Search

Background: Itolizumab downregulates the synthesis of proinflammatory cytokines and adhesion molecules by inhibiting CD6 leading to lower levels of interferon-γ, interleukin-6, and tumor necrotic factor-α and reduced T-cell infiltration at inflammatory sites. This study aims to compare the effects of tocilizumab and itolizumab in the management of severe coronavirus disease 2019 (COVID-19). Methods: The study population was adults (>18 years) with severe COVID-19 pneumonia admitted to the intensive care unit receiving either tocilizumab or itolizumab during their stay. The primary outcome was clinical improvement (CI), defined as a two-point reduction on a seven-point ordinal scale in the status of the patient from initiating the drug or live discharge. The secondary outcomes were time until CI, improvement in PO2/FiO2 ratio, best PO2/FiO2 ratio, need for mechanical ventilation after administration of study drugs, time to discharge, and survival days. Results: Of the 126 patients included in the study, 92 received tocilizumab and 34 received itolizumab. CI was seen in 46.7% and 61.7% of the patients in the tocilizumab and itolizumab groups, respectively and was not statistically significant (P=0.134). The PO2/FiO2 ratio was significantly better with itolizumab compared to tocilizumab (median [interquartile range]: 315 [200–380] vs. 250 [150–350], P=0.043). The incidence of serious adverse events due to the study drugs was significantly higher with itolizumab compared to tocilizumab (14.7% vs. 3.3%, P=0.032). Conclusions: The CI with itolizumab is similar to tocilizumab. Better oxygenation can be achieved with itolizumab and it can be a substitute for tocilizumab in managing severe COVID-19. [ABSTRACT FROM AUTHOR]

Since it emerged in December of 2019, COVID-19 has placed a huge burden on medical care in countries throughout the world, as it led to a huge number of hospitalizations and mortalities. Many medical centers were overloaded, as their intensive care units and auxiliary protection resources proved insufficient, which made the effective allocation of medical resources an urgent matter. This study describes learned survival prediction models that could help medical professionals make effective decisions regarding patient triage and resource allocation. We created multiple data subsets from a publicly available COVID-19 epidemiological dataset to evaluate the effectiveness of various combinations of covariates—age, sex, geographic location, and chronic disease status—in learning survival models (here, "Individual Survival Distributions"; ISDs) for hospital discharge and also for death events. We then supplemented our datasets with demographic and economic information to obtain potentially more accurate survival models. Our extensive experiments compared several ISD models, using various measures. These results show that the "gradient boosting Cox machine" algorithm outperformed the competing techniques, in terms of these performance evaluation metrics, for predicting both an individual's likelihood of hospital discharge and COVID-19 mortality. Our curated datasets and code base are available at our Github repository for reproducing the results reported in this paper and for supporting future research. [ABSTRACT FROM AUTHOR]

