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To support the ongoing management of viral respiratory diseases while transitioning out of the acute phase of the COVID-19 pandemic, many countries are moving toward an integrated model of surveillance for SARS-CoV-2, influenza virus, and other respiratory pathogens. Although many surveillance approaches catalyzed by the COVID-19 pandemic provide novel epidemiologic insight, continuing them as implemented during the pandemic is unlikely to be feasible for nonemergency surveillance, and many have already been scaled back. Furthermore, given anticipated cocirculation of SARS-CoV-2 and influenza virus, surveillance activities in place before the pandemic require review and adjustment to ensure their ongoing value for public health. In this report, we highlight key challenges for the development of integrated models of surveillance. We discuss the relative strengths and limitations of different surveillance practices and studies as well as their contribution to epidemiologic assessment, forecasting, and public health decision-making.

Introduction: The impact of coronavirus disease 2019 (COVID-19) on diabetic kidney disease (DKD) patients in China is not fully understood. This study aimed to investigate infection status in a DKD cohort post-renal biopsy and analyze vaccination and infection rates, as well as symptom severity, across various renal pathologies in DKD patients. Methods: This epidemiological survey, centered on COVID-19, employed a Chinese DKD and renal puncture follow-up cohort. A customized questionnaire enabled standardized data gathering. It collected data on clinical characteristics, vaccination and infection statuses, and diverse pathological types. The study analyzed the relationship between vaccination and infection statuses across various pathological types, evaluating characteristics and treatment outcomes in patients with infections. Results: In total, 437 patients with DKD from26 Chinese provinces were followed up for amedian of 44.6 ± 20 months. COVID-19 infection, vaccination, and novel coronavirus pneumonia (NCP) rates were 73.68%, 59.3%, and 6.63%, respectively. Ten patients with NCP had severe pneumonia or died of COVID-19. Renal pathology revealed that 167 (38.22%) patients had diabetic nephropathy (DN), 171 (39.13%) had non-diabetic renal disease (NDRD), and 99 had DN and NDRD (22.65%). The DN group had the lowest vaccination (54.5%), highest all-cause mortality (3.6%), and highest endpoint rates (34.10%). Compared to patients who were not vaccinated pre-infection (117 cases), vaccinated patients (198 cases) had reduced NCP (6.6% vs. 13.7%), severity (1.0% vs. 3.4%), and endpoint (9.10% vs. 31.60%) rates. Conclusion: Vaccination can prevent infection and diminish COVID-19 severity in patients with DKD; therefore, increasing vaccination rates is particularly important. Clinical Trial registration: ClinicalTrails.gov, NCT05888909. [ABSTRACT FROM AUTHOR]

The coronavirus disease of 2019 (COVID-19) emerged as a pandemic at the end of 2019. The clinical presentation of COVID-19 was comparable to bacterial infections, and due to the ambiguity of an effective treatment method, the healthcare professionals routinely used antibiotics to treat the patients. So, this study evaluated the antibiotic usage patterns at our hospitals among COVID-19 patients, considering the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve) classification. The present study was a retrospective observational hospital record-based study on COVID-19 patients admitted from March-August 2020. A total of 256 COVID-19 patients were enrolled, considering inclusion and exclusion criteria. Data collection utilizing a standardized case record form to capture all information methodically based on age, sex, comorbidities, duration, and nature of the symptoms. Drug data, for example antibiotic usage patterns were collected with detailed prescription analysis, including route, dose, frequency and number of antibiotics used. A structured proforma was used to analyze data, and descriptive statistical analysis was performed and presented as Histograms. The WHO AWaRe antibiotic classification was used to determine the antibiotics' suitability for empirical therapy. The mean age of the participants was 40.00 ± 15.46 years with male predominance, 188 (73.43%) in number, compared to females, with 68 (26.56%). Almost all the current study participants received one or more antibiotics during their hospital stay, and a maximum of the patients 126 (49.22%) received 2 antibiotics during treatment, 78 (30.47%) subjects who were managed with 3 antibiotics, and the rest, 52 (20.31%) participants received only 1 antibiotic during their hospital stay. To treat moderate to severely ill patients, the most used antibiotic was doxycycline, followed by meropenem and piperacillin/tazobactam. The findings of this study will provide baseline data that will help to generate strategies to reduce antibiotic prescriptions for the formulation of better antibiotic stewardship programs (ASP) and institutional policies to fight against any infection in a better way in the near future. [ABSTRACT FROM AUTHOR]

Purpose: To report bilateral relentless placoid chorioretinitis following Pfizer–BioNTech coronavirus disease 2019 (COVID-19) vaccine administration. Case report: A 55-year-old Caucasian New Zealand-born woman presented with progressive left eye vision loss and bilateral photopsias and floaters occurring 10 days after receiving the Pfizer–BioNTech COVID-19 vaccination. She had a similar self-limiting episode of photopsias and floaters without vision loss 1 year prior after receiving the influenza vaccine. Snellen visual acuity (VA) was 20/25 in the right eye, and count fingers at 2 m in the left eye. Bilateral, active, creamy, plaque-like lesions were present at the level of the retinal pigment epithelium and choroid, suggestive of relentless placoid chorioretinitis. Commencement of 100 mg oral prednisolone and 3 g mycophenolate daily resulted in recovery of the foveal ellipsoid layer with VA of 20/25 in each eye after 8 weeks. Subsequent activations occurred following COVID-19 infection and respiratory infection. Conclusion: This is the first reported case of relentless placoid chorioretinitis occurring as a potential side-effect of the Pfizer–BioNTech COVID-19 vaccine. Vaccination, and not infection, could be assumed to be the likely trigger. Subsequent flares following COVID-19 and a nonspecific respiratory infection during periods of inadequate immunosuppression suggest that a COVID-19 antigen or general immune activation could also be the trigger. [ABSTRACT FROM AUTHOR]

Purpose: COVID-19 (coronavirus disease 2019) is an infectious disease caused by SARS-CoV-2, first reported in 2019 in Wuhan, China. Among the common complications is a pro-inflammatory and hypercoagulative response that compromises the vasculature among various organs. Methods: In this report, we present the postmortem retinal findings of five patients observed by means of optical microscopy and transmission and scanning electron microscopy techniques. Results: Clinical manifestations such as retinal hemorrhages and exacerbated inflammatory infiltrate, altered ultra structure with swollen mitochondria and pyknotic cells in both layers of the retina were observed in all analyzed eyes. Conclusion: Our data point to the fragility of this tissue in cases of severe COVID-19. [ABSTRACT FROM AUTHOR]

