Evaluation of the Effect of COVID-19 Pneumonia on Kidney Function

Background: Severe acute respiratory tract infection, pneumonia, kidney failure, and multi-organ failure may develop in cases that result in death due to COVID-19. It is emphasized that the awareness of healthcare professionals about kidney functions should be increased in cases of COVID-19 pneumonia. Quick and effective steps can be taken in the treatment of COVID-19 pneumonia with the controlling approach of nurses to changes in kidney functions. Method: This study was carried out retrospectively to evaluate the kidney functions of patients diagnosed with COVID-19 pneumonia who were hospitalized in the pandemic hospital. Hospital and nurse observation files of 120 patients who were introduced to COVID-19 pneumonia between 1 May and 30 November 2020 were examined. Categorical data were described as continuous data as median with interquartile range (IQR) and percentages (%). Results: In total, 30 patients (25.0%) required mechanical ventilation, Overall, 39.1% (47) developed acute kidney injury during hospitalization, out of which 10.8% reached stage 1, 15.0% reached stage 2, and 13.3% reached stage 3. Dialytic support was required for seven (17.1% of all patients). COVID-19 pneumonia patients had higher levels of aspartate aminotransferase (AST) (55.02±58.04), alanine aminotransferase (ALT) (74.07±140.94), lactate dehydrogenase (LDH) (483.48±477.51), C-reactive protein (CRP) (88.02±72.17), D-dimer (1023±1548.01), procalcitonin (3.70± 6.52). In addition, a proportion of COVID-19 pneumonia patients but no non-COVID-19 pneumonia patients had abnormally increased AST (10.0-274.0), ALT (7.0-854.0), LDH (164-3547), CRP (5.10- 310.90), D-dimer (151-6212), procalcitonin (195-433). SpO2 of COVID-19 pneumonia patients had 78-97%, patients who need dialysis treatment due to pneumonia, follow-up coagulation profile (Procalcitonin, LDH, D-dimer), liver-renal function (ALT, AST, Creatine, Urea, Albumin), assessing signs of DVT and psychological support. 89 patients (74.2%) received corticosteroid, 73 patients (60.8%) received expectorant, 61 patients (50.8%) received vitamin C or B complex, 110 patients (91.7%) received anticoagulant and 73 patients (60.8%) received antibiotics. All of the COVID-19 pneumonia patients received the antiviral drug. Conclusion: As the disease progresses, differences in laboratory results and radiological findings may indicate that some complications have developed. COVID-19 pneumonia draws attention with liver function tests such as AST / ALT, LDH, infection markers in the blood, and the high rate of coagulation factors such as PCT and D-dimer during the hospital stay. The fact that these elevated values ​​may cause necrosis in the kidneys also brings about the truth. Careful monitoring of laboratory findings such as elevation of AST / ALT, LDH, PCT, and D-dimer in patients who develop pneumonia due to COVID-19 may provide early action for kidney damage.

EFFECTIVENESS OF PARENTAL PARTICIPATION PROGRAMME REGARDING PREVENTION OF PNEUMONIAAMONG PARENTS OF CHILDREN DIAGNOSED WITH ACUTE RESPIRATORY TRACT INFECTION (ARTI) IN SELECTED HOSPITAL OF DEHRADUN

AQuasi -experimental research design was adopted as research design for the study with the objectives to assess parents' knowledge and practice regarding prevention of pneumonia after ARTI of under ve children. Total 64 parents of under ve children were selected as sample by purposive sampling technique. It was done at Paediatric ward of Himalayan hospital in Dehradun. Data were collected by using structured knowledge questionnaire and self- reported practice checklist. Data were analyzed by used of descriptive and inferential statistics based on objectives and hypotheses .The assessment of the pretest knowledge score of Parents had average knowledge 33 (51.57%) regarding prevention of pneumonia and 24(37.50%) had good knowledge, 4(6.25%) had excellent knowledge and only 3(4.69 %) parent had poor knowledge at the base line before interventions. After implementation of parental participation programme the mean post-test knowledge of parents (21.36±2.509) score was more than pre-test knowledge score (12.88±3.994). The practice score of parents was 2(3.13%) had average practice and 62(96.87%) had good practice where as in post-test practice score 64 (100%) had good practice after implementation of parental participation programme. And there was no signicant association found between pre-test knowledge and Pretest practice with their selected socio demographic variables, and week correlation found between knowledge and practice of parents.

