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Vitamin D status has been involved with coronavirus disease 19 (COVID‐19) severity. This may be mediated by vitamin D metabolism regulatory genes. Of interest is the vitamin D receptor (VDR) gene, which has been previously associated with other inflammatory and respiratory diseases. In order to investigate the role of VDR gene polymorphisms in COVID‐19 severity and outcome, a total of 292 COVID‐19 patients were classified according to severity in moderate (n = 56), severe (n = 89) and critical (n = 147) and, according to outcome in survivor (n = 163) and deceased (n = 129), and analysed for FokI and TaqI VDR gene polymorphisms by polymerase chain reaction‐based restriction enzyme digestion. The FokI and TaqI single nucleotide polymorphisms (SNPs) were not associated with COVID‐19 severity or mortality individually but when analysed by haplotype, TC was associated with an increased risk of presenting critical COVID‐19. Additionally, FokI CT genotype was more frequent in COVID‐19 patients with hypertension, and T allele carriers presented higher aspartate aminotransferase levels. Our results suggest a relationship between VDR FokI and TaqI SNPs and COVID‐19 severity in Mexican population. Although there are some previous reports of VDR polymorphisms in COVID‐19, this represents the first report in Latin American population. Further studies on other populations are encouraged. [ABSTRACT FROM AUTHOR]

Abstract Background Thyroid carcinoma (TC) accounts for almost 0.5%–1% of total malignancies. Its incidence is increasing rapidly worldwide. Several studies have drawn up the epidemiological profile of TC and its clinical and pathological features. However, to date, no similar studies have been conducted in Tunisia. Aims To establish an epidemiological profile of TC in a Tunisian health care institute and to analyze its clinical and histopathological characteristics in our institute. Materials and Methods We present a retrospective study reviewing the cases of TC diagnosed in our institution in a 4‐year period. Results We collected a sample of 192 cases of TC. It consisted of 31 males and 161 females (83.8%) with a sex‐ratio M/F of 0.19. The mean age was 46.4 years. Papillary thyroid carcinoma was the most frequent histological subtype. The multifocality rate was 33.8%. The mean size of TC was 2.2 ± 1.9 cm. 60.9% of TC were staged pT1 and 20.3% had nodal involvement. Papillary thyroid microcarcinomas were noted in 37.5% of cases. Conclusion Our results were consistent with those of the literature. A high proportion of pT1 and pN0 tumors were noted in our series, suggesting that TC's diagnosis and management was performed at an early stage of the disease in our institution. In addition, our study enabled us to notice the impact of the Coronavirus disease 19 crisis on the management of TC in our institution. Further studies are needed to establish the epidemiological profile of TC in Tunisia and to assess its clinical and pathological features.

Coronaviruses, a type of virus family, cause severe respiratory diseases in people. The coronavirus is most frequently linked to the common cold, but in persons with severe acute respiratory syndrome virus infection, it can also lead to serious respiratory sickness. The spread of the coronavirus is by having direct contact with infected saliva, mucus, or blood. Infected surfaces, such as those in hospitals or other health-care facilities, can potentially spread the infection when touched. Now, spreading globally is the Omicron version of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). According to preliminary studies, the Omicron variant of SARS-CoV-2 has a higher probability of re-infection. To recognize coronavirus disease 19 as well as Omicron people in hospitals and primary health care, this review study focuses on the symptoms and indications. The data were collected and analyzed from more than 100 high-impact original research papers to conclude their results and make a comparison between methods and findings. [ABSTRACT FROM AUTHOR]

COVID-19, caused by SARS-CoV-2, has resulted in serious economic and health burdens. Current treatments remain inadequate to extinguish the epidemic, and efficient therapeutic approaches for COVID-19 are urgently being sought. Interestingly, accumulating evidence suggests that microenvironmental disorder plays an important role in the progression of COVID-19 in patients. In addition, recent advances in nanomaterial technologies provide promising opportunities for alleviating the altered homeostasis induced by a viral infection, providing new insight into COVID-19 treatment. Most literature reviews focus only on certain aspects of microenvironment alterations and fail to provide a comprehensive overview of the changes in homeostasis in COVID-19 patients. To fill this gap, this review systematically discusses alterations of homeostasis in COVID-19 patients and potential mechanisms. Next, advances in nanotechnology-based strategies for promoting homeostasis restoration are summarized. Finally, we discuss the challenges and prospects of using nanomaterials for COVID-19 management. This review provides a new strategy and insights into treating COVID-19 and other diseases associated with microenvironment disorders.

Background: Advancing age and multimorbidity are well-established risk factors for the incidence and severity of coronavirus disease 2019 (COVID-19) infection. Aims: To describe the clinical profile of hospitalized elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to assess the risk factors for mortality. Methodology: Data on 465 consecutive patients aged 60 years and above admitted with COVID-19 at St John's Medical College Hospital, Bangalore, were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software (SPSS Inc., Chicago, IL, USA). Results: A total of 465 patients were included for the analysis. The overall mean age of the study group was 67 ± 4 years with 315 (67.9%) male patients. Eighty-one patients had mild, 117 had moderate, and 267 had severe COVID-19. After adjusting for age, gender, glycemic status, and COVID severity in the multivariate logistic regression analysis, elevated neutrophil-to-lymphocyte ratio (adjusted odds ratio [aOR] 1.93 95% confidence interval [CI] 1.14-3.29), end stage renal disease (aOR 3.49, 95% CI 1.34-9.06), acute kidney injury (aOR 3.25, 95% CI 1.94-5.41), shock (aOR 13.53 95% CI 6.35-28.82), mechanical ventilation (aOR 8.53, 95% CI 4.85-15.00), and intensive care unit care (aOR 14.5 95% CI 7.42-28.38) were the independent predictors of mortality. Conclusion: COVID-19 is characterized by poor outcomes and mortality, especially among older patients who have multiple comorbid illness. [ABSTRACT FROM AUTHOR]

Introduction: The ferritin–lymphocyte ratio (FLR) is a novel inflammatory biomarker for the assessment of acute COVID-19 patients. However, the prognostic value of FLR for predicting adverse clinical outcomes in COVID-19 remains unclear, which hinders its clinical translation. Methods: We characterised the prognostic value of FLR in COVID-19 patients, as compared to established inflammatory markers. Results: In 217 study patients (69 years [IQR: 55–82]; 60% males), FLR was weakly correlated with CRP (R = 0.108, p = 0.115) and white cell count (R = −0.144; p = 0.034). On ROC analysis, an FLR cut-off of 286 achieved a sensitivity of 86% and a specificity of 30% for predicting inpatient mortality (AUC 0.60, 95% CI: 0.53–0.67). The negative predictive values of FLR for ruling out mortality, non-invasive ventilation requirement and critical illness (intubation and/or ICU admission) were 86%, 85% and 93%, respectively. FLR performed similarly to CRP (AUC 0.60 vs. 0.64; p = 0.375) for predicting mortality, but worse than CRP for predicting non-fatal outcomes (all p < 0.05). On Kaplan–Meier analysis, COVID-19 patients with FLR values > 286 had worse inpatient survival than patients with FLR ≤ 286, p = 0.041. Conclusions: FLR has prognostic value in COVID-19 patients, and appears unrelated to other inflammatory markers such as CRP and WCC. FLR exhibits high sensitivity and negative predictive values for adverse clinical outcomes in COVID-19, and may be a good "rule-out" test. Further work is needed to improve the sensitivity of FLR and validate its role in prospective studies for guiding clinical management. [ABSTRACT FROM AUTHOR]