Background: Respiratory distress and failure is a complication of the coronavirus disease (COVID-19) and tracheostomy may be necessary in cases of prolonged intubation in order to reduce mechanical ventilation duration. However, according to the Canadian Society of Otolaryngology-Head and Neck Surgery guidelines, which our institution applies, patients should not undergo tracheostomy unless cleared of the virus to reduce its spread among healthcare workers because tracheostomy is an aerosolized procedure. This study aimed to identify the outcomes of prolonged intubation in patients with and without COVID-19 who underwent tracheostomy and to determine the morbidity and mortality rates in both groups. Methods: This retrospective cohort study included adult patients admitted to the intensive care unit of King Fahad Hospital of the University, Alkhobar, Saudi Arabia, between March 1 and October 31, 2020. This study compared and analyzed the outcomes of delayed tracheostomy in patients with and without COVID-19 in terms of complication, morbidity, and mortality rates. Results: Of the 228 study participants, 111 (48.68%) had COVID-19. The mean age of the study participants was 58.67 years (SD = 17.36, max.=93, min.=20), and the majority were males (n = 149, 65.35%). Regarding tracheostomy in patients with COVID-19, 11 (9.91%) patients underwent tracheostomy; however, four (36.36%) of them had prolonged intubation. The mean intensive care unit admission length of stay for tracheostomy patients was 37.17 days, while it was 12.09 days for patients without tracheostomy (t(226)=-9.32, p < 0.001). Regarding prolonged intubation among patients with COVID-19 (n = 7, 6.31%), the complications were as follows: six people (85.71%) had dysphonia, one (14.29%) had vocal cord granuloma, and two (28.57%) had subglottic tracheal stenosis. The mortality rate among our study participants was 51.32%, and the risk was significantly higher in older people (Odds ratio = 1.04, 95% Confidence Interval [CI] = 1.02–1.06) and in delayed tracheostomy cases (OR = 2.95, 95% CI = 1.31–6.63). However, COVID-19 status was not significantly related to the risk of mortality. Conclusions: Delaying tracheostomy increases the risk of mortality. Therefore, we recommend weighing the risks and benefits for each patient to benefit both healthcare workers and patients with COVID-19. [ABSTRACT FROM AUTHOR]

Autoimmune bullous diseases (AIBDs) are characterized by the formation of vesicles, bullous lesions, and mucosal erosions. The autoantibodies target the cellular anchoring structures from the surface of epidermal keratinocyte named desmosomes, leading to a loss of cellular cohesion named acantholysis. AIBDs are classified into intraepidermal or subepidermal types based on clinical features, histological characteristics, and immunofluorescence patterns. Pemphigus foliaceus (PF) is an acquired, rare, autoimmune skin condition associated with autoantibodies that specifically target desmoglein-1, leading to a clinical presentation characterized by delicate cutaneous blisters, typically sparing the mucous membranes. Several factors, including genetic predisposition, environmental triggers, malignancies, medication use, and vaccination (for influenza, hepatitis B, rabies, tetanus, and more recently, severe acute respiratory syndrome Coronavirus 2 known as SARS-CoV-2), can potentially trigger the onset of pemphigus. With the advent of vaccines playing a pivotal role in combatting the 2019 coronavirus disease (COVID-19), extensive research has been conducted globally to ascertain their efficacy and potential cutaneous adverse effects. While reports of AIBDs post-COVID-19 vaccination exist in the medical literature, instances of PF following vaccination have been less commonly reported worldwide. The disease's pathophysiology is likely attributed to the resemblance between the ribonucleic acid (RNA) antigen present in these vaccines and cellular nuclear matter. The protein produced by the BNT-162b2 messenger ribonucleic acid (mRNA) vaccine includes immunogenic epitopes that could potentially trigger autoimmune phenomena in predisposed individuals through several mechanisms, including molecular mimicry, the activation of pattern recognition receptors, the polyclonal stimulation of B cells, type I interferon production, and autoinflammation. In this review, we present a comprehensive examination of the existing literature regarding the relationship between COVID-19 and PF, delving into their intricate interactions. This exploration improves the understanding of both pemphigus and mRNA vaccine mechanisms, highlighting the importance of close monitoring for PF post-immunization. [ABSTRACT FROM AUTHOR]

The coronavirus disease of 2019 (COVID-19) emerged as a pandemic at the end of 2019. The clinical presentation of COVID-19 was comparable to bacterial infections, and due to the ambiguity of an effective treatment method, the healthcare professionals routinely used antibiotics to treat the patients. So, this study evaluated the antibiotic usage patterns at our hospitals among COVID-19 patients, considering the World Health Organization (WHO) AWaRe (Access, Watch, and Reserve) classification. The present study was a retrospective observational hospital record-based study on COVID-19 patients admitted from March-August 2020. A total of 256 COVID-19 patients were enrolled, considering inclusion and exclusion criteria. Data collection utilizing a standardized case record form to capture all information methodically based on age, sex, comorbidities, duration, and nature of the symptoms. Drug data, for example antibiotic usage patterns were collected with detailed prescription analysis, including route, dose, frequency and number of antibiotics used. A structured proforma was used to analyze data, and descriptive statistical analysis was performed and presented as Histograms. The WHO AWaRe antibiotic classification was used to determine the antibiotics’ suitability for empirical therapy. The mean age of the participants was 40.00 ± 15.46 years with male predominance, 188 (73.43%) in number, compared to females, with 68 (26.56%). Almost all the current study participants received one or more antibiotics during their hospital stay, and a maximum of the patients 126 (49.22%) received 2 antibiotics during treatment, 78 (30.47%) subjects who were managed with 3 antibiotics, and the rest, 52 (20.31%) participants received only 1 antibiotic during their hospital stay. To treat moderate to severely ill patients, the most used antibiotic was doxycycline, followed by meropenem and piperacillin/tazobactam. The findings of this study will provide baseline data that will help to generate strategies to reduce antibiotic prescriptions for the formulation of better antibiotic stewardship programs (ASP) and institutional policies to fight against any infection in a better way in the near future.

We conducted a longitudinal cohort study of SARS-CoV-2 and influenza rates in childcare centers and schools in Wuxi, China, collecting 1,760 environmental samples and 9,214 throat swabs from 593 students (regardless of symptoms) in weekly collections during February–June 2023. We estimated a cumulative infection rate of 124.8 (74 episodes)/1,000 persons for SARS-CoV-2 and 128.2 (76 episodes)/1,000 persons for influenza. The highest SARS-CoV-2 infection rate was in persons 18 years of age, and for influenza, in children 4 years of age. The asymptomatic proportion of SARS-CoV-2 was 59.6% and 66.7% for influenza; SARS-CoV-2 symptomatic proportion was lower in 16–18-year-olds than in 4–6-year-olds. Only samples from frequently touched surface tested positive for SARS-CoV-2 (4/1,052) and influenza (1/1,052). We found asynchronous circulation patterns of SARS-CoV-2 and influenza, similar to trends in national sentinel surveillance. The results support vaccination among pediatric populations and other interventions, such as environmental disinfection in educational settings.

Using participatory, virologic, and wastewater surveillance systems, we estimated when and to what extent reported data of adult COVID-19 cases underestimated COVID-19 incidence in Germany. We also examined how case underestimation evolved over time. Our findings highlight how community-based surveillance systems can complement official notification systems for respiratory disease dynamics.

Pneumocystis jirovecii pneumonia is an opportunistic infection that affects HIV-infected and immunocompromised persons and rarely affects immunocompetent patients. However, after the advent of the COVID-19 pandemic, some COVID-19 patients without immunocompromise or HIV were infected with P. jirovecii. Clinical manifestations were atypical, easily misdiagnosed, and rapidly progressive, and the prognosis was poor.

