Search

Abstract Early in the SARS-CoV2 pandemic, in this journal, Hou et al. (BMC Med 18:216, 2020) interpreted public genotype data, run through functional prediction tools, as suggesting that members of particular human populations carry potentially COVID-risk-increasing variants in genes ACE2 and TMPRSS2 far more often than do members of other populations. Beyond resting on predictions rather than clinical outcomes, and focusing on variants too rare to typify population members even jointly, their claim mistook a well known artifact (that large samples reveal more of a population’s variants than do small samples) as if showing real and congruent population differences for the two genes, rather than lopsided population sampling in their shared source data. We explain that artifact, and contrast it with empirical findings, now ample, that other loci shape personal COVID risks far more significantly than do ACE2 and TMPRSS2—and that variation in ACE2 and TMPRSS2 per se unlikely exacerbates any net population disparity in the effects of such more risk-informative loci.

Objective: Diabetic patients with COVID-19 are at the higher risk of clinical complications and intensive care unit )ICU( admission. There is limited information available on the risk factors of mortality in diabetic patients with COVID-19 admitted to the ICUs. The aim of this study was identifying the mortality risk factors in diabetic patients with COVID-19 who are admitted to the ICU. Materials and Methods: In this study, we conducted a descriptive-analytical observational analysis on 391 patients admitted to the ICU for 18 months. We assessed the demographic, clinical, pharmaceutical, laboratory and imaging data of diabetic patients and statistically analyzed them to identify mortality risk factors. Results: The study found 156 (39.89%) diabetic out of 391 patients. The group of diabetic patients had significantly higher rates of endotracheal intubation (P< 0.001), mortality (P< 0.001), and complications during hospitalization due to COVID-19, including secondary bacterial infections (P = 0.005), venous thrombosis (P = 0.008), and gastrointestinal bleeding (P = 0.011), compared to the nondiabetic patient. Conclusion: Patients with diabetes who also have COVID-19 tend to experience more severe clinical outcomes and a higher mortality rate when admitted to the intensive care unit. The likelihood of mortality in these patients is closely associated with factors such as stroke occurrence, oxygenation levels, and the presence of secondary infections at the time of admission.

Abstract COVID-19, caused by SARS-CoV-2, affects neuronal cells, causing several symptoms such as memory loss, anosmia and brain inflammation. Curcuminoids (Me08 e Me23) and curcumin (CUR) are derived from Curcuma Longa extract (EXT). Many therapeutic actions have been linked to these compounds, including antiviral action. Given the severe implications of COVID-19, especially within the central nervous system, our study aims to shed light on the therapeutic potential of curcuminoids against SARS-CoV-2 infection, particularly in neuronal cells. Here, we investigated the effects of CUR, EXT, Me08 and Me23 in human neuroblastoma SH-SY5Y. We observed that Me23 significantly decreased the expression of plasma membrane-associated transmembrane protease serine 2 (TMPRSS2) and TMPRSS11D, consequently mitigating the elevated ROS levels induced by SARS-CoV-2. Furthermore, Me23 exhibited antioxidative properties by increasing NRF2 gene expression and restoring NQO1 activity following SARS-CoV-2 infection. Both Me08 and Me23 effectively reduced SARS-CoV-2 replication in SH-SY5Y cells overexpressing ACE2 (SH-ACE2). Additionally, all of these compounds demonstrated the ability to decrease proinflammatory cytokines such as IL-6, TNF-α, and IL-17, while Me08 specifically reduced INF-γ levels. Our findings suggest that curcuminoid Me23 could serve as a potential agent for mitigating the impact of COVID-19, particularly within the context of central nervous system involvement.

On December 31st 2019, Chinese Health Authorities in Wuhan city of their Hubei province, diagnosed 29 pneumonia cases of unknown etiology and informed WHO (World Health Organization). The unknown virus resembled SARS (severe acute respiratory syndrome), that occurred in China in November 2002, caused by a novel corona virus spilling over from an animal reservoir and transmitted by respiratory droplets. More than 8000 cases and 774 deaths were caused by SARS and circa US$20 billion coasted for its control.

Abstract Background This study aims to assess the sustained immunological response to the SARS-CoV-2 vaccine in patients with autoimmune inflammatory rheumatic diseases (AIRD) undergoing different treatment regimens. Methods We conducted a prospective observational study involving 157 AIRD patients without prior COVID-19 infection. Treatment regimens included non-treatment or glucocorticoid-only (not-treated/GCs), non-biological drugs, biological therapy, and JAK inhibitors. All participants completed the two-dose vaccine schedule, and 110 of them received an additional booster dose. Serum samples were collected approximately 3–6 months after the second and third vaccine doses to measure antibodies against the Spike protein (antiS-AB) and neutralizing antibodies (nAB) targeting six SARS-CoV-2 variants. Results Following the third dose, all patients exhibited a significant increase in antiS-AB (FC = 15, p

Introduction: To effectively contain the disease and controlling the progression of the COVID19 pandemic, Ahmedabad Municipal Corporation (AMC) implemented a unique policy to screen symptomatic individuals with negative diagnostic tests using the High-Resolution Computed Tomography (HRCT) scan. Objective: To analyse the findings of the HRCT screening policy during the COVID19 pandemic situation. Method: During the period of HRCT Screening policy, i.e., 23 July 2020 to 31 December 2020, a total of 41034 scan record from 25 CT scan centers were available. A retrospective analysis of these secondary data available with the health department of AMC was carried out after due permission from the local authority. Results: A total of 11337 [27.63%, 95% Confidence Interval (CI) 27.20-28.06] were reported as COVID positive. Males reported higher positivity (27.87%) than females (27.17%), however the difference was statistically not significant (Z=1.512, p=0.131). Age wise positivity shows increasing trend, while zone wise comparison shows positivity in line with the cases from respective zone. Analysis of CT severity score shows that 66.15% had Mild, 26.07% had moderate and 7.78% had severe lung involvement. Conclusion :HRCT screening policy identified additional cases of COVID19 and helped in isolation/admission of a large number of suspected cases which helped immensely in better control of the pandemic. HRCT, when used in combination with other diagnostic tests, plays a crucial role in controlling the pandemic situation

The coronavirus SARS-CoV-2 protects its RNA from being recognized by host immune responses by methylation of its 5’ end, also known as capping. This process is carried out by two enzymes, non-structural protein 16 (NSP16) containing 2’-O-methyltransferase and NSP14 through its N7 methyltransferase activity, which are essential for the replication of the viral genome as well as evading the host’s innate immunity. NSP10 acts as a crucial cofactor and stimulator of NSP14 and NSP16. To further understand the role of NSP10, we carried out a comprehensive analysis of >13 million globally collected whole-genome sequences (WGS) of SARS-CoV-2 obtained from the Global Initiative Sharing All Influenza Data (GISAID) and compared it with the reference genome Wuhan/WIV04/2019 to identify all currently known variants in NSP10. T12I, T102I, and A104V in NSP10 have been identified as the three most frequent variants and characterized using X-ray crystallography, biophysical assays, and enhanced sampling simulations. In contrast to other proteins such as spike and NSP6, NSP10 is significantly less prone to mutation due to its crucial role in replication. The functional effects of the variants were examined for their impact on the binding affinity and stability of both NSP14-NSP10 and NSP16-NSP10 complexes. These results highlight the limited changes induced by variant evolution in NSP10 and reflect on the critical roles NSP10 plays during the SARS-CoV-2 life cycle. These results also indicate that there is limited capacity for the virus to overcome inhibitors targeting NSP10 via the generation of variants in inhibitor binding pockets.

