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Background: efficacy of therapeutic cholecalciferol supplementation for severe COVID-19 is sparingly studied., Objective: effect of single high-dose cholecalciferol supplementation on sequential organ failure assessment (SOFA) score in moderate-to-severe COVID-19., Methods: participants with moderate to severe COVID-19 with PaO2/FiO2 ratio < 200 were randomized to 0.6 million IU cholecalciferol oral (intervention) or placebo., Outcomes: primary outcome was change in Day 7 SOFA score and pre-specified secondary outcomes were SOFA and 28-day all-cause mortality., Results: in all, 90 patients (45 each group) were included for intention-to-treat analysis. 25(OH)D3 levels were 12 (10-16) and 13 (12-18) ng/ml (P = 0.06) at baseline; and 60 (55-65) ng/ml and 4 (1-7) ng/ml by Day 7 in vitamin D and placebo groups, respectively. The SOFA score on Day 7 was better in the vitamin D group [3 (95% CI, 2-5) versus 5 (95% CI, 3-7), P = 0.01, intergroup difference - 2 (95% CI, -4 to -0.01); r = 0.4]. A lower all-cause 28-day mortality [24% compared to 44% (P = 0.046)] was observed with vitamin D., Conclusions: single high-dose oral cholecalciferol supplementation on ICU admission can improve SOFA score at Day 7 and reduce in-hospital mortality in vitamin D-deficient COVID-19. ClinicalTrials.gov  id: NCT04952857 registered dated 7 July 2021. What is already known on this topic-vitamin D has immunomodulatory role. Observational and isolated intervention studies show some benefit in COVID-19. Targeted therapeutic vitamin D supplementation improve outcomes in severe COVID-19 is not studied in RCTs. What this study adds-high-dose vitamin D supplementation (0.6 Million IU) to increase 25(OH)D > 50 ng/ml is safe and reduces sequential organ failure assessment score, in-hospital mortality in moderate to severe COVID-19. How this study might affect research, practice or policy-vitamin D supplementation in vitamin D-deficient patients with severe COVID-19 is useful may be practiced., (© The Author(s) 2024. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Here we conducted a multicenter open-label, randomized phase 2 and 3 study to assess the safety and immunogenicity of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-specific (BA.1/B.1.1.529), monovalent, thermostable, self-amplifying mRNA vaccine, GEMCOVAC-OM, when administered intradermally as a booster in healthy adults who had received two doses of BBV152 or ChAdOx1 nCoV-19. GEMCOVAC-OM was well tolerated with no related serious adverse events in both phase 2 and phase 3. In phase 2, the safety and immunogenicity of GEMCOVAC-OM was compared with our prototype mRNA vaccine GEMCOVAC-19 (D614G variant-specific) in 140 participants. At day 29 after vaccination, there was a significant rise in anti-spike (BA.1) IgG antibodies with GEMCOVAC-OM (P < 0.0001) and GEMCOVAC-19 (P < 0.0001). However, the IgG titers (primary endpoint) and seroconversion were higher with GEMCOVAC-OM (P < 0.0001). In phase 3, GEMCOVAC-OM was compared with ChAdOx1 nCoV-19 in 3,140 participants (safety cohort), which included an immunogenicity cohort of 420 participants. At day 29, neutralizing antibody titers against the BA.1 variant of SARS-CoV-2 were significantly higher than baseline in the GEMCOVAC-OM arm (P < 0.0001), but not in the ChAdOx1 nCoV-19 arm (P = 0.1490). GEMCOVAC-OM was noninferior (primary endpoint) and superior to ChAdOx1 nCoV-19 in terms of neutralizing antibody titers and seroconversion rate (lower bound 95% confidence interval of least square geometric mean ratio >1 and difference in seroconversion >0% for superiority). At day 29, anti-spike IgG antibodies and seroconversion (secondary endpoints) were significantly higher with GEMCOVAC-OM (P < 0.0001). These results demonstrate that GEMCOVAC-OM is safe and boosts immune responses against the B.1.1.529 variant. Clinical Trial Registry India identifier: CTRI/2022/10/046475 ., (© 2024. The Author(s).)

Current study was conducted to assess the perception and barriers regarding proning among nurses. 385 nurses were conveniently surveyed using pre-tested tools. 3.9% of nurses "felt like running away" while providing care to the patients in prone position. 93.5% believed that prone position for COVID-19 patients is beneficial in reducing morbidity and that teamwork is required to be effective (96.6%). 93% nurses believed that inadequate staff-patient ratio is a significant barrier for prone positioning. Other barriers were fear of dislodgement of tubings (91.5%), difficulty in providing routine care (87.3%) and inadequate institutional protocol (83.9%). 12.5% were trained regarding proning.

Emergence of SARS-CoV-2 Omicron variant has presented a significant challenge to global health, demanding rapid development of mRNA-based vaccines. The mRNA-guided vaccine platforms offer various advantages over traditional vaccine platforms. The mRNA by nature is a short-lived molecule that guides the cells to manufacture antigenic proteins. In the present work, we have created an omicron spike antigenic protein sequence characterized by base composition analysis, modeling, and docking with the ACE-2 receptor. Further, we predicted the B-cell and T-cell epitopes followed by antigenicity, toxicity, and allergenicity. Finally, the protein was reverse translated, codon-optimized, and encoding mRNA sequence was checked for its stability by predicting the secondary structures. A comprehensive examination of in-silico data revealed 628.2 as a potent antigenic candidate that was finally used in Gemcovac®-OM, a heterologous booster mRNA vaccine for COVID-19., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Literature states a higher self-contamination rate among healthcare workers (HCWs) while doffing personal protective equipment (PPE). During the Covid-19 pandemic, onsite trained observers were not always available to monitor PPE compliance. The remote audio-visual doffing surveillance (RADS) system has the potential to overcome this limitation. We aimed to compare the efficacy of this real-time RADS system against the onsite buddy system for monitoring the doffing of PPE., Methods: This prospective, observational study was carried out at our tertiary care centre in northern India. 200 HCWs who cared for Covid-19 patients in the intensive care units/operation theatres were included. Group A included HCWs who performed doffing with the help of an onsite trained observer and group B included HCWs who performed doffing with the RADS system. An independent observer noted the error at any step using the CDC doffing checklist, in both groups. An online questionnaire to analyse the level of satisfaction post-doffing was also surveyed., Results: The proportion of errors committed during doffing was significantly lower in group B compared to group A with a low relative risk of 0.34 (95% CI 0.22-0.51) (p < 0.001) (Figure 1A,B). In both groups, there was no difference in HCWs feedback regarding the ease of the system and fear of committing an error. Though the perceived quality of monitoring was felt better with onsite buddy, the overall confidence rating of being safe after doffing was better with the RADS system., Conclusion: Real-time RADS system may be more effective than the onsite buddy system for ensuring the safety of HCWs during doffing PPE. HCWs level of satisfaction related to the ease and anxiety with the monitoring systems were comparable. RADS system can reduce reliance on HCW resources and can integrate well into existing healthcare systems., (© 2024 John Wiley & Sons Ltd.)