The aim of the research is to determine the clinical-pathogenetic and prognostic value of nitrotyrosine levels in the blood serum of patients with COVID-19 with pneumonia in the development of oxygen dependence and the risk of fatal outcome. Materials and methods. 123 patients with COVID-19 with pneumonia were examined, who were examined and treated according to the Order of the Ministry of Health of Ukraine dated March 28, 2020 No. 722. Patients were divided into groups: I group – 32 patients with a moderate course without oxygen dependence; II group – 91 patients with a severe course with the presence of oxygen dependence. Patients in the II group were additionally divided into subgroups: II-A subgroup – 45 patients who recovered; II-B subgroup – 46 patients who died. The content of nitrotyrosine (Hycult Biotech, the Netherlands) was determined in the blood serum by the immunoenzymatic method. Statistical data processing was carried out in the program Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. The content of nitrotyrosine in the blood serum of patients with COVID-19 with pneumonia in a severe course with the development of oxygen dependence is higher (p < 0.001) than in patients with a moderate course of the disease without signs of oxygen dependence. The level of its increase has an inverse correlation with the oxygen saturation index (r = -0.53, р < 0.05). When hospitalized for 9.0 [7.0; 12.0] day of the disease, under the condition of nitrotyrosine level >481.97 nmol/ml (AUC = 0.909, p < 0.001), the probability of developing oxygen dependence is significant. And under the conditions of nitrotyrosine level >521.96 nmol/ml during this observation period, the probability of a fatal outcome of the disease is significant (AUC = 0.842, p < 0.001). The established correlations confirm the clinical-pathogenetic role of nitrotyrosative stress in the development of the “cytokine storm” and multiorgan failure. The content of nitrotyrosine correlates with the level of C-reactive protein (r = +0.25, p < 0.05), the ratio of absolute neutrophil count to absolute lymphocyte count (r = +0.26, p < 0.05), alanine aminotransferase activity (r = +0.26, p < 0.05) and glomerular filtration rate (r = -0.27, p < 0.05). The diagnostic value of determining the level of nitrotyrosine in predicting the course of COVID-19 with pneumonia against the background of treatment after 7 days lies in the possibility of predicting the probability of a fatal outcome of the disease. Namely, the preservation of the level of nitrotyrosine >507.98 nmol/ml (AUC = 0.681, p < 0.001) during the specified period of observation indicates a high probability of a fatal outcome of the disease. Conclusions. In patients with COVID-19 with pneumonia, the level of nitrotyrosine elevation in the blood serum depends on the appearance of oxygen dependence and the outcome of the disease. The highest level of nitrotyrosine is in patients with COVID-19 with pneumonia with a severe course, and the degree of increase of this indicator has diagnostic value in predicting the probability of an unfavorable disease course.

Abstract Background Respiratory distress and failure is a complication of the coronavirus disease (COVID-19) and tracheostomy may be necessary in cases of prolonged intubation in order to reduce mechanical ventilation duration. However, according to the Canadian Society of Otolaryngology-Head and Neck Surgery guidelines, which our institution applies, patients should not undergo tracheostomy unless cleared of the virus to reduce its spread among healthcare workers because tracheostomy is an aerosolized procedure. This study aimed to identify the outcomes of prolonged intubation in patients with and without COVID-19 who underwent tracheostomy and to determine the morbidity and mortality rates in both groups. Methods This retrospective cohort study included adult patients admitted to the intensive care unit of King Fahad Hospital of the University, Alkhobar, Saudi Arabia, between March 1 and October 31, 2020. This study compared and analyzed the outcomes of delayed tracheostomy in patients with and without COVID-19 in terms of complication, morbidity, and mortality rates. Results Of the 228 study participants, 111 (48.68%) had COVID-19. The mean age of the study participants was 58.67 years (SD = 17.36, max.=93, min.=20), and the majority were males (n = 149, 65.35%). Regarding tracheostomy in patients with COVID-19, 11 (9.91%) patients underwent tracheostomy; however, four (36.36%) of them had prolonged intubation. The mean intensive care unit admission length of stay for tracheostomy patients was 37.17 days, while it was 12.09 days for patients without tracheostomy (t(226)=-9.32, p

To determine the characteristics of pediatric patients 0–19 years of age who died after onset of SARS-CoV-2 infection in Japan during January 1–September 30, 2022, we reviewed multiple sources. We identified 62 cases, collected detailed information from medical records and death certificates, and conducted interviews, resulting in 53 patients with detailed information for our study. Among 46 patients with internal causes of death (i.e., not external causes such as trauma), 15% were

Accurate and timely mortality surveillance is crucial for elucidating risk factors, particularly for emerging diseases. We compared use of COVID-19 keywords on death certificates alone to identify COVID-19 deaths in Minnesota, USA, during 2020–2022, with use of a standardized mortality definition incorporating additional clinical data. For analyses, we used likelihood ratio χ2 and median 1-way tests. Death certificates alone identified 96% of COVID-19 deaths confirmed by the standardized definition and an additional 3% of deaths that had been classified as non–COVID-19 deaths by the standardized definition. Agreement between methods was >90% for most groups except children, although agreement among adults varied by demographics and location at death. Overall median time from death to filing of death certificate was 3 days; decedent characteristics and whether autopsy was performed varied. Death certificates are an efficient and timely source of COVID-19 mortality data when paired with SARS-CoV-2 testing data.

Abstract Coronaviruses being capable of spreading through droplet contamination have raised significant concerns regarding high-capacity public rail transport, such as the metro. Within a rapidly moving railcar cabin, the internal airflow lags behind the bulkhead, generating internally induced airflow that accelerates droplet dispersion within a non-inertial reference system. This study investigates the impact of acceleration on the diffusion of cough droplets of varying sizes using computational fluid dynamics. The modified k–ε equation in ANSYS® Fluent was utilized to simulate droplet diffusion under different body orientations by adjusting the inertial force correction source term. Results indicate that droplets in the middle size range (50–175 μm) are primarily influenced by inertial forces, whereas smaller droplets (3.5–20 μm) are predominantly controlled by air drag forces. Regardless of facial orientation, the outlet of high-capacity public rail transport poses the highest risk of infection.

We investigated trends in notifiable infectious diseases in both humans and animals during the COVID-19 pandemic in South Korea and compared those data against expected trends had nonpharmaceutical interventions (NPIs) not been implemented. We found that human respiratory infectious diseases other than COVID-19 decreased by an average of 54.7% after NPIs were introduced. On the basis of that trend, we estimated that annual medical expenses associated with respiratory infections other than COVID-19 also decreased by 3.8% in 2020 and 18.9% in 2021. However, human gastrointestinal infectious diseases and livestock diseases exhibited similar or even higher incidence rates after NPIs were instituted. Our investigation revealed that the preventive effect of NPIs varied among diseases and that NPIs might have had limited effectiveness in reducing the spread of certain types of infectious diseases. These findings suggest the need for future, novel public health interventions to compensate for such limitations.

