command Hospital (Southern Command), Armed Forces Medical College (AFMC), Pune, India
| | - Deepak Suryavanshi
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Chandrashekhar S Mote
- Department of Veterinary Pathology, Krantisinh Nana Patil College of Veterinary Science, Shirwal, India
| | - Priya Abraham
- Maximum Containment Facility, Indian Council of Medical Research, National Institute of Virology, Pune, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
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Panda S, Dash J, Panda G. Properties of fuzzy Ito integrals with respect to fuzzy Brownian motion. IFS 2022. [DOI: 10.3233/jifs-211478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Integral of a stochastic process with respect to Brownian motion is called Ito integral. Here the stochastic process and Brownian motion are random as well as fuzzy. Hence the Ito integral is fuzzy Ito integral. This paper deals with the properties of fuzzy Ito integral for simple adapted process with respect to fuzzy Brownian motion. The quadratic variance and covariance of FII are discussed. The concept of fuzzy simple adapted process, fuzzy martingale, fuzzy functions are used to derive the properties of fuzzy Ito integrals.
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Affiliation(s)
- S. Panda
- Department of Mathematics, Siksha ‘O’ Anusandhan (Deemed to be University), Khandagiri Square, Bhubaneswar, Odisha, India
| | - J.K. Dash
- Department of Mathematics, Siksha ‘O’ Anusandhan (Deemed to be University), Khandagiri Square, Bhubaneswar, Odisha, India
| | - G.B. Panda
- Department of Mathematics, Siksha ‘O’ Anusandhan (Deemed to be University), Khandagiri Square, Bhubaneswar, Odisha, India
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Gupta N, Rana S, Panda S, Bhargava B. Use of COVID-19 Test Positivity Rate, Epidemiological, and Clinical Tools for Guiding Targeted Public Health Interventions. Front Public Health 2022; 10:821611. [PMID: 35372250 PMCID: PMC8965807 DOI: 10.3389/fpubh.2022.821611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/02/2022] [Indexed: 12/30/2022] Open
Abstract
India experienced a second wave of COVID-19 infection with an unprecedented upsurge in the number of cases. We have analyzed the effect of different restrictive measures implemented in six Indian states. Further, based on available national and international data on disease transmission and clinical presentation, we have proposed a decision-making matrix for planning adequate resources to combat the future waves of COVID-19. We conclude that pragmatic and well calibrated localized restrictions, tailored as per specific needs may achieve a decline in disease transmission comparable to drastic steps like national lockdowns. Additionally, we have underscored the critical need for countries to generate local epidemiological, clinical and laboratory data alongwith community perception and uptake of various non-pharmaceutical interventions, for effective planning and policy making.
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Affiliation(s)
| | - Salaj Rana
- Indian Council of Medical Research, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Mane A, Kasibhatla SM, Vidhate P, Saxena V, Patil S, Rao A, Nirmalkar A, Kulkarni-Kale U, Panda S. Phylogenetic Analysis of Spread of Hepatitis C Virus Identified during HIV Outbreak Investigation, Unnao, India. Emerg Infect Dis 2022; 28:725-733. [PMID: 35318918 PMCID: PMC8962895 DOI: 10.3201/eid2804.211845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
An HIV outbreak investigation during 2017–2018 in Unnao District, Uttar Pradesh, India, unearthed high prevalence of hepatitis C virus (HCV) antibodies among the study participants. We investigated these HCV infections by analyzing NS5B and core regions. We observed no correlation between HIV–HCV viral loads and clustering of HCV sequences, regardless of HIV serostatus. All HCV isolates belonged to genotype 3a. Monophyletic clustering of isolates in NS5B phylogeny indicates emergence of the outbreak from a single isolate or its closely related descendants. The nucleotide substitution rate for NS5B was 6 × 10−3 and for core was 2 × 10−3 substitutions/site/year. Estimated time to most recent common ancestor of these isolates was 2012, aligning with the timeline of this outbreak, which might be attributable to unsafe injection practices while seeking healthcare. HIV–HCV co-infection underlines the need for integrated testing, surveillance, strengthening of healthcare systems, community empowerment, and molecular analyses as pragmatic public health tools.
