Indian Journal of Communicable Diseases

The incidence and vast spread of the coronavirus disease 2019 has been quite rapid across the globe. There is no medicine approved solely by the FDA for the management of COVID-19 infection. Only symptomatic management is carried out in patients with the available medicines in the market. This review provides an overview of the drugs which are being used primarily for the management of the infection across the globe. The number of drugs being used is comparatively less, hence to provide a view on the mechanism and pharmacology, this review has been carried out. Data on drugs like remdesivir, dexamethasone and tocilizumab have been included in this review, along with supportive care from Siddha to help the medical fraternity to decide on the treatment regimen for COVID-19. Data on the current use of drugs in hospitals were provided by a medical practitioner and are included in this review.

Keywords: COVID-19; Management; Remdesivir; Dexamethasone; Tocilizumab.

Background & Aim: WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients. Methods: In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses and the vaccination status. Results: Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality. Conclusions: There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

Keywords: COVID-19; Vaccination; Public Health; Mortality; Morbidity.

Objective: The primary outcome of this study was to assess how many HCWs were taking HCQ as a prophylaxis
and to understand about its use including safety. Materials and Methods: This was a focused questionnaire based
online survey of Health Care Workers (HCWs) exposed to COVID 19patients, at various tertiary care centres in
India. Results: Among the 408 participants, 395 (96.5%) were HCWs and 13 (3.2%) were non-HCWs. Among
the 395 HCWs (96.5%), 32 HCWs (8.1%) were involved as COVID-19 frontline staff only; 274 HCWs (69.3%)
were involved as practicing doctors running OPDs/medical practice and 89 HCWs (22.5%) were actively
involved as both COVID-19 frontline staff and practicing doctor running OPDs/medical practice. Among the 253
HCWs (64%) who have taken HCQ [227 HCWs (89.7%) as per ICMR recommended dose and 26 HCWs
(10.3%) varying dosages of HCQ]; 1 HCW (0.4%) was diagnosed with COVID-19 during the prophylactic use of
HCQ and 1 HCW (0.4%) had experienced increased risk factor – Right Bundle Branch Block (RBBB) in ECG.
Adverse events such as pigment epithelium detachment of right eye, hypoglycemia; diarrhea, gastritis and skin
pruritis; nausea and migraine and headache were experienced by 6 HCWs (2.4%).Conclusions: This study
demonstrated that majority of HCWs embrace the use of HCQ despite the fact that it is an off-label drug for
COVID-19 and no significant evidence is available on its safety and efficacy. Furthermore, the use of HCQ
among HCWs did not cause any serious adverse effects or increase in co-morbidities or risk factors.

Keywords: COVID-19; Hydroxychloroquine; Health Care Workers; Pre-Exposure Prophylaxis.
 

Background: There is an ongoing pandemic of COVID-19 associated with novel corona virus, the preventive measures are effective but can only be followed by community if they are well aware about it.Objective: The study was done with the aim to assess the awareness about COVID-19 and preventive measures being used by people in an urbanized village of Delhi. Methods: We used a pre-tested semi-open-ended questionnaire comprising questions of awareness and attitude toward spread and prevention of COVID-19 disease and preventive practices. Results: Majority of the participants belonged to low socioeconomic class, were less educated, and lived with their family in single room dwellings. The main source of getting information about COVID-19 was Television (77.9%) followed by social media. No protective face cover was used by 14.2% participants, only 41.9% used mask as face cover measure and each one of these was reusing the mask. Knowledge about telephone helpline number (50.9%) and about government’s mobile app for COVID-19 (39.8%) was low. Only 35.7% participants correctly knew the recommended minimum time for hand washing and only 54.9% knew the recommended social distance between two individuals. Education status of participants and their socio-economic status were found to be significantly associated with various facets of knowledge about COVID-19.Conclusion: Greater focus from the policy makers and health agencies is required for increasing the awareness among the community, especially the clusters of urban settlements with dense population.

Keywords: COVID-19; Urban Settlement; Awareness; Less Educated; Protective Measures.