Screen COVID-19 patients for blood clotting abnormalities: Study

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Screen COVID-19 patients for blood clotting abnormalities: Study

Saying that critically ill COVID-19 patients may be at high risk for developing renal failure, venous blood clots, and other complications associated with blood clots, such as stroke, researchers have emphasised on the need for early screening.

Thromboelastography (TEG) is a whole blood assay that provides a broad picture of how an individual patient’s blood forms clots, including how long clotting takes, how strong clots are, and how soon clots break down.

TEG is highly specialised and used primarily by surgeons and anesthesiologists to evaluate the efficiency of blood clotting; it is not widely used in other clinical settings.

“The COVID-19 pandemic is opening doors for multidisciplinary collaboration so trauma acute care surgeons and intensivists can bring the tools they use in their day-to-day lives and apply them in the critical care setting to new problems,” said Franklin Wright, Assistant Professor of Surgery at the University of Colorado School of Medicine in the US.

The researchers evaluated outcomes for all patients who had a TEG assay as part of their treatment for COVID-19 infection as well as other conventional coagulation assays, including ones that measure D-dimer levels.

D-dimer is a protein fragment that is produced when a blood clot dissolves. D-dimer levels are elevated when large numbers of clots are breaking down.

A total of 44 patients treated for COVID-19 infection between March 22 and April 20 were included in the analysis.

Those whose bodies were not breaking down clots most often required hemodialysis and had a higher rate of clots in the veins.

These patients were identified by TEG assays showing no clot breakdown after 30 minutes and a D-dimer level greater than 2600 ng/mL (nanograms per millilitre).

Eighty percent of patients with both affirmative test findings were placed on dialysis compared with 14 percent who tested for neither finding.

Patients with affirmative test findings also had a 50 percent rate of venous blood clots compared with zero percent for those patients with neither finding.

“These study results suggest there may be a benefit to early TEG testing in institutions that have the technology to identify COVID-19 patients who may need more aggressive anticoagulation therapy to prevent complications from clot formation,” Wright said.

Their research was published as an “article in press” on the Journal of the American College of Surgeons website ahead of print.

The research team is now participating in a randomized clinical trial of a drug that breaks down blood clots in COVID-19-infected patients.

“This is an early step on the road to discovering treatments to prevent some of the complications that come with this disease,” said Wright who is lead author of the research article.

Patients with COVID-19 infection are being enrolled in a randomized clinical trial of tissue plasminogen activator (tPA).

This drug is a natural anticoagulant that was approved by the US Food and Drug Administration in 1996 for the treatment of diseases associated with clotting disorders, such as heart attack, stroke, and pulmonary embolism.

The trial will assess the efficacy and safety of intravenous tPA in improving respiratory function and management of patients with aggressive blood clotting.

“This study suggests that testing whole blood clotting measurements may allow physicians to identify and treat patients with COVID-19 more effectively to prevent complications and encourage further research into therapies to prevent blood clots in these patients,” Wright said.

Maharashtra records second-highest Covid-19 deaths, cases in a day

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Maharashtra records second-highest Covid-19 deaths, cases in a day

There was no let-up in the Covid-19 grip over Maharashtra on Friday as the state recorded the second-highest figures of 44 deaths and 1,576 new cases in a day, while Mumbai notched 933 new cases, state health officials said here.

With 49 fatalities – down marginally from Wednesday’s highest 54 – the state’s death toll shot up to 1,068 and the total number of coronavirus patients increased from 27,524 on Thursday to 29,100 on Friday, after the steepest jump of 1,602 recorded on May 14.

Of the new deaths, 34 were recorded only in Mumbai, taking up the city’s toll from Thursday’s 621 to 655 and the number of positive patients in the city shot up to 17,671.

Mumbai’s Dharavi slum continued to be a major hot spot and a headache for the health authorities, notching 84 new cases, taking the total number of its patients to 1,145, and 53 deaths till now.

Besides Mumbai’s 34, there were 6 deaths in Pune, 2 each in Akola, Kalyan-Dombivali (Thane) and Dhule, and one each in Jalgaon, Aurangabad and Raigad.

