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Purpose: The COVID-19 vaccine should be universally offered to pregnant women and women planning pregnancies. This is on the basis that COVID-19 infection can complicate the pregnancy and have adverse health implications in pregnancy, as compared to non-pregnant women, which the vaccine helps to mitigate. This is the recommendation of many governing bodies in medical care. However, certain issues require consideration, which are not discussed in the current guidelines. These include the induction of fever by the vaccines and the role fever can play in teratogenicity, the induction of hyper-coagulable and thrombocytopenic states by the vaccines and other known contraindications to the vaccines. In this article, we develop strategies to minimize risks in these situations. We also discuss the theoretical advantage of calling for a booster COVID-19 vaccinate in all pregnant women in the late second or early third trimester, even if previously immunized, and encourage further research, to investigate the possible benefits of this proposed intervention. This article acts as an educational supplement to help clinicians manage pregnant women and addresses many issues, not discussed in most COVID-19 vaccine recommendations by international societies related to pregnant women. Methods: This article is a literature review of the current, limited data. The information extrapolated allowed for suggestions regarding COVID-19 vaccination during pregnancy. Results and conclusions: The study discusses hypothetical issues, to minimize any risks associated with COVID-19, and serves as a compilation of data to further the current literature, in proving that COVID-19 vaccines have minimal risks in pregnancy. [ABSTRACT FROM AUTHOR]

As one of the important concepts in epidemiology, herd immunity was recommended to control the COVID-19 pandemic. Inspired by this technique, the Coronavirus Herd Immunity Optimiser has recently been introduced, demonstrating promising results in addressing optimisation problems. This particular algorithm has been utilised to address optimisation problems widely; However, there is room for enhancement in its performance by making modifications to its parameters. This paper aims to improve the Coronavirus Herd Immunity Optimisation algorithm to employ it in addressing breast cancer diagnosis problem through feature selection. For this purpose, the algorithm was discretised after the improvements were made. The Opposition-Based Learning approach was applied to balance the exploration and exploitation stages to enhance performance. The resulting algorithm was employed in the diagnosis of breast cancer, and its performance was evaluated on ten benchmark functions. According to the simulation results, it demonstrates superior performance in comparison with other well-known approaches of the similar nature. The results demonstrate that the new approach performs well in diagnosing breast cancer with high accuracy and less computational complexity and can address a variety of real-world optimisation problems. [ABSTRACT FROM AUTHOR]

Domestic violence against women increased during COVID-19 lockdowns. This inaugural study examined the content of Australian government online portals, for women seeking support and help for domestic violence, during the 2021 COVID-19 pandemic. This mixed methods study incorporated four phases: a search; measurement of portal quality standard using DISCERN; enumeration of portal items; and a qualitative exploration of portal text. Australian governments must continue to work alongside domestic violence services as we found some portals were better than others. Continued review, revision, and funding are needed to meet the demands associated with this evolving public health emergency. [ABSTRACT FROM AUTHOR]

Introduction: This study was designed before the emergence of the COVID-19 pandemic, to assess the annual changes in muscle strength in relatively young Turkish people with postpolio syndrome (PPS). After we completed the baseline measurements, the COVID-19 pandemic emerged and lockdowns followed right after. Thus, the purpose of the study turned to how these lockdowns, which induced a sedentary lifestyle, have affected muscle strength in participants with PPS compared to healthy controls. Materials and Methods: This study included 49 hip joints (21 PPS vs. 28 healthy controls) and 51 knee joints (23 PPS vs. 28 healthy controls). Concentric isokinetic testing of bilateral hip and knee muscles was performed in all participants with PPS and controls just before the outbreak of the COVID-19 pandemic. The measurements were repeated after 1 year of lockdowns. Results: Perceived physical activities were reported to be decreased by 35.9% and 32.2% in participants with PPS and controls, respectively. No significant changes were observed in muscle strengths, and these changes did not differ between PPS and healthy controls. Conclusion: This is the first and possibly the only study to show that the muscle strengths of participants with PPS did not change significantly during 1 year of physical restraints due to the COVID-19 pandemic. These findings may support the basic principle in the rehabilitation of participants with PPS, which includes conserving energy and avoiding the overuse of muscles. However, more data from studies with a larger number of participants and longer follow-ups, which will hopefully never happen again in a situation like this, are required to draw a conclusion.

