Review: What are the latest Studies saying about COVID-19 in India?
Ever since the onset of COVID-19 in India, efforts are on to understand the virus and its effects with more clarity. The latest issue of Indian Journal of Medical Research (IJMR) published a few of these studies. We summarise three such studies that look at the profile of COVID-19 patients in North India, a mathematical model to study the impact of lockdown and the comparison between RT-PCR & rapid tests for COVID-19 diagnosis in India. ... more...
In earlier stories, we looked at important research and studies around COVID-19 being carried out in India up until July 2020. We referred to the articles published in various issues of ICMR (Indian Council of Medical Research)’s Indian Journal of Medical Research (IJMR). In this article, let us understand the relevant research developments that have further informed our understanding of COVID-19 since July 2020.
While young and asymptomatic patients were in majority, patients with comorbidities more vulnerable to complications.
The COVID-19 pandemic emerged as a major public health emergency. Considerable disparities in demographic and clinical patterns have been observed between countries across different continents. A study conducted by ICMR in northern India analyses the clinical profile and outcomes of patients with COVID-19. The study was conducted at the Nehru Hospital Extension Block, a dedicated COVID hospital at the Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India, from April 1 to May 25, 2020. The major findings of the study are as follows:
This study highlights the clinical characteristics and outcomes of consecutive adult patients (12 yr) who tested positive on RT-PCR for COVID-19 on a throat and/or a nasopharyngeal swab and were admitted to a tertiary care hospital. Pregnant women and children were not included in the study.
During the study period, 114 patients with COVID-19 infection were admitted. The median age of the patients was 33.5 yr (13-79 yr), and there were 66 (58%) males. The history of contact with COVID-19-affected individuals was available in 75 (65.8%) patients. Of the total enrolled patients, 48 (42%) were symptomatic. Among the symptomatic patients, the common presenting complaints were fever (37, 77%), cough (26, 54%) and shortness of breath (10, 20.8%). Nineteen (17%) patients had hypoxia. Thirty four (29.8%) patients had an accompanying comorbid illness. These comorbidities included hypertension in 19 (16.6%), diabetes in 17 (14.9%) and chronic renal disease in three (2.6%) patients. Ten patients (8.7%) had multiple comorbidities. Age more than 60 yr and presence of diabetes and hypertension were significantly associated with severe COVID-19 disease. Admission to the intensive care unit (ICU) was needed in 18 patients, with three (2.6%) patients requiring assisted ventilation. Mortality of 2.6 per cent (3 patients) was observed.
Asymptomatic patients were younger with a mean age of 29.90 ± 12.91 yr while the mean age of patients with severe COVID-19 was 55.9 ± 12.91 yr. Comorbidities including hypertension and diabetes were observed more frequently in patients who were symptomatic as compared to those who were asymptomatic.
Fifty nine (51.75%) patients were given specific therapies for COVID-19. Thirty seven patients (32.4%) received hydroxychloroquine (HCQ), 20 (17.54%) received a study drug Immuvac-18 and two patients (1.75%) received tocilizumab (interleukin-6 inhibitor). By the end of 25 May 2020, 108 (94.7%) patients were discharged, three were still undergoing treatment and three (2.6%) patients had died. All the three patients who succumbed to the illness had diabetes mellitus, while two patients also had chronic kidney disease.
Initial lockdown slowed down the spread of COVID-19 significantly for the country.
Another important study by ICMR presented a mathematical model for a time series prediction and analysed the impact of lockdown in the country. Several existing mathematical models were not able to account for asymptomatic patients, with limited testing capability at onset and no data on sero-surveillance. In this study, a new model was used which was developed on lines of susceptible-asymptomatic-infected-recovered (SAIR) to assess the impact of the lockdown and make predictions on its future course. The major findings of the study are as follows:
A consultative committee was constituted by the Department of Science and Technology to develop a supermodel consisting of mathematical predictions as related to the COVID-19 pandemic in India. Several mathematical models namely the standard susceptible-infected-recovered (SIR)/susceptible-exposed-infected-recovered (SEIR) models failed to account for asymptomatic patients. Limited testing capability in India at the time of onset of the pandemic and non-availability of data on asymptomatic cases were some of the limitations. Building on earlier models and in-depth analysis, a new susceptible-asymptomatic-infected-recovered (SAIR) model was proposed to assess the magnitude of the impact of the lockdown on the disease burden.
The effect of lockdown and the spread in active infections and hypothetical effects of timing of lockdown are depicted in the following chart.
The mathematical model used in this study was developed to analyze the spread of the disease under three different hypothetical scenarios, namely no lockdown, lockdown starting 01 April 2020 and lockdown starting 01 May 2020. The study concludes that with no lockdown and significant travel all over, the spread of the virus would have happened much faster. It revealed that if there was no lockdown, the number of active infections would have peaked at 14+ million and the peak would have arrived by mid-May.