They comprised 29 men and 20 women, and nearly 65 percent of them suffered from other serious ailments such as diabetes, hypertension, heart problems and asthma.

On the positive side, 505 more fully cured patients returned home, taking the number of those discharged to 6,564 till date.

Chief Minister Uddhav Thackeray held a meeting with the ruling ally Nationalist Congress Party (NCP) to hammer out the nitty-gritties of the anticipated extension of the lockdown from May 18 in the state.

The Industry Minister announced that so far the state has permitted 66,953 units to resume operations, of which 38,287 have already started with over 10.66 lakh employees reporting for duties.

With the expected mega-spike in cases during the next few days, the BrihanMumbai Municipal Corporation (BMC) is making all efforts to augment the number of Covid-19 beds of different categories around the city, including three jumbo facilities.

Thackeray, Nationalist Congress Party President Sharad Pawar, different ministers, and civic and state officials inspected the three such mega facilities of 1,000-beds each in Goregaon, Bandra Kurla Complex, and National Sports Club of India in Mahalaxmi set up by the BMC.

The Mumbai Metropolitan Region (Thane Division) continued to cause huge concerns with 718 Covid-19 deaths and cases shooting beyond 21,925, with Thane district notching 38 deaths, Palghar 13 and Raigad 12 fatalities so far.

Though trailing a distant second after Mumbai, Pune division fatalities crossed the 200-mark to touch 204 fatalities, besides 3,972 patients.

The next major area of concern is Nashik division with 74 deaths and 1,238 positive cases, followed by Akola division with 28 deaths and 452 cases, and finally Aurangabad with 21 fatalities and 871 patients.

There’s also Kolhapur division with 5 deaths and 162 patients, Latur division with 5 fatalities and 96 cases, and finally Nagpur division with 3 deaths and 343 patients.

Meanwhile, the number of people shunted in home quarantine increased from 315,686 to 329,302 and those in institutional quarantine went up from 15,465 to 16,306, while the state’s containment zones came down from 1,512 to 1,473 on Friday.

As many as 14,167 teams have carried out a health survey of around 59 lakh persons in the state till date.

ELISA kits produced by Zydus Cadila has 98% sensitivity: ICMR

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ELISA kits produced by Zydus Cadila has 98% sensitivity: ICMR

Four days after successfully developing the first indigenous anti-SARS-CoV-2A (Covid-19) human IgG ELISA test kit for antibody detection of the deadly virus, the ICMR on Thursday said that the first batch of the ELISA kits produced by Zydus Cadila has similar sensitivity and specificity of 98.7 per cent and 100 per cent, respectively.

The ICMR said in a statement that the National Institute of Virology (NIV), Pune, has validated the first batch of ELISA kits produced by Zydus Cadila and found similar sensitivity and specificity of 98.7 per cent and 100 per cent, respectively.

“The ICMR is in the process of carrying out a national surveillance study with 24,000 individuals,” it said.

According to the ICMR, the ELISA kit is cost-effective, sensitive, rapid and a large number of samples can be tested at any level of clinical setting, including public health centres and hospitals.

After the development at the ICMR-NIV, the technology has been transferred for mass production to Zydus Cadila, which is an innovation driven global healthcare company, the statement said.

The news came four days after the NIV successfully developed the first indigenous anti-SARS-CoV-2A (Covid-19) human IgG ELISA test kit for antibody detection of the deadly virus.

According to the ICMR, this robust test will play a critical role in the surveillance of the proportion of population exposed to coronavirus infection.

Union Health Minister Harsh Vardhan had said on Sunday that the kit was validated at two sites in Mumbai and has high sensitivity and accuracy. Besides, it has the advantage of testing 90 samples together in a single run of 2.5 hours, so that healthcare professionals can proceed quickly with the necessary next steps on their patients’ triage paths. This is crucial since time is of essence during a pandemic.

“ELISA based testing is easily possible even at the district level. The ICMR technology has been transferred to Zydus Cadila for mass production. The Drug Controller General has granted commercial production and marketing permission to Zydus,” Harsh Vardhan had said on Sunday.