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Kumar S, Shah U, Ravipati S, Rahulan V, Kamath A, Kumar P, Panda S, Kori S, John P, Nagaraju M, Arora S, Dutta P, Attawar S. Airway Complications After Lung Transplant for Post Coronaviral Disease (COVID-19) Acute Respiratory Distress Syndrome (ARDS) Related End Stage Lung Disease: Single Centre Experience. J Heart Lung Transplant 2022. [PMCID: PMC8988571 DOI: 10.1016/j.healun.2022.01.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose Severe COVID-19 ARDS related end stage lung fibrosis with irreversible changes is a newer indication for lung transplantation with acceptable survival rate. Airway complication post lung transplant is a major source of morbidity and mortality with incidence as high as 25 to 49 percent. Patients with end stage COVID-19 fibrosis are likely to be clinically deconditioned with long duration of extracorporeal oxygenator (ECMO) support, high burden of sepsis and prolonged respiratory support which may affect the airways post lung transplantation. Methods This is a retrospective observational study after obtaining institutional ethical clearance. We reviewed electronic medical data of patients who underwent lung transplantation for post COVID-19 ARDS related fibrosis. We evaluated the incidence and type of airway complications and the various therapeutic interventions applied for its management. Results Between May 2020 and September 2021 our centre performed 23 bilateral lung transplants for end stage COVID-19 ARDS related fibrosis. 22 patients were on ECMO support with mean duration of 50.9 days before transplantation. All patients underwent lung transplantation with central Veno-Arterial ECMO support with mean organ ischaemia time of 360±154 minutes. The incidence of airway complication in our study group was 56%. We observed anastomotic narrowing in 3(13%), distal airway narrowing in 4(17%) and sloughing/coating of anastomotic site in 5(22%) patients. Nonspecific inflammatory polypi around the bronchial anastomotic site were noticed in 4(17%) and mild airway anastomotic dehiscence in 2 subjects. 8(34%) patients required serial bronchoscopy and balloon dilatation; 2 among them mandated additional cautery usage. 2 cases underwent polypectomy, further 4 subjects needed bronchial stent placement. 5 (21%) recipients were discharged with Tracheostomy while rest were successfully decannulated in the ward. Conclusion We observed a high incidence of airway complications in post lung transplant for COVID-19 ARDS related fibrosis. Early detection, timely management and serial follow up is of paramount importance in this subset of patients.
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Menon GR, Yadav J, Aggarwal S, Singh R, Kaur S, Chakma T, Periyasamy M, Venkateswaran C, Singh PK, Balachandar R, Kulkarni R, Grover A, Mishra BK, Viray M, Devi KR, Singh KHJ, Saha KB, Barde PV, Thomas B, Suresh C, A. D, Watson B, Selvaraj P, Xavier G, John D, Menon J, Philip S, Mathew G, David A, Vaman RS, Sushan A, Singh S, Jakhar K, Ketharam A, Prusty R, Kishore J, Venkatesh U, Kumar S, Kanungo S, Sahoo K, Swain S, Lyngdoh A, Diengdoh J, Syiemlieh P, Sarkar A, Velhal G, Kharnare S, Nandanwar D, Rao MVV, Panda S. Psychological distress and burnout among healthcare worker during COVID-19 pandemic in India-A cross-sectional study. PLoS One 2022; 17:e0264956. [PMID: 35271652 PMCID: PMC8912126 DOI: 10.1371/journal.pone.0264956] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/21/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. METHODS A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. RESULTS Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66-3.41), income≥20000(AOR = 1.74, 95% CI, (1.16-2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09-2.46), contact tracing (AOR = 2.05, 95% CI (1.1-3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14-6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28-2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). CONCLUSION The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.
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Affiliation(s)
- Geetha R. Menon
- Indian Council of Medical Research- National Institute of Medical Statistics, New Delhi, India
- * E-mail: (GRM); (SA)
| | - Jeetendra Yadav
- Indian Council of Medical Research- National Institute of Medical Statistics, New Delhi, India
| | - Sumit Aggarwal
- Indian Council of Medical Research, New Delhi, India
- * E-mail: (GRM); (SA)
| | | | - Simran Kaur
- Indian Council of Medical Research- National Institute of Medical Statistics, New Delhi, India
| | - Tapas Chakma
- Indian Council of Medical Research- National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Murugesan Periyasamy
- Indian Council of Medical Research- National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Prashant Kumar Singh
- ICMR-National Institute of Cancer Prevention and Research, Gautam Buddh Nagar, Uttar Pradesh, India
| | - Rakesh Balachandar
- ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Ragini Kulkarni
- ICMR- National Institute of Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Ashoo Grover
- ICMR-National Institute of Pathology, New Delhi, India
| | | | - Maribon Viray
- Martin Luther Christian University, Shillong, Meghalaya, India
| | | | - K. H. Jitenkumar Singh
- Indian Council of Medical Research- National Institute of Medical Statistics, New Delhi, India
| | - K. B. Saha
- Indian Council of Medical Research- National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - P. V. Barde
- Indian Council of Medical Research- National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Beena Thomas
- Indian Council of Medical Research- National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Chandra Suresh
- Indian Council of Medical Research- National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Dhanalakshmi A.