ABSTRACTYemeni healthcare workers (HCWs) experience high levels of psychosocial stress. The current study provides a psychosocial assessment of Yemeni HCWs during the COVID19 pandemic and the factors that influence this. Between 6 November 2020, and 3 April 2021, 1220 HCWs inside Yemen self-reported levels of stress, anxiety, insomnia, depression and quality of life using a web-based, cross-sectional survey. According to the findings, 73.0%, 57.3%, 49.8%, 53.2%, and 85.2% of all HCWs reported moderate or severe stress, insomnia, anxiety, depression, and a lower quality of life, respectively. Significant positive correlations were found between stress and anxiety, insomnia, and depression scores, as well as anxiety and insomnia and depression, and insomnia and depression (p

Background. The high mortality and morbidity rate of COVID-19 turned this pandemic into the most challenging health issue. Here we systematically reviewed the consequences of COVID-19 in heart transplant recipients. Methods. The terms "Coronavirus" or "COVID19", "SARS-CoV-2", "Heart Transplantation", and "Cardiac Graft" were searched focusing on heart transplant patients with positive severe acute respiratory syndrome of coronavirus-2 (SARS-CoV-2) on June 22, 2022, in Web of Science / ISI, PubMed and Ovid ProQuest, Scopus. Results. The results showed that of 14 eligible studies that were included in the systematic review, 8 were case reports, and 6 case series. Among 109 reported cases, 67 patients were male and 22 were female and about the rest, it was not reported. The minimum hospitalization day was one day and the maximum was 60 days. In three case reports, the studied patients died, and in one case series, 7 out of 28 patients died. The most reported symptoms were shortness of breath (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (7.7%). 66 percent). Conclusion. Although the symptoms of the disease in these patients are similar to other patients, the mortality rate is high. Considering that the studies conducted on heart transplant recipients with covid-19 have mostly been in the form of case studies, it is suggested that larger studies be conducted so that more accurate information can be obtained regarding the survival rate, symptoms of the disease, and the type of drugs used. Practical Implications. The mortality rate of heart transplant cases affected by COVID-19 was 23.6% (21 patients).In four studies the duration of hospitalization was not mentioned, but the others varied from no hospitalization in one case to up to 60 days. The most reported symptoms were dyspnea (85.7%), cough (76.2%), and myalgia/fatigue (76.2%), followed by rhinitis (66.7%) and fever (66.7%). Treatment differed for each patient, but hydroxychloroquine, antibiotic therapy including Azithromycin, and lopinavir/ritonavir were the most commonly used drugs.

Purpose: This study aimed to screen the patients admitted to our hospital for SARS-CoV-2 specific antibodies after a PCR test and understand the local serological profile. Materials and Methods: The patients tested for anti-SARS-CoV-2 IgG and/or IgM between January-June 2021 were included in the study. SARS-CoV-2 PCR test was performed simultaneously. Results: Either IgM or IgG alone was requested in 123 of 725 patients, and IgM and IgG together in 602. The PCR test was positive in 40 (13%) of 304 (42%) patients who had a PCR test after 30 days of the serology request. Of these PCR-positive patients, 60% had IgM and IgG antibodies together, whereas among 204 PCR-negative patients, 64% tested negative for IgM and IgG. 58% of the tests were ordered without a PCR request. The period between PCR and serology testing was as follows: 233 (76.6%) in 7 days, 27 (8.8%) in 8-14 days, 7 (2.3%) in 15-21 days, and 37 (12.3%) in 22-30 days. 117 (38.5%) of the requests were made simultaneously. Conclusion: WHO recommends that serology testing should be performed after the 1st and 3-4th week of the initial PCR test. The high rate of inappropriate testing demonstrates a lack of algorithms. The use of serological tests is recommended in conjunction with nucleic acid tests but not to be used alone in the diagnosis of COVID-19. Our results demonstrated the high rate of unnecessary requests for serology testing to determine the antibody response against SARS-CoV-2 vaccines.

Since the emergence of the newly identified Coronavirus SARS-CoV-2, no targeted therapeutic agents for COVID-19 treatment are available, and effective treatment options remain very limited. Successful crystallization of the SARS-CoV-2 main protease (Mpro, PDB-ID 6LU7) made possible the research on finding its potential inhibitors for the prevention of virus replication. To conduct molecular docking, we selected ten representatives of the Cathepsin inhibitors family as possible ligands with a high potential of binding the active site of SARS-CoV-2 main protease as a potential target. The results of molecular docking studies revealed that Ligand1 and Ligand2, with vina scores -8.8 and -8.7 kcal/mol for Mpro, respectively, were the most effective in binding. In silico prediction of physicochemical and toxicological behavior of assessed ligands approved the possibility of their use in clinical essays against SARS-COVID-19.

Depression can impact both the administration and efficacy of vaccines. Identifying social factors that contribute to depression, especially during a pandemic, is important for both current and future public health issues. Publicly available data can help identify key social factors contributing to depression.

Background: Covid-19 pandemic is a rapidly spreading outbreak which has caused sudden respiratory distress and death all over the world. This pandemic situation is a major concern for all the health related professionals globally. Treating patients, reducing spread of infection and side by side protecting themselves during rendering care to patients is the main concern for health care workers. Objectives: The study is aimed at assessing training status, correctness of use, problems faced during use of Personal Protective Equipment (PPE) and occurrence of Covid-19 positivity among health care workers at Pediatric Covid-19 ward at Medical College, Kolkata. Patients and methods: 194 doctors, nurses, technician, house -keeping staffs from Pediatrics department of Medical College Kolkata, engaged in Covid-19 related care from June 2020 to October, 2020 , were included in this prospective observational study. A self administered questionnaire was used to collect data. Statistical analysis was done in MS-Excel. Descriptive statistics were calculated in terms of number & proportions. Results: 84(43.3%) doctors, 70 (36.1 %) nurse, 20 (10.3%), scavengers, 20(10.3%) technician participated in the present study. Headache and difficulty in vision due to fogging, ‘fear of infection’, ‘early irritability’ are main health problems as stated by the participants after wearing PPE. Availability of PPE in different sizes, quality improvement was some of the key suggestions. 10.5% of participants contracted COVID-19 in three months follow up period. Conclusion: Adequacy of supply and familiarity with PPE was not a concern for the study subjects but there was poor comfort and difficulty in doffing.

