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Abstract Background During a COVID-19 pandemic, it is imperative to investigate the outcomes of all non-COVID-19 diseases. This study determines hospital admissions and mortality rates related to non-COVID-19 diseases during the COVID-19 pandemic among 41 million Iranians. Method This nationwide retrospective study used data from the Iran Health Insurance Organization. From September 23, 2019, to Feb 19, 2022, there were four study periods: pre-pandemic (Sept 23-Feb 19, 2020), first peak (Mar 20-Apr 19, 2020), first year (Feb 20, 2020-Feb 18, 2021), and the second year (Feb 19, 2021-Feb 19, 2022) following the pandemic. Cause-specific hospital admission and in-hospital mortality are the main outcomes analyzed based on age and sex. Negative binomial regression was used to estimate the monthly adjusted Incidence Rate Ratio (IRR) to compare hospital admission rates in aggregated data. A logistic regression was used to estimate the monthly adjusted in-hospital mortality Odds Ratio (OR) for different pandemic periods. Results During the study there were 6,522,114 non-COVID-19 hospital admissions and 139,679 deaths. Prior to the COVID-19 outbreak, the standardized hospital admission rate per million person-month was 7115.19, which decreased to 2856.35 during the first peak (IRR 0.40, [0.25–0.64]). In-hospital mortality also increased from 20.20 to 31.99 (OR 2.05, [1.97–2.13]). All age and sex groups had decreased admission rates, except for females at productive ages. Two years after the COVID-19 outbreak, the non-COVID-19 hospital admission rate (IRR 1.25, [1.13–1.40]) and mortality rate (OR 1.05, [1.04–1.07]) increased compared to the rates before the pandemic. The respiratory disease admission rate decreased in the first (IRR 0.23, [0.17–0.31]) and second years (IRR 0.35, [0.26–0.47] compared to the rate before the pandemic. There was a significant reduction in hospitalizations for pneumonia (IRR 0.30, [0.21–0.42]), influenza (IRR 0.04, [0.03–0.06]) and COPD (IRR 0.39, [0.23–0.65]) during the second year. There was a significant and continuous rise in the hematological admission rate during the study, reaching 186.99 per million person-month in the second year, reflecting an IRR of 2.84 [2.42–3.33] compared to the pre-pandemic period. The mortality rates of mental disorders (OR 2.15, [1.65–2.78]) and musculoskeletal (OR 1.48, [1.20–1.82), nervous system (OR 1.42, [1.26–1.60]), metabolic (OR 1.99, [1.80–2.19]) and circulatory diseases (OR 1.35, [1.31–1.39]) increased in the second year compare to pre-pandemic. Myocardial infarction (OR 1.33, [1.19–1.49]), heart failure (OR 1.59, [1.35–1.87]) and stroke (OR 1.35, [1.24–1.47]) showed an increase in mortality rates without changes in hospitalization. Conclusions In the era of COVID-19, the changes seem to have had a long-term effect on non-COVID-19 diseases. Countries should prepare for similar crises in the future to ensure medical services are not suspended.

Background: High mobility group box 1 (HMGB1) and interleukin-18 (IL-18) are involved in various non-coronavirus disease pathogenesis and are reported as potential biomarkers for coronavirus disease (COVID-19). However, their association with COVID-19 pathogenesis has not yet been explored. Aim: This study aimed to investigate the association between HMGB1 and IL-18 concentrations in the sera of COVID-19 patients versus non-COVID-19 patients. Material and methods: We used stored serum samples obtained from 30 COVID-19 patients and 30 non-COVID-19 patients. We collected data on age, gender, treatment status, principal diagnosis, and comorbidity from patient medical records. HMGB1 and IL-18 concentrations were analyzed in the serum by enzyme-linked immunosorbent assay (ELISA). The swab samples’ RT-PCR cycle threshold (CT) values were obtained from the laboratory database. Results: HMGB1 concentrations were increased in the COVID-19 inpatients and non-COVID-19 inpatients compared to non-COVID-19 outpatients (COVID-19 inpatients vs. non-COVID-19 outpatients: 151.33 (90.27–192.38) vs. 80.75 (54.16–128.72) ng/ml; p = 0.0316; non-COVID-19 inpatients vs. non-COVID-19 outpatients: 152.66 (104.04–288.51) vs. 80.75 (54.16–128.72) ng/ml; p = 0.0199). IL-18 concentrations were also higher in the COVID-19 inpatients and non-COVID-19 inpatients compared to non-COVID-19 outpatients (COVID-19 inpatients vs. non-COVID-19 outpatients: 620.00 (461.50–849.6) vs. 403.10 (372.70–556.90) pg/ml; p = 0.0376; non-COVID-19 inpatients vs. non-COVID-19 outpatients: 835.70 (558.30–1602.00) vs. 403.10 (372.70–556.90) pg/ml; p = 0.0026). Moreover, HMGB1 was associated with IL-18 concentrations in the sera of COVID-19 inpatients (p = 0.0337; r = 0.5500). Conclusion: The association of HMGB1 and IL-18 in COVID-19 might indicate the potential for a dangerous cycle leading to a cytokine storm to occur.