In adults, viral load and disease severity can differ by SARS-CoV-2 variant, patterns less understood in children. We evaluated symptomatology, cycle threshold (Ct) values, and SARS-CoV-2 variants among 2,299 pediatric SARS-CoV-2 patients (0–21 years of age) in Colorado, USA, to determine whether children infected with Delta or Omicron had different symptom severity or Ct values than during earlier variants. Children infected during the Delta and Omicron periods had lower Ct values than those infected during pre-Delta, and children

During December 11, 2020–March 29, 2022, the US government delivered ≈700 million doses of COVID-19 vaccine to vaccination sites, resulting in vaccination of ≈75% of US adults during that period. We evaluated accessibility of vaccination sites. Sites were accessible by walking within 15 minutes by 46.6% of persons, 30 minutes by 74.8%, 45 minutes by 82.8%, and 60 minutes by 86.7%. When limited to populations in counties with high social vulnerability, accessibility by walking was 55.3%, 81.1%, 86.7%, and 89.4%, respectively. By driving, lowest accessibility was 96.5% at 15 minutes. For urban/rural categories, the 15-minute walking accessibility between noncore and large central metropolitan areas ranged from 27.2% to 65.1%; driving accessibility was 79.9% to 99.5%. By 30 minutes driving accessibility for all urban/rural categories was >95.9%. Walking time variations across jurisdictions and between urban/rural areas indicate that potential gains could have been made by improving walkability or making transportation more readily available.

We estimated COVID-19 transmission potential and case burden by variant type in Alberta, British Columbia, and Ontario, Canada, during January 23, 2020–January 27, 2022; we also estimated the effectiveness of public health interventions to reduce transmission. We estimated time-varying reproduction number (Rt) over 7-day sliding windows and nonoverlapping time-windows determined by timing of policy changes. We calculated incidence rate ratios (IRRs) for each variant and compared rates to determine differences in burden among provinces. Rt corresponding with emergence of the Delta variant increased in all 3 provinces; British Columbia had the largest increase, 43.85% (95% credible interval [CrI] 40.71%–46.84%). Across the study period, IRR was highest for Omicron (8.74 [95% CrI 8.71–8.77]) and burden highest in Alberta (IRR 1.80 [95% CrI 1.79–1.81]). Initiating public health interventions was associated with lower Rt and relaxing restrictions and emergence of new variants associated with increases in Rt.

Background. In the context of coronavirus diseases 2019 (COVID-19) pandemic associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a significant number of cases resembling Kawasaki disease in children have been reported worldwide and eventually termed “multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2”. Objective: to compare the clinical presentation, laboratory fin­dings, and instrumental examination data in children with Kawasaki-like MIS-C phenotype and MIS-C with a shock phenotype with cases, which met the US Centers for Disease Control and Prevention criteria. Materials and methods. The article presents the results of a retrospective analysis of the disease histories in 20 children aged 2.5 to 16 years with a Kawasaki-like MIS-C phenotype and with MIS-C with a shock phenotype associated with SARS-CoV-2 infection who were hospitalized in the MNPE “Kyiv City Children’s Clinical Hospital 2” in 2002–2021. Results. Patients were divided into 2 groups according to symptoms and pathological conditions. Group I included children with clinical signs similar to the Kawasaki disease (n = 8). They were classified as those with Kawasaki-like MIS-C phenotype. Complications such as coronary artery dilatations and aneurysms occurred only in this group. Group II consisted of patients (n = 12) who were classified as those with MIS-C with a shock phenotype. Children in this group had a higher number of involved organ systems, were more likely to have shock, pleuritis, peritonitis, and a higher prevalence of abdominal pain. Furthermore, they exhibited elevated levels of leukocytes and neutrophils (p = 0.043; p = 0.047), along with a higher neutrophil-to-lymphocyte ratio (p = 0.05), compared to the patients with Kawasaki-like phenotype. Conclusions. Our results suggest that multisystem inflammatory syndrome associated with SARS-CoV-2 in children is characterized by a wide range of clinical, laboratory and instrumental signs. Moreover, our findings highlight that children with features that correspond to MIS-C with a shock phenotype tend to have a more severe course of the disease and a higher rate of complications.

Abstract Background and purpose The COVID-19 pandemic has presented unprecedented public health challenges worldwide. Understanding the factors contributing to COVID-19 mortality is critical for effective management and intervention strategies. This study aims to unlock the predictive power of data collected from personal, clinical, preclinical, and laboratory variables through machine learning (ML) analyses. Methods A retrospective study was conducted in 2022 in a large hospital in Abadan, Iran. Data were collected and categorized into demographic, clinical, comorbid, treatment, initial vital signs, symptoms, and laboratory test groups. The collected data were subjected to ML analysis to identify predictive factors associated with COVID-19 mortality. Five algorithms were used to analyze the data set and derive the latent predictive power of the variables by the shapely additive explanation values. Results Results highlight key factors associated with COVID-19 mortality, including age, comorbidities (hypertension, diabetes), specific treatments (antibiotics, remdesivir, favipiravir, vitamin zinc), and clinical indicators (heart rate, respiratory rate, temperature). Notably, specific symptoms (productive cough, dyspnea, delirium) and laboratory values (D-dimer, ESR) also play a critical role in predicting outcomes. This study highlights the importance of feature selection and the impact of data quantity and quality on model performance. Conclusion This study highlights the potential of ML analysis to improve the accuracy of COVID-19 mortality prediction and emphasizes the need for a comprehensive approach that considers multiple feature categories. It highlights the critical role of data quality and quantity in improving model performance and contributes to our understanding of the multifaceted factors that influence COVID-19 outcomes.

Nowadays, knowledge about the causal relationships between concomitant chronic diseases and the course of coronavirus infection (COVID-19) can make a huge contribution to saving the lives of patients. Determining the impact of concomitant pathology on the severity of the course of COVID-19 will contribute to the identification and assessment of the risk of deterioration of the condition, as well as the implementation of preventive measures in high-risk individuals (vaccination). The aim of the work was to assess the influence of age and sex on the presence of comorbid pathology and the course of the disease in patients who were hospitalized with community-acquired viral pneumonia associated with COVID-19. We carried out a retrospective analysis of the case histories of 260 patients with community-acquired pneumonia associated with coronavirus disease, who were treated in the therapeutic departments of the Covid Center of ME “Dnipropetrovsk regional clinical hospital named after Mechnikov” DRC in 2020-2021. (September-December 2020, January- December 2021), single-center study. All patients included in the analysis underwent general clinical and laboratory methods of research regulated by national recommendations for the management of patients with COVID-19, PCR tests (polymerase chain reaction) for verification of coronavirus disease, CT(computed tomography)/radiography of the lungs. Comorbidity was assessed as the development of the disease before the onset / verification of coronavirus disease according to a patient survey recorded in medical records. One or more comorbid conditions were recorded in 195 (75%) patients. Multimorbidity was recorded in 111 (56.9%) patients from the total number of patients with COVID-19 and comorbid pathology. Analyzing the influence of gender in patients with comorbid pathology, men were significantly more likely to have coronary artery disease (CAD) (p=0.04) and chronic obstructive pulmonary disease (COPD) (p=0.04). A significant difference in age among hospitalized patients with a diagnosis of COVID-19 was revealed, depending on sex (p

The COVID-19 pandemic disproportionately affected persons held in and working in correctional and detention facilities, causing facilities’ traditional priorities to shift when healthcare and public health needs temporarily drove many aspects of operations. During July–August 2022, we interviewed members of health departments and criminal justice organizations to document lessons learned from the COVID-19 response in correctional settings. Participants valued enhanced partnerships, flexibility, and innovation, as well as real-time data and corrections-specific public health guidance. Challenges included cross-sector collaborations, population density, scarcity of equipment and supplies, and mental health. Most participants reported improved relationships between criminal justice and public health organizations during the pandemic. Lessons from COVID-19 can be applied to everyday public health preparedness and emergency response in correctional facilities by ensuring representation of correctional health in public health strategy and practice and providing timely, data-driven, and partner-informed guidance tailored to correctional environments when public health needs arise.