Risk Factors and Medical Resource Utilization of Respiratory Syncytial Virus, Human Metapneumovirus and Influenza Related Hospitalizations in Adults – A Global Study During the 2017-2019 Epidemic Seasons (Hospitalized Acute Respiratory Tract Infection [HARTI] Study)

Background Respiratory syncytial virus (RSV), human metapneumovirus (hMPV) and influenza are respiratory pathogens leading to hospitalization in adults. Understanding disease burden is limited to data from single-center or one-season studies in elderly patients. The HARTI study allows comparison of risk factors for progression to severe disease and medical resources utilization (MRU) during and post-hospitalization in adults diagnosed with influenza, RSV, or hMPV. Methods This was a prospective global study in adults hospitalized with acute respiratory tract infection (40 centers, 12 countries). Participants with influenza, RSV, or hMPV were enrolled in a substudy and followed up to three months post-discharge. Results Overall, 366 influenza, 238 RSV, and 100 hMPV-infected participants enrolled in the substudy. RSV participants were older, had greater frequency of risk factors, and longer duration of symptoms prior to hospitalization than influenza participants. RSV and hMPV groups received more bronchodilators, corticosteroids, and oxygen supplementation. No significant differences in intensive care unit admissions or complications were observed. Readmission occurred in 20-33% of patients within three months post-discharge, with highest rates for RSV and hMPV. In-hospital death occurred in 2.5% RSV, 1.6% influenza, and 2% hMPV participants. In multivariate analyses, length of stay was independently associated with country, renal disease, and increased age; probability of receiving supplemental oxygen was associated with pathogen (hMPV>RSV>influenza), abnormal chest x-ray, and increased age. Conclusions Although influenza is more frequent, the HARTI study demonstrates greater frequency of underlying risk factors and MRU for RSV and hMPV versus influenza in hospitalized adults, indicating need for effective interventions.

CORRELATION OF PARENTING STYLE AND INFECTIOUS DESEASE TOWARDS TODDLERS NUTRITIONAL STATUS IN SCAVENGER FAMILIES

ABSTRACT The period of toodler (below five years old children) is very important; it is also a critical period which determines their future. Today, there are many children who have no adequate nutrients in their growth and development. The data in 2013 revealed that 17% or 98 million children in the developing countries underwent nutrition deficiency. The objective of the research was to find out the correlation of care pattern and infectious diseases with nutrition status of scavengers’ children at the Terjun Landfill, Medan Marelan Sub-district. The research used a survey method with cross sectional design. The samples were 84 toodlers at Lingkungan I, Kelurahan Paya Pasir. The variables were care pattern and infectious diseases. The data were analyzed by using chi square test. The result of the research showed that 45 children had good nutritional status, based on BB/U (Weight/Age), TB/U (Height/Age), and BB/TB (Weight/Height). Care pattern was assessed from three sub-variables: feeding pattern, health practice, and sanitation practice. All in all, the majority of the women had care pattern well, and there were two infectious diseases: diarrhea and ISPA (Acute Respiratory Tract Infection). The result of chi square test showed that there was no correlation between care pattern and toodler’s nutritional status, but there was the correlation between infectious diseases and their nutritional status (p=0.002). It is recommended that women not take their children to a landfill since children are vulnerable to infection. Hygiene and environmental sanitation should be promoted so that the respondent will be prevented from infectious diseases.Keywords: Balita, Care Pattern, Infectious Disease, Nutritional Status, Scavengers

The correlation between serum selenium, zinc, and COVID-19 severity: an observational study

Background Without an adequate immune response, SARS-CoV2 virus can simply spread throughout the body of the host. Two of the well-known immunonutrients are selenium (Se) and zinc (Zn). Se and Zn deficiency might lead to inflammation, oxidative stress, and viral entry into the cells by decreasing ACE-2 expression; three factors that are proposed to be involved in COVID-19 pathogenesis. Thus, in the current study we aimed at evaluating the correlation between serum Se and Zn status and COVID-19 severity. Methods Eighty-four COVID-19 patients were enrolled in this observational study. Patients were diagnosed based on an infectious disease specialist diagnosis, using WHO interim guidance and the recommendations of the Iranian National Committee of Covid-19. The patients with acute respiratory tract infection symptoms were checked for compatibility of chest computed tomography (CT) scan results with that of Covid-19 and Real-time polymerase chain reaction (RT-PCR) for corona virus infection. The severity of Covid-19 was categorized into three groups (mild, moderate, and severe) using CDC criteria. Serum Zn and Se level of all subjects was measured. The severity of the disease was determined only once at the onset of disease. Results According to the results of linear regression test, there was a significant association between Zn and Se level and COVID-19 severity (β = − 0.28, P-value = 0.01 for Se; β = − 0.26, P-value = 0.02). However the significance disappeared after adjusting for confounding factors. Spearman correlation analysis showed a significant negative association between serum Zn, Se and CRP level (r = − 0.35, P-value = 0.001 for Se; r = − 0.41, P-value < 0.001 for Zn). Conclusion Results suggest that increasing levels of Se and Zn were accompanied by a decrease in serum CRP level. However, the significant association between Se, Zn, and disease severity was lost after adjusting for confounding factors.