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Background and Objectives: Spinal cord injury (SCI) is a severe affliction that can have a profound impact on a person's ability to move and feel, affecting a significant number of individuals. However, rehabilitation after SCI treatment remains a critical method to improve motor–sensory functions, which improves the patient's quality of life. This study aims to describe the epidemiological profile of SCI during the COVID-19 pandemic ("COVID-19 period") and before and after the COVID-19 pandemic ("non-COVID-19 period") in Wuhan City, Hubei Province, China. Materials and Methods: Medical records of 93 patients diagnosed with SCI admitted to the rehabilitation department of Wuhan Tongji Hospital from January 2019 to May 2023 were retrospectively reviewed. Basic demographics and clinical characteristics such as level of injury, American Spinal Injury Association (ASIA) Impairment Scale, treatment method, and concomitant injuries were analyzed. Results: Forty patients with SCI from the non-COVID-19 period and fifty-three patients from the COVID-19 period were identified. The mean ages were 38.80 ± 17.71 and 44.53 ± 13.27 years, respectively, with a consistent male-to-female ratio of 2:1 across both periods. Notably, falls accounted for the most prevalent mechanism of injury, constituting 50% of cases during the non-COVID-19 period and 37.74% during the COVID-19 period. The most common initial ASIA grade was B in the non-COVID-19 period and grade C in the COVID-19 period. In addition, the final ASIA grade after treatment was grade C in the non-COVID-19 period and grade D in the COVID-19 period. Conclusions: A greater proportion of males suffer from SCI, and the primary causes are falls and traffic accidents. Workers are the most vulnerable group to SCI among all patients. Prevention strategies should be customized based on the unique characteristics of SCI patients. This study highlights the importance of SCI rehabilitation. [ABSTRACT FROM AUTHOR]

Non-SARS-CoV-2 respiratory viral infections, such as influenza virus (FluV) and human respiratory syncytial virus (RSV), have contributed considerably to the burden of infectious diseases in the non-COVID-19 era. While the rates of co-infection in SARS-CoV-2-positive group (SCPG) patients have been determined, the burden of other respiratory viruses in the SARS-CoV-2-negative group (SCNG) remains unclear. Here, we conducted a cross-sectional study (São José do Rio Preto county, Brazil), and we collected our data using a meta-analysis to evaluate the pooled prevalence of FluV and RSV among SCNG patients. Out of the 901 patients suspected of COVID-19, our molecular results showed positivity of FluV and RSV in the SCNG was 2% (15/733) and 0.27% (2/733), respectively. Co-infection with SARS-CoV-2 and FluV, or RSV, was identified in 1.7% of the patients (3/168). Following our meta-analysis, 28 studies were selected (n = 114,318 suspected COVID-19 patients), with a pooled prevalence of 4% (95% CI: 3–6) for FluV and 2% (95% CI: 1–3) for RSV among SCNG patients were observed. Interestingly, FluV positivity in the SCNG was four times higher (OR = 4, 95% CI: 3.6–5.4, p < 0.01) than in the SCPG. Similarly, RSV positivity was significantly associated with SCNG patients (OR = 2.9, 95% CI: 2–4, p < 0.01). For subgroup analysis, cold-like symptoms, including fever, cough, sore throat, headache, myalgia, diarrhea, and nausea/vomiting, were positively associated (p < 0.05) with the SCPG. In conclusion, these results show that the pooled prevalence of FluV and RSV were significantly higher in the SCNG than in the SCPG during the early phase of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Hospitals worldwide implemented visitor restrictions policies due to the SARS-CoV-2 pandemic. Aim: To investigate the impact of visitor restrictions experienced by non-Covid-19 orthopaedic patients, their relatives, and health professionals from a person-centred practice (PCP) perspective. Methods: Seventy-eight patients/relatives completed a self-reported survey. Template Analysis was conducted on twenty-five telephone interviews and one focus group interview. Findings: Despite accepting the restrictions for the country's good, we found a profound need for visits among the relatives. However, one-fifth of the patients were content, and one-third got more rest than earlier admissions. We uncovered a current readiness to develop an organisational PCP culture focused on the good of the patient. All stakeholders were attentive to the importance of the relatives' role, and the need for the involvement of relatives as team players became evident. Conclusion: The study emphasised the need for PCP strategies to involve relatives when visitor restrictions are necessary. [ABSTRACT FROM AUTHOR]