Confinement facilities are high-risk settings for the spread of infectious disease, necessitating timely surveillance to inform public health action. To identify jail-associated COVID-19 cases from electronic laboratory reports maintained in the Minnesota Electronic Disease Surveillance System (MEDSS), Minnesota, USA, the Minnesota Department of Health developed a surveillance system that used keyword and address matching (KAM). The KAM system used a SAS program (SAS Institute Inc., https://www.sas.com) and an automated program within MEDSS to identify confinement keywords and addresses. To evaluate KAM, we matched jail booking data from the Minnesota Statewide Supervision System by full name and birthdate to the MEDSS records of adults with COVID-19 for 2022. The KAM system identified 2,212 cases in persons detained in jail; sensitivity was 92.40% and specificity was 99.95%. The success of KAM demonstrates its potential to be applied to other diseases and congregate-living settings for real-time surveillance without added reporting burden.

To examine the risk associated with bus riding and identify transmission chains, we investigated a COVID-19 outbreak in Germany in 2021 that involved index case-patients among bus-riding students. We used routine surveillance data, performed laboratory analyses, interviewed case-patients, and conducted a cohort study. We identified 191 case-patients, 65 (34%) of whom were elementary schoolchildren. A phylogenetically unique strain and epidemiologic analyses provided a link between air travelers and cases among bus company staff, schoolchildren, other bus passengers, and their respective household members. The attack rate among bus-riding children at 1 school was ≈4 times higher than among children not taking a bus to that school. The outbreak exemplifies how an airborne agent may be transmitted effectively through (multiple) short (

In September 2021, a total of 25 patients diagnosed with COVID-19 developed acute melioidosis after (median 7 days) admission to a COVID-19 field hospital in Thailand. Eight nonpotable tap water samples and 6 soil samples were culture-positive for Burkholderia pseudomallei. Genomic analysis suggested contaminated tap water as the likely cause of illness.

Coronaviruses being capable of spreading through droplet contamination have raised significant concerns regarding high-capacity public rail transport, such as the metro. Within a rapidly moving railcar cabin, the internal airflow lags behind the bulkhead, generating internally induced airflow that accelerates droplet dispersion within a non-inertial reference system. This study investigates the impact of acceleration on the diffusion of cough droplets of varying sizes using computational fluid dynamics. The modified k–ε equation in ANSYS® Fluent was utilized to simulate droplet diffusion under different body orientations by adjusting the inertial force correction source term. Results indicate that droplets in the middle size range (50–175 μm) are primarily influenced by inertial forces, whereas smaller droplets (3.5–20 μm) are predominantly controlled by air drag forces. Regardless of facial orientation, the outlet of high-capacity public rail transport poses the highest risk of infection. [ABSTRACT FROM AUTHOR]

Purpose: Protective factors against coronavirus disease 2019 (COVID-19), an illness caused by a new type of virus, identified as severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), are very important because there is no 100% effective treatment. The aim of this study was to investigate the effect of physical activity levels on the subsequent symptoms and treatment of COVID-19 patients. Methods: A total of 321 volunteers participated in the study: 169 women (age = 30.17 ± 9.22) and 152 men (age = 34.47 ± 9.65), who had been diagnosed with COVID-19 and received inpatient (n = 23, age = 35.74 ± 9.69) or outpatient (n = 298, age = 31.94 ± 9.61) treatment. Physical activity levels were determined by a Physical Activity Assessment Questionnaire and participants were classified into sedentary, low, active, and very active categories. Results: The physical activity level did not have a significant effect on symptom type, hospitalization, and drug use (p > 0.05). We observed that age was significantly higher (p < 0.001), and BMR (Basal Metabolic Rate) was lower (p < 0.05) in those treated with medication than those recovered without medication. Body Mass Index (BMI) values of inpatients were significantly higher than those of outpatients. Age was lower, and BMR was higher in symptomless patients than in those whose symptoms were persistent (more than 2 weeks) (p < 0.05). As BMI increases by one unit, the probability of being a hospitalized patient increases 1.13 times (95% CI 1.040–1.228, p < 0.05). As age increases by one unit, the probability of using drugs in the treatment increases 1.06 times (95% CI 1.028–1.088, p < 0.001). Conclusions: Although there was no direct effect of physical activity level on the treatment and symptoms of COVID-19, age, BMR, and BMI variables, which cannot be considered independently of physical activity, have effects on the treatment and symptoms of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a global pandemic in late 2019, quickly affecting millions worldwide. It presents with a range of symptoms, from mild respiratory issues to severe cases requiring hospitalisation. The disease's long-term effects, especially cognitive impairments post-recovery, remain an area of active research and concern. Aim: To assess the prevalence and severity of cognitive impairments, including memory loss, attention deficits, and executive function disorders, in individuals who have recovered from COVID-19 in Riyadh, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted from May to August 2023 in Riyadh, Saudi Arabia, involving 539 participants confirmed to have recovered from COVID-19 via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests. Cognitive impairments, including memory loss, attention deficits, and executive function disorders were assessed. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 22.0 Chi-square tests and T-tests were utilised to examine the statistical significance of differences between recovered individuals and controls. Results: The study identified significant memory changes in 211 (39.15%) of post-COVID-19 patients, with specific challenges including difficulty recalling names/faces in 146 (27.09%), reduced attention span in 45 (8.35%), and verbal communication issues in 145 (26.9%) study subjects. Demographically, females (n=134, 24.86%) and individuals aged 21-30 reported higher rates of memory impairments compared to males (n=77, 14.29%) or other age groups, challenging prior assumptions about cognitive recovery and age. Further, patients with brain injuries and mental health conditions experienced exacerbated memory issues, underscoring the need for thorough patient assessments. Despite the considerable impact on daily activities reported by 111 (20.59%) of participants, only 17 (3.15%) sought medical help for these memory concerns. The findings highlight the prevalence of memory impairments among Saudi post-COVID-19 patients and call for increased healthcare interventions to manage these long-term cognitive effects. Conclusion: The study conclusively demonstrated that post-COVID-19 memory impairment was prevalent among recovered patients in Saudi Arabia, with significant variations by age, gender, and medical history. This underscored the critical need for healthcare providers to have enhanced awareness and to have developed targeted support services to effectively address and manage the long-term cognitive consequences of COVID-19. [ABSTRACT FROM AUTHOR]

Without the availability of a vaccine (at the time of writing) to control the spread of the COVID-19 virus, countries must rely largely on lockdown measures to limit population movement and community spread. The case of COVID-19 in small island territories is particularly important given their vulnerabilities to external shocks, limited capacity to prepare for and respond to a health crisis, and a population susceptible to non-communicable diseases. This article utilise novel crowdsourced cell phone data gathered by Facebook Data for Good and difference-in-differences estimation as well as event studies to examine the effectiveness of shelter-in-place orders (SIPOs) on population movement patterns across Trinidad and Tobago. We find that most SIPOs result in reductions in population movement patterns across the country, the most effective being the closure of all public places and non-essential businesses. Also, the relaxation of these measures does not readily result in increasing population movement patterns, indicating relative embeddedness in population movement. Our results further suggest that voluntary compliance, adaptive behaviour among citizens, government transparency and public information can also be important motivations for reduced population movement during the pandemic. [ABSTRACT FROM AUTHOR]