COVID-19, caused by SARS-CoV-2, has resulted in serious economic and health burdens. Current treatments remain inadequate to extinguish the epidemic, and efficient therapeutic approaches for COVID-19 are urgently being sought. Interestingly, accumulating evidence suggests that microenvironmental disorder plays an important role in the progression of COVID-19 in patients. In addition, recent advances in nanomaterial technologies provide promising opportunities for alleviating the altered homeostasis induced by a viral infection, providing new insight into COVID-19 treatment. Most literature reviews focus only on certain aspects of microenvironment alterations and fail to provide a comprehensive overview of the changes in homeostasis in COVID-19 patients. To fill this gap, this review systematically discusses alterations of homeostasis in COVID-19 patients and potential mechanisms. Next, advances in nanotechnology-based strategies for promoting homeostasis restoration are summarized. Finally, we discuss the challenges and prospects of using nanomaterials for COVID-19 management. This review provides a new strategy and insights into treating COVID-19 and other diseases associated with microenvironment disorders. Nanomaterials can server as potential strategies to ameliorate COVID-19 via regulating the disordered microenvironment of patients. [Display omitted] [ABSTRACT FROM AUTHOR]

ObjectiveDuring the COVID-19 pandemic, quaternary-care facilities continue to provide care for patients in need of urgent and emergent invasive procedures. Perioperative protocols are needed to streamline care for these patients notwithstanding capacity and resource constraints.MethodsA multidisciplinary panel was assembled at the University of California, San Francisco, with 26 leaders across 10 academic departments, including 7 department chairpersons, the chief medical officer, the chief operating officer, infection control officers, nursing leaders, and resident house staff champions. An epidemiologist, an ethicist, and a statistician were also consulted. A modified two-round, blinded Delphi method based on 18 agree/disagree statements was used to build consensus. Significant disagreement for each statement was tested using a one-sided exact binomial test against an expected outcome of 95% consensus using a significance threshold of p < 0.05. Final triage protocols were developed with unblinded group-level discussion.ResultsOverall, 15 of 18 statements achieved consensus in the first round of the Delphi method; the 3 statements with significant disagreement (p < 0.01) were modified and iteratively resubmitted to the expert panel to achieve consensus. Consensus-based protocols were developed using unblinded multidisciplinary panel discussions. The final algorithms 1) quantified outbreak level, 2) triaged patients based on acuity, 3) provided a checklist for urgent/emergent invasive procedures, and 4) created a novel scoring system for the allocation of personal protective equipment. In particular, the authors modified the American College of Surgeons three-tiered triage system to incorporate more urgent cases, as are often encountered in neurosurgery and spine surgery.ConclusionsUrgent and emergent invasive procedures need to be performed during the COVID-19 pandemic. The consensus-based protocols in this study may assist healthcare providers to optimize perioperative care during the pandemic.

Background: Advancing age and multimorbidity are well-established risk factors for the incidence and severity of coronavirus disease 2019 (COVID-19) infection. Aims: To describe the clinical profile of hospitalized elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to assess the risk factors for mortality. Methodology: Data on 465 consecutive patients aged 60 years and above admitted with COVID-19 at St John's Medical College Hospital, Bangalore, were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software (SPSS Inc., Chicago, IL, USA). Results: A total of 465 patients were included for the analysis. The overall mean age of the study group was 67 ± 4 years with 315 (67.9%) male patients. Eighty-one patients had mild, 117 had moderate, and 267 had severe COVID-19. After adjusting for age, gender, glycemic status, and COVID severity in the multivariate logistic regression analysis, elevated neutrophil-to-lymphocyte ratio (adjusted odds ratio [aOR] 1.93 95% confidence interval [CI] 1.14–3.29), end stage renal disease (aOR 3.49, 95% CI 1.34–9.06), acute kidney injury (aOR 3.25, 95% CI 1.94–5.41), shock (aOR 13.53 95% CI 6.35–28.82), mechanical ventilation (aOR 8.53, 95% CI 4.85–15.00), and intensive care unit care (aOR 14.5 95% CI 7.42–28.38) were the independent predictors of mortality. Conclusion: COVID-19 is characterized by poor outcomes and mortality, especially among older patients who have multiple comorbid illness.

Ongoing novel coronavirus (COVID-19) with high mortality is an infectious disease in the world which epidemic in 2019 with human-human transmission. According to the literature, S-protein is one of the main proteins of COVID-19 that bind to the human cell receptor angiotensin-converting enzyme 2 (ACE2). In this study, it was attempted to identify the main effective drugs approved that may be repurposed to the binding site of ACE2. High throughput virtual screening based on the docking study was performed to know which one of the small-molecules had a potential interaction with ACE2 structure. Forasmuch as investigating and identifying the best ACE2 inhibitors among more than 3,500 small-molecules is time-consuming, supercomputer was utilized to apply docking-based virtual screening. Outputs of the proposed computational model revealed that vincristine, vinbelastin and bisoctrizole can significantly bind to ACE2 and may interface with its normal activity.

Background: In COVID-19 patients, lymphocyte–CRP ratio (LCR) is a promising biomarker for predicting adverse clinical outcomes. How well LCR performs compared to conventional inflammatory markers for prognosticating COVID-19 patients remains unclear, which hinders the clinical translation of this novel biomarker. Methods: In a cohort of COVID-19 inpatients, we characterised the clinical applicability of LCR by comparing its prognostic value against conventional inflammatory markers for predicting inpatient mortality and a composite of mortality, invasive/non-invasive ventilation and intensive care unit admissions. Results: Of the 413 COVID-19 patients, 100 (24%) patients suffered inpatient mortality. On Receiver Operating Characteristics analysis, LCR performed similarly to CRP for predicting mortality (AUC 0.74 vs. 0.71, p = 0.049) and the composite endpoint (AUC 0.76 vs. 0.76, p = 0.812). LCR outperformed lymphocyte counts (AUC 0.74 vs. 0.66, p = 0.002), platelet counts (AUC 0.74 vs. 0.61, p = 0.003) and white cell counts (AUC 0.74 vs. 0.54, p < 0.001) for predicting mortality. On Kaplan–Meier analysis, patients with a low LCR (below a 58 cut-off) had worse inpatient survival than patients with other LCR values (p < 0.001). Conclusion: LCR appears comparable to CRP, but outperformed other inflammatory markers, for prognosticating COVID-19 patients. Further studies are required to improve the diagnostic value of LCR to facilitate clinical translation. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to investigate the prevalence of coronavirus disease 19 (COVID-19) vaccination, the level of COVID-19 fear, and associated factors among university students. Methods: This study is a cross-sectional study participated by university students from Maltepe University, Türkiye, between September 23 and November 26, 2021. An online questionnaire form was used in the study due to the pandemic. The questionnaire included sociodemographic and related COVID-19 characteristics and the fear of COVID-19 scale (FCV-19S). Results: A total of 3216 university students, 2276 (70.8%) female, participated in this study. Three thousand ninety-two (96.1%) were vaccinated against COVID-19. The FCV-19S scores of those vaccinated against COVID-19 were 18.0±7.2, while the FVS scores of those who were not vaccinated were 15.7±8.3 (p=0.001). When the factors affecting vaccination with COVID-19 were evaluated by regression analysis, it was determined that the history of COVID-19 infection (OR=1.837, 95% CI=1.173-2.876, and p=0.008), FCV-19S (OR=1.041, 95% CI=1.014-1.070, and p=0.003), and recommending the COVID-19 vaccine to others (OR=24.585, 95% CI=15.658--38.602, and p<0.001) had an effect on vaccination. Conclusion: This study revealed that the overall vaccination frequency among university students is >96%, with different hesitancy frequency among university departments. Medical and health science students have the lowest frequency of vaccine hesitancy and lowest fear levels, suggesting that they know the COVID-19 process, and its consequences, and have accurate information about vaccines. [ABSTRACT FROM AUTHOR]