Background Objectives: The Omicron sub-lineages are known to have higher infectivity, immune escape and lower virulence. During December 2022 - January 2023 and March - April 2023, India witnessed increased SARS-CoV-2 infections, mostly due to newer Omicron sub-lineages. With this unprecedented rise in cases, we assessed the neutralization potential of individuals vaccinated with ChAdOx1 nCoV (Covishield) and BBV152 (Covaxin) against emerging Omicron sub-lineages., Methods: Neutralizing antibody responses were measured in the sera collected from individuals six months post-two doses (n=88) of Covishield (n=44) or Covaxin (n=44) and post-three doses (n=102) of Covishield (n=46) or Covaxin (n=56) booster dose against prototype B.1 strain, lineages of Omicron; XBB.1, BQ.1, BA.5.2 and BF.7., Results: The sera of individuals collected six months after the two-dose and the three-dose demonstrated neutralizing activity against all variants. The neutralizing antibody (NAbs) level was highest against the prototype B.1 strain, followed by BA5.2 (5-6 fold lower), BF.7 (11-12 fold lower), BQ.1 (12 fold lower) and XBB.1 (18-22 fold lower)., Interpretation Conclusions: Persistence of NAb responses was comparable in individuals with two- and three-dose groups post six months of vaccination. Among the Omicron sub-variants, XBB.1 showed marked neutralization escape, thus pointing towards an eventual immune escape, which may cause more infections. Further, the correlation of study data with complete clinical profile of the participants along with observations for cell-mediated immunity may provide a clear picture for the sustained protection due to three-dose vaccination as well as hybrid immunity against the newer variants., (Copyright © 2024 Copyright: © 2024 Indian Journal of Medical Research.)

Severe acute respiratory syndrome coronavirus 2, abbreviated as SARS-CoV-2, has been associated with the transmission of infectious COVID-19 disease through breathing and speech droplets emitted by infected carriers including asymptomatic cases. As part of SARS-CoV-2 global pandemic preparedness, we studied the transmission of aerosolized air mimicking the infected person releasing speech aerosol with droplets containing CorNPs using a vibrating mesh nebulizer as human patient simulator. Generally speech produces nanoaerosols with droplets of <5 μm in diameter that can travel distances longer than 1 m after release. It is assumed that speech aerosol droplets are a main element of the current Corona virus pandemic, unlike droplets larger than 5 m, which settle down within a 1 m radius. There are no systemic studies, which take into account speech-generated aerosol/droplet experimental validation and their aerodynamics/particle kinetics analysis. In this study, we cover these topics and explore role of residual water in aerosol droplet stability by exploring drying dynamics. Furthermore, a candle experiment was designed to determine whether air pollution might influence respiratory virus like nanoparticle transmission and air stability., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

The severity of global pandemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has engaged the researchers and clinicians to find the key features triggering the viral infection to lung cells. By utilizing such crucial information, researchers and scientists try to combat the spread of the virus. Here, in this work, we performed in silico analysis of the protein-protein interactions between the receptor-binding domain (RBD) of the viral spike protein and the human angiotensin-converting enzyme 2 (hACE2) receptor to highlight the key alteration that happened from SARS-CoV to SARS-CoV-2. We analyzed and compared the molecular differences between spike proteins of the two viruses using various computational approaches such as binding affinity calculations, computational alanine, and molecular dynamics simulations. The binding affinity calculations showed that SARS-CoV-2 binds a little more firmly to the hACE2 receptor than SARS-CoV. The major finding obtained from molecular dynamics simulations was that the RBD-ACE2 interface is populated with water molecules and interacts strongly with both RBD and ACE2 interfacial residues during the simulation periods. The water-mediated hydrogen bond by the bridge water molecules is crucial for stabilizing the RBD and ACE2 domains. Near-ambient pressure X-ray photoelectron spectroscopy (NAP-XPS) confirmed the presence of vapor and molecular water phases in the protein-protein interfacial domain, further validating the computationally predicted interfacial water molecules. In addition, we examined the role of interfacial water molecules in virus uptake by lung cell A549 by binding and maintaining the RBD/hACE2 complex at varying temperatures using nanourchins coated with spike proteins as pseudoviruses and fluorescence-activated cell sorting (FACS) as a quantitative approach. The structural and dynamical features presented here may serve as a guide for developing new drug molecules, vaccines, or antibodies to combat the COVID-19 pandemic.