Introduction: Since 1990, internet usage is increasing day by day and availability of smart mobile phones and electronic gazettes like tablet, laptop etc. has given it an exponential rise. During COVID-19 lockdown period, internet usage pattern has changed a lot as per behaviour of students studying in schools, colleges, educational and coaching institutes etc. Objective: Tostudy the prevalence of internet addiction and the effect of internet usage on lifestyle of college students of Haryana. Method: Total 1035 students, of various educational streams in various colleges of Haryana state were included in the study and data was collected by pretested self-designed questionnaire and young’s internet addiction test questionnaire was used to assess its effect on life style.Results: Out of 1035 students, 436(42%) participants were below average users of internet, followed by 369(36%) average users and 230(22%) excessive users of internet. Average of total score of young internet addiction questionnaire was 27.72. Various life style factors like feeling stressed while working, neglects other activities, miss a diet, checks internet many times, obsessed with phone and internet usage per day were found significantly associated with internet addiction(p

Introduction:The most important lesson COVID-19 pandemic thought is basic hygiene practices. It is important to understand hygiene practices among patients during first wave, when meager knowledge about the management of COVID-19 was available. Objective: To assess the adopted behavioral practices and predictors for COVID-19 infection among screened individuals during the 1st wave. Method: A cross-sectional study included COVID-19 screened individuals attending COVID -19 screening OPD at Mumbai. Total 950 participants were interviewed telephonically using convenient sampling method. Logistic regression nanalysis was performed. Results: A total 950 respondents participated, with median age of36 years (range:18yrs to 83 years). Respondents,RTPCR positive or quarantined were 36%. Analysis concludes that practices of having seen or read about hand hygiene, face hygiene, maintaining social distancing, cough etiquettes and enforcement ofstrict lockdown were significantly associated with lower risk of COVID-19 infection (p value

Abstract Backgrounds A physical therapist may become infected while treating a patient since they are in direct contact with them or within a two-meter radius. In addition, physical therapists may feel that they are more susceptible to COVID-19 infection when applying rehabilitation practices, which often involve direct contact with patients. The physical therapist were surveyed on their level of anxiety and depression due to the Coronavirus disease pandemic (COVID-19). Methods The physical therapists were asked to complete two reliable and validated scales, the Generalized Anxiety Disorder scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), to identify the presence of anxiety and depression in the participants. In addition, logistic regression models were used to determine the general characteristics of anxiety or depression. Results Among the 117 physical therapists who completed and participated in the study, 74 (63%) and 65 (55.5%) physical therapists reported having symptoms of anxiety and depression, respectively. The prevalence of overall anxiety levels was higher; mild (OR = 2.09; P = 0.08), moderate (OR = 2.26; P = 0.15), and severe levels six times as high (OR = 6.28; P = 0.1) in females compared to male physical therapists. Females, younger age, unmarried individuals, not having children, and not living with family showed a higher prevalence of anxiety and depression. Binary logistic regression analysis also revealed that the female gender, a single individual, and having no children were associated with anxiety and depression. Conclusions A significant percentage of physical therapists reported symptoms of anxiety and depression, especially among females, younger age, single individuals, not having children, and not living with family. Thus, the mental health of physical therapists is suggested to be constantly and cautiously monitored, especially for those at high risk of developing psychological symptoms.

The Coronavirus Disease 2019 (COVID-19) pandemic continues to infect people worldwide. While the vaccinated population has been increasing, the rising breakthrough infection persists in the vaccinated population. For living with the virus, the dietary guidelines to prevent virus infection are worthy of and timely to develop further. Tannic acid has been demonstrated to be an effective inhibitor of coronavirus and is under clinical trial. Here we found that two other members of the tannins family, oligomeric proanthocyanidins (OPCs) and punicalagin, are also potent inhibitors against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with different mechanisms. OPCs and punicalagin showed inhibitory activity against omicron variants of SARS-CoV-2 infection. The water extractant of the grape seed was rich in OPCs and also exhibited the strongest inhibitory activities for viral entry of wild-type and other variants in vitro. Moreover, we evaluated the inhibitory activity of grape seed extractants (GSE) supplementation against SARS-CoV-2 viral entry in vivo and observed that serum samples from the healthy human subjects had suppressive activity against different variants of SARS-CoV-2 Vpp infection after taking GSE capsules. Our results suggest that natural tannins acted as potent inhibitors against SARS-CoV-2 infection, and GSE supplementation could serve as healthy food for infection prevention.

An immune response to invasion of viral pathogens is an integral part of maintaining the physiological functioning of the bronchopulmonary system and effective gas exchange. Collagen-containing C-type lectins (lung collectins) are some of the key proteins in the identification of viral particles. They have image-recognizing receptors that identify pathogen-associated molecular patterns, particularly viral glycoproteins. The surfactant proteins SP-A and SP-D, which are composed of trimerized units, belong to pulmonary collectins and oligomerize into higher-order structures. These proteins play an essential role in recognition and elimination of microbial pathogens (viruses, bacteria, fungi, parasites, nanoparticles, allergens) through a variety of mechanisms. Taking into account the burden of the novel coronavirus infection caused by the SARS-CoV-2 virus, it is important to consider the role of the surfactant proteins SP-A and SP-D in the pathogenesis of the immune response to viral invasion. Currently, there are data on the direct relationship between surfactant proteins and viruses belonging to the Coronaviridae family. The SP-A and SP-D proteins modulate inflammatory responses and cytokine synthesis, but prevent an excessive inflammatory response (cytokine storm). There is also an assumption that SARSCoV-2 directly suppresses and alters the production of surfactant proteins. Thus, the key pathogenetic role of the surfactant proteins SP-A and SP-D in the response to the viral pathogen SARS-CoV-2 is evident. Today, this is a promising area of translational medicine, which will contribute to a profound understanding of the pathogenesis of coronavirus infection for assessing the diagnostic and prognostic potentials of the surfactant proteins SP-A and SP-D in COVID-19. Additionally, it will help evaluate the therapeutic potential of recombinant fragments of human SP-A and SP-D.

