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OBJECTIVE: Association of educational status, as marker of socioeconomic status, with COVID-19 outcomes has not been well studied. We performed a hospital-based cross-sectional study to determine its association with outcomes. METHODS: Successive patients of COVID-19 presenting at government hospital were recruited. Demographic and clinical details were obtained at admission, and in-hospital outcomes were assessed. Cohort was classified according to self-reported educational status into group 1: illiterate or ≤primary; group 2: higher secondary; and group 3: some college. To compare intergroup outcomes, we performed logistic regression. RESULTS: 4645 patients (men 3386, women 1259) with confirmed COVID-19 were recruited. Mean age was 46±18 years, most lived in large households and 30.5% had low educational status. Smoking or tobacco use was in 29.5%, comorbidities in 28.6% and low oxygen concentration (SpO(2) <95%) at admission in 30%. Average length of hospital stay was 6.8±3.7 days, supplemental oxygen was provided in 18.4%, high flow oxygen or non-invasive ventilation 7.1% and mechanical ventilation 3.6%, 340 patients (7.3%) died. Group 1 patients had more tobacco use, hypoxia at admission, lymphocytopaenia, and liver and kidney dysfunction. In group 1 versus groups 2 and 3, requirement of oxygen (21.6% vs 16.7% and 17.0%), non-invasive ventilation (8.0% vs 5.9% and 7.1%), invasive ventilation (4.6% vs 3.5% and 3.1%) and deaths (10.0% vs 6.8% and 5.5%) were significantly greater (p<0.05). OR for deaths were higher in group 1 (1.91, 95% CI 1.46 to 2.51) and group 2 (1.24, 95% CI 0.93 to 1.66) compared with group 3. Adjustment for demographic and comorbidities led to some attenuation in groups 1 (1.44, 95% CI 1.07 to 1.93) and 2 (1.38, 95% CI 1.02 to 1.85); this persisted with adjustments for clinical parameters and oxygen support in groups 1 (1.38, 95% CI 0.99 to 1.93) and 2 (1.52, 95% CI 1.01 to 2.11). CONCLUSION: Low educational status patients with COVID-19 in India have significantly greater adverse ...

Technological advancements in the field of chemical threat have made it possible to create extremely dangerous chemical warfare agents (CWA). Hence, the effective protection of personnel is very important in a chemical warfare scenario amidst the current climate of terrorism awareness. In particular, body protection plays a substantial role in the chemical defence considering the urgency of situation in the nuclear, biological and chemical environment. Activated carbon spheres (ACS) based permeable chemical protective clothing (coverall) was developed for protection against CWA. The adsorbent material i.e, ACS used in this protective clothing provided higher adsorption capacity (1029 mg/g in terms of iodine) and low thermal burden (34 °C WBGT index) compared to earlier indigenously developed NBC suit. This article focuses on the extensive evaluation of chemical protective clothing against sulfur mustard (HD), a CWA. The results revealed that the developed protective clothing provided more than 24 h protection against HD. This chemical protective suit is light weight (< 2.75 kg for XL size). It also has higher air permeability (> 30 cm3/s/cm2) as well as less water vapour resistance (< 9.6 m2Pa/W). With continued innovations in materials and attention to key challenges it is expected that advanced, multifunction chemical protective suit will play a pivotal role in the CWA protection scenario.