Data science has been an invaluable part of the COVID-19 pandemic response with multiple applications, ranging from tracking viral evolution to understanding the vaccine effectiveness. Asymptomatic breakthrough infections have been a major problem in assessing vaccine effectiveness in populations globally. Serological discrimination of vaccine response from infection has so far been limited to Spike protein vaccines since whole virion vaccines generate antibodies against all the viral proteins. Here, we show how a statistical and machine learning (ML) based approach can be used to discriminate between SARS-CoV-2 infection and immune response to an inactivated whole virion vaccine (BBV152, Covaxin). For this, we assessed serial data on antibodies against Spike and Nucleocapsid antigens, along with age, sex, number of doses taken, and days since last dose, for 1823 Covaxin recipients. An ensemble ML model, incorporating a consensus clustering approach alongside the support vector machine model, was built on 1063 samples where reliable qualifying data existed, and then applied to the entire dataset. Of 1448 self-reported negative subjects, our ensemble ML model classified 724 to be infected. For method validation, we determined the relative ability of a random subset of samples to neutralize Delta versus wild-type strain using a surrogate neutralization assay. We worked on the premise that antibodies generated by a whole virion vaccine would neutralize wild type more efficiently than delta strain. In 100 of 156 samples, where ML prediction differed from self-reported uninfected status, neutralization against Delta strain was more effective, indicating infection. We found 71.8% subjects predicted to be infected during the surge, which is concordant with the percentage of sequences classified as Delta (75.6%-80.2%) over the same period. Our approach will help in real-world vaccine effectiveness assessments where whole virion vaccines are commonly used., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background & Objectives: The high mortality associated with the thrombotic events in hospitalized COVID-19 patients resulted in the usage of anticoagulants in varying doses. Whether high-dose anticoagulants have led to better outcomes or higher incidence of clinically significant bleeding events is debatable. Thus, this study was conducted to find the incidence of clinically significant bleeding events in moderate-to-severe COVID-19 ARDS (acute respiratory distress syndrome) patients on therapeutic anticoagulation and their outcomes., Methods: In this retrospective, single-centre study of 155 critically ill COVID-19 patients, the incidence of clinically significant bleeding was observed. Multivariate regression models were used to evaluate the association between anticoagulant regimen, coagulation and inflammatory markers with the incidence of bleeding and thrombotic events., Results: The incidence of clinically relevant non-major bleeding was 33.54 per cent (26.17-41.46%) and major bleeding was 9.03 per cent (5.02-14.69%). The anticoagulation intensity at baseline had a high odds of major bleeding when enoxaparin and dual antiplatelet therapy were used together [adjusted odds ratio OR of 434.09 (3.81-49502.95), P<0.05]. At admission, bleeders had a poorer PaO 2 /FiO 2 ratio with more patients on invasive ventilation. At the time of bleeding, the bleeders had a higher D-dimer, ferritin, C-reactive protein and procalcitonin compared to non-bleeders. The subhazard ratio for death in bleeders was 3.35 (95% confidence interval, 1.97-5.65; P<0.001)., Interpretation & Conclusions: The incidence of bleeding in critically ill COVID-19 patients on therapeutic anticoagulation may increase with the severity of the disease as well as with concurrent use of dual antiplatelets. Major bleeding may also contribute to higher mortality.

The ongoing pandemic that resulted from coronavirus disease (COVID-19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), had been spiraling out of control with no known antiviral drugs or vaccines. Due to the extremely serious nature of the disease, it has claimed many lives, with a mortality rate of 3.4% declared by the World Health Organization (WHO) on March 3, 2020. The aim of this study is to gain an understanding of the regulatory nature of the proteins involved in COVID-19 and to explore the possibility that microRNA (miRNA) could become a major component in the decoding of the virus. In the study, we were able to correlate the host protein gene BCL2L1 with miRNA miR-23b via network analysis. MiRNAs have previously been associated with the antiviral properties of various viral diseases, such as enterovirus 71 and hepatitis. They have been reported to act as antiviral regulators, since they are an integral component in the direct regulation of viral genes. MiRNAs are also capable of enabling the virus to avoid the host immune response by suppressing the IFN-α/β signaling pathway or increasing the production of IFN-α/β and as a result, inhibiting the viral infection. Here, we explain and shed light on the various correlations in the miRNA-gene-disease association that are seen in the host proteins of COVID-19., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

The coronavirus disease 2019 pandemic has had an unprecedented effect on health and health care and posed challenges to the conduct of clinical trials.Targeted mitigating strategies, on the basis of early and continued data collection from site surveys, limited disruption to the ASCEND trials.Flexibly allowing hemoglobin assessment at local laboratories to inform randomized treatment dosing was key to limiting the discontinuation of treatment., Competing Interests: A. Acharya reports consultancy fees from GlaxoSmithKline. B. Cizman, A.R. Cobitz, and A.M. Meadowcroft are employees of and stockholders in GlaxoSmithKline. R. Correa-Rotter reports scientific consulting and financial support for participation in clinical trials: AstraZeneca DAPA-CKD trial steering committee, GlaxoSmithKline for ASCEND Investigator and National Leader, Novonordisk FLOW national leader and investigator; is an advisory board member for Amgen, AbbVie, Boehringer Ingelheim, and Medtronic; and is a speaker for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Janssen, and Sanofi. I. Dasgupta reports research grants from Medtronic and Sanofi-Genzyme and is an advisory board member for AstraZeneca and GlaxoSmithKline. K.L. Johansen reports consultancy fees from GlaxoSmithKline and Akebia. V. Kher reports local INDA consultancy agreements with AstraZeneca, Biocon Pharmaceuticals, GlaxoSmithKline, Intas Pharmaceuticals, Novartis, Panacea, Roche, RPG Life Sciences, Sanofi Aventis, and Torrent Pharmaceuticals; research funding from Astellas India, Novartis India, and Sanofi Aventis India; honoraria from Astellas India, Intas India, JB Pharmaceuticals India, Novartis India, Reddy’s India, Roche India, and Torrent India; is a scientific advisor for Biocon India, Medtronics, Novartis India, Reddy’s India, Roche India, Sanofi Aventis, Torrent, and Wockhardt India; participates in a speakers’ bureau for AstraZeneca India, Biocon India, Intas India, JB Pharmaceuticals, Johnson and Johnson, Novartis India, Panacea India, Pfizer, Roche India, and Sanofi Aventis India. R.D. Lopes reports grants and personal fees from Bristol-Myers Squibb and Pfizer, personal fees from Bayer AG and Boehringer Ingelheim, and research grants from Amgen, Inc., GlaxoSmithKline, Medtronic plc, and Sanofi Aventis. B. Rayner reports honoraria for CME talks from AstraZeneca, Boehringer Ingelheim, Merck, Novartis, Sandoz, and Servier, and has served on a Servier Advisory Board. A.L. Silver reports research funding from Akebia, Ardelyx, Boehringer Ingelheim, Bayer AG, DiaMedica, Fibrogen/AstraZeneca, GlaxoSmithKline, Goldfinch Bio, Novartis, ProKidney, Reata, and Retrophin; consultancy fees from Ardelyx, Boehringer Ingelheim, Novartis, ProKidney, and Reata; and participates in a speakers’ bureau for Amgen, AstraZeneca, and Aurinia. A.K. Singh reports consultancy fees from GlaxoSmithKline. All remaining authors have nothing to disclose., (Copyright © 2022 by the American Society of Nephrology.)