Objective: To assess the influence of the COVID-19 pandemic on hospital admissions (HA), intra-hospital deaths (HD), and intra-hospital lethality rates (HL) related to respiratory diseases (RD) other than COVID-19 in Brazil. Methods: This observational time-series study was conducted through comparative analyses of the HA, HD, and HL related to non-COVID-19 RD registered between March and December 2020 by the Brazilian Unified Public Health System on the DataSUS Tabnet platform, using as reference the values recorded in the same period of 2019 and those projected by linear regression methods for 2020, considering the period from 2015 to 2019. The adopted statistical significance level was 5% (p < 0.05). Results: Compared to 2019, in 2020, there was a 42% decrease in HA and a 7.4% decrease in total HD related to non-COVID-19 RD, followed by a 60% increase in HL associated with this group of diseases. The HA and HL registered in 2020 differed significantly from the projected trend for that year by linear regression (p < 0.05). Of note, a significant reduction in hospitalizations due to asthma (-46%), chronic obstructive pulmonary disease (-45%), bronchiectasis (-54%), pneumonia (-46%), and acute bronchitis (-73%) was observed. Conclusions: During the first 8 months of the pandemic, there was a decline in HA and an increase in HL related to non-COVID-19 RD in Brazil, which can hypothetically reflect logistical challenges and delays in the management of this group of diseases. [ABSTRACT FROM AUTHOR]

We aimed to contribute to increase the efficiency of the Cardiopulmonary Resusitation (CPR) interventions by comparing the code blue applications activated for patients with and without COVID 19 during the pandemic process. The code blue registration forms who were diagnosed with and without COVID-19 and underwent resuscitation, between March 15-November 30, 2020 were examined retrospectively through the hospital information processing system. Demographic data, time of code blue activation, COVID-19 status, call accuracy, initial heart rhythm, respiratory arrest, survival in the first 24 hours, 30-day survival, discharge, time to reach unit. CPR durations were recorded. 79% of patients with code blue were covid-19. İnitial asystolic rhythm was present 16.7%, VF arrest was present in 34.8% and respiratory arrest was present in 71.7% patients and 53.6% of the patients died in the first 24 hours. The average time the team reaches the unit was aproximately 3 minutes, and the mean CPR duration was apoximately 30 minute. The rate initial asystolic rhythm was found higher in COVID- patients . The rate being declared exitus was higher in COVID-19 patients. The time to reach the place of activation and the duration of CPR were found higher in COVID-19 patients. The time to reach the place was found to be delayed for about 1 minute in our study. To develop strategies for minimizing the time between wearing the protective equipment properly and the response to the blue code without delay should be our first goal for the success of resuscitation. [Med-Science 2022; 11(1.000): 195-8]

ABSTRACT Objective: To assess the influence of the COVID-19 pandemic on hospital admissions (HA), intra-hospital deaths (HD), and intra-hospital lethality rates (HL) related to respiratory diseases (RD) other than COVID-19 in Brazil. Methods: This observational time-series study was conducted through comparative analyses of the HA, HD, and HL related to non-COVID-19 RD registered between March and December 2020 by the Brazilian Unified Public Health System on the DataSUS Tabnet platform, using as reference the values recorded in the same period of 2019 and those projected by linear regression methods for 2020, considering the period from 2015 to 2019. The adopted statistical significance level was 5% (p < 0.05). Results: Compared to 2019, in 2020, there was a 42% decrease in HA and a 7.4% decrease in total HD related to non-COVID-19 RD, followed by a 60% increase in HL associated with this group of diseases. The HA and HL registered in 2020 differed significantly from the projected trend for that year by linear regression (p < 0.05). Of note, a significant reduction in hospitalizations due to asthma (-46%), chronic obstructive pulmonary disease (-45%), bronchiectasis (-54%), pneumonia (-46%), and acute bronchitis (-73%) was observed. Conclusions: During the first 8 months of the pandemic, there was a decline in HA and an increase in HL related to non-COVID-19 RD in Brazil, which can hypothetically reflect logistical challenges and delays in the management of this group of diseases.