Abstract Background Monoclonal antibodies (mAb) prevent COVID-19 progression when administered early. We compared mAb treatment outcomes among vaccinated and unvaccinated patients during Delta wave and assessed the feasibility of implementing stricter eligibility criteria in the event of mAb scarcity. Methods We conducted a retrospective observational study of casirivimab/imdevimab recipients with mild-to-moderate COVID-19 infection in an emergency department or outpatient infusion center (July 1–August 20, 2021). Primary outcome was all-cause hospital admission within 30 days post-treatment between vaccinated vs. unvaccinated patients during Delta surge in the Bronx, NY. Results A total of 250 patients received casirivimab/imdevimab (162 unvaccinated vs. 88 vaccinated). The median age was 39 years for unvaccinated patients, and 52 years for vaccinated patients (p

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus discovered in December 2019 that causes coronavirus disease 19 (COVID-19) and various vaccinations have been developed. The extent to which COVID-19 infections and/or COVID-19 vaccinations alter antiphospholipid antibodies (aPL) in patients with thromboembolic antiphospholipid syndrome (APS) remains unclear. Eighty-two patients with confirmed thromboembolic APS were included in this prospective non-interventional trial. Blood parameters including lupus anticoagulants, anticardiolipin IgG- and IgM-antibodies, and anti-ß2-glycoprotein I IgG- and IgM-antibodies were assessed prior to and after COVID-19 vaccination and/or COVID-19 infection. No increases in aPL in the total study population were detected. In fact, low but significant decreases were observed for anticardiolipin IgG- and anti-β2-glycoprotein I IgG-antibodies, while anticardiolipin IgM- and anti-b2-glycoprotein I IgM-antibodies slightly increased only in patients with COVID-19 infection and vaccination. Although the investigated patient group is known to have a high risk of recurrent thrombosis, only one arterial thrombotic event was diagnosed (1.2%, 1/82). This low recurrence rate was probably due to the high vaccination rates prior to infections and a high rate of effective anticoagulation. Our data show that COVID-19 infections and/or vaccinations do not deteriorate the clinical course of anticoagulated thromboembolic APS patients. [ABSTRACT FROM AUTHOR]

Objectives: Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) is a single-stranded positive ribonucleic acid virus of the coronaviridae family. The disease caused by this virus has been named by the World Health Organization coronavirus disease 19 (COVID-19), whose main manifestation is interstitial pneumonia. Aim of this study is to describe the radiological features of SARS-CoV-2 infection in its original form, to correlate the high-resolution computed tomography (HRCT) patterns with clinical findings, prognosis and mortality, and to establish the need for treatment and admission to the intensive care unit. Material and Methods: From March 2020 to May 2020, 193 patients (72 F and 121 M) who were swab positive for SARS-CoV-2 were retrospectively selected for our study. These patients underwent HRCT in the clinical suspicion of SARS-CoV-2 interstitial pneumonia. Results: Our results confirm the role of radiology and, in particular, of chest HRCT as a technique with high sensitivity in the recognition of the most peculiar features of COVID-19 pneumonia, in the evaluation of severity of the disease, in the correct interpretation of temporal changes of the radiological picture during the follow-up until the resolution, and in obtaining prognostic information, also to direct the treatment. Conclusion: Chest computed tomography cannot be considered as a substitute for real-time - polymerase chain reaction in the diagnosis of COVID-19, but rather supplementary to it in the diagnostic process as it can detect parenchymal changes at an early stage and even before the positive swab, at least for patients who have been symptomatic for more than 3 days. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) has become a common cause of febrile seizures (FS), especially after the Omicron surge. This study aimed to determine the incidence of COVID-19-associated FS in children. The number of confirmed COVID-19 cases in patients aged below five years residing in the Jeonbuk province from January 2020 to June 2022 was obtained from official data provided by the Ministry of Public Administration and Security. During the same period, data on FS patients with COVID-19 were obtained from all local hospitals capable of FS treatment and were analyzed retrospectively. The number of children under five years of age in Jeonbuk was 62,772, of which 33,457 (53.2%) were diagnosed with COVID-19 during the study period. Of these, 476 patients (1.4%) required hospitalization, and 64 (0.19%, 44 boys; 68.8%: 20 girls; 31.2%) developed FS. All patients with FS presented with symptoms after the Omicron surge. Before the Omicron variant, 23.4% of the patients (89 of 381) required hospitalization; however, no children with COVID-19 were hospitalized for FS. Twenty-five patients (39.1%) had complex FS while one (1.6%) presented with febrile status epilepticus. Forty-two patients (65.6%) experienced first-time FS with an average of 1.5 convulsive events. [ABSTRACT FROM AUTHOR]

Vulnerable patients such as immunosuppressed or elderly patients are at high risk for a severe course of COVID-19 upon SARS-CoV-2 infection. Immunotherapy with SARS-CoV-2 specific monoclonal antibodies (mAb) or convalescent plasma represents a considerable treatment option to protect these patients from a severe or lethal course of infection. However, monoclonal antibodies are not always available or less effective against emerging SARS-CoV-2 variants. Convalescent plasma is more commonly available and may represent a good treatment alternative in low-income countries. We retrospectively evaluated outcomes in individuals treated with mAbs or convalescent plasma and compared the 30-day overall survival with a patient cohort that received supportive care due to a lack of SARS-CoV-2 specific therapies between March 2020 and April 2021. Our data demonstrate that mAb treatment is highly effective in preventing severe courses of SARS-CoV-2 infection. All patients treated with mAb survived. Treatment with convalescent plasma improved overall survival to 82% compared with 61% in patients without SARS-CoV-2 targeted therapy. Our data indicate that early convalescent plasma treatment may be an option to improve the overall survival of high-risk COVID-19 patients. This is especially true when other antiviral drugs are not available or their efficacy is significantly reduced, which may be the case with emerging SARS-CoV-2 variants. [ABSTRACT FROM AUTHOR]

Background: Although many studies highlighted the clinical features of coronavirus disease (COVID-19), still the clinical profile and associated factors of critically ill patients is limited. Thus, it was aimed to evaluate the clinical characteristics and outcomes of COVID-19-infected patients admitted to the intensive care units (ICU) in the Kingdom of Saudi Arabia (KSA). Methods: This study was a retrospective noninterventional chart review. Charts and data of all COVID-19-infected patients who required admission to ICU in KSA between August 2020 and April 2021 were obtained from the National Health Observatory Portal of ICU Bed Management System, KSA. Results: A total of 9,111 patients were included with a mean age of 59.26 ± 16.08. Nearly half of them (N = 4,706, 51.7%) had diabetes and 47.1% had hypertension. Totally 3,114 (34.2%) patients received invasive ventilation. Among the studied patients, 81 (0.9%) received extracorporeal membrane oxygenation, while 415 (4.6%) required hemodialysis in the ICU. As for the length of stay (LOS) in the ICU, the mean LOS in days was 11.73 ± 13.36. Having at least one comorbidity (p = [SJEMed 2022; 3(1.000): 054-062]