The most important way to control COVID-19, with high contagiousness and no specific treatment, is prevention. Due to the lack of a similar study, this research aimed to assess Covid-19 anxiety and the factors affecting the preventive behaviors of Covid-19 from the perspective of clients referring to the comprehensive health centers according to the social and cultural beliefs of the region. This cross-sectional study was conducted on 400 patients referring to comprehensive health centers of Birjand during the outbreak of COVID-19 in 2022. In this study, after obtaining informed consent from the clients, a researcher-made questionnaire regarding COVID-19 preventive behaviors, the COVID-19 anxiety scale, and the demographic information checklist were completed by participants. The most preventive behavior in the studied clients was wearing a mask when leaving home. The mean score of preventive behavior in women was significantly higher than that of men (P

The emergence of the coronavirus COVID-19 in December 2019 in Wuhan, China, affected all facets of people’s lives worldwide. As a result of the severity of the pandemic, governments worldwide adopted several policies and containment measures, such as social isolation, especially for vulnerable populations, including older adults. This study aimed to explore these older adults’ experiences of social isolation during COVID-19. A systematic review method based on the PRISMA protocol was used, and five databases (EMBASE, PsycINFO, PsycEXTRA, CINAHL, and Medline) were comprehensively searched. Studies were limited to those published between 2020 and 2023. Thirteen qualitative studies met the inclusion criteria and were analysed thematically. A thematic analysis identified the following five major themes: intense feeling of loneliness due to social isolation; use of social media as a coping mechanism during social isolation; anxiety during social isolation; fear during social isolation; and financial security during social isolation. This review provides useful information on how to mitigate the effects of social isolation on the elderly population during future public health crises.

Abstract Purpose: To investigate oculoplastic conditions in patients diagnosed with coronavirus disease 2019 (COVID-19) seen at ophthalmology departments of three tertiary referral centers in the United Kingdom and the United States, and review of the literature. Methods: Retrospective multicenter case series studied over 18 months. Results: A total of four patients developed eyelid, orbital, or lacrimal gland pathology within four weeks of testing positive for COVID-19. All were male, and the mean age at presentation was 49 (range, 31–58 years). Suspected diagnoses included anterior idiopathic orbital inflammation, facial angioedema, dacryoadenitis, and anophthalmic socket inflammation. Three patients recovered fully and one patient recovered partially (mean 2.7 weeks) from ocular manifestations with steroids hastening recovery. Conclusion: Adnexal manifestations of COVID-19 include self-limiting orbital inflammation and eyelid lymphedema.

The use of directives in communicating the nature of the pandemic and reference to social experiences were promoted using images on social media platforms. The images or memes are used to create awareness and reinforce the criteria for safety during the pandemic. Previous studies on internet memes have concentrated on humor generation, speaker-hearer shared knowledge, neologism, and multimodality among others, with insufficient attention paid to the use of directives and references in such coronavirus-motivated memes. This paper, therefore, examines how directives and references are employed in conveying expected social responsibilities through coronavirus-motivated internet memes in Nigeria and other socio-cultural contexts. For data, one hundred coronavirus-motivated memes were purposively selected from Facebook, and eight representative memes were subjected to pragmatic analysis using aspects of Jacob Mey’s (2001. Pragmatics: An introduction, 2nd edn. USA: Blackwell Publishing) pragmatic acts theory to unearth insights from them. The paper observes that the various spheres of life that are relatable to an online audience help to express what the pandemic is about and enhance the meaning of the pandemic with the context of the use of the memes, giving clearer perspectives on the pandemic. Directives and references are useful tools for conveying social responsibilities to online audience.