- Indian Council of Medical Research- National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Basilea Watson
- Indian Council of Medical Research- National Institute of Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Pradeep Selvaraj
- Directorate of public health and Preventive Medicine, Chennai, Tamil Nadu, India
| | | | - Denny John
- Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | - Jaideep Menon
- Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala, India
| | - Sairu Philip
- Believers Church Medical College Hospital, Tiruvalla, Kerala, India
| | - Geethu Mathew
- Believers Church Medical College Hospital, Tiruvalla, Kerala, India
| | - Alice David
- Believers Church Medical College Hospital, Tiruvalla, Kerala, India
| | | | - Abey Sushan
- Believers Church Medical College Hospital, Tiruvalla, Kerala, India
| | - Shalini Singh
- ICMR-National Institute of Cancer Prevention and Research, Gautam Buddh Nagar, Uttar Pradesh, India
| | - Kiran Jakhar
- Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Asha Ketharam
- ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India
| | - Ranjan Prusty
- ICMR- National Institute of Research in Reproductive Health, Mumbai, Maharashtra, India
| | - Jugal Kishore
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - U. Venkatesh
- Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Subrata Kumar
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Krushna Sahoo
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Swagatika Swain
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | | | - AbuHasan Sarkar
- ICMR -Regional Medical Research Centre, Dibrugarh, Assam, India
| | - Gajanan Velhal
- Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | | | - Deepika Nandanwar
- Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - M. Vishnu Vardhana Rao
- Indian Council of Medical Research- National Institute of Medical Statistics, New Delhi, India
| | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Yadav P, Mohandas S, Sarkale P, Nyayanit D, Shete A, Sahay R, Potdar V, Baradkar S, Gupta N, Sapkal G, Abraham P, Panda S, Bhargava B. Isolation of SARS-CoV-2 B.1.1.28.2 (P2) variant and pathogenicity comparison with D614G variant in hamster model. J Infect Public Health 2022; 15:164-171. [PMID: 34959053 PMCID: PMC8690136 DOI: 10.1016/j.jiph.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/23/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022] Open
Abstract
Background Considering the potential threat from emerging Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) variants and the rising COVID-19 cases, SARS-CoV-2 genomic surveillance is ongoing in India. We report herewith the isolation of the P.2 variant (B.1.1.28.2) from international travelers and further its pathogenicity evaluation and comparison with D614G variant (B.1) in hamster model. Methods Virus isolation was performed in Vero CCL81 cells and genomic characterization by next generation sequencing. The pathogenicity and host immune response of the isolate was assessed in Syrian hamster model and compared with B.1 variant. Results B.1.1.28.2 variant was isolated from nasal/throat swabs of international travelers returned to India from United Kingdom and Brazil. The B.1.1.28.2 variant induced body weight loss, viral replication in the respiratory tract and caused severe lung pathology in infected Syrian hamster model in comparison, with B.1 variant infected hamsters. The sera from B.1.1.28.2 infected hamsters efficiently neutralized the D614G variant virus whereas 6-fold reduction in the neutralization was seen in case of D614G variant infected hamsters’ sera with the B.1.1.28.2 variant. Conclusions B.1.1.28.2 lineage variant could be successfully isolated and characterization could be performed. Pathogenicity of the isolate was demonstrated in Syrian hamster model and the findings of neutralization reduction is of great concern and point towards the need for screening the vaccines for efficacy.
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Affiliation(s)
- Pragya Yadav
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India.
