key: cord-1033631-ybh9r91c
authors: nan
title: P5‐63: Effect of hyperbaric oxygen therapy among COVID19 patients: A meta‐analysis
date: 2021-11-19
journal: Respirology
DOI: 10.1111/resp.14150_270
sha: ae1ea69595cf0961e7b74eb975ca4ae24574fe69
doc_id: 1033631
cord_uid: ybh9r91c

nan

Background: During the Coronavirus (COVID-19) pandemic medical education has undergone a paradigm shift towards e-learning. In our study, we utilize the online teambased learning (TBL) teaching-learning technique to teach students bio-safety protocols for COVID-19. Methodology: We combined Zoom™ (San Jose, CA, USA) platform, WhatsApp (CA, USA), and Google Forms (Google Inc, CA, USA) based online assessment system, to build the online Team-based learning session. Our undergraduate batch comprises 100 students, hence 8 teams with a minimum of 12 and a maximum of 13 members were made with a team leader assigned to each group. An orientation was conducted for the facilitators and team leaders before the actual TBL session. A pre-RAT session was conducted via Zoom for the teams in which all team members and team leaders were instructed about the sequence of the TBL session. With the teams logged into the breakout rooms, each team member took the IRAT via Google forms. This was followed by a group discussion facilitated by the team leader. Finally, a GRAT was conducted for each team via Google forms. Following this, the facilitator clarified additional points as needed and conducted the application focused-exercise ensuring further discussion on the topic. Feedback from the students, team leaders, and facilitators was collected by using Google forms. Results: 92.7% of students attended the TBL sessions. 64.3 % of students responded to the feedback questionnaire with an 83.8 % satisfaction rate. Conclusion: Online team-based learning has the potential to be an online interactive teaching-learning methodology.

P5-62 | Evaluation of lung cell populations in severe COVID-19 pneumonia Shuichi Abe 1 , Yu Suzuki 1 , Daisuke Akaneya 1 , Takafumi Aizawa 1 , Hiroki Ota 1 , Mari Aso 1 , Hitomi Nogawa 1 , Kazunori Moriya 1 , Hiroki Suzuki 1 , Dhammika Leshan Wannigama 2 1 Yamagata Prefectural Central Hospital, Japan, 2 Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thailand Background and Aims: Coronavirus disease 2019 (COVID-19) is a novel viral infection that can cause severe pneumonia and acute respiratory failure; however, the mechanism of disease progression is still unclear. The aim of this study is to evaluate inflammatory cells in the lung by analyzing cell populations of bronchial aspirates of COVID-19 pneumonia. Methods: Three COVID-19 cases confirmed by SARS-CoV-2 PCR were investigated in this study. These 3 cases had undergone invasive positive pressure ventilation for the treatment of respiratory failure. Bronchial aspirates were collected at the time of endotracheal intubation and SARS-CoV-2 PCR was done. The populations of obtained cells from bronchial aspirates were examined by Giemsa staining as well as immunohistochemical staining of CD3, CD4, CD8 CD20 and CD68 antigens. Results: SARS-CoV-2 PCR of bronchial aspirates were positive in all cases. Bacterial pneumonia as co-infection was developed in 2 cases. Cell populations of bronchial aspirates in 3 cases were as follows: neutrophils 18.7%, 42.9%, 40.7%; CD3+ mononuclear cells (MNCs) 6.5%, 5.5%, 2.1%; CD4+ MNCs 1.4%, 18.9%, 8.8%; CD8+ MNCs 2.1%, 9.8%, 5.0%; CD20+ MNCs 0.5%; 0%, 0%; CD68+ MNCs 47.8%, 52.8%, 65.2%, respectively. Conclusions: CD68 antigen is mainly expressed in monocytes/macrophages. CD68+ MNCs were dominant in bronchial aspirates of the cases with severe COVID-19 pneumonia. Our data suggests that CD68+ MNCs, which are presumably macrophages, would play an important role during innate immune response to acute SARS-CoV-2 infection in the lung.

Martin Kristoffer Ogbac 1 , Euodia Guinmapang 1 , Jose Edzel Tamayo 1 1 Perpetual Help Medical Center -Las Piñas, Philippines

Background and Aims: COVID-19 disease continues to be a major health concern despite numerous preventive measures and treatment availability. Hyperbaric oxygen therapy (HBOT) has been used in cases of severe anemia, air embolism, decompression sickness, and carbon monoxide poisoning. In COVID-19, the use of HBOT has been considered as it showed favorable results in restoring normal oxyhemoglobin and tissue oxygenation in severe hypoxemia and tissue hypoxia. It has also exhibited anti-inflammatory effects on inflammasomes, proinflammatory and inflammatory cytokines, and chemokines. With the given physiologic benefits of HBOT, this study aims to identify the effect of HBOT among severe COVID-19 patients. Methods: Several trials using HBOT among COVID-19 patients were analyzed in this meta-analysis. The treatment group utilized HBOT while standard of care was used in the control group. The primary outcome is the incidence of inpatient mortality. The secondary outcome is the incidence of progression to invasive mechanical ventilation (IMV). Results and Conclusions: 3 trials were included in this study. The incidence of mortality was 12% in the HBOT group and 26% in the standard of care group (P = 0.02). Progression to IMV was also lower in the HBOT with 13% compared to the control group with 46% (P = 0.003). HBOT for viral infections has been documented even before the COVID-19 pandemic. In this study, the use of HBOT among severe COVID-19 patients have shown favorable results. HBOT is a promising alternative or additional treatment for COVID-19. Larger trials are needed to better demonstrate the benefit of HBOT. 

Methods: Retrospective cohort study was conducted in favipiravir treated high risk (age >50 years and ≥1 comorbidity) COVID-19 patients at 4 Indian centres after ethics committee approval

Requirement of respiratory support reduced from 28.6% at baseline to 3.9% by D7. Progression of disease was observed in 10(6.5%) with mortality in 3 patients

Conclusion: We observed trend of early clinical resolution & limited disease progression with favipiravir in high risk COVID-19 patients. Our findings need to be evaluated in bigger and controlled clinical trial settings