Importance: A surge of COVID-19 occurred from March to June 2021, in New Delhi, India, linked to the B.1.617.2 (Delta) variant of SARS-CoV-2. COVID-19 vaccines were rolled out for health care workers (HCWs) starting in January 2021., Objective: To assess the incidence density of reinfection among a cohort of HCWs and estimate the effectiveness of the inactivated whole virion vaccine BBV152 against reinfection., Design, Setting, and Participants: This was a retrospective cohort study among HCWs working at a tertiary care center in New Delhi, India., Exposures: Vaccination with 0, 1, or 2 doses of BBV152., Main Outcomes and Measures: The HCWs were categorized as fully vaccinated (with 2 doses and ≥15 days after the second dose), partially vaccinated (with 1 dose or 2 doses with <15 days after the second dose), or unvaccinated. The incidence density of COVID-19 reinfection per 100 person-years was computed, and events from March 3, 2020, to June 18, 2021, were included for analysis. Unadjusted and adjusted hazard ratios (HRs) were estimated using a Cox proportional hazards model. Estimated vaccine effectiveness (1 - adjusted HR) was reported., Results: Among 15 244 HCWs who participated in the study, 4978 (32.7%) were diagnosed with COVID-19. The mean (SD) age was 36.6 (10.3) years, and 55.0% were male. The reinfection incidence density was 7.26 (95% CI: 6.09-8.66) per 100 person-years (124 HCWs [2.5%], total person follow-up period of 1696 person-years as time at risk). Fully vaccinated HCWs had lower risk of reinfection (HR, 0.14 [95% CI, 0.08-0.23]), symptomatic reinfection (HR, 0.13 [95% CI, 0.07-0.24]), and asymptomatic reinfection (HR, 0.16 [95% CI, 0.05-0.53]) compared with unvaccinated HCWs. Accordingly, among the 3 vaccine categories, reinfection was observed in 60 of 472 (12.7%) of unvaccinated (incidence density, 18.05 per 100 person-years; 95% CI, 14.02-23.25), 39 of 356 (11.0%) of partially vaccinated (incidence density 15.62 per 100 person-years; 95% CI, 11.42-21.38), and 17 of 1089 (1.6%) fully vaccinated (incidence density 2.18 per 100 person-years; 95% CI, 1.35-3.51) HCWs. The estimated effectiveness of BBV152 against reinfection was 86% (95% CI, 77%-92%); symptomatic reinfection, 87% (95% CI, 76%-93%); and asymptomatic reinfection, 84% (95% CI, 47%-95%) among fully vaccinated HCWs. Partial vaccination was not associated with reduced risk of reinfection., Conclusions and Relevance: These findings suggest that BBV152 was associated with protection against both symptomatic and asymptomatic reinfection in HCWs after a complete vaccination schedule, when the predominant circulating variant was B.1.617.2.

Background & Objectives: The safety of the ChAdOx1 nCoV-19 vaccine is a cause of concern for many who have been vaccinated. The people have multiple concerns and fear regarding the adverse events of the vaccine. Thus, this study was undertaken to establish the safety profile of ChAdOx1 nCoV-19 Corona Virus Vaccine (Recombinant) among the healthcare professionals., Methods: This was a descriptive cross-sectional survey. After taking clearance from the institutional ethics committee 1500 healthcare professionals, who had their vaccination in the past two weeks were selected. They were provided with an online survey proforma regarding adverse events following immunization (AEFIs) of COVID-19 vaccine developed using google forms with an informed consent form affixed to it., Results: A total of 1036 individuals participated in the study. The mean and median (inter quartile range) age of the participants was 37.7 ±11.25 and 35 (29-46) yr, respectively. Of these, 52.1 per cent were female, 29.3 per cent were doctors, 33.4 per cent were nurses and 9.5 per cent were paramedical staff. Forty six per cent participants experienced one or more minor AEFIs such as pain, tenderness, redness, etc. at the injection site. Fatigue (31.75%), generalized feeling of unwell (28.57%), muscle pain (23.16%) and fever (21.71%) were the most commonly reported systemic AEFIs followed by headache (20.07%), dizziness (10.03%) and joint pains (15.25%). Most of them experienced these AEFIs within 24 h of the first dose of administration. About 42 per cent of the participants took oral antipyretics/analgesics for managing the AEFIs., Interpretation & Conclusions: ChAdOx1 nCoV-19 Corona Virus Vaccine was found to be associated with mild local and systemic AEFIs that were more common after the first dose as compared to the second dose. There adverse events could be dealt with oral over-the-counter medications, with no requirement of hospitalization.