Cervical cancer has killed millions of women over the past decade. In 2019 the World Health Organization launched the Cervical Cancer Elimination Strategy, which included ambitious targets for vaccination, screening, and treatment. The COVID-19 pandemic disrupted progress on the strategy, but lessons learned during the pandemic – especially in vaccination, self-administered testing, and coordinated mobilization on a global scale – may help with efforts to achieve its targets. However, we must also learn from the failure of the COVID-19 response to include adequate representation of global voices. Efforts to eliminate cervical cancer will only succeed if those countries most affected are involved from the very start of planning. In this article we summarize innovations and highlight missed opportunities in the COVID response, and make recommendations to leverage the COVID experience to accelerate the elimination of cervical cancer globally.

Background: Worldwide COVID-19 infection has played havoc. The number of COVID-positive pregnant cases in this study was not far behind the National average. The present study was conducted to evaluate the outcome of COVID-19 infection in pregnant women during their antenatal, intrapartum, and postnatal periods. Methodology: The study design was a prospective cohort study. The total number of COVID-19 pregnant patients admitted to this tertiary care hospital from March 2020 to June 2021 was 106 cases at various trimesters. This hospital caters to serving personnel, ex-servicemen, and dependents of the Indian Armed Forces. The community being studied were only the dependents and the serving female personnel. Proper history, presenting complaints, period of gestation, obstetric and systemic examination findings, the severity of symptoms, home isolation or hospital stay, and treatment were all recorded in the form of the questionnaire. Finally, the antenatal, intrapartum, postnatal, and neonatal outcomes of these COVID-positive pregnant patients were compiled and studied. Results: The prevalence of COVID-positive pregnant women in the community being studied was 9.9%. About 43.39% of the cases were diagnosed in the third trimester. Ninety-three percent of the patients in the present study were asymptomatic or with very mild symptoms. The mode of delivery in the present study was mostly by cesarean section (69.56%). Conclusion: In the present study, pregnancy-associated complications were within the range of 2.8%–3% and only two newborns were COVID positive.

Community involvement is of utmost importance in the management of ongoing COVID-19 pandemic from compliance with lockdown, to the steps taken during easing restrictions, to community support through volunteering. Government of India used “Test, Track, and Treat” strategy to control the outbreak, which mainly focuses on strict legislative actions and capacity building. The strategies are predominately top-down, centralized, and government owned, where community participation and involvement were grossly missing. While visiting different high burden states of Maharashtra as members of central rapid response team, the researchers observed excellent community involvement models in some resource-poor settings, which were quite successful in controlling and managing pandemic at local level, and worth replicating in other settings. In this article, some of such evidences have been highlighted. This study also emphasized how community involvement could be more effectively used as a strategy to fight pandemic.

La enfermedad por SARS-CoV-2/COVID-19, clasificada por la OMS en leve, moderada, severa y crítica, causa lesiones hepáticas que se manifiestan a través de pruebas hepáticas anormales. Objetivo: determinar la relación entre la severidad de la infección por SARS CoV-2 y las alteraciones de pruebas hepáticas. Métodos: estudio observacional descriptivo correlacional transversal, conformado por pacientes adultos, ambos sexos, ingresados en el Centro Médico Docente La Trinidad con infección confirmada por SARS CoV-2, en marzo de 2021. Resultados: se estudiaron 276 pacientes con Infección por COVID19, con una media de edad de 56,4 ± 15,8 años, a predominio del sexo masculino. Bilirrubina Total, en pacientes leves sin alteración, moderados 4/9 (44,4%), severos 6/16 (37,5%) y críticos 22/23 (95,7%) con elevación. Bilirrubina Directa e Indirecta, paciente crítico 1/ 2 presentó elevación de ambas. Alanina aminotransferasa, pacientes Leve, 28/85 (32,9%), moderado, 82/117 (70,1%), severo, 35/45 (77,8%) y crítico, 23/29 (79,3%) con ALT elevada. Aspartato aminotransferasa, pacientes Leve, 16/85 (18,8%), moderado, 74/117 (63,2%), severo, 36/45 (80%) y crítico, 28/29 (96,6%) con elevación. Fosfatasa Alcalina, en moderado, 2/4 elevada. Gamma-Glutamil transferasa, en moderado 4/4 elevada. Albúmina, en Leve, 2/83 (2,4%), moderado, 59/117 (50.4%), severo: 37/45 (82,2%) y crítico, 29/29 (100%) presentaron hipoalbuminemia. Conclusiones: La asociación entre la severidad de infección por SARS-CoV-2 y las pruebas hepáticas son estadísticamente significativos, caracterizado por elevación de AST, ALT, BT e hipoalbuminemia.

COVID19 has aptly revealed that airborne viruses such as SARS-CoV-2 with the ability to rapidly mutate combined with high rates of transmission and fatality can cause a deadly worldwide pandemic in a matter of weeks (Plato et al., 2021). Apart from vaccines and post-infection treatment options, strategies for preparedness will be vital in responding to the current and future pandemics. Therefore, there is wide interest in approaches that allow predictions of increase in infections (‘surges’) before they occur. We describe here real-time genomic surveillance particularly based on mutation analysis, of viral proteins as a methodology for a priori determination of surge in number of infection cases. The full results are available for SARS-CoV-2 at http://pandemics.okstate.edu/covid19/, and are updated daily as new virus sequences become available. This approach is generic and will also be applicable to other pathogens.

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has greatly affected medical education in addition to clinical systems. Residency training has probably been the most affected aspect of medical education during the pandemic, and research on this topic is crucial for educators and clinical teachers. The aim of this study was to understand the effect of the COVID-19 pandemic comprehensively through a systematic review and analysis of related published articles. Methods A systematic review was conducted based on a predesigned protocol. We searched MEDLINE and EMBASE databases until November 30, 2020, for eligible articles. Two independent reviewers extracted data by using a customized form to record crucial information, and any conflicts between the two reviewers were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. Results In total, 53 original articles that investigated the effect of the COVID-19 pandemic on residency training were included. Studies from various regions were included in the research, with the largest percentage from the United States (n = 25, 47.2%). Most of these original articles were questionnaire-based studies (n = 44, 83%), and the research target groups included residents (79.55%), program directors (13.64%), or both (6.82%). The majority of the articles (n = 37, 84.0%) were published in countries severely affected by the pandemic. Surgery (n = 36, 67.92%) was the most commonly studied field. Conclusions The COVID-19 pandemic has greatly affected residency training globally, particularly surgical and interventional medical fields. Decreased clinical experience, reduced case volume, and disrupted education activities are major concerns. Further studies should be conducted with a focus on the learning outcomes of residency training during the pandemic and the effectiveness of assisted teaching methods.

