A,good informative post as saliva samples are an easy option with no discomfort to the patient , less risk of transmission of disease to person taking the sample and particularly in DNS and hypertrophied turbinates it is difficult to do .Also risk of epistaxis is avoided. Let's hope now it becomes a routine if it is approved by ICMR and WHO
An informative post. If saliva test proves to be more reliable,it may be hassle free,can avoid nasal innury & in some cases epistasis.The technician must be well versed in inserting the probe.in the nostrils deep in leading to discomfort to the patient leading to.sneezing or coughing.In mass collection errors can occur. But to be on the safer side saliva testing must be foolproof and 100% reliable.
This would be a great step becoz ontaining nasopharyngeal specimen is a difficult proposition with high risk to the the healthcare workers obtaining the swab. Need to have more and more studies to compare and validate this in India. It was very nice and a thought-provoking post. Hope it is practised soon in our part .
Informative and educative post with great hope the saliva Based COVID 19 test might be a changing aspect in sampling instead of deep nasal swab which is painful and needs technical technician to collect.
Combination of Saliva & Nasal Swab would be the best, which would reach the comparable sensitivity of Nasopharyngeal Swab Testing.
& it's high time to spread this awareness for the frontline warriors of covid19, so that they can initiate & follow this!
It is excellent that an easy method is coming out as a good alternative, beneficial for both patient and health workers.
Very useful information. This procedure is easy and safe.
Educative post boss Thank you for Sharing this with us
This will be simple, safe and easy to healthcare workers .
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The Toughest Triage — Allocating Ventilators in a Pandemic The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale. Of all the medical care that will have to be rationed, the most problematic will be mechanical ventilation. Several countries, but not the United States, have already experienced a shortage of ventilators. Although shortages of other goods and services may lead to deaths, in most cases it will be the combined effects of a variety of shortages that will result in worse outcomes. Mechanical ventilation is different. When patients’ breathing deteriorates to the point that they need a ventilator, there is typically only a limited window during which they can be saved. And when the machine is withdrawn from patients who are fully ventilator-dependent, they will usually die within minutes. Anticipating the need to allocate ventilators to the patients who are most likely to benefit, clinicians should proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups of patients before their health deteriorates. Once patients have already been placed on mechanical ventilation, decisions to withdraw it are especially fraught. In the weeks ahead, physicians in the United States may be asked to make decisions that they have never before had to face, and for which many of them will not be prepared. Though some people may denounce triage committees as “death panels,” in fact they would be just the opposite — their goal would be to save the most lives possible in a time of unprecedented crisis. To read more- https://www.nejm.org/doi/full/10.1056/NEJMp2005689?query=featured_home Source-The New England Journal Of Medicine Authors- Robert D. Truog, M.D., Christine Mitchell, R.N., and George Q. Daley, M.D., Ph.D. Do Such situation may arise in India in the Near Future? Share your views Doctors.Dr. Pushker Mehra16 Likes12 Answers
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The severity of COVID-19 illness may be influenced by what researchers call "cytokine storms." In a new study, investigators assessed 522 COVID-19 patients, aged 5 days to 97 years, who were admitted to two hospitals in Wuhan, China, in December and January. The study also included a "control group" of 40 healthy people. Compared to the control group, 76% of COVID-19 patients had significantly lower levels of T cells -- a type of white blood cell that plays a crucial role in immune response against viral infections. Patients admitted to the intensive care unit had much lower T cell counts than those who didn't require ICU care. Patients over age 60 had the lowest T cell counts, the findings showed. And the T cells that did survive in COVID-19 patients were exhausted and unable to function at full capacity, the study authors said. COVID-19 patients also had high levels of cytokines -- a protein that normally helps fight off infection. Too many cytokines can prompt an excessive inflammatory response called a "cytokine storm," which causes the proteins to attack healthy cells. That suggests the new coronavirus does not attack T cells directly. Instead, it triggers the cytokine release, which results in the loss and exhaustion of T cells, according to the authors of the study published May 1 in the journal Frontiers in Immunology. The study results provide new clues on how to treat COVID-19, the researchers said. "We should pay more attention to T cell counts and their function, rather than respiratory function of patients," study author Dr. Yongwen Chen of Third Military Medical University in Chongqing, China, said in a journal news release. Chen added that "more urgent, early intervention may be required in patients with low T lymphocyte counts." In addition, he noted, future research should focus on pinpointing subgroups of T cells that may be most important in COVID-19, along with identifying drugs that boost T cell counts and functioning. Source-https://www.drugs.com/news/blood-count-may-offer-clues-covid-19-study-89971.htmlDr. Priyank Jha4 Likes10 Answers