ABSTRACT BACKGROUND: Coronavirus disease 19 (COVID-19) is a multisystemic disease with high incidence of acute kidney injury (AKI). OBJECTIVE: To describe the clinical characteristics and factors associated with AKI among patients hospitalized with COVID-19. DESIGN AND SETTING: Retrospective cohort conducted at Hospital Civil de Culiacan, Mexico. METHODS: We included 307 patients hospitalized due to COVID-19. AKI was defined and staged based on serum creatinine levels in accordance with the criteria of the Acute Kidney Injury Network (AKIN). Multivariate logistic regression analysis was used to determine factors associated with AKI. RESULTS: The patients’ age was 56 ± 15 years (64.5% male). The incidence of AKI was 33.6% (n = 103). Overall, 53.4% of patients had community-acquired AKI, and 46.6% had hospital-acquired AKI. Additionally, 15.5% of them presented AKIN stage 1; 34% had AKIN stage 2; and 50.5% had AKIN stage 3. Hemodialysis was required for 10.7% of the patients. The factors associated with AKI were chronic kidney disease (odds ratio, OR: 10.8; P = 0.04), use of norepinephrine (OR: 7.3; P = 0.002), diabetes mellitus (OR: 2.9; P = 0.03), C-reactive protein level (OR: 1.005; P = 0.01) and COVID-19 severity index based on chest tomography (OR: 1.09; statistical trend, P = 0.07). Hospital stay (11 ± 7 days; P < 0.001) and mortality (83.5 versus 31.4%; P < 0.05) were greater among patients with AKI. CONCLUSION: AKI was a frequent and serious complication in our cohort of patients hospitalized with COVID-19, which was associated with high mortality and long hospital stay.

Background: COVID-19 has spread worldwide and become a pandemic. We report the epidemiological and clinical characteristics of cluster infections. Methods: Data of clustered cases were retrieved from the public health emergency monitoring information system of China. We analyzed the incubation period, generation gap, secondary attack rate, and viral load in various grouped cases. Results: A total of 60 COVID-19 infection clusters including 226 patients and 19 asymptomatic cases involving four generations were analyzed. With the increase of transmission generations, secondary attack rate decreased (P＜0.001) and severity alleviated (P = 0.008). The median incubation period and intergenerational interval were 9 and 6 days, respectively. The secondary attack rate was 7.1% in the index cases, 5.0% in the first generation, 1.0% in the second generation, and 4.7% overall. Severe cases were seen more in the index (13, 65%) and first generation (7, 35%) ones, who had a significantly higher viral load than the mild and moderate ones. Conclusions: With the increase of transmission generation, secondary infection rate and severity decreased. Severe patients had a higher virus load. Patients in the incubation period and asymptomatic carriers were potential infection sources who might play an important role in transmission.

Introduction: The ferritin–lymphocyte ratio (FLR) is a novel inflammatory biomarker for the assessment of acute COVID-19 patients. However, the prognostic value of FLR for predicting adverse clinical outcomes in COVID-19 remains unclear, which hinders its clinical translation. Methods: We characterised the prognostic value of FLR in COVID-19 patients, as compared to established inflammatory markers. Results: In 217 study patients (69 years [IQR: 55–82]; 60% males), FLR was weakly correlated with CRP (R = 0.108, p = 0.115) and white cell count (R = −0.144; p = 0.034). On ROC analysis, an FLR cut-off of 286 achieved a sensitivity of 86% and a specificity of 30% for predicting inpatient mortality (AUC 0.60, 95% CI: 0.53–0.67). The negative predictive values of FLR for ruling out mortality, non-invasive ventilation requirement and critical illness (intubation and/or ICU admission) were 86%, 85% and 93%, respectively. FLR performed similarly to CRP (AUC 0.60 vs. 0.64; p = 0.375) for predicting mortality, but worse than CRP for predicting non-fatal outcomes (all p < 0.05). On Kaplan–Meier analysis, COVID-19 patients with FLR values > 286 had worse inpatient survival than patients with FLR ≤ 286, p = 0.041. Conclusions: FLR has prognostic value in COVID-19 patients, and appears unrelated to other inflammatory markers such as CRP and WCC. FLR exhibits high sensitivity and negative predictive values for adverse clinical outcomes in COVID-19, and may be a good “rule-out” test. Further work is needed to improve the sensitivity of FLR and validate its role in prospective studies for guiding clinical management.

Abstract Background In December of 2019, a new disease which is caused by SARS-CoV-2, as an epidemic disease out of Wuhan, China, began to circulate. On March 11, 2020, the Republic of Turkey Ministry of Health had announced the first case from Turkey. The aim of this study is to analyze the scientific publications in the field of COVID-19 included in Science Citation Index Expanded (SCIE) from Turkey and to establish a theoretical background for future studies in the health literature with obtained valuable information about the publications. We searched all papers published in the field of COVID-19 by using the terms of “COVID-19,” “2019-n-CoV,” “SARS-CoV-2,” “Coronavirus disease 19,” and “2019 novel coronavirus” as scientific nomenclatures of COVID-19 in the topic search section of the software. Results Overall, 47,368 papers, indexed by SCI-E, were found related to COVID-19 between January 1, 2020, and December 13, 2020. Of these, 931 were from Turkey. In terms of specialities, the most contribution was from the Medicine General Internal followed by Dermatology. Most of the publications were article. English was the most preferred language in papers. Dermatological Theraphy published the most paper. Conclusions Applying this kind of analysis on an intermittent basis gives a general perspective for contribution of a countries to scientific publications and useful for the further studies.

Dissemination of the Covid-19 pandemic has impacted various in human life sectore. One of the one most an influenced is field of education. This discussion intend to reveal about online-based learning process during the pandemic in high class at Daarul Huda Islamic Elementary School Tangerang city along with the obstacles that occur during online learning and what efforts can minimize these obstacles. Online learning used within this disccus is the use of existing applications on smartphones, laptops and computers. Qualitative approach with case study method used by researcher to solve this problem and by using a descriptive design conducted at the Daarul Huda Islamic Elementary School in Tangerang, involving 3 students and 3 teachers as informants. Data collection was obtained based on observations and interviewr carried out in a structured manner with question that have been compile and linked and developed with related literature. This study show the results that online-based learning process at Daarul Huda Islamic Elementary School can run smoothly, but it is felt that most teachers and students are less effective than conventional face-to-face learning.

Background: Health-care specialists and clinical researchers worldwide have been concentrating more on the acute and intense phase of the coronavirus disease 19 (COVID-19) infection, but there is an exigency toward the incessant monitoring in the postdischarge period to foresee the long-lasting effects of the disease. The main objective of this study is to evaluate the post-COVID-19 health and functional status (PCFS) and the long-term health implications of severe acute respiratory syndrome coronavirus-2 infection among COVID-19 recovered patients. Materials and Methods: An observational, cross-sectional, and hospital-based study was conducted among the COVID-19 recovered patients. The PCFS scale was used as a study tool to assess the functional status. Data were entered into Excel spreadsheets 2019, and statistical analysis was performed using the SPSS version 24.0. Descriptive statistics were used, and the Chi-square test was used to determine the role of sociodemographic characteristics on questions. The statistical significance level was set at P < 0.05 (two-sided). Results: A total of 80 patients were included in the study and the mean age was 37.03 ± 15.15 years. More than half of the participants (52.5%) showed functional limitations. Fatigue (30%), anxiety (23.75%), and cough (6.25%) were noted to be persistent symptoms reported post-COVID-19 recovery. The majority (88.75%) of the study participants experienced at least one symptom post-COVID-19 and 52.5% have experienced at least one functional limitation. The presence of comorbidities (r = 0.664; likelihood ratio [LR] = 0.968), and vaccination (r = 0.700; LR = 0.611) considerably influenced the PCFS. Conclusion: Our study revealed that there is a significant limitation of PCFS among recovered patients. The presence of comorbidities and vaccination significantly correlated with the PCFS. Standard identification tools, extensive screening, and wide education of consequences related to post-COVID-19 along multicentric and global studies are the need of the hour.