Purpose: Whether hypertension is an independent risk factor for the severity of COVID-19 symptoms and COVID-19 mortality is still unclear. In this study, it was aimed to investigate the effect of hypertension independently in the course of COVID-19 by comparing clinical characteristics and laboratory measurements in COVID-19 patients with and without preexisting hypertension. Materials and Methods: Fifty COVID-19 patients under the age of 45 with preexisting hypertension without accompanying chronic diseases were compared with 50 normotensive COVID-19 patients. All patients received the same treatment protocol. The frequency of symptoms, blood levels of inflammatory markers, length of hospital stay, intensive care unit (ICU) requirement, and mortality rates were compared between the groups. Results: Peak leukocyte count (8.1±2.7 x 103/mm3 vs. 6.9±1.9x103/mm3, p=0.012), peak C-reactive protein (52.7±9.7mg/L vs. 18.9±3.7 mg/L, p=0.024), and peak erythrocyte sedimentation rate (ESR) (55.5±5.7 mm/h, vs. 33.4±5.1 mm/h, p

Background: Corona virus disease 2019 (COVID-19) infections may be associated with a wide range of bacterial and fungal co-infections. Candida and mucor are the common fungus encountered during this pandemic. Candida is one of the commonly encountered opportunistic fungi that cause superficial mucosal infections usually, but can invade tissue and produce life threatening infections. Candida species recognized as one of the major agent of hospital Acquired (nosocomial) fungal infections. Keeping this in background the current study was conducted. Aims and Objective: To estimate the prevalence of candida infection in tertiary care hospital of Indore. Materials and Methods: The present study was done in the period of one and half year. During this period all received clinical specimens like urine, sputum; high vaginal swab and pus suspected for fungal infection from Covid as well as non-Covid patients were processed according to standard protocol. The specimen was subjected to preliminary tests like wet mount, Gram’s stain, culture on sabourads dextrose agar (SDA) and Hichrome agar, germ tube test, sugar assimilation test and culture on Cornmeal agar (dalmau technique) for candida species were done. For statistical analysis Chi-square test was performed and p ≤ 0.05 was considered statistically significant. Results: The prevalence of Candidiasis was 0.86%. Non-albicans candida (65.9%) isolates was more than Candida albicans (34.07%). Among non-albicans species, C. tropicalis was 27.4% followed by C. glabrata 16.29%, C. krusei 15.55%,C. parapsilosis 5.92% and C. lusitenia 0.74% were the major isolates. Males were affected more than the females. In both the genders maximum patients were from the age group of >60 years. Maximum number of Candida isolates was from blood followed by urine, pus, sputum, vaginal swab and aural swab. Most common risk factors for candidiasis noted in this study was diabetes mellitus in both Covid as well as non-Covid patients. Conclusion: Non albicans candida are gradually increasing in India. Speciation of candida play an important role in preliminary treatment because different species is intrinsically resistant to different antifungal drugs and have different antifungal susceptibility pattern.

Abstract Background and Aims Antibiotic resistance is seen as a worldwide health risk as a result of the overuse of antibiotics. Many countries noted that antibiotic usage was high during the COVID‐19 pandemic. The purpose of this study is to evaluate Syrians' knowledge, attitudes, and practice about the use of antibiotics and antibiotic resistance during the COVID‐19 epidemic. Methods A cross‐sectional study was conducted using an online questionnaire to collect the data from the Syrian population from February 5 to March 4, 2022. Syrians 18 years or older all over the world were able to participate in this study. A convenience snowball sampling method was used. SPSS version 20.0 was used to analyze the data. To examine the results, binominal logistic regression was used. Statistical significance was defined as a p

Copyright of Malaysia Journal Syariah & Law is the property of Universiti Sains Islam Malaysia (USIM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In a COVID19 pandemic, pregnant women become infected no more frequently than the general population. COVID19 in pregnant women is associated with a higher risk of caesarean section. Pregnant women with COVID19 who are obese, have high blood pressure, or a combination of two or more conditions are at risk for more severe disease and longer hospital stays.

RESUMEN Introducción: La pandemia por COVID 19 ha generado una atmósfera de interrogantes sobre el proceder más adecuado del reparto de bienes escasos, invitándonos a reflexionar sobre cómo los principios bioéticos y la calidad asistencial en el campo de los cuidados paliativos se han visto amenazados en aras proteger la salud pública. Métodos: Revisión de la literatura desde el 1 de marzo 2020 hasta el 11 de noviembre del 2021 con los descriptores “ bioethics”, “ end of life” , “ palliative care” , “SARS CoV2” y “quality of life ” en bases de datos biomédicas (PUBMED, MEDLINE, WOS, PLOs) y en Google Académico; documentación de asociaciones destacadas en materia de bioética y legislación española relacionada con la autonomía del paciente, seguridad y salud laboral publicada en el Boletín Oficial del Estado. Resultados y discusión: El sistema sanitario se ha visto obligado a modificar los cuidados de fin de vida con el objetivo común de disminuir la expansión del virus, la incidencia de la enfermedad y la tasa de letalidad del virus. La sanidad reinventa la asistencia médica para poder mantener una adecuada calidad asistencial sin menoscabar los principios éticos básicos. Conclusiones y perspectivas: Existe una escasa protocolización sobre la atención de los pacientes al final de vida en la era post-COVID. La implementación de nuevas guías y protocolos de aislamiento, asistencia domiciliaria,pases de visita médica telemáticos, entre otros, podrían ayudar a respetar en mayor medida los criterios bioéticos básicos y mejorar la calidad asistencial en este subgrupo de pacientes. ABSTRACT Introduction: The COVID 19 pandemic has generated an atmosphere of questioning about the most appropriate course of action in the sharing of scarce goods, inviting us to reflect on how bioethical principles and quality of care in the field of palliative care have been threatened in the interest of protecting public health. Methods: Literature review from March 1, 2020 through November 11, 2021 with the descriptors " bioethics", " end of life" , "palliative care", " SARS CoV2" and "quality of life " in biomedical databases (PUBMED, MEDLINE, WOS, PLOs) and in Google Scholar; documentation of leading associations in bioethics and Spanish legislation related to patient autonomy, occupational safety and health published in the Official State Gazette. Results and discussion: The healthcare system has been forced to modify end-of-life care with the common goal of decreasing the spread of the virus, the incidence of the disease and the case fatality rate of the virus. The health system is reinventing medical care in order to maintain an adequate quality of care without undermining basic ethical principles. Conclusions and perspectives: There is little protocolization of end-of-life care in the post-COVID era. The implementation of new guidelines and protocols for isolation, home care, telematic medical visit passes, among others, could help to respect basic bioethical criteria to a greater extent and improve the quality of care in this subgroup of patients.