SARS-CoV2 pandemic exposed the limitations of artificial intelligence based medical imaging systems. Earlier in the pandemic, the absence of sufficient training data prevented effective deep learning (DL) solutions for the diagnosis of COVID-19 based on X-Ray data. Here, addressing the lacunae in existing literature and algorithms with the paucity of initial training data; we describe CovBaseAI, an explainable tool using an ensemble of three DL models and an expert decision system (EDS) for COVID-Pneumonia diagnosis, trained entirely on pre-COVID-19 datasets. The performance and explainability of CovBaseAI was primarily validated on two independent datasets. Firstly, 1401 randomly selected CxR from an Indian quarantine center to assess effectiveness in excluding radiological COVID-Pneumonia requiring higher care. Second, curated dataset; 434 RT-PCR positive cases and 471 non-COVID/Normal historical scans, to assess performance in advanced medical settings. CovBaseAI had an accuracy of 87% with a negative predictive value of 98% in the quarantine-center data. However, sensitivity was 0.66-0.90 taking RT-PCR/radiologist opinion as ground truth. This work provides new insights on the usage of EDS with DL methods and the ability of algorithms to confidently predict COVID-Pneumonia while reinforcing the established learning; that benchmarking based on RT-PCR may not serve as reliable ground truth in radiological diagnosis. Such tools can pave the path for multi-modal high throughput detection of COVID-Pneumonia in screening and referral., (© 2021. The Author(s).)

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. The pathophysiology of this virus is not very clearly known, thus, enormous efforts are being made by the scientific community to delineate its evading mechanism. In this review, we have summarized the hyperinflammation and humoral and cell-mediated immune response generated in human body after infection with the SARS-CoV-2 virus. The inflammatory response generated after infection by increased proinflammatory cytokines and chemokines, and complement proteins activation may likely contribute to disease severity. We also discussed the other factors that may affect immunity and could be important comorbidities in the disease severity and outcome., (© 2020 S. Karger AG, Basel.)

Higher education institutions (HEIs) usually work open throughout the academic session. In the COVID-19 pandemic time, all the HEIs were also closed temporarily. The study examined the major challenges faced by the teachers and students from the virtual classroom during the nationwide lockdown. Due to the nationwide lockdown and lack of funding, convenience sampling and snowball sampling techniques were used for data collection. A total of 893 responses were analyzed for this study. Data was collected through a structured questionnaire on a Likert scale from 305 teachers and 588 students of higher education institutes from the entire India. Network connectivity was the major challenge faced by the faculty members (mean value of 3.68) followed by 3.17 mean value for lack of professional environment at home, 3.03 for lack of teaching material at home, 2.92 for lack of personal computer/laptop. Lack of professional environment at home (mean value of 3.59) was the major challenge faced by the students followed by 3.57 for lack of teaching material at home, 3.35 for network connectivity, 3.31 for lack of personal computer/laptop. Virtual classrooms have challenges such as poor internet connectivity, non-availability of appropriate electronic devices, lack of a teaching environment at home, less information and communication technology (ICT) knowledge among students and teachers. It implied less engagement of students and teachers in the teaching and learning process.

The massive open online course (MOOC) and online learning concepts have received a lot of attention from educational stakeholders all around the world as a result of COVID-19. Initial studies demonstrated that people may use MOOCs as a tool for academic and professional advancement. This micro-study was conducted at two adjacent national higher educational institutions (HEIs) in India as case study sites (CSS) to learn more about the attitude of the students and faculties there. The research strategy used for the study was a mixed-method approach. To collect data, a tool that was created by the researchers was used. There was a type of atypical relationship between the institutions and the professionals. Comparing CSS2 students and CSS1 teachers to their peers from other institutions, it was discovered that they both displayed more optimistic attitude. The attitude of all four groups were discovered to be favorable. The study served as an example of some educational ramifications in the neighborhoods.

Purpose: Due to the COVID-19 pandemic, the Higher Education Institutes (HEIs) was closed temporarily. During this historical lockdown, the face-to-face mode classroom was temporarily got replaced by a virtual classroom. The objective of this study was to analyze the impact of nationwide lockdown on the benefits of the virtual classroom for the teaching-learning process for teachers and students due to change in the teaching-learning process in higher education during the COVID-19 pandemic. Design: A total of 893 responses have been used for this study. We have collected data through a structured questionnaire on a Likert scale from 305 teachers and 588 students of Higher Education Institutes (HEIs) from all India levels. Descriptive and frequency statistics, t-test was used in SPSS software to analyze the data collected through the primary source. Findings: The mean difference between expected benefits from the virtual classroom and actual benefits from the classroom is positive for students as well as faculty members. That indicates the overall mean of expected benefits is higher than the overall mean of actual benefits, and that difference value is 0.250055, with a Sig. (2-tailed) value of 0.036 which is less than 0.05 for teachers and 0.3872827, with a Sig. (2-tailed) value of 0.000 which is less than 0.05 for students. That indicates the significant difference between means of actual benefits and expected. The mean value of the expected benefit is higher than the mean value of actual benefits for 11 pairs and 08 pairs in the case of teachers and students respectively. Discussion: Technical barriers are the reasons for not being able to attend the expected benefits from virtual classrooms in full capacity by students as well as by faculty members. Poor digital skills of teachers and students, lack of electricity facilities, less availability and accessibility of internet, connection issues, inadequate facilities, training, funding, and unacceptability of technology, etc. were the barriers to online education at the time of closure of colleges due to COVID-19 pandemic Onyema et al. (2020). Students can also have a casual attitude, less attendance, feeling of isolation and less interaction can lead to mental distress, spending more time in front of a computer could be hazardous for health too Surkhali and Garbuja (2020). Higher Education Institutes (HEIs) faculty members, as well as students, were not able to perceive actual benefits in full in comparison to expected benefits due to the presence of challenges in the virtual classroom as moderators. The higher education authorities, colleges/institutes/universities need to fix the above issues to enhance the quality of the teaching-learning process. The higher education authorities, institutes/colleges/universities must work together to resolve the issues and challenges of virtual classrooms to improve their effectiveness of the virtual classroom. Higher Education Institutes (HEIs) may provide technical support, and training to the faculty members as well as students for a better experience in the virtual classroom. Students who are lacking technical infrastructures such as computers/laptops and internet connectivity may be provided by Higher Education Institutes (HEIs) with financial and technical support to these students.