Background: On March 30, 2020, coronavirus disease 19 was declared pandemic and many countries of the world started working on the development of vaccine soon after China released the genetic structure of severe acute respiratory syndrome coronavirus 2. Drugs Controller General of India on January 3, 2021, accorded emergency use authorization to Oxford-AstraZeneca's ChAdOx1 nCoV-19 vaccine and vaccination drive commenced in India on January 16, 2021. The present study was conducted to determine the incidence adverse event following immunization (AEFI) among recipients of the first and second dose of the vaccine. Materials and Methods: A longitudinal descriptive study was conducted among 2529 vaccine beneficiaries who were asked about the side effects at 24 and 72 h after the first dose and second dose of vaccination with ChAdOx1 nCoV-19 vaccine. Passive surveillance was also done for 4 months. Results: AEFI was reported in 27.59%, 38.4%, and 19.96% of vaccines after both doses, first dose, and second dose, respectively. 14% did not report any AEFI with either dose of vaccine. Younger people had higher rates of AEFIs with both the doses. Pain at injection site and fever

Objective: Pneumocystis pneumonia (PcP) is a life-threatening infection caused by the opportunistic fungi Pneumocystis jirovecii. The emergence of the COVID-19 pandemic forced the focus of attention of health policymakers on these two infections due to their clinical and paraclinical similarities, which cause diagnostic dilemmas. This study was undertaken to evaluate and estimate the global prevalence and main leading risk factors of coronavirus-associated pneumocystosis (CAP). Methods: We searched related databases between December 2019 and May 2022 for studies reporting CAP. Meta-analysis was performed using StatsDirect software (version 2.7.9) according to the DerSimonian and Laird method applying the random-effects model. We evaluated heterogeneity using the χ2-based Q statistic (significant for P75% indicative of “notable” heterogeneity). Moreover, an odds ratio (OR) analysis was performed for eligible data. Results: Our meta-analysis included eight studies with 923 patients hospitalized with COVID-19; among them, 92 were PcP cases. The overall pooled prevalence of CAP was estimated at 11.5%. The mortality among CAP patients was lower than that of non-PcP patients (OR 1.93; 95% CI 0.86-4.31). Long-term corticosteroid therapy (OR 28.22; 95% CI 0.54-1 480.84) was the most predisposing factor for PcP among COVID-19 patients, followed by pulmonary diseases (OR 1.46; 95% CI 0.43-4.98), kidney diseases (OR 1.26; 95% CI 0.21-7.49), and acute respiratory destruction syndrome (OR1.22; 95% CI 0.05-29.28). Conclusions: The prevalence of PcP among the COVID-19 population is almost similar to the pre-COVID era. However, PcP-related mortality was decreased by the emergence of the COVID-19 pandemic. Women with COVID-19 are more susceptible to PcP than men. Acute respiratory distress syndrome, kidney diseases, pulmonary diseases, and long-term corticosteroid therapy increased the risk of PcP; however, transplantation and malignancy decreased the risk for PcP among COVID-19 patients. Further retrospective, case-control, prospective, and more precisely systematic review and meta-analysis studies are needed in this field.

Coronavirus disease 19 (COVID-19) is a systematic multitropic disease. Sustaining blood homeostasis is a mission of multiple factors includes procoagulant and anticoagulant systems. Subsequently, maintaining a precise equilibrium between these antagonists' systems is crucial to prevent hemostasis. Frequently, during severe forms of COVID-19 patients, studies reported a discrepancy between the procoagulant and anticoagulant that usually results in fatal outcomes through multiorgan ischemia by thrombotic events. The proper interpreting of the anticoagulant status changes in COVID-19 patients is sufficient for effective and safe anticoagulant treatment. Our postulation is the first to address the pathophysiology of anticoagulant status under COVID-19.

Purpose: To study the ocular symptomatology and clinical profile of coronavirus disease-19 (COVID-19) positive patients admitted at a tertiary care institute. Methods: This cross-sectional, observational, and descriptive study was conducted on 200 reverse transcriptase-polymerase chain reaction positive confirmed COVID-19 patients in a tertiary care institute from September 2020 to October 2020. Ocular and systemic history was collected from the patients, clinical findings and investigation values were noted and analyzed. Results: Out of 200 COVID-19 positive patients in our study, 54% of the patients were graded as mild COVID-19 cases, 34% of the patients were graded as moderate, and 12% of the patients were graded as severe COVID-19 cases. The prevalence of ocular symptoms was 10.5%. Burning sensation of the eyes was the most common ocular symptom. A higher occurrence of ocular symptoms was observed in febrile patients and it was found to be statistically significant. The ocular symptoms worsened with a rise in temperature. Conclusion: Our study reveals that in COVID-19 positive patients, the most common systemic symptom was fever and the most common ocular symptom was burning sensation. In most of the cases, ocular symptoms appeared before or with the appearance of systemic symptoms. Most ocular symptoms were either mild or moderate grade. Ocular symptoms were higher in febrile patients with the severity increasing during febrile period in most patients. With this, we need to consider all patients coming to the outpatient department with complaints of burning sensation of eyes, eye pain and red eye as possible COVID-19 cases, and do due diligent workup.

Unanticipated pathogenic risk and emerging transmittable diseases can result from interspecies exchanges of viruses among animals and humans. The emergence of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing coronavirus disease-19 (COVID-19) pandemic has recently exemplified this mechanism. Cough, fever, fatigue, headache, sputum production, hemoptysis, dyspnea, diarrhea, and gastrointestinal disorders are the characteristic features of the disease. The most prevalent and serious manifestation of the infection tends to be pneumonia. The new strains of SARS-CoV-2 with more infectivity have been emerging at regular intervals. There is currently no World Health Organization-approved particular drug for COVID-19. Besides, developing novel antivirals would take much time. Thus, repurposing the application of natural products can provide alternatives and can facilitate medication against COVID-19 as well as can slow down the aggressive progression of the disease before the arrival of approved drugs. Probiotics have long been known for their positive effects on the gut microbiome and impact on immune responses. Particularly, their involvement against viral diseases, especially those of the upper and lower respiratory tract, is of current interest for their prospective application against COVID-19. In this review, we comprehensively address the mode of action of probiotics and their possible intervention against coronavirus diseases correlating with their efficacy against viral diseases. In this regard, we explored recently published relevant research and review articles in MEDLINE/PubMed related to COVID-19 and the effects of probiotics on viral infections.