Abstract COVID-19 surveillance in Ukraine ceased after the Russian invasion of the country in 2022, on a background of low vaccination rates of 34.5% for two doses at this time. We conducted a modelling study to estimate the epidemic trajectory of SARS-COV-2 in Ukraine after the start of the war. We use a COVID-19 deterministic Susceptible-Exposed-Infected-Recovered (SEIR) model for Ukraine to estimate the impact of increased vaccination coverage and masking as public health interventions. We fit the model output to case notification data between 6 January and 25 February 2022, then we forecast the COVID-19 epidemic trajectory in different scenarios of mask use and vaccine coverage. In the best-case scenario, 69% of the Ukrainian population would have been infected in the first half of 2022. Increasing mask use from 50 to 80% reduces cases and deaths by 17% and 30% respectively, while increasing vaccination rates to 60% and 9.6% for two and three doses respectively results in a 3% reduction in cases and 28% in deaths. However, if vaccination is increased to a higher coverage of 80% with two doses and 12.8% with three, or mask effectiveness is reduced to 40%, increasing vaccination coverage is more effective. The loss of health services, displacement, and destruction of infrastructure will amplify the risk of COVID-19 in Ukraine and make vaccine programs less feasible. Masks do not need the health infrastructure or cold-chain logistics required for vaccines and are more feasible for rapid epidemic control during war. However, increasing vaccine coverage will save more lives. Vaccination of refugees who have fled to other countries can be more feasibly achieved.

Advantageous variants of the SARS-CoV-2 virus have arisen through mutations, particularly on a single amino acid basis. These point mutations can cause changes in the structure of SARS-CoV-2 and affect the efficiency of interaction with the ACE2 protein. N501Y and E484K mutations affecting binding by ACE2 have been widely observed. This study aimed to predict SARS-CoV-2 mutations that could be as effective as N501Y and E484K and pose a danger due to their high contagiousness. Experimental data on SARS-CoV-2 and ACE2 binding and stability were associated with different amino acid properties and integrated into machine learning and computational biology techniques. As a result of the analyses made in algorithms, N501M, Q414A, N354K, Q498H and N460K have been predicted to be likely to have a dangerous effect. The N501W mutations are most likely to have dangerous effects on the spread of the coronavirus. We suggest that attention should be paid to the position 501 mutation since this position is repeated in the lists of mutations that the algorithm detected as dangerous. G446, G447, Y505, T500, Q493, Y473, and G476 were determined as the positions where dangerous variants could be seen as a result of the analyses of the multiple interaction data created with the ACE2 and RBD interaction data. The 13 dangerous positions and mutations have been detected to accurately describe the position of the mutations caused by the Omicron variant and were among the known dangerous mutations similar to those occurring at Q498, G446, Y505 and Q493 positions.

At the beginning of December 2019, a new type of coronavirus emerged, SARS-CoV-2. This virus causes COVID-19, a highly contagious disease that can initially present asymptomatically and can also lead to death. Our ecological study goal was to evaluate the incidence, mortality, and lethality rates for COVID-19 between the states of Espírito Santo and Minas Gerais, with time series analysis using secondary and public databases on COVID-19 from January 2020 to December 2022. Prais–Winsten linear regression was used for trend analyses. In 2020, the rate in Espírito Santo was 2.19 times greater than in Minas Gerais. This trend continued in 2021, with Espírito Santo’s rate being 1.29 times greater. In 2022, Espírito Santo’s rate remained 2.65 times higher than Minas Gerais. Furthermore, Espírito Santo had the highest mortality, with the exception of 2021. In turn, Minas Gerais had the highest fatality rate throughout the analyzed pandemic period. The state of Espírito Santo had a higher incidence of COVID-19, as well as higher mortality when compared to the state of Minas Gerais. Furthermore, both states showed similar trends for mortality, lethality, and incidence in the years 2020 and 2021.

Background: Reverse transcription polymerase chain reaction (RT-PCR) is the main technique used to identify COVID-19 from respiratory samples. It has been suggested in several articles that chest CTs could offer a possible alternate diagnostic tool for COVID-19; however, no professional medical body recommends using chest CTs as an early COVID-19 detection modality. This literature review examines the use of CT scans as a diagnostic tool for COVID-19. Method: A comprehensive search of research works published in peer-reviewed journals was carried out utilizing precisely stated criteria. The search was limited to English-language publications, and studies of COVID-19-positive patients diagnosed using both chest CT scans and RT-PCR tests were sought. For this review, four databases were consulted: these were the Cochrane and ScienceDirect catalogs, and the CINAHL and Medline databases made available by EBSCOhost. Findings: In total, 285 possibly pertinent studies were found during an initial search. After applying inclusion and exclusion criteria, six studies remained for analysis. According to the included studies, chest CT scans were shown to have a 44 to 98% sensitivity and 25 to 96% specificity in terms of COVID-19 diagnosis. However, methodological limitations were identified in all studies included in this review. Conclusion: RT-PCR is still the suggested first-line diagnostic technique for COVID-19; while chest CT is adequate for use in symptomatic patients, it is not a sufficiently robust diagnostic tool for the primary screening of COVID-19.