Background: Development and worldwide availability of safe and effective vaccines against severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) to fight severe symptoms of coronavirus disease 2019 (COVID-19) and block the pandemic have been a great achievement and stimulated researchers on understanding the efficacy and duration of different vaccine types. Methods: We investigated the levels of anti-SARS-CoV-2 antibodies (IgG) and neutralizing antibodies (NAbs) in 195 healthy adult subjects belonging to the staff of the University-Hospital of Ferrara (Italy) starting from 15 days up to 190 days (about 6 months) after the second dose of the BNT162b2 (Pfizer-BioNTech) mRNA-based vaccine (n = 128) or ChAdOx1 (AstraZeneca) adenovirus-based vaccine (n = 67) using a combined approach of serological and genomics investigations. Results: A strong correlation between IgG and NAb levels was detected during the 190 days of follow-up (r² = 0.807; p < 0.0001) and was confirmed during the first 90 days (T1) after vaccination (r² = 0.789; p = 0.0001) and 91-190 days (T2) after vaccination (r² = 0.764; p = 0.0001) for both vaccine types (r² = 0.842; p = 0.0001 and r² = 0.780; p = 0.0001 for mRNA- and adenovirus-based vaccine, respectively). In addition to age (p < 0.01), sex (p = 0.03), and type of vaccine (p < 0.0001), which partially accounted for the remarkable individual differences observed in the antibody levels and dynamics, interesting genetic determinants appeared as significant modifiers of both IgG and NAb responses among the selected genes investigated (TP53, rs1042522; APOE, rs7412/rs429358; ABO, rs657152; ACE2, rs2285666; HLA-A rs2571381/rs2499; CRP, rs2808635/rs876538; LZTFL1, rs35044562; OAS3, rs10735079; SLC6A20, rs11385942; CFH, rs1061170; and ACE1, ins/del, rs4646994). In detail, regression analysis and mean antibody level comparison yielded appreciable differences after genotype stratification (P1 and P2, respectively, for IgG and NAb distribution) in the whole cohort and/or in the mRNA-based vaccine in the following genes: TP53, rs1042522 (P1 = 0.03; P2 = 0.04); ABO, rs657152 (P1 = 0.01; P2 = 0.03); APOE, rs7412/rs429358 (P1 = 0.0018; P2 = 0.0002); ACE2, rs2285666 (P1 = 0.014; P2 = 0.009); HLA-A, rs2571381/rs2499 (P1 = 0.02; P2 = 0.03); and CRP, rs2808635/rs876538 (P1 = 0.01 and P2 = 0.09). Conclusion: High- or low-responsive subjects can be identified among healthy adult vaccinated subjects after targeted genetic screening. This suggests that favorable genetic backgrounds may support the progression of an effective vaccine-induced immune response, though no definite conclusions can be drawn on the real effectiveness ascribed to a specific vaccine or to the different extent of a genotype-driven humoral response. The interplay between data from the polygenic predictive markers and serological screening stratified by demogeographic information can help to recognize the individual humoral response, accounting for ethnic and geographical differences, in both COVID-19 and anti-SARS-CoV-2 vaccinations. [ABSTRACT FROM AUTHOR]

Sustainable development goals (SDGs) are intended to be attained as a balanced whole. However, significant interactions (the synergies and trade-offs) between the SDGs have caused the need, especially in developing economies, to identify and pursue them in line with their particular developmental needs. The research intends to empirically investigate the relationship between selected UN SDGs and GDP growth rate as a proxy for economic well-being in Saudi Arabia. We also investigate the role of education and training in achieving SDGs in accordance with the Saudi Vision 2030, which places emphasis on the knowledge economy. This research employs multiple regression analysis to explore the relationship between the SDG variables and the GDP. The results show that education and training, gender equity/women's empowerment, greenhouse gas emissions, and decent employment are positively and significantly related to the GDP growth, whereas poverty, hunger, and health appear to be negatively related. The research indicates that education and training can promote economic, socioeconomic, and health goals without compromising environmental goals. Consequently, the Saudi government should invest more in education and training to maximize synergies and minimize tradeoffs between the SDGs. This will help to promote sustainable employment generation, build human capital, improve socioeconomic empowerment through technology, and boost economic growth. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 has affected millions of people around the world. There is a need for data on the effects of this infection on neonates admitted to neonatal intensive care (NICU) units born to infected mothers. Here, we decided to analyze neonates born to mothers who tested positive for SARS-CoV-2 and admitted to NICU compared with neonates who remained with their mothers. Methods: All pregnant mothers who tested positive for SARS-CoV-2 during pregnancy between 1 June 2020 and 30 June 2021, along with all neonates born to infected pregnant women, were included in this study. We then compared the neonates admitted to NICU with the neonates who remained with their mothers. Results: Eighty-eight neonates were born to eighty-eight SARS-CoV-2-positive mothers. Fifteen of these neonates were admitted to the NICU. The mothers of the neonates admitted to the NICU were more likely to have received prenatal care outside of the USA. In addition, the neonates admitted to the NICU were more likely to have needed significant resuscitation at birth. Respiratory distress was the most common reason for NICU admission. None of the NICU-admitted neonates were SARS-CoV-2-positive. There were no differences between the values of the complete blood counts, morbidities at discharge, lengths of hospitalization, or rates of readmission to hospital in the first month of life observed between the two groups. Conclusions: The vertical transmission of the SARS-CoV-2 infection remains rare; there was no difference in the hospital outcomes in the neonates of infected mothers. Unlike other studies, which show an increased tendency toward preterm birth in SARS-CoV-2-positive mothers, our study indicates no such association. [ABSTRACT FROM AUTHOR]

A smart and scalable system is required to schedule various machine learning applications to control pandemics like COVID‐19 using computing infrastructure provided by cloud and fog computing. This paper proposes a framework that considers the use case of smart office surveillance to monitor workplaces for detecting possible violations of COVID effectively. The proposed framework uses deep neural networks, fog computing and cloud computing to develop a scalable and time‐sensitive infrastructure that can detect two major violations: wearing a mask and maintaining a minimum distance of 6 feet between employees in the office environment. The proposed framework is developed with the vision to integrate multiple machine learning applications and handle the computing infrastructures for pandemic applications. The proposed framework can be used by application developers for the rapid development of new applications based on the requirements and do not worry about scheduling. The proposed framework is tested for two independent applications and performed better than the traditional cloud environment in terms of latency and response time. The work done in this paper tries to bridge the gap between machine learning applications and their computing infrastructure for COVID‐19. [ABSTRACT FROM AUTHOR]

