The coronavirus disease 2019 pandemic has posed severe threats to humans and the geoenvironment. The findings of severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) traces in waste water and the practice of disinfecting outdoor spaces in several cities in the world, which can result into the entry of disinfectants and their by-products into storm drainage systems and their subsequent discharge into rivers and coastal waters, raise the issue of environmental, ecological and public health effects. The aims of the current paper are to investigate the potential of water and waste water to operate as transmission routes for Sars-CoV-2 and the risks of this to public health and the geoenvironment. Additionally, several developing countries are characterised by low water-related disaster resilience and low household water security, with measures for protection of water resources and technologies for clean water and sanitation being substandard or not in place. To mitigate the impact of the pandemic in such cases, practical recommendations are provided herein. The paper calls for the enhancement of research into the migration mechanisms of viruses in various media, as well as in the formation of trihalomethanes and other disinfectant by-products in the geoenvironment, in order to develop robust solutions to combat the effects of the current and future pandemics.

Introduction: The novel coronavirus pandemic has caused significant mortality throughout the world. This study was done as there is scarce data on mortality predictors in severe COVID-19 pneumonia patients admitted to ICU in the Indian population. Material and methods: A retrospective study was conducted on COVID-19 pneumonia patients admitted to tertiary care center during June–October 2020. The records of patients admitted to ICU were collected and data included demography, symptoms, comorbidites and vital parameters. Laboratory parameters included complete hemogram, random blood sugar, S.Ferritin, S.LDH, renal function test, liver function test. Treatment-associated information such as the use of remdesivir, timing of initiating rem-desivir after the symptom onset, the use of steroids, use of anticoagulants, use of HFNC, NIV, ventilator were collected. 30 days mortality data post-discharge was collected via telephonic interview. Results: 4,012 confirmed cases of COVID-19 were admitted to hospital, of which 560 (13.95%) with severe pneumonia were included in the study. Mean age was 57.75 ± 13.96 years. The mortality rates were 54.64% among severe COVID-19 cases and 5% among mild to moderate COVID-19 cases. The Cox multinominal regression analysis identified SpO2/FiO2 < 400, age > 50 years, duration of symptom > 4 days, serum ferritin > 450 µg/L, respiratory rate > 23/min, the presence of comorbidities and non-usage of remdesivir were independently associated with increased mortality. Mortality rate at 30 days was 56.60%. Conclusion: Severe COVID-19 pneumonia is associated with very high mortality, especially in a resource-constrained setting. The use of remdesivir may have to be considered early in the course of disease to prevent excess mortality related to COVID-19.

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