Most countries in the world are struggling to contain the spread of the pandemic using possible interventions. There is an augmented demand of various types of diagnostic tests by countries across the globe.

Most of the diagnostic material for Covid-19 is imported into India from other countries. Therefore, Indian scientists are tirelessly engaged in developing indigenous diagnostics for SARS-CoV-2, the causative agent of Covid-19.

Kids with cancer not at greater COVID-19 risk

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Kids with cancer not at greater COVID-19 risk

Researchers have found that children with cancer are no more vulnerable than other children to COVID-19 infection or morbidity resulting from the disease.

For the study, the researchers from MSK Kids at Memorial Sloan Kettering Cancer Center in New York performed COVID-19 testing on pediatric patients and their adult caregivers.

Of the 178 pediatric cancer patients tested, the rate of positivity for COVID-19 was 29.3 percent in children with symptoms, but only 2.5 percent in asymptomatic children.

Of all children with cancer infected with COVID-19, 95 percent had mild symptoms and did not require hospitalisation, said the study published in the journal JAMA Oncology.

“We are encouraged by these latest findings that kids with cancer are not more endangered by COVID-19 and their symptoms are mild like in healthy children,” said and corresponding author on the study Andrew Kung, Chair of MSK Kids.

“These findings allow us to continue lifesaving cancer-directed therapy with standard precautions and safeguards but without heightened concern about adverse effects from COVID-19 infection.”

Only half of the children with COVID-19 positive caregivers were themselves also COVID-19 positive, the results showed.

The researchers also found very significant sex skewing with the vast majority of COVID-19 infections occurring in males.

Together, these results suggest that children with cancer are not more susceptible than other children to infection or symptoms resulting from COVID-19, and that children are not an unrecognised reservoir of asymptomatic COVID-19 infection.

Del Monte forays into health and wellness space

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Del Monte forays into health and wellness space

Food brand Del Monte has forayed into the health and wellness space with the launch of cholesterol-reducing fruit juice.

Del Monte also announced the launch of Del Monte’s ACE, a 100 percent mixed fruit juice fortified with Vitamins A, C, E and rich in antioxidants that help in boosting immunity.

“Del Monte’s Heart Smart — a 100 percent mixed fruit juice with Reducol, is a natural plant-based ingredient that is clinically proven to reduce cholesterol in 8 weeks,” the company said in a statement.

The juices will be available online on Amazon exclusively, and subsequently, they will be available across all leading supermarkets on e-commerce portals across top cities including Delhi-NCR, Mumbai and Bengaluru.

Both the products have a shelf life of 12 months, it said.

“We have always given the highest priority to quality and healthy options while bringing new products to the market. We hope to create new benchmarks in this segment as our beveragewith Reducol will be India’s first juice that helps lower cholesterol. We are focused on helping consumers improve their health through our products,” said Yogesh Bellani, CEO FieldFresh Foods Pvt. Ltd, that manages the Del Monte brand in India.

Govt to use Rs 3,100 cr from PM-CARES for ventilators, migrants’ welfare

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Govt to use Rs 3,100 cr from PM-CARES for ventilators, migrants’ welfare

The Centre allocated Rs 3,100 crore from the PM CARES (Prime Minister’s Citizen Assistance and Relief in Emergency Situations) Fund on Wednesday evening to fight against COVID-19.

The bulk of it, Rs 2,000 crore, will be spent to buy ventilators, while a significant Rs 1,000 crore is being earmarked for the migrant labourers. As much as Rs 100 crore is kept for supporting vaccine development.

To ramp up the health infrastructure, as much as 50,000 ‘Made in India’ ventilators will be purchased from PM CARES Fund at a cost of about Rs 2,000 crore. These ventilators will be provided to government-run COVID hospitals in all states and Union Territories for better treatment of critical COVID-19 cases.

Also to address one of the most pressing humanitarian crisis of our time, a lump-sum assistance of total Rs 1,000 crore from the Fund is earmarked for the welfare of the migrant labourers. The money will be given to different states and UTs. The money is meant to strengthen districts’ efforts in providing accommodation facilities, making food arrangements, providing medical treatment and making transportation arrangements of the migrants.