The coronavirus (COVID-19) pandemic continues to claim victims. According to the World Health Organization, in the 28 days leading up to 25 February 2024 alone, the number of deaths from COVID-19 was 7141. In this work, we aimed to model the waves of COVID-19 through artificial neural networks (ANNs) and the sigmoidal–Boltzmann model. The study variable was the global cumulative number of deaths according to days, based on the Peru dataset. Additionally, the variables were adapted to determine the correlation between social isolation measures and death rates, which constitutes a novel contribution. A quantitative methodology was used that implemented a non-experimental, longitudinal, and correlational design. The study was retrospective. The results show that the sigmoidal and ANN models were reasonably representative and could help to predict the spread of COVID-19 over the course of multiple waves. Furthermore, the results were precise, with a Pearson correlation coefficient greater than 0.999. The computational sigmoidal–Boltzmann model was also time-efficient. Moreover, the Spearman correlation between social isolation measures and death rates was 0.77, which is acceptable considering that the social isolation variable is qualitative. Finally, we concluded that social isolation measures had a significant effect on reducing deaths from COVID-19. [ABSTRACT FROM AUTHOR]

The fields of artificial intelligence (AI) and machine learning (ML) have attracted significant interest and investment from a diverse range of industries, especially during the last several years. Despite the fact that AI methods have been used extensively and put through extensive testing in the healthcare industry, the recently discovered coronavirus disease (COVID-19) necessitates the use of these methods in order to prevent the emergence of the disease. The proposed system is based on six ML algorithms to predict COVID-19 infection as random forest (RF) algorithm, naive bayes (NB) algorithm, support vector machine (SVM) algorithm, decision tree (DT) algorithm, multi-layer perceptron (MLP), and k-nearest neighbor (KNN). It is based on two steps: first, we uploaded the dataset to train the model. Then, we test our model on those cases to work directly after making a trained classifier so it can directly discover with automatic COVID-19 prediction state of a patient suspected or not. The proposed system results showed the high accuracy of NB, DT, and SVM as 98.646%. Besides the better time to build the model and early predict the state of patients is 31 ms of the NB algorithm. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic has put health care systems of many countries under major stress. Due to its high transmission capacity, it has spread across the globe at a rampant pace. India is one of the countries which has been severely affected by COVID-19. It has posed onerous tasks in front of doctors. Along with it, it has left physical, social and mental implications on well-being of doctors. OBJECTIVES: The purpose of this study is to get an in-depth understanding about the implications of COVID-19 on physical, social and mental aspects of resident doctors in tertiary care hospital. METHOD: We performed a qualitative study which involved in-depth interviews of resident doctors who have worked during the COVID-19 pandemic from general medicine department of tertiary care hospital. Interviews were then manually transcribed and analyzed. RESULT: Data analysis by preparing transcript unveiled that doctors were constantly facing burnout and mental distress along with less social support. Our study also found that there was a shortage of resources and demonstrated poor doctor patient ratio which led to a decrease in efficiency of doctors. Our findings are not only confined to doctors facing burden but has also explored sanguine perceptions of resident doctors. CONCLUSION: While treating COVID-19 patients, resident doctors suffered a great setback. Providing them with mental aid, social support, ample resources and decreasing their work burden is recommended to effectively manage future pandemic. [ABSTRACT FROM AUTHOR]

Due to the COVID-19 pandemic, many children missed their routine vaccinations globally. There is insufficient evidence on the trends in vaccination coverage in the private healthcare sector in South Africa. This study explored the changes in childhood vaccination patterns (non-COVID vaccines) in the private healthcare sector in South Africa using medicine claim data. Using the information on medication claims from a South African pharmaceutical benefit management (PBM) company, we performed a quantitative cross-sectional analysis comparing the period before (2018–2019) and during the COVID-19 pandemic (2020–2021). All patients who made claims within the study period were included. This study included 67,830 children aged two years and younger. In particular, from 2018 to 2021, boys (52%) outnumbered girls (48%). Pharmacists consistently held the predominant prescriber role before and during the COVID-19 pandemic. The proportion of children receiving non-COVID-19 vaccines was higher before the pandemic (60%) than during the pandemic (55%). Furthermore, there was a notable decline of 5% in measles vaccination rates during the children's first year of life, while a notable increase was observed for measles (5%), hepatitis A (7.7%), and the pentavalent vaccine (5%) during the second year of life. Governments and private healthcare providers must take action to enhance vaccination coverage rates for children in their first year of life to prevent a resurgence of vaccine-preventable diseases. The results obtained in this study underscore the significance of implementing vaccine catch-up campaigns to address missed vaccination opportunities arising from the impact of the COVID-19 pandemic. Moreover, pharmacists emerged as the predominant healthcare providers responsible for administering vaccinations within the private healthcare sector in South Africa, both prior and during the COVID-19 pandemic. Their pivotal role in the vaccination process warrants due recognition and should not be underestimated. [ABSTRACT FROM AUTHOR]

The present research reports the findings of three studies, with objectives to demonstrate the impacts of health-promoting behaviors on psychological well-being as well as the mediating roles of sense of control (SOC) and perceived severity of COVID-19 in these relationships. Study 1 was a cross-sectional survey conducted in 473 middle-aged and older Chinese adults before the COVID-19 pandemic to assess their health-promoting behaviors, personal mastery and perceived constraints, life satisfaction, and depressive symptoms. Study 2 was conducted during the second wave of the COVID-19 outbreak in Hong Kong (between March to April 2020), in which 292 participants from Study 1 were successfully contacted to report their emotional responses to the pandemic. Using a different sample, Study 3 was a longitudinal study that measured 495 participants' health-promoting behaviors, personal mastery and perceived constraints at baseline, and their perceived severity and mental health outcomes during the outbreak of omicron cases in Hong Kong (i.e., the fifth wave of the COVID-19 outbreak) in March 2022. All three studies demonstrate that the beneficial effects of health behaviors can be extended to psychological well-being and reveal possible underlying mechanisms through enhancing one's SOC and lowering perceived severity of the COVID-19 outbreak. These results provide important insights to future health promotion programs for improving psychological resources and psychological well-being of middle-aged and older adults in face of disease-related threats. [ABSTRACT FROM AUTHOR]