Background: Severe acute respiratory illness caused by SARS-CoV-2 has been a health emergency of great concern in the year 2020. This study was undertaken to identify characteristics of hospitalized patients with Coronavirus Disease 19 (COVID-19) and hypoxia in the form of disease course and outcome with special reference to the presence or absence of comorbidities. Materials and Methods: A prospective observational study was conducted at a tertiary hospital recognized as Dedicated COVID Hospital during the period of June 2020 to September 2020. The study included a total of 249 patients of COVID-19 with hypoxia who required oxygen or noninvasive ventilation/invasive ventilation. Patients were divided into two groups as per the presence or absence of comorbidity (175 and 74 patients, respectively). Their clinical and laboratory findings, course in the hospital, and outcomes were noted. Data were analyzed using SPSS software. Results: Among all the study patients, more patients from comorbidity group presented with a N:L ratio >3.5 and raised inflammatory markers (like serum ferritin) than patients in the no comorbidity group. In patients with comorbidities, 47.43% required noninvasive or invasive ventilation as against 18.92% in those without any comorbidities. Development of deranged renal function was noted in 32.57% of patients in the comorbidity group and only 9.46% in the noncomorbid group. All except one death during the study period were in the patients with comorbidities. Conclusion: COVID-19 patients with hypoxia and the presence of comorbidities in this study had more complications and a worse outcome.

Background: On March 30, 2020, coronavirus disease 19 was declared pandemic and many countries of the world started working on the development of vaccine soon after China released the genetic structure of severe acute respiratory syndrome coronavirus 2. Drugs Controller General of India on January 3, 2021, accorded emergency use authorization to Oxford-AstraZeneca's ChAdOx1 nCoV-19 vaccine and vaccination drive commenced in India on January 16, 2021. The present study was conducted to determine the incidence adverse event following immunization (AEFI) among recipients of the first and second dose of the vaccine. Materials and Methods: A longitudinal descriptive study was conducted among 2529 vaccine beneficiaries who were asked about the side effects at 24 and 72 h after the first dose and second dose of vaccination with ChAdOx1 nCoV-19 vaccine. Passive surveillance was also done for 4 months. Results: AEFI was reported in 27.59%, 38.4%, and 19.96% of vaccines after both doses, first dose, and second dose, respectively. 14% did not report any AEFI with either dose of vaccine. Younger people had higher rates of AEFIs with both the doses. Pain at injection site and fever <102°F were the most common symptoms. Only three patients required admission after first dose and nil required admission after second dose, all three were discharged after 24 h observation without any complication or sequelae. Conclusion: The results of our study indicate that the vaccine has good safety profile and is recommended for use among 18–60 years. However, since majority of individuals in our study were young, studies may be undertaken in more than 60 years of age, persons with a history of allergy, and comorbidities to further evaluate safety profile of the vaccine among these groups of people. [ABSTRACT FROM AUTHOR]

Ongoing novel coronavirus (COVID-19) with high mortality is an infectious disease in the world which epidemic in 2019 with human-human transmission. According to the literature, S-protein is one of the main proteins of COVID-19 that bind to the human cell receptor angiotensin-converting enzyme 2 (ACE2). In this study, it was attempted to identify the main effective drugs approved that may be repurposed to the binding site of ACE2. High throughput virtual screening based on the docking study was performed to know which one of the small-molecules had a potential interaction with ACE2 structure. Forasmuch as investigating and identifying the best ACE2 inhibitors among more than 3,500 small-molecules is time-consuming, supercomputer was utilized to apply docking-based virtual screening. Outputs of the proposed computational model revealed that vincristine, vinbelastin and bisoctrizole can significantly bind to ACE2 and may interface with its normal activity. [ABSTRACT FROM AUTHOR]

Objective: Pneumocystis pneumonia (PcP) is a life-threatening infection caused by the opportunistic fungi Pneumocystis jirovecii. The emergence of the COVID-19 pandemic forced the focus of attention of health policymakers on these two infections due to their clinical and paraclinical similarities, which cause diagnostic dilemmas. This study was undertaken to evaluate and estimate the global prevalence and main leading risk factors of coronavirusassociated pneumocystosis (CAP). Methods: We searched related databases between December 2019 and May 2022 for studies reporting CAP. Meta-analysis was performed using StatsDirect software (version 2.7.9) according to the DerSimonian and Laird method applying the random-effects model. We evaluated heterogeneity using the χ2-based Q statistic (significant for P<0.05) and the I2 statistic (>75% indicative of "notable" heterogeneity). Moreover, an odds ratio (OR) analysis was performed for eligible data. Results: Our meta-analysis included eight studies with 923 patients hospitalized with COVID-19; among them, 92 were PcP cases. The overall pooled prevalence of CAP was estimated at 11.5%. The mortality among CAP patients was lower than that of non-PcP patients (OR 1.93; 95% CI 0.86-4.31). Long-term corticosteroid therapy (OR 28.22; 95% CI 0.54-1 480.84) was the most predisposing factor for PcP among COVID-19 patients, followed by pulmonary diseases (OR 1.46; 95% CI 0.43-4.98), kidney diseases (OR 1.26; 95% CI 0.21-7.49), and acute respiratory destruction syndrome (OR 1.22; 95% CI 0.05-29.28). Conclusions: The prevalence of PcP among the COVID-19 population is almost similar to the pre-COVID era. However, PcPrelated mortality was decreased by the emergence of the COVID-19 pandemic. Women with COVID-19 are more susceptible to PcP than men. Acute respiratory distress syndrome, kidney diseases, pulmonary diseases, and long-term corticosteroid therapy increased the risk of PcP; however, transplantation and malignancy decreased the risk for PcP among COVID-19 patients. Further retrospective, case-control, prospective, and more precisely systematic review and meta-analysis studies are needed in this field. [ABSTRACT FROM AUTHOR]

Coronavirus disease 19 (COVID-19) is a systematic multitropic disease. Sustaining blood homeostasis is a mission of multiple factors includes procoagulant and anticoagulant systems. Subsequently, maintaining a precise equilibrium between these antagonists' systems is crucial to prevent hemostasis. Frequently, during severe forms of COVID-19 patients, studies reported a discrepancy between the procoagulant and anticoagulant that usually results in fatal outcomes through multiorgan ischemia by thrombotic events. The proper interpreting of the anticoagulant status changes in COVID-19 patients is sufficient for effective and safe anticoagulant treatment. Our postulation is the first to address the pathophysiology of anticoagulant status under COVID-19. [ABSTRACT FROM AUTHOR]

TMEM16 proteins, which function as Ca 2+ ‑activated Cl ‑ channels are involved in regulating a wide variety of cellular pathways and functions. The modulators of Cl ‑ channels can be used for the molecule‑based treatment of respiratory diseases, cystic fibrosis, tumors, cancer, osteoporosis and coronavirus disease 2019. The TMEM16 proteins link Ca 2+ signaling, cellular electrical activity and lipid transport. Thus, deciphering these complex regulatory mechanisms may enable a more comprehensive understanding of the physiological functions of the TMEM16 proteins and assist in ascertaining the applicability of these proteins as potential pharmacological targets for the treatment of a range of diseases. The present review examined the structures, functions and characteristics of the different types of TMEM16 proteins, their association with the pathogenesis of various diseases and the applicability of TMEM16 modulator‑based treatment methods.