Background: The aim of the current study is to determine vitamin D supplement usage among adults living in Baghdad city, Iraq during COVID19 pandemic. Methods: A cross-sectional study was conducted among 480 adults living in Baghdad city, Iraq through convince sampling. An online administered questionnaire was used to collect the data from respondents. Results: Around two-thirds of respondents used Vitamin D supplements (65%). There was a significant association between taking Vitamin D3 supplements and educational level, getting COVID19 infection with P value of (0.01,

The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

The severity of SARS-CoV2 infection, Covid19 disease, should account for the diversity of human individual immunoinflammatory responses. Serum immunological markers during Covid19 illness may lead to individualized therapeutics with better outcomes. Efficient treatment for Covid19 may require: 1) early disease detection, 2) combined drug therapy for 3) targeting the virus replication cycle, and 4) individualized drug treatment for specific immunoinflammatory human profile responses administered in a 5) timely manner. Covid19 is unlikely to be the last emergent human disease with fast pandemic potential. Gathering knowledge on the individual human host profiles of immunoinflammatory responses is an opportunity that could lead us to understand individual differences in response to infection at the individual and population level, paving the way to faster, more efficient strategies to tackle upcoming infectious diseases. This is a position paper based on an integrative non-exhaustive literature revision.

Background: This study aimed to evaluate short- and long-term humoral and T-cell-specific immune responses to SARS-CoV-2 vaccines in patients with multiple sclerosis (MS) treated with different disease-modifying therapies (DMTs). Methods: Single-center observational longitudinal study including 102 patients with MS who consecutively received vaccination against SARS-CoV-2. Serum samples were collected at baseline and after receiving the second dose of the vaccine. Specific Th1 responses following in vitro stimulation with spike and nucleocapsid peptides were analyzed by quantifying levels of IFN-γ. Serum IgG-type antibodies against the spike region of SARS-CoV-2 were studied by chemiluminescent microparticle immunoassay. Results: Patients undergoing fingolimod and anti-CD20 therapies had a markedly lower humoral response than those treated with other DMTs and untreated patients. Robust antigen-specific T-cell responses were detected in all patients except those treated with fingolimod, who had lower IFN-γ levels than those treated with other DMTs (25.8 pg/mL vs. 868.7 pg/mL, p = 0.011). At mid-term follow-up, a decrease in vaccine-induced anti-SARS-CoV-2 IgG antibodies was observed in all subgroups of patients receiving DMTs, although most patients receiving induction DMTs or natalizumab and non-treated patients remained protected. Cellular immunity was maintained above protective levels in all DMT subgroups except the fingolimod subgroup. Conclusions: SARS-CoV-2 vaccines induce robust and long-lasting humoral and cell-mediated specific immune responses in most patients with MS.

The clinical data obtained during the pandemic of coronavirus disease 2019 (COVID-19) indicated that this is a disease associated with an increased risk of thrombosis. Thromboembolic events in patients with COVID-19 lead to a worse clinical evolution and a poor prognosis. Some studies analyzed the prevalence and risk factors for thrombotic complications in patients with COVID-19. An observational study on 3,334 patients admitted for COVID-19 has found that 16% of patients had a thrombotic complication during hospitalization(1). 11.1% of these cases had an arterial thrombosis, 8.9% had myocardial infarction, 1.6% ischemic stroke and 1% systemic arterial thrombosis(1). Venous thromboembolism was encountered in 6.2% of patients(1). Older age, man sex, personal history of ischemic heart disease, and increased D-dimers were all risk factors for thrombosis in this study1. Almost one third of patients admitted in the intensive care unit presented thrombotic events and these were associated with a higher risk for in-hospital mortality(1). Interestingly, another study on non-hospitalized patients with COVID-19 did not find a significant difference regarding the incidence of venous thromboembolism between these patients and those without COVID-19(2). The authors analyzed data of 220,588 patients tested for COVID-19 and reported the incidence of thrombosis in out-patients and in-patients, at 30 days. From these patients, 11.8% tested positive for infection with SARS-CoV-2; within 30 days after the positive test, 0.8% of patients developped venous thromboembolism, compared to 0.5% of patients with negative tests(2). However, this study had some limitations regarding the diagnosis of venous thromboembolism and the empirical use of anticoagulants and/or anti-inflammatory drugs. The authors of this study suggested that anticoagulants need to be studied in prospective clinical trials, to evaluate the impact of anticoagulant treatment on outpatients’ outcomes. Regarding the pathophysiology of thrombosis in COVID-19, new data highlight that patients with severe forms of disease have sustained platelet activation, that contribute to the increased risk of thrombosis. Endhotelial injury is another pathophysiological factor that may intervene, by altering hemostasis. Cytokine storm, that appears in patients with severe forms of the disease, will also increase the risk of coagulopathy and thrombosis. The overproduction of inflammatory cytokines, such as tumor necrosis factor (TNF), interleukin-6, interleukin-8 and interleukin-1 is considered the cause of cytokine storm, that may cause multiorgan failure and possibly death(3). Laboratory tests usually reveal increased D-dimers, thrombocytopenia, elevated fibrin degradation products, and fibrinogen(4). D-dimer levels are especially increased in patients with critical forms of disease, admitted in intensive care units(4) and may be a surrogate marker for the disease severity(5). Because of the clinical consequences of hypercoagulability in patients with COVID-19, hemogram with platelet count, peripheral blood smear, prothrombin time, aPTT, fibrinogen and D-dimers should be monitored in all hospitalized patients with COVID-19. Furthermore, these patients must be investigated and screened for deep venous thrombosis, preferably by duplex scan. Pulmonary thromboembolism, in some studies, has been more frequent than deep venous thrombosis in patients with COVID-19. A study of 1,765 patients diagnosed with COVID-19 reported an incidence of pulmonary embolism of 22%, and even higher in patients admitted in intensive care units(6). Patients with COVID-19 may also present coagulation abnormalities similar to thrombotic thrombocytopenic purpura, disseminated intravascular coagulation, or hemolytic uremic syndrome. Thrombotic complications in COVID-19 have some unique characteristics that must be deeper investigated, for a better management of this disease.

Due to the constant need for research to develop new and effective antiviral agents, medicinal plants can be a very good tool for the discovery and production of antiviral drugs. Extensive studies have been conducted in this field so far. Nurses, as one of the most important members of the health care team in COVID19 diseases, can play an important role in preventing the excessive and excessive consumption of medicinal plants prescribed by non-specialists.The importance of topics such as the interaction of active ingredients in medicinal plants with the routine treatments and even the precautions of their use with many underlying diseases, can be taught through nurses. On the other hand, by educating and using medicinal plants in the form of clinical trials and under the supervision of specialized physicians, it can be helpful to identify effective medicinal plants and new medicinal sources.