The most common host entry point of human adapted coronaviruses (CoV) including SARS-CoV-2 is through the initial colonization in the nostril and mouth region which is responsible for spread of the infection. Most recent studies suggest that the commercially available oral and nasal rinse products are effective in inhibiting the viral replication. However, the anti-viral mechanism of the active ingredients present in the oral rinses have not been studied. In the present study, we have assessed in vitro enzymatic inhibitory activity of active ingredients in the oral mouth rinse products: aloin A and B, chlorhexidine, eucalyptol, hexetidine, menthol, triclosan, methyl salicylate, sodium fluoride and povidone, against two important proteases of SARS-CoV-2 PLpro and 3CLpro. Our results indicate only aloin A and B effectively inhibited proteolytic activity of PLpro with an IC50 of 13.16 and 16.08 μM. Interestingly, neither of the aloin isoforms inhibited 3CLpro enzymatic activity. Computational structural modelling of aloin A and B interaction with PLpro revealed that, both aloin isoforms form hydrogen bond with Tyr268 of PLpro, which is critical for their proteolytic activity. Furthermore, 100 ns molecular dynamics (MD) simulation studies predicted that both aloin isoforms have strong interaction with Glu167, which is required for PLpro deubiquitination activity. Our results from the in vitro deubiquitinase inhibition assay show that aloin A and B isomers exhibit deubiquitination inhibitory activity with an IC50 value of 15.68 and 17.51 µM, respectively. In conclusion, the isoforms of aloin inhibit both proteolytic and the deubiquitinating activity of SARS-CoV-2 PLpro, suggesting potential in inhibiting the replication of SARS-CoV-2 virus. [ABSTRACT FROM AUTHOR]

World health organization has declared covid-19 as pandemic. Worldwide efforts are being made to increase the awareness about covid-19 in general public and as well as in patients through various health education programs. The study included 500 patients of Tuberculosis both pulmonary and extra-pulmonary who has been started on anti-tubercular treatment, or who came for follow up in Department of Pulmonary medicine, Chest and T.B hospital Patiala during the 6 month period from January 2021 to June 2021. All walk in patients above 15yr of age were included. To assess the knowledge, attitude, and practice of the participants, 26 questions (including 14 for knowledge, 5 for attitude, 07 for practice) were included. The questions were directly asked from patients in there vernacular language along with demographic details and response noted. The results of this study will reveal research gaps to guide health experts in decision-making, as well as develop policies and interventions tailored towards bridging the gap and to use that knowledge in decreasing the spread of covid-19 in tuberculosis patients as they are more vulnerable for COVID-19 infection due to decrease in immunity and also to inform future prospects focusing on societal readiness to comply with pandemic control measures. [ABSTRACT FROM AUTHOR]

Objective: The impact of the COVID-19 pandemic on the functioning and services of academic high-risk infant follow-up (HRIF) clinics throughout North America. Study Design: Prospective 25-question questionnaire survey through REDCAP links that was sent over 10 weeks, to 105 US and 10 Canadian programs. Finally, 59 of 105 US programs and 5 of 10 Canadian responses were analyzed using SAS version 9.4. Results: In the US, 67% of programs reported closures between 1–5 months, whereas in Canada 80% of programs closed for 1–3 months. In the US 86% of programs provided telemedicine visits and only 42.5% provided multidisciplinary HRIF telemedicine visits. We enumerated innovative approaches specifically for the conduct of Telemedicine visits, the need for the standardization of various tests and services in a telemedicine setting, and to emphasize the urgent need for more government funding to improve follow-up and developmental services to this fragile group of newborns. [ABSTRACT FROM AUTHOR]

The Aami river is one of the most prominent rivers in Gorakhpur. The river can play a vital role to contribute social-economic structure of Gorakhpur. The study was conducted to assess the physical and chemical water quality parameters of the Aami River. The water samples were collected in a plastic container of 2 liters capacity from three different sites, one each from upstream, midstream and downstream along the river in 2020 during summer, winter and rainy season. Maghar was selected for upstream (Site-1), Chataye bridge was selected for midstream (Site-2) and Sahgaura village was selected for downstream (Site-3) sampling sites in the present study. A number of physicochemical water quality parameters including water temperature, dissolved oxygen (DO) biochemical oxygen demand (BOD), chemical oxygen demand (COD), pH, suspended solids and total solids were measured in laboratory base analysis. The mean values of such respective parameters in all were compared with the water quality before the Covid 19 and during the covid-19 lockdown period. The study result revealed that comparatively river water quality improved in several parameters, during covid-19 lockdown period than before covid-19 lockdown. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. The pathophysiology of this virus is not very clearly known, thus, enormous efforts are being made by the scientific community to delineate its evading mechanism. In this review, we have summarized the hyperinflammation and humoral and cell-mediated immune response generated in human body after infection with the SARS-CoV-2 virus. The inflammatory response generated after infection by increased proinflammatory cytokines and chemokines, and complement proteins activation may likely contribute to disease severity. We also discussed the other factors that may affect immunity and could be important comorbidities in the disease severity and outcome. [ABSTRACT FROM AUTHOR]