Abstract A newly discovered coronavirus called COVID-19 poses the greatest threat to mankind in the twenty-first century. Mortality has dramatically increased in all cities and countries due to the virus's current rate of spread. A speedy and precise diagnosis is also necessary in order to treat the illness. This study identified three groups for chest X-ray images: Covid, normal, and pneumonia. This study's objective is to present a framework for categorizing chest X-ray images into three groups of pneumonia, normal, and Covid scenarios. To do this, chest X-ray images from the Kaggle database which have been utilized in previous studies were obtained. It is suggested to use an Efficientnet_b0 model to identify characteristics in raw data hierarchically. An unedited X-ray image of the chest is enhanced for more reasonable assumptions in order to apply the proposed method in real-world situations. With an overall accuracy of 93.75%, the proposed network correctly identified the chest X-ray images to the classes of Covid, viral pneumonia, and normal on the test set. 90% accuracy rate for the test dataset was attained for the viral pneumonitis group. On the test dataset, the Normal class accuracy was 94.7%, while the Covid class accuracy was 96%. The findings indicate that the network is robust. In addition, when compared to the most advanced techniques of identifying pneumonia, the concluded findings from the suggested model are highly encouraging. Since the recommended network is successful at doing so utilizing chest X-ray imaging, radiologists can diagnose COVID-19 and other lung infectious infections promptly and correctly.

Abstract The coronavirus disease 19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a global health crisis with millions of confirmed cases and related deaths. The main protease (Mpro) of SARS-CoV-2 is crucial for viral replication and presents an attractive target for drug development. Despite the approval of some drugs, the search for effective treatments continues. In this study, we systematically evaluated 342 holo-crystal structures of Mpro to identify optimal conformations for structure-based virtual screening (SBVS). Our analysis revealed limited structural flexibility among the structures. Three docking programs, AutoDock Vina, rDock, and Glide were employed to assess the efficiency of virtual screening, revealing diverse performances across selected Mpro structures. We found that the structures 5RHE, 7DDC, and 7DPU (PDB Ids) consistently displayed the lowest EF, AUC, and BEDROCK scores. Furthermore, these structures demonstrated the worst pose prediction results in all docking programs. Two structural differences contribute to variations in docking performance: the absence of the S1 subsite in 7DDC and 7DPU, and the presence of a subpocket in the S2 subsite of 7DDC, 7DPU, and 5RHE. These findings underscore the importance of selecting appropriate Mpro conformations for SBVS, providing valuable insights for advancing drug discovery efforts.

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact, with millions of confirmed cases and deaths worldwide. While most cases are mild, a subset progresses to severe respiratory complications and death, with factors such as thromboembolism, age, and underlying health conditions increasing the risk. Vascular endothelial damage has been implicated in severe outcomes, but specific biomarkers remain elusive. This study investigated syndecan-1 (SDC-1), a marker of endothelial damage, as a potential prognostic factor for COVID-19, focusing on the Japanese population, which is known for its aging demographics and high prevalence of comorbidities. Methods A multicenter retrospective study of COVID-19 patients in Fukushima Prefecture in Japan who were admitted between February 2020 and August 2021 was conducted. SDC-1 levels were measured along with other clinical and laboratory parameters. Outcomes including thrombosis, 28-day survival, and disease severity were assessed, and disease severity was categorized according to established guidelines. Results SDC-1 levels were correlated with disease severity. Patients who died from COVID-19 had greater SDC-1 levels than survivors, and the area under the receiver operating characteristic curve (AUC) analysis suggested the potential of the SDC-1 level as a predictor of mortality (AUC 0.714). K‒M analysis also revealed a significant difference in survival based on an SDC-1 cutoff of 10.65 ng/mL. Discussion This study suggested that SDC-1 may serve as a valuable biomarker for assessing COVID-19 severity and predicting mortality within 28 days of hospitalization, particularly in the Japanese population. However, further investigations are required to assess longitudinal changes in SDC-1 levels, validate its predictive value for long-term survival, and consider its applicability to new viral variants. Conclusions SDC-1 is emerging as a potential biomarker for assessing the severity and life expectancy of COVID-19 in the Japanese population, offering promise for improved risk stratification and patient management in the ongoing fight against the virus.