The confirmed cases with COVID-19 in children account for just 1% of the overall confirmed cases. Severe COVID-19 in children is rare. Case Presentation: Our patient was 16 years old with a severe case of COVID-19 and did not survive due to the presence of Granulomatosis with polyangiitis and being treated with immunosuppressive drugs. We used lopinavir, ritonavir, hydroxy chloroquine, intravenous immunoglobulin and continuous veno-venous hemodialysis for treatment. Conclusion: In this patient, an underlying disease and delayed admission to the hospital were two factors complicating his condition.

Background/ Aims: Understanding the epidemiological features and transmission dynamic during the initial phase of the COVID-19 epidemic provide valuable information for control and mitigation of the outbreak. Thus, this study focused on a cohort who represent early cases in Thi-Qar governorate for describing the early epidemiological features during the initial phase of the COVID-19 outbreak. Subject & Methods: This case series study was conducted in AL-Hussien Teaching Hospital, Thi-Qar governorate, from 27, February to 8, May 2020. Patient's data were obtained from official records of the Public Health Department of ThiQar Health Directory. A descriptive and analytical statistic were used by the aid of SPSS, also household secondary attack rate was estimated. Results: The median age was 37 years (IQR:31,20-51), females were 57.2% and males were 42.8%. According to age groups, as a higher infection rate (30.61% %) was found in the age group (14-26), while only (4%) found old age groups(66-78,79-91). Only six patients(12.25%) had comorbidities. Clinically, majority(79.6%) of cases were mild and (18.4%) moderate while only (4%) were severe. The age and comorbidities had an effect on the severity of symptoms. Family transmission(80.43%) was the predominant dynamic of disease transmission. Three index cases in this cohort fulfill the criteria of super-spreader as collectively transmitted the disease to 79.6% individuals, the household secondary attack rates were 22%, 24%, and 17% respectively. Conclusion: Family transmission was the predominant dynamic of transmission which was the result of the presence of a super-spreader event in the early infected patients in the governorate.

Motivation Since the identification of the novel coronavirus (SARS-CoV-2), the scientific community has made a huge effort to understand the virus biology and to develop vaccines. Next-generation sequencing strategies have been successful in understanding the evolution of infectious diseases as well as facilitating the development of molecular diagnostics and treatments. Thousands of genomes are being generated weekly to understand the genetic characteristics of this virus. Efficient pipelines are needed to analyze the vast amount of data generated. Here we present a new pipeline designed for genomic analysis and variant identification of the SARS-CoV-2 virus. Results PipeCoV shows better performance when compared to well-established SARS-CoV-2 pipelines, with a lower content of Ns and higher genome coverage when compared to the Wuhan reference. It also provides a variant report not offered by other tested pipelines. Availability https://github.com/alvesrco/pipecov.

Introduction: Long-term COVID-19 pandemic which has existed in Indonesia since 2020 not only poses a risk to public health but also to their social conditions. Indonesia, as a country with strong social fabric within its people, has a high sense of social responsibilities in facing the pandemic. The aim of this study is to describe Indonesians’ readiness in facing long-term COVID-19 pandemic. Methods: This descriptive study used a cross-sectional design with a sample of 305 residents of five cities in Indonesia. They were chosen not randomized by distributing a survey invitation via WhatsApp group with the background of the general public, and health cadres. We waited until the response received reached the targeted number of respondents. The data were collected using Google Forms, and were analyzed by using a descriptive method (percentage, P-value, and odds ratio) by SPSS statistical software version 25. Results: The readiness in facing the pandemic fell into two categories: the high readiness level (77.1%) and the low readiness level (22.9%). Gender and age do not affect the level of readiness, while the level of education and employment status influenced the level of readiness. Conclusions: The majority of Indonesians have high readiness level. Public participation can decrease COVID-19 transmission rate.

Today, there is an explosion of discoveries related to a growing understanding of the role of microbial communities, key species of bacteria, products or metabolites derived from commensals, and in particular the relationship between some of these components and painful conditions in humans. Microbiota plays a fundamental role in the induction, training and functioning of the host’s immune system. In turn, the immune system has evolved significantly as a means of maintaining the host’s symbiotic relations with these very diverse and developing microbes. At optimal performance, this alliance of the immune system and microbiota allows to induce protective reactions to pathogens and maintain regulatory pathways involved in maintaining tolerance to harmless antigens. In this review, we outline the role of the intestinal microbiota in the immune system, starting with initial information supporting further insights into the effects of intestinal microbiota dysbacteriosis on the host’s susceptibility to infection. Probiotics are considered a good form of therapy to control harmful intestinal microorganisms, improve digestion and the absorption of nutrients. The beneficial effects of probiotics have been demonstrated in many diseases. One of the main mechanisms of probiotics is the regulation of the immune response of the host. The article reviews and discusses the regulatory role of probiotics in the “intestine-lungs” system and the immune system of mucous membranes for potential antiviral mechanisms. The unique role of probiotics in modulation of intestinal microbes and establishment of intestinal homeostasis and production of interferon as antiviral mechanism is described. In addition, the regulatory role of probiotics in the system «intestine-lungs» and the immune system of the mucous membranes for potential antiviral mechanisms, including in COVID-19 is considered and discussed. Symbiotic products Bac-Set® Forte and Bac-Set® Cold/Flu are described.

Objective: To compile the information for the management of the patient who is hospitalized by COVID19 to establish concrete and effective nursing care actions that allow the objectives of nursing care to be conducted, as well as its results. Method: Documentary review of the evidence regarding nursing management and isolation guidelines for patients with COVID19 in the hospitalization service, determining the main isolation and protection measures for health workers. Conclusions: The constant updating allows nursing professionals and the health team to articulate guidelines that allow establishing concrete care actions for patients hospitalized by COVID19, as well as strengthening the isolation and care measures of the interdisciplinary team to reduce the risk of infection. and spread. Key words: Hospitalization, isolation, COVID19, nursing.

SARS-COV-2 is a highly contagious anthroponotic infection. The relevance of the study of the disease is due to the wide prevalence of the pandemic worldwide to the extent that it affects all age groups and populations, the lack of long-term and intense immunity, and high mortality, mainly among adults.Children are also susceptible to SARS-COV-2 infection, but this age group is more likely to be asymptomatic. This article summarizes the main trends in clinical manifestations and treatment of coronavirus infection in children available in current moment.