The Covid-19 induced strict measures like strict lockdown caused schools to be shut down. The classes turned into non-contact and online. This caused children and adolescents to stay at home and take classes from the comfort of their rooms. The lockdown had a positive impact on sleep pattern of children and adolescents as they are not under pressure to wake up early nor they have serious deadlines to submit homework. The data of children and adolescents were collected by the means of questionnaire which was distributed to them. The questionnaire was taken back and analysed. The lack of pressure on students has helped them get positive sleep patterns. Of 44 respondents who took part in the study 68% reported change in sleep time. Out of these 88% were from urban area. Similarly, 57% respondents reported sleeping better during the lockdown and subsequent unlock periods. 68% students experienced that they do not require help in waking up which was around 41% before Covid-19 induced lockdown. This happened because students wake up late as there was no pressure to wake up early. This study again provided evidence in support of late start of school. The policy makers and school administrators should consider the increasing amount of evidence and change the school timings in such a way that student is not forced to wake up too early. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic is an emerging, rapidly evolving public health emergency where a nation's health-care system can face a marked surge in demand for intensive care unit (ICU) beds and organ support. In regions with insufficient medical resources, it may further aggravate the existing shortage, limiting an ICU's ability to provide the normal standard of care. It can present ethically or legally demanding questions about how to prioritize the allocation of life-saving medical resources. In developing countries like India, still many hospitals are challenged by competing priorities and remain underprepared. In the wake of COVID-19 pandemic, to guide the intensive care disaster planners in regions with low resources and to ensure ICU readiness, this review shares our experience and strategies for preparing ICU with existing and alternative resources, focusing on space, equipment, and health-care workers' safety and training. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 18-year-old-female, from the urban background with no past or family history of mental illness presented to emergency services with symptoms of anxiety for 1 week. She would be following up various news channels and videos in the social media platforms about how the lives of people have been affected in different countries COVID-19. It explains how the excessive use of social media and telecommunication materials can affect mental well-being of teenagers.

Simple Summary: In this review, we discuss the potential use of extracellular vesicles (EVs) to deliver dietary supplements to the brain to reduce brain complications associated with HIV, COVID-19, and other brain disorders. Brain-related complications affect people with HIV and COVID-19 alike. Moreover, since HIV patients are at a higher risk of contracting COVID-19, their neurological problems can be exacerbated by COVID-19. The use of dietary supplements together with available treatment options has been shown to reduce the severity of infections. However, these treatments are not chemically compatible with the body's blood–brain barrier defense mechanism. Therefore, a viable delivery method is needed to deliver drugs and nutraceuticals to the brain in HIV and COVID-19 comorbid patients. People living with HIV/AIDS (PLWHA) are at an increased risk of severe and critical COVID-19 infection. There is a steady increase in neurological complications associated with COVID-19 infection, exacerbating HIV-associated neurocognitive disorders (HAND) in PLWHA. Nutraceuticals, such as phytochemicals from medicinal plants and dietary supplements, have been used as adjunct therapies for many disease conditions, including viral infections. Appropriate use of these adjunct therapies with antiviral proprieties may be beneficial in treating and/or prophylaxis of neurological complications associated with these co-infections. However, most of these nutraceuticals have poor bioavailability and cannot cross the blood–brain barrier (BBB). To overcome this challenge, extracellular vesicles (EVs), biological nanovesicles, can be used. Due to their intrinsic features of biocompatibility, stability, and their ability to cross BBB, as well as inherent homing capabilities, EVs hold immense promise for therapeutic drug delivery to the brain. Therefore, in this review, we summarize the potential role of different nutraceuticals in reducing HIV- and COVID-19-associated neurological complications and the use of EVs as nutraceutical/drug delivery vehicles to treat HIV, COVID-19, and other brain disorders. [ABSTRACT FROM AUTHOR]

The potential of computational models to identify new therapeutics and repurpose existing drugs has gained significance in recent times. The current 'COVID-19' pandemic caused by the new SARS CoV2 virus has affected over 200 million people and caused over 4 million deaths. The enormity and the consequences of this viral infection have fueled the research community to identify drugs or vaccines through a relatively expeditious process. The availability of high-throughput datasets has cultivated new strategies for drug development and can provide the foundation towards effective therapy options. Molecular modeling methods using structure-based or computer-aided virtual screening can potentially be employed as research guides to identify novel antiviral agents. This review focuses on in-silico modeling of the potential therapeutic candidates against SARS CoVs, in addition to strategies for vaccine design. Here, we particularly focus on the recently published SARS CoV main protease (Mpro) active site, the RNA-dependent RNA polymerase (RdRp) of SARS CoV2, and the spike S-protein as potential targets for vaccine development. This review can offer future perspectives for further research and the development of COVID-19 therapies via the design of new drug candidates and multi-epitopic vaccines and through the repurposing of either approved drugs or drugs under clinical trial. [ABSTRACT FROM AUTHOR]

The article offers information on the public health challenges faced by the Covid-19 pandemic in the U.S. It mentions on how Covid-19 associated with high mortality rate among patients with underlying diseases. It discusses the benefits of the remote intensive care unit surveillance technology amid Covid-19 pandemic.

Co-infection in patients with viral infection as a predisposing factor is less focused on during epidemic outbreaks, resulting in increased morbidity and mortality. Recent studies showed that patients with coronavirus disease 2019 (COVID-19) often have both bacterial and fungal co-infections. In this study, sputum samples of 120 OPD (outdoor patients) suffering from respiratory tract infection (RTI) but negative for tuberculosis infection were collected with informed consent. Morphological, biochemical, and resistance criteria were used to classify isolates and to distinguish multidrug resistant (MDR) isolates, which were further classified on a molecular basis. We found that the isolates, including MDR strains, showed remarkable sensitivity against acetone and methanol extracts of Moringa oleifera, Adhatoda vasica, and Cassia fistula. The results strongly confirmed that multifactorial infections can produce MDR characteristics against antimicrobial drugs, which gave insight into the use of herbal drugs with their age-old traditional importance as having antiviral, antibacterial, antifungal, anti-inflammatory, and immunomodulatory effects. We conclude that apart from this, the anti-infective potential of these plants can be used in the future in the form of products such as cosmetics, pharmaceutical coatings, surface coatings, drug delivery vehicle coatings, and other bioengineered coatings for public use. Future studies are required to assess therapeutics for co-infective resistant strains and nosocomial infections with immune-enhancing effects, thereby promoting their function in holistic treatment and therapy of COVID-19 patients. [ABSTRACT FROM AUTHOR]