Comparison of test accuracy for rRT-PCR and RDT
In another interesting study by ICMR, diagnostic test accuracy was studied along with its implications for COVID-19 management in India. In an earlier article, we discussed how WHO has recommended real-time reverse transcription-polymerase chain reaction (RT-PCR) as the diagnostic method to be used for COVID-19. The limited supply of RT-PCR kits and reagents made meeting the rising demand for increased testing incompetent, worldwide. The objective of this study was to evaluate the performance of a rapid chromatographic immunoassay-based test (index test) compared with a clinical reference standard (RT-PCR).
The RT-PCR received emergency use authorization (EUA) by the Center for Disease Control and Prevention (CDC) for the qualitative detection of COVID-19 from the respiratory specimens. The RT-PCR testing requires a sophisticated Biosafety level (BSL)-2/BSL3 laboratory setup and trained technicians to run the test and interpret results. The RT-PCR takes a minimum of 8-10 h from the collection of swab to reporting of results, which can further increase in resource-limited and high-burden settings. In small towns and cities, molecular diagnostic laboratories are non-existent and the reagents/viral transport medium (VTM) and resources are difficult to procure. Therefore, the study argues that a highly sensitive and specific antigen-based rapid diagnostic test (RDT) is the need of the hour.
Many diagnostic test manufacturers are developing/have developed rapid diagnostic kits and devices to facilitate point-of-care testing. These sample kits are based on either antibody detection from blood/plasma/serum or the detection of SARS-CoV-2 antigens from respiratory samples. However, there is very limited data on the performance and potential diagnostic utility of a rapid chromatographic immunoassay-based test for COVID-19 in suspected patients. Therefore, the study evaluates the results with RDT & compares it with RT-PCR for the diagnosis of COVID-19 in India.
A cross-sectional, single-blinded, single-centre study was conducted at a tertiary care teaching hospital in north India. Patients eligible for inclusion were consecutive adults (18 yr) with suspected COVID-19 infection. Paired samples were taken for RDT and RT-PCR (reference standard) from consecutive participants screened for COVID-19 to calculate the sensitivity and specificity of the RDT. Further subgroup analysis was done based on the duration of illness and cycle threshold values.
Of the 330 participants, 77 were RT-PCR positive for COVID-19. Sixty four of these patients also tested positive for COVID-19 by RDT. The RDT was found to have an acceptable overall sensitivity and specificity of 81.8% and 99.6% respectively. The sensitivity of RDT was higher (85.9%) in participants with a duration of illness ≤5 days.
The study concludes that RDT may be used to rule in COVID-19 in patients with a duration of illness ≤5 days. The advantages of RDT such as yielding rapid results, being at a reasonable price and being safe due to viral inactivation and the fact that this does not require sophisticated laboratory set-up or technical expertise make it an ideal test to be rolled out in high-prevalence community settings. However, this test may not be good for surveillance purposes because negative results cannot rule out COVID-19 infection, all negative tests should be covered by RT-PCR. Moderate sensitivity of the RDT can lead to false-negative results, which must be taken into consideration while making diagnostic algorithms.
A lot of us wait for winters to arrive as it brings respite from the summer heat and humidity. But with the nip in the air, one needs to be extra careful with their physical regime and daily dietary habits by including seasonal foods to ensure the body’s immunity is at its best. While there are many such foods that can help you with the same, have you ever tried jaggery or gur in combination with other common ingredients?
Celebrity nutritionist Rujuta Diwekar recently shared an informative post on Instagram. ... more...
Take a look.
A post shared by Rujuta Diwekar (@rujuta.diwekar)
“On its own, jaggery can do many things — works as a digestive, improves fertility, bone density etc. But when mixed with others, it uses its power to improve their efficacy. In that sense, I find jaggery or gul or gud, very giving and generous,” she said.
Here’s how you can pair jaggery with other kitchen ingredients to alleviate recurring winter health issues.
*With ghee – relief from constipation
From Ayurvedic kadhas to herbal meals: Immunity boosters are now serious business
*With dhaniya or coriander seeds – eases bleeding, reduces period pain, useful when you are only spotting and want periods to start
*With fennel seeds – removes bad breath and reduces plaque formation
*With methi or fenugreek seeds – for stronger, lustrous hair; prevents greying
*With gond – improves bone density and works as a lactation agent in nursing mothers
*With aliv or halim seeds- improves folic acid and iron assimilation, reduces skin pigmentation, good for hair growth too
*With til or sesame seeds – reduces chances of cold, cough and flu
*With peanuts – improves strength, regulates appetite and reduces cravings
*With haldi or turmeric– boosts immunity
*With soonth or dry ginger – accelerates recovery from fever and reduces inflammation
School Reopening News: The Madhya Pradesh government also confirmed that the board examinations 2021 will be conducted. Besides, those studying in Class IX and XI will be called to the school once or twice a week.
New Delhi: The Shivraj Singh Chouhan-led Madhya Pradesh government has decided to extend the closure of schools at least till March 31, in the wake of the coronavirus pandemic. However, regular classes for Class 10th and 12th students will commence shortly. Also Read - Millionaire Overnight! MP Farmer Finds Diamond Worth Rs 60 lakh in Land He... more...