| | - Sreelekshmy Mohandas
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Prasad Sarkale
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Dimpal Nyayanit
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Anita Shete
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Rima Sahay
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Varsha Potdar
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Shrikant Baradkar
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Gajanan Sapkal
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology (ICMR-NIV), Pune, Maharashtra, 411021, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, P.O. Box No. 4911, Ansari Nagar, New Delhi, 110029, India
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Yadav PD, Sapkal GN, Abraham P, Ella R, Deshpande G, Patil DY, Nyayanit DA, Gupta N, Sahay RR, Shete AM, Panda S, Bhargava B, Mohan VK. Neutralization of Variant Under Investigation B.1.617.1 With Sera of BBV152 Vaccinees. Clin Infect Dis 2022; 74:366-368. [PMID: 33961693 DOI: 10.1093/cid/ciab411] [Citation(s) in RCA: 138] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Gajanan N Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Priya Abraham
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Raches Ella
- Bharat Biotech International Limited, Genome Valley, Hyderabad, India
| | - Gururaj Deshpande
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Dimpal A Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Nivedita Gupta
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, India
| | - Samiran Panda
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - Balram Bhargava
- Indian Council of Medical Research, V. Ramalingaswami Bhawan, New Delhi, India
| | - V Krishna Mohan
- Bharat Biotech International Limited, Genome Valley, Hyderabad, India
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Panda S, Rao A, Patil S, Nirmalkar A, Bagul R, Ghule U, Panchal N. HIV oral self-screening test among HIV/STD/TB clinic attendees: A mixed-method pilot investigation examining merit for larger evaluation. Indian J Med Res 2022; 155:403-412. [DOI: 10.4103/ijmr.ijmr_3131_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Singh H, Lohia R, George LS, Gupta N, Thangaraj JW, Rana S, Rana S, Kaur J, Shivam S, Arora NK, Muliyil JP, Murhekar MV, Lodha R, Pandey R, Rao VV, Dhandore S, Malik A, Kumar V, Tripathi A, Panda S, Bhargava B. Development of the India COVID-19 vaccine tracker. Indian J Med Res 2022; 155:513-517. [PMID: 35859397 PMCID: PMC9807209 DOI: 10.4103/ijmr.ijmr_3500_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Since then, efforts were initiated to develop safe and effective vaccines. Till date, 11 vaccines have been included in the WHO's emergency use list. The emergence and spread of variant strains of SARS-CoV-2 has altered the disease transmission dynamics, thus creating a need for continuously monitoring the real-world effectiveness of various vaccines and assessing their overall impact on disease control. To achieve this goal, the Indian Council of Medical Research (ICMR) along with the Ministry of Health and Family Welfare, Government of India, took the lead to develop the India COVID-19 Vaccination Tracker by synergizing three different public health databases: National COVID-19 testing database, CoWIN vaccination database and the COVID-19 India portal. A Vaccine Data Analytics Committee (VDAC) was constituted to advise on various modalities of the proposed tracker. The VDAC reviewed the data related to COVID-19 testing, vaccination and patient outcomes available in the three databases and selected relevant data points for inclusion in the tracker, following which databases were integrated, using common identifiers, wherever feasible. Multiple data filters were applied to retrieve information of all individuals ≥18 yr who died after the acquisition of COVID-19 infection with or without vaccination, irrespective of the time between vaccination and test positivity. Vaccine effectiveness (VE) against the reduction of mortality and hospitalizations was initially assessed. As compared to the hospitalization data, mortality reporting was found to be much better in terms of correctness and completeness. Therefore, hospitalization data were not considered for analysis and presentation in the vaccine tracker. The vaccine tracker thus depicts VE against mortality, calculated by a cohort approach using person-time analysis. Incidence of COVID-19 deaths among one- and two-dose vaccine recipients was compared with that among unvaccinated groups, to estimate the rate ratios (RRs). VE was estimated as 96.6 and 97.5 per cent, with one and two doses of the vaccines, respectively, during the period of reporting. The India COVID-19 Vaccination Tracker was officially launched on September 9, 2021. The high VE against mortality, as demonstrated by the tracker, has helped aid in allaying vaccine hesitancy, augmenting and maintaining the momentum of India's COVID-19 vaccination drive.