Abstract Background Cystatin F is a secreted lysosomal cysteine protease inhibitor that has been implicated in affecting the severity of demyelination and enhancing remyelination in pre-clinical models of immune-mediated demyelination. How cystatin F impacts neurologic disease severity following viral infection of the central nervous system (CNS) has not been well characterized and was the focus of this study. We used cystatin F null-mutant mice (Cst7-/-) with a well-established model of murine coronavirus-induced neurologic disease to evaluate the contributions of cystatin F in host defense, demyelination and remyelination. Methods Wildtype controls and Cst7-/- mice were intracranially (i.c.) infected with a sublethal dose of the neurotropic JHM strain of mouse hepatitis virus (JHMV), with disease progression and survival monitored daily. Viral plaque assays and qPCR were used to assess viral levels in CNS. Immune cell infiltration into the CNS and immune cell activation were determined by flow cytometry and 10X genomics chromium 3’ single cell RNA sequencing (scRNA-seq). Spinal cord demyelination was determined by luxol fast blue (LFB) and Hematoxylin/Eosin (H&E) staining and axonal damage assessed by immunohistochemical staining for SMI-32. Remyelination was evaluated by electron microscopy (EM) and calculation of g-ratios. Results JHMV-infected Cst7-/- mice were able to control viral replication within the CNS, indicating that cystatin F is not essential for an effective Th1 anti-viral immune response. Infiltration of T cells into the spinal cords of JHMV-infected Cst7-/- mice was increased compared to infected controls, and this correlated with increased axonal damage and demyelination associated with impaired remyelination. Single-cell RNA-seq of CD45 + cells enriched from spinal cords of infected Cst7-/- and control mice revealed enhanced expression of transcripts encoding T cell chemoattractants, Cxcl9 and Cxcl10, combined with elevated expression of interferon-g (Ifng) and perforin (Prf1) transcripts in CD8 + T cells from Cst7-/- mice compared to controls. Conclusions Cystatin F is not required for immune-mediated control of JHMV replication within the CNS. However, JHMV-infected Cst7-/- mice exhibited more severe clinical disease associated with increased demyelination and impaired remyelination. The increase in disease severity was associated with elevated expression of T cell chemoattractant chemokines, concurrent with increased neuroinflammation. These findings support the idea that cystatin F influences expression of proinflammatory gene expression impacting neuroinflammation, T cell activation and/or glia cell responses ultimately impacting neuroinflammation and neurologic disease.

Abstract Background A significant proportion of the global population has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at some point since the onset of the pandemic. Although most individuals who develop coronavirus disease 2019 (COVID-19) recover without complications, about 6% have persistent symptoms, referred to as post-COVID-19 condition (PCC). Intervention studies investigating treatments that potentially alleviate PCC-related symptoms and thus aim to mitigate the global public health burden and healthcare costs linked to PCC are desperately needed. The PYCNOVID trial investigates the effects of Pycnogenol®, a French maritime pine bark extract with anti-inflammatory and antioxidative properties, versus placebo on patient-reported health status in people with PCC. Methods This is a single-center, placebo-controlled, quadruple blind, randomized trial. We aim to randomly assign 150 individuals with PCC (1:1 ratio) to receive either 200 mg Pycnogenol® or placebo daily for 12 weeks. Randomization is stratified for duration of PCC symptoms (≤ 6 months versus > 6 months) and presence of symptomatic chronic disease(s). The primary endpoint is perceived health status at 12 weeks (EuroQol—Visual Analogue Scale) adjusted for baseline values and stratification factors. Secondary endpoints include change in self-reported PCC symptoms, health-related quality of life, symptoms of depression and anxiety, cognitive function, functional exercise capacity, physical activity measured with accelerometry, and blood biomarkers for endothelial health, inflammation, coagulation, platelet function, and oxidative stress. Investigators, study participants, outcome assessors, and data analysts are blinded regarding the intervention assignment. Individuals with PCC were involved in the design of this study. Discussion This is the first trial to investigate the effects of Pycnogenol® versus placebo on patient-reported health status in people with PCC. Should the trial proof clinical effectiveness, Pycnogenol® may serve as a therapeutic approach to mitigate symptoms associated with PCC. Trial registration The study is registered at ClinicalTrials.gov. :NCT05890534, June 6, 2023.