1378The effect of vitamin D supplementation on acute respiratory infection -analysis of the D-Health Trial

Background Observational studies link vitamin D deficiency with acute respiratory tract infection (ARTI) but results from randomised controlled trials are heterogeneous. Methods We used data from The D-Health Trial (N = 21,315); ARTI was a pre-specified trial outcome. Participants were men and women aged 60 to 79 years (with volunteers aged up to 84 years), supplemented with monthly doses of 60,000 international units of vitamin D and followed for up to 5 years. Participants were asked to report occurrence of ARTI over the previous month via annual surveys, and a subset of participants completed 8-week respiratory symptom diaries in winter. We used regression models to estimate odds ratios, rate ratios and rate differences. Results Vitamin D supplementation did not reduce the risk of ARTI (survey OR 0.98, 95% CI 0.93 to 1.02; diary OR 0.98, 95% CI 0.83 to 1.15). Analyses of diary data showed that vitamin D reduced the average duration by 0.5 days (95% CI 0.2 to 0.7 days) and the average number of days with severe symptoms by 0.4 days (95% CI 0.3 to 0.6 days). Conclusions Monthly bolus doses of 60,000 IU of vitamin D did not reduce the overall risk of ARTI but slightly reduce the duration of symptoms in the general population. Key messages The reduction in the duration of symptoms suggests a potential impact of vitamin D on the immune response to infection.

Animal Models for COVID-19: Hamsters, Mouse, Ferret, Mink, Tree Shrew, and Non-human Primates

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus causing acute respiratory tract infection in humans. The virus has the characteristics of rapid transmission, long incubation period and strong pathogenicity, and has spread all over the world. Therefore, it is of great significance to select appropriate animal models for antiviral drug development and therapeutic effect evaluation. Here, we review and compare the current animal models of SARS-CoV-2.

Etiological and epidemiological features of acute respiratory infections in China

Nationwide prospective surveillance of all-age patients with acute respiratory infections was conducted in China between 2009‒2019. Here we report the etiological and epidemiological features of the 231,107 eligible patients enrolled in this analysis. Children <5 years old and school-age children have the highest viral positivity rate (46.9%) and bacterial positivity rate (30.9%). Influenza virus, respiratory syncytial virus and human rhinovirus are the three leading viral pathogens with proportions of 28.5%, 16.8% and 16.7%, and Streptococcus pneumoniae, Mycoplasma pneumoniae and Klebsiella pneumoniae are the three leading bacterial pathogens (29.9%, 18.6% and 15.8%). Negative interactions between viruses and positive interactions between viral and bacterial pathogens are common. A Join-Point analysis reveals the age-specific positivity rate and how this varied for individual pathogens. These data indicate that differential priorities for diagnosis, prevention and control should be highlighted in terms of acute respiratory tract infection patients’ demography, geographic locations and season of illness in China.

Anxiety of Dental Professionals during Covid-19 Pandemic

Coronavirus (COVID-19) is an enveloped RNA virus with a size of ~350 kilobase-pair and COVID-19 is commonly transmitted via aerosols, saliva, nasal droplets, and surface contact which causes severe acute respiratory tract infection among infected humans, and recently many cases declared with severe blood clotting. The average incubation period ranges from 4 to 14 days. The infected person usually presents fever accompanying an upper respiratory tract infection (RTI) and complaints of dry cough, and dyspnea. It is highly recommended to keep any suspected individuals in quarantine (isolation). After its first emergence in Wuhan, China in 2019 and then intercontinental spread it was declared as a pandemic by the World Health Organization in March 2020. The pandemic of COVID-19 deeply affected the whole world and healthcare workers as front liners are most at risk among professional groups. Dentistry is among the riskiest occupational groups that include all direct and indirect ways of COVID-19 spread. In this process, the dentists who experienced the effects of COVID-19 in the working conditions, economy, and social fields were psychologically negatively affected, and their anxiety, fear, and stress levels increased. In this review, we discuss the increased risk of the spread of coronavirus during dental operative procedures and the effects of the COVID-19 pandemic on the anxiety level, depression, and mental health of dental professionals.