Introduction: The onset of COVID‐19 challenged dental schools worldwide, impacting clinical training. In Australasia, New Zealand adopted a COVID‐19 'elimination strategy', involving nationwide lockdowns that halted face‐to‐face education. The 'elimination strategy' adopted at the pandemic onset, which permitted return to 'normal life' in 2021, allowed the pandemic impacts and those related workforce transition to be teased out. This study aimed to evaluate perceived impacts of the COVID‐19 pandemic on health and well‐being, clinical competency and employment opportunities of dental students. Materials and Methods: Two surveys were distributed to final year dental students (n = 94; age range 20–35): one during their final semester and the second six months following graduation. Surveys included open and closed ended questions on participants' self‐perceived impacts of COVID‐19 on health and well‐being, clinical competency and employment opportunities. Average percentages were calculated and descriptive statistics performed. Results: Pre‐graduation, participants reported COVID‐19 negatively impacted their mental and social health. Slightly lower scores on all dimensions of health post‐graduation were likely due to transitioning to the workforce. Pre‐graduation, less than half of participants felt prepared to provide the full scope of dental treatment; post‐graduation most felt confident to do so. Most participants expected COVID‐19 would negatively impact employment opportunities for their cohort, despite all participants being employed when the second survey was conducted. Conclusion: Participants self‐rated health and clinical competency scores were lower post‐graduation when NZ returned to 'normal life', meaning lower scores were related to workforce transition. Dental schools need to be prepared to provide alternative forms of dental education and help mitigate mental health impacts of future major course disruptions. [ABSTRACT FROM AUTHOR]

COVID-19 infection is caused by the novel severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2). This novel virus has transformed into different resistant variants (e.g., omicron; delta; alpha; epsilon) since its first emergence in 2019. The National Institutes of Health and Infectious Diseases Society of America guidelines currently recommend adding either baricitinib or tocilizumab to the standard of care for severe COVID-19 treatment. An outcome comparison between baricitinib and tocilizumab is needed to determine which agent is more appropriate and safer in clinical practice when deciding treatment. We aimed to compare mortality and clinical outcomes between tocilizumab and baricitinib in the management of severe COVID-19 infection. A total of 5638 adult patients from 16 acute care hospitals in a large healthcare system in Texas were included in this multicentered retrospective cohort study. The median age of the patients was 56 years and 46.67% of them were female. Severe COVID-19 patients were treated with standard of care and either tocilizumab or baricitinib. The primary outcome of hospital admission mortality rates was found to be higher with tocilizumab (odd ratio (OR) of 1.56; p = 0.001; 95% CI 1.19 to 2.008) compared to that with baricitinib (OR 0.65; p = 0.001; 95% CI 0.50 to 0.84). For one of the secondary outcomes, patients who received tocilizumab were 3.75 times more likely to be admitted to the ICU than those receiving baricitinib (p = 0.001; 95% CI 2.89 to 4.85). Among the 1199 COVID-19 patients who were admitted to the ICU, the ICU length of stay was shorter among patients receiving baricitinib with a mean difference of 4.42 days and a median difference of 2.54 days, compared to those receiving tocilizumab (p < 0.0001; 95% CI −5.97 to −2.62) as another secondary outcome. Our large retrospective observational study showed that baricitinib reduced mortality; the likelihood of ICU admission; and the ICU length of stay compared to tocilizumab in patients with severe COVID-19 infection. [ABSTRACT FROM AUTHOR]

The aim - to determine the diagnostic value of lung ultrasound parameters in predicting outcomes of coronavirus disease 2019 (COVID-19) in oxygen-dependent patients requiring intensive care unit treatment. Materials and methods. We examined 105 patients with COVID-19 who needed supplemental oxygen and were treated in the Department of Anesthesiology and Intensive Care. The age of patients ranged between 39 and 80 years, 63 participants were male and 42 - female. To determine the diagnostic value of lung ultrasound parameters in predicting the severe course of COVID-19 in oxygen-dependent patients, they were divided into groups: Group I - recovered patients (n = 39); Group II - patients with a fatal outcome (n = 66). In all the patients, the diagnosis of COVID-19 was confirmed by RNA-SARS-CoV-2 detection in nasopharyngeal swab specimens. The patients were examined and treated according to the Protocol of the Ministry of Health of Ukraine. The lung ultrasound protocol used in the study included 14 lung examination zones and a score of lung tissue infiltration degree from 0 to 3 points. Statistical processing of the data was performed with Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. In oxygen-dependent patients with severe COVID-19 and a fatal outcome, infiltrative changes in the lung parenchyma were more severe based on the lung ultrasound total score both at the time of admission (p < 0.01) and after 5 days of treatment (p < 0.01). The cutoff score of ≥19 at the time of hospitalization (AUC = 0.753, p < 0.01; sensitivity - 76.9 %, specificity - 68.2 %) and ≥17 after 5 days of treatment (AUC = 0.799, p < 0.01; sensitivity - 71.4 %, specificity - 92.1 %) had a prognostic value for assessing the risk of death in oxygen-dependent patients with severe COVID-19. A lung ultrasound score >19 at the time of admission increased the risk of death by 2.96 times (RR = 2.96, 95 % CI 1.43-2.87, p < 0.001). Lung ultrasound found pleural effusion only in oxygen-dependent COVID-19 patients who died. In the treatment dynamics after 5 days, the rate of pleural effusion detection in this group of patients was three times increased (from 9.1 % to 27.3 %, p < 0.01). Conclusions. The study has revealed the diagnostic value of lung ultrasound parameters in predicting outcomes of COVID-19 in oxygen-dependent patients requiring intensive care unit treatment. Cutoffs of the total score characterizing the degree of lung tissue infiltration have been determined, that allowing to assert a high probability for a lethal outcome of the disease. [ABSTRACT FROM AUTHOR]

Background and purpose: The COVID-19 pandemic has presented unprecedented public health challenges worldwide. Understanding the factors contributing to COVID-19 mortality is critical for effective management and intervention strategies. This study aims to unlock the predictive power of data collected from personal, clinical, preclinical, and laboratory variables through machine learning (ML) analyses. Methods: A retrospective study was conducted in 2022 in a large hospital in Abadan, Iran. Data were collected and categorized into demographic, clinical, comorbid, treatment, initial vital signs, symptoms, and laboratory test groups. The collected data were subjected to ML analysis to identify predictive factors associated with COVID-19 mortality. Five algorithms were used to analyze the data set and derive the latent predictive power of the variables by the shapely additive explanation values. Results: Results highlight key factors associated with COVID-19 mortality, including age, comorbidities (hypertension, diabetes), specific treatments (antibiotics, remdesivir, favipiravir, vitamin zinc), and clinical indicators (heart rate, respiratory rate, temperature). Notably, specific symptoms (productive cough, dyspnea, delirium) and laboratory values (D-dimer, ESR) also play a critical role in predicting outcomes. This study highlights the importance of feature selection and the impact of data quantity and quality on model performance. Conclusion: This study highlights the potential of ML analysis to improve the accuracy of COVID-19 mortality prediction and emphasizes the need for a comprehensive approach that considers multiple feature categories. It highlights the critical role of data quality and quantity in improving model performance and contributes to our understanding of the multifaceted factors that influence COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusion Alpha‐1 receptor antagonists may interfere with IL‐6 signaling and could therefore be a potential treatment for COVID‐19. However, the effectiveness of these drugs in mitigating the risk of clinical deterioration among non‐hospitalized patients with COVID‐19 is unknown.The aim of this study is to examine the association between alpha‐1 antagonist exposure and the 30‐day risk of a hospital encounter or death in nonhospitalized patients with COVID‐19.We conducted a population‐based cohort study of Ontario residents aged 35 years and older who were eligible for public drug coverage and who had a positive test for SARS‐CoV‐2 between January 1, 2020, and March 1, 2021. We matched each individual receiving an alpha‐1 antagonist at the time of their positive test with two non‐exposed individuals using propensity scores. Our outcome was a composite of a hospital admission, emergency department visit, or death, 1 to 30 days following the positive test.We matched 3289 alpha‐1 antagonist exposed patients to 6189 unexposed patients. Overall, there was no difference in the 30‐day risk of the primary outcome among patients exposed to alpha‐1 antagonists at the time of their diagnosis relative to unexposed individuals (28.8% vs. 28.0%; OR 1.00, 95% CI 0.91 to 1.11). In a secondary analysis, individuals exposed to alpha‐1 antagonists had a lower risk of death in the 30 days following a COVID diagnosis (OR 0.79; 95% CI 0.66 to 0.93).Alpha‐1 antagonists did not mitigate the 30‐day risk of clinical deterioration in non‐hospitalized patients with COVID‐19. Our findings do not support the general repurposing of alpha‐1 antagonists as a treatment for such patients, although there may be subgroups of patients in whom further research is warranted. [ABSTRACT FROM AUTHOR]