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection affects the cardiovascular system at many levels. It initially infects endothelial cells, inducing marked endothelial damage and inflammation. However, there was no empirical evidence of functional compromise of arterial walls. Aims and objective: Our primary objective was to study functional arterial damage in coronavirus disease 2019 (COVID-19) and establish the noninvasive measurement of arterial stiffness as an independent marker of disease severity. Materials and methods: We recorded the arterial stiffness of 23 mild, 21 moderate, and 20 severe COVID-19 patients grouped on the latest National Institute of Health (NIH) severity criteria. We observed arterial stiffness of COVID-19 patients with standard parameters like noninvasive estimated carotid--femoral pulse wave velocity (cfPWV), age-normalized increase in cfPWV (ANI&lowbar;cfPWV), age-normalized increase in aortic augmentation pressure (ANI&lowbar;AugP), and heart rate-normalized augmentation index (HRN_ AIx). All the parameters were also corrected for statistically significant confounding factors. Results: Moderate and severe COVID-19 patients have extremely significantly elevated arterial stiffness than mild patients. In mild patients, cfPWV (829.1 ± 139.2 cm/second) was significantly lower than both moderate (1067 ± 152.5 cm/second, p <0.0001) and severe (1416 ± 253.9 cm/second, p <0.0001) patients. ANI&lowbar;cfPWV in moderate and severe patients was significantly higher than mild patients (mild: 101.2 ± 126.1 cm/second; moderate: 279 ± 114.4 cm/second; severe: 580.1 ± 216.4 cm/second; intergroup p <0.0001). The results even after correction for significant confounding factors did not show any considerable change in the increasing trend of arterial stiffness. Conclusion: This study establishes the functional deterioration of arteries in proportion to the severity of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Aims: The Nutrition Risk in Critically ill (NUTRIC) score is an appropriate nutritional assessment tool in mechanically ventilated patients. We retrospectively observed the applicability of the NUTRIC score for predicting outcomes in coronavirus disease (COVID)-19 acute respiratory distress syndrome (ARDS) patients. Methods: All adult COVID-19 ARDS patients admitted to the intensive care unit and requiring various forms of oxygen therapy were included in the study. The demographic characteristics and clinical information about the patients were obtained from the hospital's medical records department. The nutritional risk for each patient was assessed using the NUTRIC score at 72 hours of ICU admission. The discriminating power and ability of NUTRIC score, Sequential Organ Failure Assessment (SOFA) score, age and Acute Physiology and Chronic Health Evaluation (APACHE) II to predict the 28-day mortality and need for mechanical ventilation (MV) was calculated using receiver operating characteristic curves and area under this curve. Results: A total of 80 COVID-19 ARDS patients fitted into the inclusion criteria. Among non-survivors, the median Glasgow Coma Score, APACHE II score, NUTRIC score and SOFA score were 10, 16, 6 and 4, respectively. The cut-off values for NUTRIC score, SOFA, and APACHE II to predict 28-day mortality and need for MV was obtained as 3.5, 3.5 and 11.5, respectively. These cut-off values of NUTRIC score, SOFA score, and APACHE II have a sensitivity of 62%, 72.5% and 75.5%, respectively, and specificity of 95%, 72% and 83% for predicting mortality. Conclusions: Most COVID-19 ARDS patients requiring MV in the ICU are at nutritional risk, and a high NUTRIC score is associated with higher mortality. [ABSTRACT FROM AUTHOR]

Background: Gargling had been reported to have some roles in the prevention and treatment of respiratory tract infections. The purpose of this study was to assess the ability of regular gargling using 7.5% sodium bicarbonate to eliminate SARS-CoV-2 in the oropharynx and nasopharynx. Materials and methods: This pilot, open-labeled, nonrandomized, parallel single-center study. The effect of 30 seconds, three times per day gargling using 7.5% sodium bicarbonate solution--25 mL on SARS-CoV-2 viral clearance among coronavirus disease-2019 (COVID-19) patients in a dedicated COVID hospital at All India Institute of Medical Sciences, Patna, Bihar, India. We monitored the progress on by days 0, 1, 2, 3, 4, 5, 6, and 7 by observing variables like clinical category, P/F ratio, neutrophil/lymphocyte ratio (NLR) ratio, platelet count, ferritin, lactate dehydrogenase (LDH), CRP, procalcitonin, d-dimer, INR, APTT, and sequential organ function assessment (SOFA) score. We have also done repeat reverse transcription-polymerase chain reaction (RT-PCR) testing on day 5 and day 7. Results: A total of 10 patients (7 males and 3 females) were included in our study after confirmed COVID positivity. The age range was from 30 to 61 years. Based on clinical severity and P/F ratio, 7 patients were included in the milder group as their ratio was more than 200 and the rest 3 patients were included in the moderate group as P/F ratio was less than 200. Two respondents had comorbidities, which were non-Hodgkin's lymphoma and ovarian carcinoma. Viral clearance was achieved at day 7 in 3 of 10 patients. However, the analysis of using 7.5% sodium bicarbonate 25 mL gargle statistically showed nonsignificant p-value for all of our studied variables. However, the PCR results were negative on 24 hours apart, i.e., on day 5 and day 7. Conclusions: This is only a preliminary study which showed that gargling with 7.5% sodium bicarbonate may not be effective in achieving early SARS-CoV-2 viral clearance among mild COVID-19 patients. However, still larger studies are required to ascertain the benefit of gargling for different stages of COVID-19 patients with keeping in mind the important variables suggestive of viremia clearance. [ABSTRACT FROM AUTHOR]

Acute Necrotizing Encephalitis as a Probable Association of COVID-19 [ABSTRACT FROM AUTHOR]

Sir, A high-flow nasal cannula (HFNC) has become to be widely used in intensive care units (ICUs) treating patients suffering from COVID-19. Nebulizer aerosol drug delivery through high flow nasal cannula in adult patients. To mitigate this difficult challenge, we made an assembly using HFNC circuit and T-piece jet nebulizer interface so that we can give the aerosolized drug through HFNC only instead of face mask interface which is not being accepted by the patient. [Extracted from the article]