But which state will get how much? “State/UT-wise funds will be released on the weightage of (a) population of the state/UT as per 2011 Census — 50% weightage (b) Number of positive COVID-19 cases as on date — 40% weightage and (c) equal share (10% weightage) for all states/UTs to ensure basic minimum sum for all states.

“The fund will be released to the District Collector/District Magistrate/Municipal Commissioner through the State Disaster Relief Commissioner of the States/UTs concerned,” said a government statement.

Meanwhile, Rs 100 crore is kept for developing a vaccine for COVID-19. Indian academia, start-ups and industry have come together in cutting-edge vaccine design and development an the money is meant to support their research and development. However, it will be utilized under the supervision of the Principal Scientific Advisor.

The PM-CARES was formed on March 27 this year, three days into the lockdown, and is headed by Prime Minister Narendra Modi. Other ex-officio members of the trust are Defence Minister Rajnath Singh, Home Minister Amit Shah and Finance Minister Nirmala Sitharaman.

ICMR fast-tracks roll out of global Covid-19 ‘Solidarity’ trial

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ICMR fast-tracks roll out of global Covid-19 ‘Solidarity’ trial

The Indian Council of Medical Research (ICMR) has fast-tracked the roll out of global ‘Solidarity’ trial launched by the World Health Organisation (WHO), to help find an effective treatment for Covid-19.

‘Solidarity’ is an international clinical trial to compare four treatment options against standard of care to assess their relative effectiveness against Covid-19.

By enrolling patients in multiple countries, the solidarity trial aims to rapidly discover whether any of the drugs slow the disease’s progression or improve survival. Importantly, this initiative provides for both speed and scale.

About India’s participation in this global endeavour, ICMR’s Director General, Dr. Balram Bhargava, said: “ICMR is working relentlessly to implement scientific interventions to combat the Covid-19 pandemic. The decision to join the WHO solidarity trial is an important step in this endeavour.”

“The ICMR-National AIDS Research Institute (NARI) is the national coordination site for the trial in India. Four potential anti-viral agents, Remdesivir, Chloroquine/Hydroxychloroquine, Lopinavir-Ritonavir and Lopinavir-Ritonavir with Interferon (I1a) are to be evaluated in the trial.”

Welcoming India’s participation in the WHO global solidarity trial, WHO Representative to India, Dr. Henk Bekedam, said: “We congratulate the Government of India, particularly ICMR for joining the global Solidarity trial. Through this collaboration, Indian researchers and institutions will participate in a global initiative to find effective treatment options for Covid-19.”

India plays a critical role in both research as well as in manufacturing once trials conclude successfully. WHO India is extending the required support to conduct the trial in India, he added.

The trial has begun recruiting Covid-19 patients in the country. Elaborating on the progress, Dr Sheela Godbole, Senior Scientist, NARI and National Coordinator for the Solidarity trial in India, said: “The required regulatory and ethical approvals have already been obtained and clinical trial sites have started to recruit patients in the trial.”

Till now a total of 9 sites have been approved. The Solidarity trial provides simplified procedures to enable even overloaded hospitals to participate. Over 100 countries have requested participation to find effective therapeutics as soon as possible, via the trial.

The participation of multiple clinical trial units or hospitals in multiple countries will ensure adequate enrolment of participants in the shortest possible time. This will help fast-track identification of correct treatment options for the Covid-19 disease.

Mexico in talks with US, Canada to coordinate response to COVID-19

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Mexico in talks with US, Canada to coordinate response to COVID-19

Mexico has been in talks with the US and Canada to address common challenges during the COVID-19 pandemic, the Foreign Ministry has said.

“The dialogue has allowed the three countries to identify shared challenges and best practices to deal with the pandemic,” said the Ministry in a statement on Tuesday.