Background We have planned this study to determine opinions of this patient group, who are affected negatively both in physical aspect during the treatment process of cancer and who are fragile and sensitive for psycho-social aspects, their opposition level and misimpressions related to vaccine and for eliminating these reluctances if possible. Methods Between February 2021 and 15 April 2021, all cancer patients applying to our oncology clinic have been first asked to fill in the questionnaire, which includes three articles where suggestions expressing their attitude towards vaccination were asked and subsequently nine articles expressing suggestions about vaccine opposition. Results According to responses to a decision for vaccination, we have learned that 446 (79,6%) patients thought to have the Covid-19 vaccine, 62 (11.1%) were hesitant, and 52 (9.3%) did not think to have a vaccine. Conclusions The most critical data obtained from this study is that there were severe biases related to adverse effects due to vaccines, although patients have a positive attitude about vaccination. The most important task of health authorities should be to eliminate reluctance without waiting for patients to take a more negative attitude on this subject. [ABSTRACT FROM AUTHOR]

Introduction: There is limited information regarding the clinical and angiographic characteristics and outcomes of patients with Coronavirus disease 2019 (COVID-19) presenting with ST segment elevation myocardial infarction (STEMI). The aim of this study was to describe the clinical and angiographic characteristics, as well as clinical outcomes, in COVID-19 positive patients with STEMI compared with COVID-19 negative STEMI patients. Methods: This was a single-center observational study conducted between May 2020 and May 2021. The study population consisted of 35 patients who were followed with active COVID-19 and diagnosed with STEMI, and 35 STEMI patients without COVID-19 infection. Results: Groups were similar in terms of gender, hypertension, obstructive airway disease, SYNTAX score, and localization of myocardial infarction (MI). Glucose levels, BUN, creatinine, and CRP levels were significantly higher in the COVID-19 group. LDL and hemoglobin levels were lower in the COVID-19 group (p<0.05). There was a positive correlation between in-hospital death and modified thrombus grade post-first device and a negative correlation between in-hospital death and post-procedural TIMI flow (p=0.001, r=0.480). Discussion and Conclusion: Our results demonstrate that patients presenting with STEMI and concurrent COVID-19 infection have a higher post-procedural thrombus burden and worse Thrombolysis in Myocardial Infarction (TIMI) flow. STEMI patients with COVID-19 face procedural challenges and are associated with poorer clinical outcomes. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 transmits principally by air; contact and fomite transmission may also occur. Variants of concern are more transmissible than ancestral SARS-CoV-2. We found indications of possible increased aerosol and surface stability for early variants of concern, but not for the Delta and Omicron variants. Stability changes are unlikely to explain increased transmissibility.

Background/purposePoor oral hygiene and periodontal disease have been identified as potential risk factors for the coronavirus disease 2019 (COVID-19). The present study aimed to determine the association between periodontitis and COVID-19 severity, nature of symptoms, mortality, and hospital stay.MethodsIn total, 163 COVID-19-positive patients (men: 93; women: 70) were categorized into two groups: the control group, consisting of 120 patients with asymptomatic or mild symptoms, and the case group, consisting of 43 patients with moderate-to-severe symptoms. The severity of periodontal disease, oral hygiene status (OHI), pocket depth (PD), bleeding on probing (BOP), number of decayed/missing/filled teeth, mortality, duration of stay in the hospital, oxygen requirement, and nature of COVID-19 symptoms were assessed in both groups. The association between periodontitis and COVID-19 was analyzed with other confounding factors such as age, sex, comorbidities, oral hygiene, and smoking status.ResultsThe presence of periodontitis increases the severity of COVID-19 by 3.7 times (p = 0.002). A statistically significant difference was noted for symptoms such as dizziness (p = 0.036), running nose/cold (p = 0.009), and headache (p = 0.005) in the presence of periodontitis. The risk estimate for death associated with periodontitis was 1.03. Additionally, the average duration of stay was longer for individuals with periodontitis than for those in the control group.ConclusionThere is a positive association between periodontal disease and COVID-19. Periodontitis increases the severity of COVID-19 and alters the symptoms. Hence, periodontal disease management should be an integral part of managing patients with coronavirus infection.

BACKGROUND: Composite Autonomic Symptom Score-31 (COMPASS-31) is an easy-to-use screening tool for the evaluation of autonomic dysfunction in various diseases affecting neural function but has rarely been used in the assessment of long coronavirus disease 2019 (COVID-19). This study aimed to evaluate the diagnostic accuracy of the COMPASS-31 score in detecting dysfunction of the autonomic nervous system in patients 3 months after COVID-19 infection. MATERIALS AND METHODS: Fifty-nine subjects were recruited and grouped into 2: (a) controls (n = 31) who had never had positive polymerase chain reaction results for COVID-19 before and (b) the post-COVID-19 patients (n = 28) who had confirmed COVID-19 infection 3–6 months before recruitment. COMPASS-31 questionnaire was utilized to evaluate subjective symptoms or evidence of autonomic dysfunction. Autonomic dysfunction was assessed objectively by cardiovascular autonomic reflex tests (CARTs) and heart rate variability (HRV). For comparison of quantitative variables between two groups, t-test or Mann-Whitney U test, as appropriate, were used. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), negative likelihood ratio (LR), and positive LR were used as measures of diagnostic accuracy. Receiver operating characteristic (ROC) curve analysis determined the overall accuracy of COMPASS-31. RESULTS: The median COMPASS score was found to be significantly higher in post-COVID-19 participants than controls (15.5 vs. 10, P = 0.021). The median total CART score was also significantly higher in post-COVID-19 participants (0 vs. 1, P < 0.001). Out of 6 domains of the COMPASS score, the median value for orthostatic dysfunction was found to be significantly higher in post-COVID-19 participants than controls (12 vs. 0, P = 0.008). There was significantly fair accuracy of the COMPASS score with an area under the receiver operating curve 0.68 (0.54–0.82) following the total CART score ≥2 as the gold standard in the diagnosis of autonomic dysfunction (P = 0.021). The best cutoff point of the total COMPASS score was 12.5, where the optimal values of sensitivity, specificity, and positive and negative predictive values were achieved. Nonsignificant and weak correlations between CARTs, HRV parameters, and COMPASS score were found. CONCLUSION: COMPASS-31 could be used as a user-friendly screening tool to detect autonomic dysfunction in post-COVID-19 cases with acceptable sensitivity and specificity.