Coronavirus disease-2019 (COVID-19) disease is often complicated by venous thrombosis and embolism. However, arterial thrombosis in a patient already on therapeutic anticoagulation is a rare occurrence. In one patient, we found thrombosis of the radial artery leading to ischemia of the fingers and lateral part of the palm. In another patient, thrombosis was found in the anterior tibial artery, resulting in ischemia of the limb and amputation. Both these patients were on a therapeutic dose of low-molecular-weight heparin. In both cases, heparin infusion was started but with little benefit. It is suggested that intensified anticoagulation should be done in patients at high-risk venous thrombosis, and prompt interventional thrombectomy should be done in cases of failure of pharmacological anticoagulation. [ABSTRACT FROM AUTHOR]

[Display omitted] • SARS-CoV-2 detection and monitoring by different electrochemical sensors. • Sensors are based on targets viz., nucleocapsid, spike antigen, immuno-globulin and viral nucleic acids. • Voltammetric, impedimetric, and amperometric techniques are the best practices. • High sensitivity and low limit of detection are observed with electrochemical sensors. Coronavirus (COVID-19), a deadly pandemic has spread worldwide and created many global health issues. Though methods of its detection are being continuously developed for the early detection and monitoring of COVID-19, still there is need for more novel methods. The presently used methods include rapid antigen tests, serological surveys, reverse transcription-polymerase chain reaction (RT-PCR), artificial intelligence-based techniques, and assays based on sensors/biosensors. Of all these, RT-PCR test has high sensitivity and specificity though it requires more time for testing and need for skilled technicians. Recently, electrochemical sensors have been developed for rapid monitoring and detection of SARS-CoV-2 from the patient's biological fluid samples. This review covers the recently developed electrochemical sensors that are focused on the detection of viral nucleic acid, immunoglobulin, antigen, and the entire viral particles. In addition, we also compare and assess their detection limits, sensitivities and specificities for the identification and monitoring of COVID-19. Furthermore, this review will address the best practices for the development of electrochemical sensors such as electrode fouling, limit of detection/limit of quantification determination and verification. [ABSTRACT FROM AUTHOR]

The importance of this intubation box has come to light recently in view of the COVID-19 pandemic and the fact that intubation is an aerosolgenerating procedure (AGP). Risks of the healthcare worker attending to the airway of COVID-19 patients is high and the intubation box aims to minimize that and reduce contamination of the environment. To address this objective of decreasing transmission during AGP, we created a negative airflow aerosol box with a leak-proof airway handling system using readily available and affordable materials. The dimension of this box was 24 x 17.5 x 17.5 cm and it was made of high-quality 4 mm transparent acrylic sheet with two arm holes of 10 cm diameter. The caudal end of the negative airflow aerosol prevention box is wrapped with disposable plastic sheet and the both hand slots are sealed using camera cover and latex hand gloves and it decreases the risk of contamination. [ABSTRACT FROM AUTHOR]

During this swab testing, it produces symptoms such as mild discomfort, sneezing, and coughing of COVID19 patients, which not only produces droplets and aerosol but also directly cause respiratory tract infections in health-care professionals.[[2]] This can lead to an increased risk of patient cross-infection and environmental contamination.[[3]] All health-care professionals before nasopharyngeal sampling must wear personal protective equipment. The gold standard method for diagnosing COVID-19 is real-time fluorescence-based real-time polymerase chain reaction of the upper respiratory tract samples, which includes throat swab, nasal swab, and lower respiratory tract samples like bronchoalveolar lavage.[[1]] The nucleic acid testing of COVID-19 mainly involves the nasopharyngeal swabs. [Extracted from the article]