The rapid development of coronavirus disease nineteen (COVID-19) into a pandemic within months has posed significant risks, particularly for the elderly and individuals with underlying medical conditions. The primary driver of COVID-19 severity and mortality is the cytokine inflammatory storm. Elevated levels of ferritin, resulting from this storm and secondary hemophagocyticlymphohistiocytosis, have been observed in severe COVID-19 patients. The cytokine storm represents an uncontrolled and dysfunctional immune response within the pathogenic mechanism of COVID-19, leading to acute respiratory distress syndrome (ARDS) and systemic organ failure. Ferritin, an iron storage protein crucial for regulating cellular oxygen metabolism, shows a significant correlation with disease severity in COVID-19 patients.This study, conducted across three Libyan hospitals and two private laboratories from 2018 to 2022, targeted 500 cases to investigate ferritin's role in COVID‐19. Polymerase Chain Reaction (PCR) tests confirmed COVID-19 positivity. Ferritin levels were measured using a fully automatic device, revealing high levels in almost all positive cases, with some experiencing levels as high as 4532 ng/ml. Analysis of 209 negative COVID-19 cases before and after the pandemic showed consistently low or normal ferritin levels. Among the positive cases, 250 were admitted to the ICU, with a significant proportion experiencing elevated ferritin levels, and 82 ICU patients succumbed to the disease. Gender and age did not seem to influence ferritin elevation in COVID-19 cases.In conclusion, increased ferritin levels may indicate worsening COVID-19 cases and could be associated with disease severity and mortality.

The Intelligent Nursing Assistant Robot (INA) emerged as an innovative solution with COVID straining the healthcare systems and over 180 million cases globally by April 2021. INA protects overworked and exposed staff by remotely monitoring patients in quarantine. This robot boasts features like a thermal camera for precise temperature readings and a high-definition camera for visual checks. Facial recognition aids in patient identification, while its mobile control via an Android app and Pixy camera with Arduino connection offers flexibility. Built with durable Cagebot materials, INA provides a safe and versatile tool for overwhelmed healthcare professionals during this critical time.

Background: The RECOVERY trial demonstrated that the use of dexamethasone is associated with a 36% lower 28-day mortality in hospitalized patients with COVID-19 on invasive mechanical ventilation. Nevertheless, the optimal timing to start dexamethasone remains uncertain. Methods: We conducted a quasi-experimental study at National Taiwan University Hospital (Taipei, Taiwan) using propensity score matching to simulate a randomized controlled trial to receive or not to receive early dexamethasone (6 mg/day) during the first 7 days following the onset of symptoms. Treatment was standard protocol-based, except for the timing to start dexamethasone, which was left to physicians’ decision. The primary outcome is 28-day mortality. Secondary outcomes include secondary infection within 60 days and fulfilling the criteria of de-isolation within 20 days. Results: A total of 377 patients with COVID-19 were enrolled. Early dexamethasone did not decrease 28-day mortality in all patients (adjusted odds ratio [aOR], 1.03; 95% confidence interval [CI], 0.97–1.10) or in patients who required O2 for severe/critical disease at admission (aOR, 1.05; 95%CI, 0.94–1.18); but is associated with a 24% increase in superinfection in all patients (aOR, 1.24; 95% CI, 1.12–1.37) and a 23% increase in superinfection in patients of O2 for several/critical disease at admission (aOR, 1.23; 95% CI, 1.02–1.47). Moreover, early dexamethasone is associated with a 42% increase in likelihood of delayed clearance of SARS-CoV-2 virus (adjusted hazard ratio, 1.42; 95% CI, 1.01–1.98). Conclusion: An early start of dexamethasone (within 7 days after the onset of symptoms) could be harmful to hospitalized patients with COVID-19.