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People with asthma and other lung diseases are at increased risk for serious complications from COVID-19, caution experts from the American Lung Association. "Everyone's health is at risk from COVID-19, and those living with a lung disease or who are immunocompromised may be more vulnerable to the impacts of the virus," said Dr. Albert Rizzo, the association's chief medical officer. COVID-19 can cause a pneumonia-like lung infection, with a range of symptoms from mild or absent in some to life-threatening in others, he said. It's crucial for people with chronic lung diseases such as asthma or chronic obstructive pulmonary disease (COPD) to keep taking their maintenance medications and tell their health care provider about any symptoms or changes in their health, Rizzo said. All lung disease patients -- including those with lung cancer who may have a weakened immune system -- need to take steps avoid contact with the coronavirus. Besides social distancing, measures include thorough hand-washing; not touching face, nose, mouth and eyes; and avoiding contact with people who may have been infected. "The healthcare system and hospitals are already stressed with admissions as a result of the pandemic," Rizzo said. "It's important for those with lung disease to use their best practices in managing their disease." People who smoke or vape are also at increased risk of serious COVID-19 complications. "Cigarette smoking and vaping are linked to lung inflammation and lowered immune function in the lung's airways, both of which can increase likelihood of complications if exposed to COVID-19," he said. "Therefore, long-term smokers and e-cigarette users may have a higher risk of developing chronic lung conditions associated with severe cases." Source- https://www.drugs.com/news/asthma-copd-raise-odds-severe-covid-19-lung-experts-warn-89379.htmlDr. Vivek Jain6 Likes9 Answers
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Studies are beginning to show that, in rare cases, people with severe COVID-19 may develop the serious nervous system disorder known as Guillain-Barre syndrome. "Guillain-Barre syndrome is a well-known condition in which one's immune system targets peripheral nerves as foreign and attacks them, resulting in the cardinal features of the disease," explained Dr. Anthony Geraci, who directs neuromuscular medicine at Northwell Health in Great Neck, N.Y. The symptoms of the disorder "include weakness, areflexia [absence of reflexes], paresthesia [tingling], and in some cases facial weakness and ataxia [poor balance]," Geraci said. It's not uncommon for severe cases of infectious disease to trigger Guillain-Barre, experts noted. According to the Italian authors of a new study, the syndrome has also been seen in patients battling Epstein-Barr virus, cytomegalovirus and, most notably, infection with mosquito-borne Zika. The new study was authored by a team of doctors battling a major outbreak of COVID-19 in the northern Italian city of Pavia. Between Feb. 28 and March 21, three hospitals in the region treated about 1,200 patients with COVID-19. Five of those patients displayed symptoms most likely caused by Guillain-Barre, the team said. Symptoms of Guillain-Barre tended to arise within five to 10 days of the first onset of common COVID-19 symptoms, the researchers said. These first Guillain-Barre symptoms included weakness in the legs, tingling and facial weakness. Within another two days, neurologic symptoms got worse until all four limbs were weakened or paralyzed, the Italian group said. All five patients received immune globulin therapy to boost their immune response to the coronavirus, and one patient was treated with the antibody-rich blood plasma of a COVID-19 survivor. A month into treatment, "two patients remained in the intensive care unit [ICU] and were receiving mechanical ventilation, two were undergoing physical therapy because of flaccid paraplegia and had minimal upper-limb movement, and one had been discharged and was able to walk independently," according to the report. Dr. Sami Saba is a neurologist at Lenox Hill Hospital in New York City. Reading over the findings, he agreed that "many infections can be triggers for Guillain-Barre syndrome, so it is not entirely surprising that we are seeing cases associated with the novel coronavirus." "In those cases, weakness and sensory loss can be very difficult to identify if they are not awake, moving their limbs, or able to tell you what they are experiencing," Saba said. "However, since Guillain-Barre can affect the muscles that help us breathe, it will be very important to consider the diagnosis in those who have trouble coming off the ventilator, especially if their lung function looks to be recovering." For his part, Geraci stressed that Guillain-Barre remains quite rare -- just five cases out of 1,200 in this new study. He agreed that a variety of tests are needed before a firm diagnosis of the syndrome can be made. Source-https://www.drugs.com/news/some-covid-19-patients-stricken-guillain-barre-syndrome-89736.htmlDr. Kashish Garg9 Likes7 Answers
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Common Heart Drugs' Risk With COVID-19 Unproven, Experts Say Could a blood pressure or diabetes medicine make COVID-19 more severe? A proposed new theory says the coronavirus could be binding to angiotensin converting enzyme 2 (ACE2) receptors in the lower respiratory tracts. Commonly used drugs ACE inhibitors and angiotensin II receptor blockers (ARBs), often used to control heart failure and blood pressure, can increase the number of ACE2 receptors in the body -- making these patients more susceptible to severe COVID-19. Dr. James Diaz, a professor at Louisiana State University's School of Public Health in New Orleans, warned of the possible risk in a letter to the editor published online March 24 in the Journal of Travel Medicine, based on an analysis of nearly 1,100 COVID-19 patients by Chinese researchers. That analysis found COVID-19 patients with high blood pressure, heart disease, diabetes or chronic kidney disease often required treatment in an intensive care unit, were placed on ventilators or died. Diaz wrote these patients all had conditions that probably were treated with ACE inhibitors or ARBs and called for studies to see if these drugs were at least partially responsible for the severe outcomes. Diaz said the Chinese researchers did not include information on whether the patients studied were taking these drugs. However, cardiologists like Dr. David Kass, a professor at Johns Hopkins School of Medicine in Baltimore, are urging that "people who take these drugs, definitely don't stop taking them." To read more- https://www.drugs.com/news/common-heart-risk-covid-19-unproven-experts-say-89261.htmlDr. Vedant Sharma5 Likes6 Answers