Construction project delays are costly to stakeholders. Therefore, extensive research has been carried out in various countries covering different types of construction projects to identify delay factors and mitigation strategies. However, the literature has not documented the impact of a once-in-a-century event such as the COVID-19 pandemic on construction projects' schedules and costs. The present study uses a case study approach to examine the effect of the COVID-19 pandemic on three lift irrigation projects' construction programs and the financial implications for the contractor in the Indian construction industry. The findings reveal that the main factors responsible for delays due to the COVID-19 pandemic were fear of an outbreak, imposition of a nationwide lockdown, late return of workers, resource shortages, and changes in operating procedures. Furthermore, the study found that the contract conditions and government directives allowed for time extensions in construction projects by recognizing the pandemic as a force majeure. However, such provisions did not protect contractors' financial interests. This study evaluates the financial implications of the COVID-19 pandemic for the contractor in terms of worker compensation during the lockdown, idling of resources, overhead costs, cost escalation, and liquidity. The public health crisis from the COVID-19 pandemic led to a series of preventive measures from the government and organizations worldwide that caused severe disruptions in construction projects and disturbed the construction supply chain. This study recommends rethinking the scope and coverage of force majeure and excusable delay clauses in standard construction contracts beyond provisions for an extension of time to protect the financial interests of different stakeholders. The vagueness in assessing and compensating for the losses from unprecedented events such as the COVID-19 pandemic could expose construction organizations to significant financial risks and threaten their existence in a highly competitive industry. Therefore, construction organizations should carefully review the contract provisions of future projects for proper risk allocations to accommodate unprecedented events and pandemics to help them recover successfully from various disruptions and associated financial losses. Moreover, proper communication and negotiation, a supportive and collaborative project culture, and early government interventions are crucial in dealing with such events and avoiding disputes among project stakeholders. [ABSTRACT FROM AUTHOR]

Despite the effectiveness of COVID-19 vaccination in reducing the severity of the disease, the demand for booster is increasing in vulnerable populations like elderly and immunocompromised individuals especially with each new wave of COVID-19 in different countries. There is limited data on the sustained immunity against COVID-19 in patients with liver cirrhosis. The study was aimed to compare the T cell and humoral immune response after 1 year of ChAdOx1nCoV-19 Vaccine in patients with liver cirrhosis and healthy health care workers (HCW). This was a prospective observational study including 36 HCW, 19 liver cirrhosis patients and 10 unvaccinated individuals. Anti-SARS-CoV-2S antibody, neutralizing antibody and memory T cell subsets were evaluated by ELISA and flow cytometry, respectively, in all three groups after 1 year of initial vaccination. Compared to HCW and unvaccinated individuals, liver cirrhosis patients had significantly depleted T cells, although CD4:CD8 + T cell ratio was normal. Both cirrhotic patients and HCW developed memory T cell subset [effector memory RA (P = 0.141, P < 0.001), effector memory (P < 0.001, P < 0.001), central memory (P < 0.001, P < 0.01), stem cell memory (P = 0.009, P = 0.08) and naïve (P < 0.001, P = 0.02)] compared to unvaccinated unexposed individuals of CD4 + T and CD8 + T, respectively. However, among HCW and cirrhotic group no difference was noted on central memory and stem cell memory cells on T cells. Patients with liver cirrhosis developed comparable memory T cells after vaccination which can evoke sustainable immune response on reinfection. Therefore, additional vaccine doses may not be necessary for cirrhosis patients. [ABSTRACT FROM AUTHOR]

The outbreak of coronavirus COVID-19 not only brings great disaster to the people of the world, but also brings heavy burden to the medical and health network system. Massive network data traffic and resource optimization requests make traditional network architectures unable to calmly deal with the impact of COVID-19. Artificial intelligence (AI) can effectively raise the upper limit of the medical and health network, as evidenced by the ever-increasing restorative clinical data. In addition, the development of next-generation network (NGN) technologies based on machine learning (ML) has created unlimited possibilities for the emergence of emerging medical methods. In order to reflect the effective results of the current application of AI technologies in the fight against the COVID-19 epidemic and provide a reliable guarantee for subsequent diagnosis and treatment of COVID-19 epidemics, a series of AI technologies which can be used in the diagnosis and treatment of COVID-19 are systematically summarized and analyzed. Based on various AI technologies and methods, we try to propose an AI-based medical network architecture. The architecture uses AI technologies to quickly and effectively realize the monitoring, diagnosis and treatment of patients. Finally, we rationally analyzed the technical challenges and practical problems that may be faced in implementing the architecture. The purpose of this article is to inspire scholars and medical researchers to carry out the latest research in response to the COVID-19 epidemic and make breakthrough medical technology progress. [ABSTRACT FROM AUTHOR]