The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome-related coronavirus-2 continues its effects around the world with its new variants. Coronavirus disease 2019 infection may continue with a post-coronavirus disease period, which is characterized by high morbidity apart from the acute and subacute phases. Host immune response quality and inflammasome-induced uncontrollable inflammatory response take a role together in the pathogenesis of severe acute respiratory syndrome-related coronavirus- 2 infection. Therefore, treatment of severe acute respiratory syndrome-related coronavirus-2 infection should basically include 3 measures: Viral replication, inflammation, and tissue damage control. Today, there is no effective therapy to control these points. At this point, preclinical studies have shown that mesenchymal stem cells can control inflammatory reactions and lung damage through both immune regulation and inflammasome control. Subsequently, controlled clinical studies on severe acute respiratory syndrome-related coronavirus-2 infection confirm their ability, indicating that mesenchymal stem cells may be a safe treatment option while reducing severe acute respiratory syndrome-related coronavirus-2-r elate d morbidity and mortality. On the other hand, post-coronavirus syndrome is as important as acute coronavirus syndrome, it is a picture that can cause morbidity and mortality. Mesenchymal stem cell application can prevent the development of post-coronavirus syndrome through the mechanism of an inflammasome. However, there is no study that analyzes the effects of current treatments using mesenchymal stem cells in the post-coronavirus disease period, and that tests the use of mesenchymal stem cells when post-coronavirus syndrome develops. In this respect, studies that test the efficacy of mesenchymal stem cells in the post-coronavirus disease period are certainly needed. [ABSTRACT FROM AUTHOR]

Background: Severe acute respiratory illness caused by SARS-CoV-2 has been a health emergency of great concern in the year 2020. This study was undertaken to identify characteristics of hospitalized patients with Coronavirus Disease 19 (COVID-19) and hypoxia in the form of disease course and outcome with special reference to the presence or absence of comorbidities. Materials and Methods: A prospective observational study was conducted at a tertiary hospital recognized as Dedicated COVID Hospital during the period of June 2020 to September 2020. The study included a total of 249 patients of COVID-19 with hypoxia who required oxygen or noninvasive ventilation/invasive ventilation. Patients were divided into two groups as per the presence or absence of comorbidity (175 and 74 patients, respectively). Their clinical and laboratory findings, course in the hospital, and outcomes were noted. Data were analyzed using SPSS software. Results: Among all the study patients, more patients from comorbidity group presented with a N:L ratio >3.5 and raised inflammatory markers (like serum ferritin) than patients in the no comorbidity group. In patients with comorbidities, 47.43% required noninvasive or invasive ventilation as against 18.92% in those without any comorbidities. Development of deranged renal function was noted in 32.57% of patients in the comorbidity group and only 9.46% in the noncomorbid group. All except one death during the study period were in the patients with comorbidities. Conclusion: COVID-19 patients with hypoxia and the presence of comorbidities in this study had more complications and a worse outcome. [ABSTRACT FROM AUTHOR]

Background: Monoclonal antibodies (mAb) prevent COVID-19 progression when administered early. We compared mAb treatment outcomes among vaccinated and unvaccinated patients during Delta wave and assessed the feasibility of implementing stricter eligibility criteria in the event of mAb scarcity.Methods: We conducted a retrospective observational study of casirivimab/imdevimab recipients with mild-to-moderate COVID-19 infection in an emergency department or outpatient infusion center (July 1-August 20, 2021). Primary outcome was all-cause hospital admission within 30 days post-treatment between vaccinated vs. unvaccinated patients during Delta surge in the Bronx, NY.Results: A total of 250 patients received casirivimab/imdevimab (162 unvaccinated vs. 88 vaccinated). The median age was 39 years for unvaccinated patients, and 52 years for vaccinated patients (p < 0.0001). The median number of EUA criteria met was 1 for unvaccinated and 2 for vaccinated patients (p < 0.0001). Overall, 6% (15/250) of patients were admitted within 30 days post-treatment. Eleven unvaccinated patients (7%) were admitted within 30-days compared to 4 (5%) vaccinated patients (p = 0.48).Conclusions: All-cause 30-day admission was not statistically different between vaccinated and unvaccinated patients. When federal allocation of therapies is limited, programs must prioritize patients at highest risk of hospitalization and death regardless of vaccination status. [ABSTRACT FROM AUTHOR]

The epidemiology of multisystem inflammatory syndrome in children (MIS-C) and the provisional case definition are still being updated by the WHO. There is no solid evidence regarding the clinical presentations, severity, and outcomes. This case report tackles a 4-year-old female. Her main manifestations were persistent high-grade fever (40.0°C), diarrhea, poor oral intake, fatigue, and less activity with mucocutaneous involvement. Blood test revealed elevated inflammatory markers, as well as D-dimer, cardiac enzymes, and IL-6 with lymphopenia. She had a history of coronavirus disease (COVID-19) infection 4 weeks prior to admission. We describe a patient diagnosed as MIS-C or so-called SARS-CoV-2-induced Kawasaki-like hyperinflammatory syndrome. It seems to be caused by delayed response to SARS-CoV-2. It mimics Kawasaki disease, with unique presentations, such as diarrhea, capillary leak, and myocardial dysfunction, complicated by macrophage activation syndrome. Eventually, she completely improved with aggressive management including intravenous immunoglobulin, intravenous methylprednisolone, anti-IL-6, and aspirin. This is one of the early cases presented to our tertiary hospital fulfilling the CDC criteria of MIS-C. Based on this case, we suggest that pediatricians need to be aware of such clinical presentations and early referral to tertiary care health facility for further diagnosis and management. MIS-C is not common but a highly critical complication of COVID-19 infection in pediatrics resulting in life-threatening illnesses. Knowledge about the wide spectrum of presenting clinical manifestations, disease severity, and early detection and management is crucial to prevent a serious outcome.

ABSTRACT BACKGROUND: Hesitation and refusal to take a second dose of the vaccine for coronavirus disease 19 (COVID-19) are prevalent. OBJECTIVES: We aimed to identify predictive factors for hesitation or refusal and describe groups with higher rates of vaccine hesitancy. DESIGN AND SETTING: A cross-sectional study in Assis City, Brazil. METHODS: The study included adults who passed the due date for taking the COVID-19 second dose vaccine. Participants were recruited in December 2021 using a mobile-based text message. Sociodemographic and clinical data and reasons for hesitance were collected. The outcome was the attitude towards completing the recommended second dose of the vaccine. Bivariate and multivariate Poisson analyses were performed to determine the adjusted predictors. RESULTS: Participants between 30–44 years of age had a 2.41 times higher prevalence of hesitation than those aged 18–29 years. In addition, people who had adverse events or previously had COVID-19 had 4.7 and 5.4 times higher prevalences of hesitation, respectively (P value < 0.05). CONCLUSION: We found a significant group of adults aged between 30–44 years who refused the second dose of the COVID-19 vaccine. Furthermore, those who reported adverse effects after the first dose and those who had COVID-19 previously were a significant group for refusal.

Abstract Background To investigate whether methotrexate treatment may affect the susceptibility to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods Clinical assessment of symptoms, SARS-CoV-2 RNA, and anti-SARS-CoV-2 IgG in an initial case series of four families and confirmatory case series of seven families, within which one family member developed coronavirus disease 19 (COVID-19) and exposed another family member receiving methotrexate treatment; experimental part with methotrexate treatment of mice and organoids followed by the assessment of mRNA and protein expression of the SARS-CoV-2 receptor angiotensin-converting enzyme (ACE)-2. Results In the initial case series, three of four women on a joint ski trip developed COVID-19, while the fourth woman, under treatment with methotrexate, remained virus-free. Two of the three diseased women infected their husbands, while the third husband treated with methotrexate remained virus-free. In addition, 7 other families were identified in a follow-up case series, in which one member developed COVID-19, while the other, receiving methotrexate, remained healthy. Experimentally, when mice were treated with methotrexate, ACE2 expression significantly decreased in the lung, in the intestinal epithelium, and in intestinal organoids. Conclusion These clinical and experimental data indicate that methotrexate has certain protective effects on SARS-CoV-2 infection via downregulating ACE2.

