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Standard precautions practices are crucial management skills among nurses against the highly infectious novel COVID-19. The study aimed to investigate the level of nurses' compliance infected with standard precautions, and identify the main challenges experienced by nurses during their work with COVID-19 patients. A cross-sectional survey design was used. The study was done at the beginning of the pandemic in public and private hospitals in Jordan. About 386 front-line nurses filled out the online questionnaire. Most of the participants revealed dealing with COVID-19 patients (73.6%). Generally, nurses demonstrated a good level of compliance with standard practices (71%). The staff reported that they mostly adhere to performing hand hygiene after all procedures (65.8%). On the other hand, they were the least adherence to maintaining a physical distance of patients and staff of at least 6 feet apart (28.5%). Strict observation of the compliance of nurses with the standard precautions practices is crucial to be maintained at the highest level to eliminate the spreading of COVID-19 among other community members. More efforts should be come to light including continuous training and education sessions to enhance nurses' level of knowledge and practice concerning controlling the outbreak of the novel pandemic.

In Syria, medical students were placed on call to provide sufficient human resources during COVID-19 pandemic. This research aimed to explore the ability and willingness of the final-year medical students to assist during COVID-19 in the Syrian war-torn and fragile health-system. Final-year Syrian medical students were approached between 9th-17th April 2020 through an online questionnaire. Students' COVID-19-related medical knowledge (5-point score), clinical judgement (5-point score), and preparedness and willingness to integrate in healthcare facilities were assessed. A 10-point score was created, and linear regression and Tukey's HSD test were conducted. 1673 valid responses were received, of which 1199 (71.66%) responses were from the final-year students. Of the latter, 728 (60.71%) scored 4 points or higher in the medical knowledge score (mean 3.69 points), while 298 (24.85%) scored 4 or higher in the clinical judgement score. Final-year students scored significantly higher than the fourth-year students in the clinical judgement score. Finally, 682 (56.88%) of the final-year students expressed willingness to volunteer with healthcare teams. Final-year medical students may provide medical aid, on voluntary basis, by working in fragile health systems during pandemics. However, this should be undertaken in cases of extreme need. Sufficient personal protective measures, intensive training, and adequate supervision should be guaranteed.

Objective: This study aimed to assess the protective measures among health-care workers (HCWs) in a war-torn area during coronavirus disease 2019 (COVID-19) pandemic., Methods: An online cross-sectional questionnaire was administrated to HCWs in Syria between April 1 and May 21, 2020. The questions aimed to assess the HCWs' application of safety, hygiene, and necessary protection considerations while attending to suspected or proven COVID-19 cases. Unpaired t-test and 1-way analysis of variance (ANOVA) were used for statistical analysis., Results: Of the 290 participants included in the statistical analysis, 250 were medical doctors. Low scores of protective practices were noticed among the participants, as only 12% of doctors had a score above 6/15 points, and only 37.5% of nurses had a score of more than 4/12 points. Medical doctors who were not on the frontlines scored significantly higher than those who were on the frontlines (4.69 vs 3.80 points, respectively; P < 0.001)., Conclusions: More courses and training sessions should be implemented to improve the practice of protective measures among HCWs (frontliners in particular) in areas with fragile health systems, such as Syria, during the COVID-19 pandemic, especially those on the frontlines. Moreover, specific COVID-19 protection measures guidelines to low-income countries are needed.

Rationale: The ongoing coronavirus pandemic has caused severe acute respiratory syndrome, posing a significant challenge for patients receiving immunotherapy for immune-mediated inflammatory diseases. As of January 2022, immunosuppressants such as tumor necrosis factor inhibitors (anti-TNFα) and azathioprine are inadvisable for an infectious disease caused by the SARS-CoV-2 virus (COVID-19). We continued infliximab as a second induction dose nine days after the onset of COVID-19 symptoms in a patient with acute severe ulcerative colitis., Patient Concerns: We report the case of a 34-year-old male with 6 to 8 times bloody diarrhea, fever, and cramping abdominal pain. Ulcerative colitis was diagnosed 6 months earlier and treated with mesalamine 80 mg/kg/day and azathioprine 2.5 mg/kg/day. The patient had never undergone surgery before. Sigmoidoscopy revealed multiple ulcerations and spontaneous bleeding, and the colon samples tested negative for cytomegalovirus and Clostridium difficile. However, intravenous corticosteroids did not induce remission. A nasopharyngeal swab tested positive for SARS-CoV-2., Diagnosis: Acute severe ulcerative colitis and SARS-CoV-2 (COVID-19) pneumonia., Interventions: The second loading dose of infliximab was administered nine days after the diagnosis of COVID-19., Outcome: The patient completed infliximab induction at a dose of 5 mg/kg at weeks 0, 2, and 6, with no complications., Lessons: It is unclear whether anti-TNF-α treatment improves or deteriorates COVID-19 patient outcomes, and this case demonstrates that infliximab can be used safely. Current guidelines make a weak recommendation to avoid using anti-TNFα agents in the presence of acute COVID-19 infection. There is an urgent need for research on biologics therapy., Competing Interests: The authors have no funding and conflicts of interests to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)