Unmanned Air Vehicles (UAVs) are becoming popular in real-world scenarios due to current advances in sensor technology and hardware platform development. The applications of UAVs in the medical field are broad and may be shared worldwide. With the recent outbreak of COVID-19, fast diagnostic testing has become one of the challenges due to the lack of test kits. UAVs can help in tackling the COVID-19 by delivering medication to the hospital on time. In this paper, to detect the number of COVID-19 cases in a hospital, we propose a deep convolution neural architecture using transfer learning, classifying the patient into three categories as COVID-19 (positive) and normal (negative), and pneumonia based on given X-ray images. The proposed deep-learning architecture is compared with state-of-the-art models. The results show that the proposed model provides an accuracy of 94.92%. Further to offer time-bounded services to COVID-19 patients, we have proposed a scheme for delivering emergency kits to the hospitals in need using an optimal path planning approach for UAVs in the network. [ABSTRACT FROM AUTHOR]

Background: The second wave of COVID‐19 in India was followed by large number of mucormycosis cases. Indiscriminate use of immunosuppressive drugs, underlying diseases such as diabetes, cancers, or autoimmune diseases was thought to be the cause. However, the mortality was not as high as that seen in non‐COVID mucormycosis. Objective: To study the detailed characteristics of T‐cells for evaluating the underlying differences in the T‐cell immune dysfunction in post‐COVID and non‐COVID mucor patients. Material and method: The study included histopathologically confirmed cases of mucor (13 post‐COVID, 13 non‐COVID) and 15 healthy individuals (HI). Expression of T‐cell activation (CD44, HLADR, CD69, CD38) and exhaustion (CTLA, PD‐1, LAG‐3 and TIM‐3) markers was evaluated by flow cytometry. Results: All cases showed significant depletion of T‐cells compared to HI. Both post‐COVID and non‐COVID groups showed increased activation and exhaustion as compared to HI. Non‐COVID mucor group showed significant activation of CD4+ T cells for HLADR and CD38 (p =.025, p =.054) and marked T‐cell exhaustion in form of expression of LAG‐3 on both CD4+ T and CD8+ T cells in comparison with post‐COVID patients (p =.011, p =.036). Additionally, co‐expression of PD‐1 & LAG‐3 and LAG‐3 & TIM‐3 on CD8+ T cells was statistically significant in non‐COVID mucor patients (p =.016, p =.027). Conclusion: Immunosuppression in non‐COVID mucor showed pronounced exhaustion of T‐cells in comparison to post‐COVID mucor cases implicating T‐cell immune dysfunction is much more severe in non‐COVID mucor which are in a state of continuous activation followed by extreme exhaustion leading to poorer outcome. [ABSTRACT FROM AUTHOR]

Indian data regarding serious neurological and psychiatric adverse events, following coronavirus disease 2019 (COVID‑19) vaccination, are lacking. We, therefore, systematically evaluated cases of post‑vaccinal serious neurological and psychiatric adverse reactions published from India. A systematic review of cases published from India, which were archived in PubMed, Scopus, and Google Scholar databases, was performed; pre‑print databases along with ahead‑of‑print contents were searched in addition. Retrieved articles, as on June 27, 2022, were evaluated following PRISMA guidelines. EndNote 20 web tool was used to make a PRISMA flow chart. Individual patients’ data were compiled in a tabular form. The protocol of the systematic review was registered with PROSPERO (CRD42022324183). A total of 64 records describing 136 instances of serious neurological and psychiatric adverse events were identified. More than 50% (36/64) reports were from the following four states, namely, Kerala, Uttar Pradesh, New Delhi, and West Bengal. The mean age of persons developing these complications was 44.89 ± 15.77 years. In the majority, adverse events occurred within 2 weeks of administration of the first dose of COVISHIELD vaccine. Immune‑mediated central nervous system (CNS) disorders were identified in 54 instances. Guillain‑Barre syndrome and other immune‑mediated peripheral neuropathies were reported in 21 cases. Post‑vaccinal herpes zoster was recorded in 31 vaccine recipients. Psychiatric adverse events were recorded in six patients. In Indian recipients of COVID‑19 vaccine, a variety of serious neurological complications were reported. The overall risk appears minuscule. Immune‑mediated central and peripheral neuronal demyelinations were the most frequently reported post‑vaccinal adverse events. A large number of cases of herpes zoster have also been reported. Immune‑mediated disorders responded well to immunotherapy. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is rapidly spreading across the globe and infected millions of people that take hundreds of thousands of lives. Over the years, the role of Artificial intelligence (AI) has been on the rise as its algorithms are getting more and more accurate and it is thought that its role in strengthening the existing healthcare system will be the most profound. Moreover, the pandemic brought an opportunity to showcase AI and healthcare integration potentials as the current infrastructure worldwide is overwhelmed and crumbling. Due to AI's flexibility and adaptability, it can be used as a tool to tackle COVID-19. Motivated by these facts, in this paper, we surveyed how the AI techniques can handle the COVID-19 pandemic situation and present the merits and demerits of these techniques. This paper presents a comprehensive end-to-end review of all the AI-techniques that can be used to tackle all areas of the pandemic. Further, we systematically discuss the issues of the COVID-19, and based on the literature review, we suggest their potential countermeasures using AI techniques. In the end, we analyze various open research issues and challenges associated with integrating the AI techniques in the COVID-19. [ABSTRACT FROM AUTHOR]