According to the statement, the weekly calls between Deputy Secretary of Foreign Affairs Julian Ventura and his US and Canadian counterparts, Stephen Biegun and Marta Morgan, have enabled the three countries to strengthen coordination for the repatriation of nationals from other parts of the world, monitor channels for the delivery of essential medical supplies, and supervise border management, Xinhua news agency reported.

The trilateral exchange is part of the ongoing dialogue on issues such as economic and health cooperation, and transportation of people and essential goods, it said, adding that Mexico will continue to promote regional cooperation through institutional mechanisms.

Mexico declared a national health emergency at the end of March in response to the COVID-19 pandemic, and the country has, to date, registered 36,327 cases and 3,573 deaths.

S’pore Indian restaurant serves meals to hospital workers

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S’pore Indian restaurant serves meals to hospital workers

An Indian restaurant in Singapore has started serving hot meals and beverages to frontline medical workers in the city-state amid the COVID-19 pandemic, a media report said on Tuesday.

The popular vegetarian restaurant Mavalli Tiffin Rooms is serving up Indian snacks like vadai, a savoury fried snack, coffee and masala tea, said the Straits Times report.

Operations director Raghavendra Shastry and his staff were also preparing packets of fruits to send to hospitals.

The restaurant is still operational during the ‘circuit breaker’ lockdown for takeaway and delivery services.

“Dry snacks such as biscuits and sweets are readily available to the front-liners in hospitals. But the hot snacks and coffee we deliver can complement these snacks and help keep the medical fraternity going,” said Shastry, who is originally from Bengaluru, Karnataka.

The first set of goodies was sent to the National Centre for Infectious Diseases on April 17.

Deliveries were now being made twice a week to various hospitals across Singapore and will continue until at least June 1.

On Tuesday, Shastry was joined at the restaurant’s kitchen by the Indian High Commissioner to Singapore, Jawed Ashraf, who spent the morning assisting with the packing of goods for the day’s deliveries, the Straits Times report added.

Thanking the workers, Ashraf said: “No amount of what we do for them is enough to express the appreciation that we have for their commitment, their courage and their selflessness. They are the ones who give us hope and confidence.”

The Ministry of Health has confirmed 884 new COVID-19 cases in Singapore as of Tuesday, taking the total count to 24,671.

Among these, migrant workers living in dormitories form the bulk of the cases.

The death toll currently stands at 21.

Too little sleep may lead to asthma attacks in adults

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Too little sleep may lead to asthma attacks in adults

A good night’s sleep is crucial to good health because researchers have found that too little sleep, and occasionally too much sleep, can negatively impact adults with asthma.

Previous research revealed that poor sleep quality has a negative effect on asthma symptoms in adolescents.

“Our study shows that adults with asthma are equally affected by too little (or sometimes too much) sleep,” said study lead author Faith Luyster from the University of Pittsburgh in the US.

Compared to normal sleepers, short and long sleepers had a higher proportion of people who reported having an asthma attack in the past year (45 percent vs. 59 percent and 51 percent respectively) and had more days with impaired health-related quality of life.

According to the researchers, impaired quality of life was characterized by more days of poor physical and mental health.For the findings, published in the journal Annals of Allergy, Asthma and Immunology, the research team surveyed 1,389 adults who were 20 years and older who self-identified as having asthma. A Of the group, 25.9 percent slept 5 hours or less, 65.9 percent slept 6-8 hours and 8.2 percent slept 9 or more hours

Sleep duration was measured by a single question, “How much sleep do you usually get at night on weekdays or workdays?”

“Short sleepers” were more likely to be younger and non-White, while “long sleep were more likely to be older, female and a smoker. Short sleepers, as compared to normal sleepers, had a greater likelihood of an asthma attack, dry cough, and an overnight hospitalization during the past year.

Short sleepers also had the significantly worse health-related quality of life — including days of poor physical and mental health and inactive days due to poor health — and more frequent general healthcare use during the past year as compared to normal sleepers.

“This study adds solid evidence to the practice of asthma patients discussing sleep issues with their allergist to help determine if they need to change their asthma plan to achieve adequate sleep as a component of overall good asthma management,” said Gailen D Marshall, Editor-in-Chief of Annals Journal.

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