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Affiliation(s)
- Harpreet Singh
- Division of Bio-Medical Informatics, Trials & Projections Unit, New Delhi, India
| | - Rohan Lohia
- Clinton Health Access Initiative, India Office, New Delhi, India
| | | | - Nivedita Gupta
- Virology Unit, New Delhi, India,For correspondence: Dr Nivedita Gupta, Virology Unit, Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi 110 029, India e-mail:
| | | | - Salaj Rana
- Division of Bio-Medical Informatics, Trials & Projections Unit, New Delhi, India
| | - Shweta Rana
- Division of Bio-Medical Informatics, Trials & Projections Unit, New Delhi, India
| | - Jasmine Kaur
- Division of Bio-Medical Informatics, Trials & Projections Unit, New Delhi, India
| | - Shashwat Shivam
- Clinton Health Access Initiative, India Office, New Delhi, India
| | | | - Jai Prakash Muliyil
- Department of Community Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Rakesh Lodha
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - R.M. Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Suhas Dhandore
- Division of Immunization, Ministry of Health & Family Welfare, New Delhi, India
| | - Akash Malik
- United Nations Development Programme, New Delhi, India
| | - Vijay Kumar
- Division of eHealth, Ministry of Health & Family Welfare, New Delhi, India
| | - Ankit Tripathi
- Centre for Health Informatics, Ministry of Health & Family Welfare, New Delhi, India
| | - Samiran Panda
- United Nations Development Programme, New Delhi, India
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Kumar G, Mukherjee A, Turuk A, Bhalla A, Talukdar A, Shivnitwar SK, Ojha U, Menon GR, Sahu D, Panda S, Rao VV, Singh SK, Bhargava B. Characterizing the third wave of COVID-19: An analysis from the National Clinical Registry of COVID-19. Indian J Med Res 2022; 155:478-484. [PMID: 35946230 PMCID: PMC9807205 DOI: 10.4103/ijmr.ijmr_276_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Background & objectives Data from the National Clinical Registry for COVID-19 (NCRC) were analyzed with an aim to describe the clinical characteristics, course and outcomes of patients hospitalized with COVID-19 in the third wave of the pandemic and compare them with patients admitted earlier. Methods The NCRC, launched in September 2020, is a multicentre observational initiative, which provided the platform for the current investigation. Demographic, clinical, treatment and outcome data of hospitalized COVID-19 patients were captured in an electronic data portal from 38 hospitals across India. Patients enrolled during December 16, 2021 to January 17, 2022 were considered representative of the third wave of COVID-19 and compared with those registered during November 15 to December 15, 2021, representative of the tail end of the second wave. Results Between November 15, 2021 and January 17, 2022, 3230 patients were recruited in NCRC. Patients admitted in the third wave were significantly younger than those admitted earlier (46.7±20.5 vs. 54.6±18 yr). The patients admitted in the third wave had a lower requirement of drugs including steroids, interleukin (IL)-6 inhibitors and remdesivir as well as lower oxygen supplementation and mechanical ventilation. They had improved hospital outcomes with significantly lower in-hospital mortality (11.2 vs. 15.1%). The outcomes were better among the fully vaccinated when compared to the unvaccinated or partially vaccinated. Interpretation & conclusions The pattern of illness and outcomes were observed to be different in the third wave compared to the last wave. Hospitalized patients were younger with fewer comorbidities, decreased symptoms and improved outcomes, with fully vaccinated patients faring better than the unvaccinated and partially vaccinated ones.
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Affiliation(s)
- Gunjan Kumar
- Clinical Studies, Trials & Projection Unit, New Delhi, India
| | - Aparna Mukherjee
- Clinical Studies, Trials & Projection Unit, New Delhi, India,For correspondence: Dr Aparna Mukherjee, Clinical Studies, Trials & Projection Unit, Indian Council of Medical Research, New Delhi 110 029, India e-mail:
| | - Alka Turuk
- National Clinical Registry for COVID-19, New Delhi, India
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Arunansu Talukdar
- Department of Geriatric Medicine, Medical College, Kolkata, West Bangal, India
| | - Sachin K. Shivnitwar
- Department of Medicine, Dr. D.Y. Patil Medical College Hospital & Research Centre, Pune, Maharashtra, India
| | - U.K. Ojha
- Department of Medicine, Saheed Nirmal Mahto Medical College & Hospital, Dhanbad, Jharkhand, India
| | - Geetha R. Menon
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Samiran Panda
- Division of Epidemiology & Communicable Diseases, New Delhi, India
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Panda S. Looking back to move forward: A travel rule underlined by the current pandemic. Indian J Public Health 2022; 66:403-406. [PMID: 37039163 DOI: 10.4103/ijph.ijph_1513_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Learning from the past - is easier said than done. In this narrative, "travel" refers to the forward movement of the society at large on the path of health and development. It is suggested that looking back and learning from the lived experiences of the past outbreaks could help generating public health insights and incorporating them in planning for a better future. In the process, a country may choose to revisit what took place in the recent past during the COVID-19 pandemic within its boundary and beyond. However, unfolding of events in the past, which is not as immediate as COVID neither too far as the flu pandemic of 1918, also has lessons to offer. Recognizably, a few alarms, that rang in the recent past and cried for mass attention towards beefed up public health preparedness, were missed. It is therefore necessary now to critically examine the past-efforts to eradicate, eliminate or control diseases such as small pox, polio, HIV, tuberculosis, leprosy, measles or malaria. Results of such evaluation could inform the future courses of actions around disease elimination science and health (DESH) and help develop better nations.
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