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The Madhya Pradesh government also confirmed that the board examinations 2021 will be conducted. Besides, those studying in Class IX and XI will be called to the school once or twice a week. Also Read - COVID-19 May Cause Long-Term Erectile Dysfunction In Men, Warns Expert
“There will be no classes for Class I to VIII in the state till March 31. The upcoming academic session will start from April 1, 2021. Classes I to VIII will be evaluated on the basis of project work. Board exams will be held for Class X and XII and their classes will begin soon. Social distancing and other precautions will be fully observed in the classrooms. ,” a leading portal quoted CM Chouhan as saying. Also Read - Varun Dhawan Confirms he Has Tested Positive For Coronavirus
He made the announcement after a review meeting of the School Education Department which took place in Bhopal on Friday.
Notably, schools and colleges across the country have been closed since March 16 when the Centre announced a countrywide classroom shutdown as part of measures to contain the spread of the novel coronavirus. While several restrictions have been eased in different phases of Unlock’ since June 8, educational institutions continue to remain shut as a precautionary measure.
Deputy Chief Minister and Health Minister Alla Kali Krishna Srinivas enquiring the health condition of the patients who were admitted in Eluru Government General Hospital with giddiness and epilepsy symptoms. | Photo Credit: Special Arrangement
Over 170 people, including several women and children, were admitted with some unknown disease in the Government General Hospital (GGH) in Eluru in West Godavari district during the last couple of days, according to officials. ... more...
The number of in-patients which was 55 on Saturday midnight went up to 170 by Sunday morning, the officials said.
Patients were suffering from dizziness, headache and epilepsy-type symptoms, said a doctor treating them.
Most of the cases were reported from Kobbari Thota, Kothapeta, Toorpu Veedhi and Arundhati Peta.
Medical teams from different hospitals in West Godavari and Krishna districts were rushed to the colonies, where the patients are being treated in special camps.
“Water, food and blood samples have been sent to the Forensic Science Laboratory (FSL) and the reports are awaited. CT scan and X-ray reports are normal,” the doctors said.
Deputy Chief Minister and Health Minister Alla Kali Krishna Srinivas, Collector R. Mutyala Raju, Superintendent of Police K. Narayan Naik, Joint Collector Himanshu Shukla and other officials visited the GGH and enquired about the condition of the patients.
Mr. Shukla said call centres had been set up at the Eluru municipal office. Residents may call phone Nos. 9154565529 or 9154592617 in case of any emergency.
Some patients were undergoing treatment in various private hospitals also, the Joint Collector said.
“About 30 patients were discharged from the GGH. There is no need to panic. Patients are responding well to treatment and the recovery rate is good,” said Mr. Shukla.
On Sunday, during the 2nd ODI between India and Australia, an unsual sight took the audience by surpirse. During the 20th over, an Indian man in the crowd decided to propose to his Australian girlfriend in between the match. He bent on his knees, pulled out a ring and asked her for marriage. The beautiful moment was captured on camera and the crowd went gaga over the spectacular event.
SHE SAID YES ‼️ 💍📺 Watch Game 2 of the #AUSvIND ODI Series Ch 501 or 💻 Stream on Kayo: click here... more...
While the crowd cheered and applauded, the girl was seen nodding in affirmation. The duo kissed and the waved to the camera and the overzealous crowd. “Well! Here we go… Please say Yes! Please say yes! That’s the confirmation. It is always a risky play, isn’t it?” a commentator exclaimed.
Netizens appreciate the idea behind the proposal
Netizens were also in awe of the romantic gesture of the Indian man towards his girlfriend. Twitter user Suchita Sharma wrote, “Aww this is so cute and romantic. Love has no boundaries. She said Yes.”
Aww this is so cute & romantic😍😍😍 Love has no boundaries😍😍😍#She said Yes💑💋💋❤❤❤ click here
Another user (@purpplebella) tweeted, “Wow… It is so romantic.. I want my future partner to do this for me.”
Wow… It is so romantic.. I want my future partner to do this for me click here
Twitter user Shraddha wrote, “This is honest to God the most beautiful thing ever”
This is honest to god the most beautiful thing ever 😭 click here
Netizens use ‘cricketing references’ to applaud the gesture
Although dismayed by the bowling performance of India in the said match, netizens appreciate the proposal of the man using cricketing references. Twitter user Suryam KV tweeted, “I think the guy knows the match outcome already, so why to waste time when your gf is next to you..Let’s make SCG more interesting..”
I think the guy know the match outcome already, so why waste time when your gf is next to you..Let’s make #SCG more interesting..#AUSvsIND #INDvsAUS #Captaincy #propose #Love click here
Other Twitter users pull his leg with ‘only Indian winning today’, ‘India winning over Australia’ and ‘player of the match’ titles.
Several Twitter users also jokingly hinted that the man’s visa is to Australia is permanently secured. “Today during a match… one more Indian successfully get a permanent residency in Australia,” one Kashif Baig remarked. Another Twitter user (@JaydenCFC04) wrote, “My man secured his Australia visa now.”
Today during a match … one more Indian successfully get a permanent residency in Australia. click here