Oxygen supplementation is required for approximately 14% of the patients diagnosed of having COVID-19 infection. Despite the use of conventional oxygen therapy, 5% among these require treatment in the intensive care unit (ICU). Here, we are describing a situation in which oxygen therapy was delivered to the patients by making an assembly of oxygen tubing, three-way stopcock, and high-flow nasal cannula (HFNC) present in the hospital setting following the malfunction of air blender of HFNC machine (Fig. 1). This assembly might be useful as rescue oxygen therapy during a malfunction of HFNC machine and in resource-limited settings where HFNC machine is not available. The mechanisms of action could be (1) washout of anatomic dead space due to medium oxygen flow, (2) improved gas mixing in large airways, and (3) increased oxygen concentration inside the conducting airway. [ABSTRACT FROM AUTHOR]

[Display omitted] • MIPs-based electrochemical sensors for COVID-19 diagnostic are cost-effective, exhibit high selectivity and specificity. • MIPs nano-sensors are stable at extreme conditions. • MIPs nano-sensors can be easily fabricated and integrated with IoT. The importance of early diagnosis of infectious disease has been revealed well by the COVID-19 pandemic. The current methods for testing SARS-CoV-2 mainly utilize biorecognition elements. The process of production of these biorecognition elements is not only tedious, time-consuming but also costly. The molecularly imprinted polymers recently have gained considerable attention as they are stable and also offer high selectivity and specificity than conventional labels. The present review discussed the MIPs-based electrochemical nano-sensors diagnostic of SARS-CoV-2. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 has caused a global pandemic, and has taken over 1.7 million lives as of mid-December, 2020. Although great progress has been made in the development of effective countermeasures, with several pharmaceutical companies approved or poised to deliver vaccines to market, there is still an unmet need of essential antiviral drugs with therapeutic impact for the treatment of moderate-to-severe COVID-19. Towards this goal, a high-throughput assay was used to screen SARS-CoV-2 nsp15 uracil-dependent endonuclease (endoU) function against 13 thousand compounds from drug and lead repurposing compound libraries. While over 80% of initial hit compounds were pan-assay inhibitory compounds, three hits were confirmed as nsp15 endoU inhibitors in the 1–20 μM range in vitro. Furthermore, Exebryl-1, a ß-amyloid anti-aggregation molecule for Alzheimer's therapy, was shown to have antiviral activity between 10 to 66 μM, in Vero 76, Caco-2, and Calu-3 cells. Although the inhibitory concentrations determined for Exebryl-1 exceed those recommended for therapeutic intervention, our findings show great promise for further optimization of Exebryl-1 as an nsp15 endoU inhibitor and as a SARS-CoV-2 antiviral. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) is an emerging and highly infectious disease making global public health concern and socio-economic burden. It is caused due to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). It has the tendency to spread rapidly through person-to-person. Currently, several molecular diagnostic platforms such as PCR, qRT-PCR, reverse transcription loop-mediated isothermal amplification (RT-LAMP), CRISPR are utilized for the diagnosis of SARS-CoV-2. These conventional techniques are costly, time consuming and require sophisticated instrumentation facility with well trained personnel for testing. Hence, it is tough to provide testing en-masse to the people in developing countries. On the other hand, several serological biosensors such as lateral flow immunosensor, optical, electrochemical, microfluidics integrated electrochemical/fluorescence is currently utilized for the diagnosis of SARS-CoV-2. In current pandemic situation, there is an urgent need of rapid and efficient diagnosis on mass scale of SARS-CoV-2 for early stage detection. Early monitoring of viral infections can help to control and prevent the spreading of infections in large chunk of population. In this review, the SARS-CoV-2 and their biomarkers in biological samples, collection of samples and recently reported potential electrochemical immunosensors for the rapid diagnosis of SARS-CoV-2 are discussed. [ABSTRACT FROM AUTHOR]