In this article, we aimed to review the preparations that made from the past to present, and the effects of these preparations on the novel coronavirus outbreak, which is the greatest and ongoing pandemic of the 21st century, in the light of the studies done across the world and Turkey. Pandemics have caused millions of people to die and become ill for centuries. They affect society profoundly, socially, and economically. Lessons should be drawn from the past to reduce the effects of a pandemic. Preparations may not go as planned. Desperation may occur for unforeseen situations. Despite these despair, besides the basic principles in combating pandemic, there are definitely tools that can contribute to practice. Covid-19 pandemics will definitely end one day like all epidemics. When the things that done and the things not done after the epidemic are evaluated, common mind and evidence-based practices will win and those shared will be remembered.

Interferons are low-molecular weight glycoproteins. They are characterized by paracrine and autocrine activity. Their production and release occurs through various types of cells, which ultimately leads to the protection of the body against viral infections. Interferons do not have direct antiviral activity but affect cells, inducing the formation of antiviral agents and "antiviral readiness" in them. Thanks to their properties interferons have been widely used in the treatment of many diseases, among others hepatitis B, hepatitis C and multiple sclerosis. In addition, they show anti-cancer effects, even in the case of chronic myeloid leukemia. They are currently an important element in the search for a drug against SARS-CoV-2.

Epidemiological Features of COVID-19 Epidemic in Basrah-Southern Iraq-First Report Abstract Background: COVID- 19 expanded from an outbreak in China to a devastating pandemic across the world. . Objective: To describe the epidemiology of COVID-19 in Basrah Province-Southern Iraq Methods: Data were obtained from the Department of Public Health in Basrah and the daily communique of the Ministry of Health. Data on population were obtained from the Ministry of Planning. For all provinces the total number of cases and their fate in terms of being under treatment, cured or died was obtained. For cases in Basrah, data on age, sex, residence, fate, travel history and presence of co-morbidity for 152 cases. Results: In Basrah, The mean age was 46 years (Median 45 years) and the range was 13-98 years. No difference in the risk of COVID-19 was related to sex. Geographical variation was inconclusive The time trend of the epidemic is modest in both new daily cases and in cumulative numbers. At one point in time (April 10) the incidence rate was 56.28 per million , which was at intermediate level among other provinces. The total cases used for Iraq was 1279. The highest numbers were reported in Baghdad, Najaf, Erbil, Basrah and Sulaymaniyah.The lowest incidence rate was in Salah Al-Din (0.61 per million) and the highest was in Najaf (170.16 per million). The case fatality ratio for closed cases and for all cases was variable among provinces. Conclusion: COVID-19 in Basrah and Iraq is modest until today the 10th of April 2020.

Background: As the number of cases of COVID19 from novel corona virus 2019 rises so are the number of deaths ensuing from it. Doctors have been in front in these calamitous times across the world. India has less number of doctors so doctors are overwhelmed with more number of patients to cater. Thereby they are also fearing that they will be exposed much as they often work in limited resource settings. Methods: An on line survey was to include doctors from eastern states in India for measuring the reasons of their fear and suggest possible solutions based on the results achieved thus. After IEC clearance a semi-structured anonymous questionnaire was sent on google forms as links on known to doctors, working in screening OPDs or flu clinics especially for COVID-19. Results: Out of 59 Doctors majority were provided with sanitizers for practicing hand hygiene. Gloves were provided everywhere but masks particularly N95 and Triple Layer surgical masks were not there for all. Training was not given universally. Fear was dependent on age in our sample. Conclusion: Training and strict adherence to infection control measures along with resources can help in removing the fear.

The aim of our study is to evaluate the accuracy of CURB-65 and Pneumonia Severity Index (PSI), the most widely used scores for community acquired pneumonia, and MuLBSTA, a viral pneumonia score, in predicting 28-day mortality in Coronavirus Disease 2019 (COVID-19) pneumonia.We retrospectively collected clinical data of consecutive patients with laboratory-confirmed COVID-19 pneumonia admitted at Papa Giovanni XXIII Hospital from February 23rd to March 14th, 2020. We calculated at Emergency Department (ED) presentation CURB-65, PSI and MuLBSTA and we compared their performances in discriminating between survivors and non-survivors at 28 days. Among 431 hospitalized patients, the majority presented with hypoxic respiratory failure: median (interquartile range, IQR) PaO2/FiO2 ratio at admission was 228.6 (142.0-278.1). In the first 24 hours, 111 (27%) patients were administered low-flow oxygen cannula, 50 (12%) Venturi Mask, 95 (23%) non-rebreather mask, 106 (26%) non-invasive ventilation, 12 (3%) mechanical ventilation and 41 (9%) were not administered oxygen therapy. Mortality rate at 28-day was 35% (150/431). Between survivors and non-survivors, median (IQR) scores were, respectively, 1.0 (1.0-2.0) and 2.0 (2.0-3.0) for CURB-65 (p0,05). PSI and MuLBSTA did not show a better performance when compared to CURB-65. Although CURB-65, PSI and MuLBSTA scores are useful tools to discriminate between survivors and non-survivors in COVID-19 pneumonia, their diagnostic accuracy in discriminating 28-day mortality in COVID-19 pneumonia is moderate, as confirmed by AUCs

The performance of diagnostic tests crucially depends on the disease prevalence, test sensitivity, and test specificity. However, these quantities are often not well known when tests are performed outside defined routine lab procedures which make the rating of the test results somewhat problematic. A current example is the mass testing taking place within the context of the world-wide SARS-CoV-2 crisis. Here, for the first time in history, laboratory test results have a dramatic impact on political decisions. Therefore, transparent, comprehensible, and reliable data is mandatory. It is in the nature of wet lab tests that their quality and outcome are influenced by multiple factors reducing their performance by handling procedures, underlying test protocols, and analytical reagents. These limitations in sensitivity and specificity have to be taken into account when calculating the real test results. As a resolution method, we have developed a Bayesian calculator, the Bayes Lines Tool (BLT), for analyzing disease prevalence, test sensitivity, test specificity, and, therefore, true positive, false positive, true negative, and false negative numbers from official test outcome reports. The calculator performs a simple SQL (Structured Query Language) query and can easily be implemented on any system supporting SQL. We provide an example of influenza test results from California, USA, as well as two examples of SARS-CoV-2 test results from official government reports from The Netherlands and Germany-Bavaria, to illustrate the possible parameter space of prevalence, sensitivity, and specificity consistent with the observed data. Finally, we discuss this tool’s multiple applications, including its putative importance for informing policy decisions.

Abstract Abdominal pain in children in COVID‐19 era should be carefully evaluated and weighing risk‐benefit of surgical procedure in suspected cases should be more discussed. Surgery in patients with high suspicious to MIS‐C should be delayed for preventing critical outcomes.