Abstract Background We investigated college students’ attitude and compliance towards a prevention strategy involving use of non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19). Methods We conducted a cross-sectional online survey in four universities in Guangdong Province (China) based on purposive sampling. A self-administered questionnaire was given to College students (CSs) to measure the supportive attitude towards an outbreak control strategy and adoption of NPIs in respondents. Results A total of 44,446 CSs participated between 31 January and 10 February 2020; 92.7% of respondents supported the outbreak control strategy. The proportion of respondents who avoided public places, wore a facemask, avoid gatherings, and washed hands more frequently than usual was 94.8, 92.8, 91.2 and 86.9%. respectively. A total of 76.5% respondents adopted all four measures. A supportive attitude was associated with NPI adoption. Students who were female, postgraduate, anxious, and not depressed tended to have a higher supportive attitude and higher chance of NPI adoption. Conclusions Higher supportiveness towards the disease control strategy for the Chinese public may lead to higher adoption rate of NPIs. Psychosocial factors were related to a supportive attitude and adoption of the NPI. We believe that our findings could aid policymakers to create NPIs to prevent and control emerging infectious diseases such as COVID-19.

The potential of targeting the Renin-Angiotensin-Aldosterone System (RAAS) as a treatment for the coronavirus disease 2019 (COVID-19) is currently under investigation. One way to combat this disease involves the repurposing of angiotensin receptor blockers (ARBs), which are antihypertensive drugs, because they bind to angiotensin-converting enzyme 2 (ACE2), which in turn interacts with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein. However, there has been no in silico analysis of the potential toxicity risks associated with the use of these drugs for the treatment of COVID-19. To address this, a network-based bioinformatics methodology was used to investigate the potential side effects of known Food and Drug Administration (FDA)-approved antihypertensive drugs, Sartans. This involved identifying the human proteins targeted by these drugs, their first neighbors, and any drugs that bind to them using publicly available experimentally supported data, and subsequently constructing proteomes and protein–drug interactomes. This methodology was also applied to Pfizer’s Paxlovid, an antiviral drug approved by the FDA for emergency use in mild-to-moderate COVID-19 treatment. The study compares the results for both drug categories and examines the potential for off-target effects, undesirable involvement in various biological processes and diseases, possible drug interactions, and the potential reduction in drug efficiency resulting from proteoform identification.

• COVID-19 tends to be clustered. • Severity of COVID-19 decreases between generations. • Secondary attack rates decrease over time. • Severely ill patients had a higher viral load. COVID-19 has spread worldwide and become a pandemic. We report the epidemiological and clinical characteristics of cluster infections. Data of clustered cases were retrieved from the public health emergency monitoring information system of China. We analyzed the incubation period, generation gap, secondary attack rate, and viral load in various grouped cases. A total of 60 COVID-19 infection clusters including 226 patients and 19 asymptomatic cases involving four generations were analyzed. With the increase of transmission generations, secondary attack rate decreased (P ＜0.001) and severity alleviated (P = 0.008). The median incubation period and intergenerational interval were 9 and 6 days, respectively. The secondary attack rate was 7.1% in the index cases, 5.0% in the first generation, 1.0% in the second generation, and 4.7% overall. Severe cases were seen more in the index (13, 65%) and first generation (7, 35%) ones, who had a significantly higher viral load than the mild and moderate ones. With the increase of transmission generation, secondary infection rate and severity decreased. Severe patients had a higher virus load. Patients in the incubation period and asymptomatic carriers were potential infection sources who might play an important role in transmission. [ABSTRACT FROM AUTHOR]

Unanticipated pathogenic risk and emerging transmittable diseases can result from interspecies exchanges of viruses among animals and humans. The emergence of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing coronavirus disease-19 (COVID-19) pandemic has recently exemplified this mechanism. Cough, fever, fatigue, headache, sputum production, hemoptysis, dyspnea, diarrhea, and gastrointestinal disorders are the characteristic features of the disease. The most prevalent and serious manifestation of the infection tends to be pneumonia. The new strains of SARS-CoV-2 with more infectivity have been emerging at regular intervals. There is currently no World Health Organization-approved particular drug for COVID-19. Besides, developing novel antivirals would take much time. Thus, repurposing the application of natural products can provide alternatives and can facilitate medication against COVID-19 as well as can slow down the aggressive progression of the disease before the arrival of approved drugs. Probiotics have long been known for their positive effects on the gut microbiome and impact on immune responses. Particularly, their involvement against viral diseases, especially those of the upper and lower respiratory tract, is of current interest for their prospective application against COVID-19. In this review, we comprehensively address the mode of action of probiotics and their possible intervention against coronavirus diseases correlating with their efficacy against viral diseases. In this regard, we explored recently published relevant research and review articles in MEDLINE/PubMed related to COVID-19 and the effects of probiotics on viral infections. [ABSTRACT FROM AUTHOR]

Despite the widespread of coronavirus disease-19 (CO­VID-19) infection around the world, there are very scarce reported literature about the care of patients with a known diagnosis of hemoglobin disorders such as sickle cell disease (SCD) or thalassemia and confirmed COVID-19 infection. Thalassemia International Federation issued a position statement to include patients with thalassemia and SCD among the high-risk groups of patients. Here, we present an interesting case of a 42-year-old patient know to have SCD presenting with Vaso-occlusive (VOC) pain episode in the absence of COVID-19 signs and symptoms, who tested positive for COVID-19 infection and had a smooth recovery. This case highlights the importance of screening SCD patients presenting with VOC-related events even in the absence of COVID-19 signs and symptoms.

CONTEXT: Exploring clinical characteristics of coronavirus disease-19 (COVID-19) in children may help in prevention and treatment guidelines. AIMS: The aim of the to describe the spectrum of pediatric COVID-19 in Saudi Arabia. SETTINGS And DESIGN: A multicenter, retrospective, cross-sectional study involving pediatric COVID-19 patients across all Saudi regions. METHODS: All patients aged between 2 months and 18 years with a confirmed diagnosis of COVID-19 were included. The primary end point was the hospitalization. STATISTICAL ANALYSIS USED: Descriptive statistics were used to describe the baseline demographic data and clinical characteristics. Numerical data were explored using Kolmogorov–Smirnov test and Shapiro–Wilk test, while Chi-square or Fisher's exact test were used for categorical data. RESULTS: Among the 654 pediatric COVID-19 patients, 4.7% (n = 31) were hospitalized, with one patient only needing pediatric intensive care admission. Sex, breastfeeding, birth status, and the patients' living environment showed no significant association with hospitalization. Most children (80.3%, n = 525) were symptomatic, with two symptoms that were significantly associated with admission, namely, vomiting (P = 0.007) and nausea (P = 0.026). History of admission within the last year was identified in 10.4% (n = 68) children but had no association with worse outcome. The median duration of hospitalization for the entire group was 5.5 days, with longest hospital stay for age group 7–12 years (median 6 days). CONCLUSIONS: COVID-19 is usually a milder disease in children. Although having preexisting medical conditions was linked to a longer hospitalization, it was not associated with worse outcome. Continuous surveillance will allow additional characterization of the burden and outcomes of pediatric COVID-19-associated hospitalizations.

The coronavirus disease 19 (COVID-19) pandemic has negatively affected people's day-to-day lives, especially those with mental illness. We present a case of a manic episode with psychotic features induced by dexamethasone administered as part of COVID-19 treatment. The patient had underlying depression, anxiety, and posttraumatic stress disorder, but was stable before contracting COVID-19. The implications of quarantine and social stress on mood stability are also discussed. We call for better patient education on the risks of steroid-induced mania and psychosis as well as increased attention to mental illness screening and treatment during this unprecedented pandemic time.