Severe coronavirus disease-2019 (COVID-19) is a distinct entity that rapidly evolves and may abruptly culminate in to a critical illness. As per Chinese experience, approximately, 15% of patients of COVID-19 progress to severe disease and 5% become critically ill. The incidence of severe and critical illness is higher among men, patients older than 65 years of age and in persons with other medical comorbidities. Cytokine storm cause pronounced lung damage and multiorgan failure. Coagulopathy is a key component of severe COVID-19. Critically ill patients are generally predisposed to a high risk of thromboembolism as well. Lymphopenia predisposes to severe disease. None of the antiviral or immunomodulators has proven efficacy in severe COVID-19. Supplemental oxygen need be administered in patients with hypoxemia. Excessive breathing effort, acute respiratory distress syndrome (ARDS), encephalopathy, and multiorgan failure are indications for mechanical ventilation. In a large number of patients, the overall outcome is poor. Health care workers in intensive care units are exposed to the enormous risk of acquiring hospital acquired SARS-COV-2 infection. [ABSTRACT FROM AUTHOR]

Approximately 5-6% of patients diagnosed to have COVID-19 infection present with severe hypoxemia requiring invasive ventilation or noninvasive ventilation (NIV). Additional oxygen to patients on NIV can be given by nasal prong or by connecting oxygen tubing directly to the O2 pick-off port of the NIV mask or by connecting oxygen tubing to the single-limb circuit in between ventilator and patient. Dual oxygen therapy improves oxygenation in COVID-19 patients on NIV. This method may make the patient more comfortable, increase tolerance to NIV, increase the usefulness of NIV for moderate and severe COVID-19 acute respiratory distress syndrome (ARDS). [ABSTRACT FROM AUTHOR]

The proliferating outbreak of COVID-19 raises global health concerns and has brought many countries to a standstill. Several restrain strategies are imposed to suppress and flatten the mortality curve, such as lockdowns, quarantines, etc. Artificial Intelligence (AI) techniques could be a promising solution to leverage these restraint strategies. However, real-time decision-making necessitates a cloud-oriented AI solution to control the pandemic. Though many cloud-oriented solutions exist, they have not been fully exploited for real-time data accessibility and high prediction accuracy. Motivated by these facts, this paper proposes a cloud-oriented AI-based scheme referred to as D-espy (i.e., Disease-espy) for disease detection and prevention. The proposed D-espy scheme performs a comparative analysis between Autoregressive Integrated Moving Average (ARIMA), Vanilla Long Short Term Memory (LSTM), and Stacked LSTM techniques, which signify the dominance of Stacked LSTM in terms of prediction accuracy. Then, a Medical Resource Distribution (MRD) mechanism is proposed for the optimal distribution of medical resources. Next, a three-phase analysis of the COVID-19 spread is presented, which can benefit the governing bodies in deciding lockdown relaxation. Results show the efficacy of the D-espy scheme concerning 96.2% of prediction accuracy compared to the existing approaches. [Display omitted] • An AI-based disease prediction model that predicts the COVID-19 cases. • A medical resource distribution (MRD) scheme that help to allocate medical resources. • A three-phase analysis of the proposed scheme is done in the Indian context. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 is the pathogen that causes coronavirus disease-2019 (COVID-19). Recent studies have shown that the "cytokine storm" (high concentration of proinflammatory cytokines) may contribute to the mortality of COVID-19. Repeated exposure to the virus can lead to a dose-dependent immune response that may be associated with more disease severity and higher mortality. Sudden deterioration/increased oxygen consumption after initial improvement may be due to multiple surges of cytokines storm within a short period, the possible cause may be due to multiple exposures within the incubation period. We hypothesize that multiple surges in cytokines storm in some patients may be due to multiple exposures of the same patient within the incubation period, sepsis, or other inflammatory lesions inside the body. In our cases, sepsis as a cause of cytokine storm was ruled out by doing the procalcitonin test, which was within the normal limit. [ABSTRACT FROM AUTHOR]