COVID-19 vaccine-associated lymphadenopathy (C19-VAL) is increasingly encountered with the widespread use of the vaccine in controlling the outbreak. We aim to characterize the pathological findings of COVID-19 and non-COVID-19 vaccine-associated lymphadenopathy (NC19-VAL). A search for studies that reported pathological findings in vaccine-associated lymphadenopathy on PubMed and Google Scholar was performed on 11 December 2021. C19-VAL studies were pooled for analysis. These studies were split into clinical lymphadenopathy (CL) and subclinical lymphadenopathy detected on imaging (SLDI) for subgroup analysis. A total of 25 studies were related to COVID-19 vaccines, and 21 studies were included in the pooled analysis. The pooled analysis included 37 patients with a mean age of 47.8 ± 19.1 years old, and 62.2% were females. The mean duration from last vaccination to development of CL/SLDI was 14.5 ± 11.0 days. Most were diagnosed as reactive or negative for malignancy (28/37, 75.5%), followed by Kikuchi–Fujimoto disease (KFD) (3/37, 8.1%), florid lymphoid hyperplasia (2/37, 5.4%), and granulomatous inflammation (2/37, 5.4%). Metastases were reported in two patients with a history of malignancy (2/37, 5.4%). Cases with florid lymphoid hyperplasia and KFD were younger than those with reactive changes. A total of 14 studies were related to non-COVID-19 vaccines. Caseating granulomatous inflammation was reported in BCG vaccine-associated lymphadenopathy, while other vaccines were associated with reactive lymphoid hyperplasia, florid post-vaccinal reactions, and KFD. Although most C19-VAL cases were reported as reactive or negative for malignancy, other diagnoses included florid lymphoid hyperplasia, KFD, and granulomatous inflammation. Metastases were reported in lymphadenopathy of patients with a history of malignancy, who had been incidentally vaccinated. In conclusion, C19-VAL can yield different histopathological diagnoses when sampled, most of which require clinical and radiological correlation for optimal patient management. [ABSTRACT FROM AUTHOR]

Background and Objectives: Spinal cord injury (SCI) is a severe affliction that can have a profound impact on a person’s ability to move and feel, affecting a significant number of individuals. However, rehabilitation after SCI treatment remains a critical method to improve motor–sensory functions, which improves the patient’s quality of life. This study aims to describe the epidemiological profile of SCI during the COVID-19 pandemic (“COVID-19 period”) and before and after the COVID-19 pandemic (“non-COVID-19 period”) in Wuhan City, Hubei Province, China. Materials and Methods: Medical records of 93 patients diagnosed with SCI admitted to the rehabilitation department of Wuhan Tongji Hospital from January 2019 to May 2023 were retrospectively reviewed. Basic demographics and clinical characteristics such as level of injury, American Spinal Injury Association (ASIA) Impairment Scale, treatment method, and concomitant injuries were analyzed. Results: Forty patients with SCI from the non-COVID-19 period and fifty-three patients from the COVID-19 period were identified. The mean ages were 38.80 ± 17.71 and 44.53 ± 13.27 years, respectively, with a consistent male-to-female ratio of 2:1 across both periods. Notably, falls accounted for the most prevalent mechanism of injury, constituting 50% of cases during the non-COVID-19 period and 37.74% during the COVID-19 period. The most common initial ASIA grade was B in the non-COVID-19 period and grade C in the COVID-19 period. In addition, the final ASIA grade after treatment was grade C in the non-COVID-19 period and grade D in the COVID-19 period. Conclusions: A greater proportion of males suffer from SCI, and the primary causes are falls and traffic accidents. Workers are the most vulnerable group to SCI among all patients. Prevention strategies should be customized based on the unique characteristics of SCI patients. This study highlights the importance of SCI rehabilitation.

Purpose: To analyze the trend of COVID-19-related and non-COVID-19-related articles published in the Indian Journal of Ophthalmology (IJO) during the COVID-19 pandemic. Methods: A retrospective analysis of all COVID-19 and non-COVID-19-related articles published in all the issues of IJO from January 2020 to March 2021 was performed. The data were obtained from the official website of IJO, Editor IJO monthly email, and PubMed. The monthly data were analyzed and a comparative analysis was done. The articles were segregated as Original, Review, Case Report/Series, Letter to the Editor/Commentary, Guest Editorial, Research methodology, Point-Counterpoint, Consensus Criteria, Ophthalmic Images, Photo Essay, Surgical Techniques, and AIOS Meeting Papers. Results: Out of 1343 articles published in IJO during the pandemic, 182 (13.55%) were COVID-19-related and 1161 (86.45%) were non-COVID-19-related articles. Among COVID-19 articles (182), majority were letter to the editors 66 (36.26%), followed by original articles 39 (21.42%), commentaries 24 (13.18%), editorials 18 (9.89%), and preferred practices 13 (7.14%). The least were case reports five (2.74%), current ophthalmology and innovation three (1.64%) each, and one (0.54%) each of consensus criteria, images, and photo assays. In the non-COVID-19-related articles (1161), maximum were original articles 276 (23.77%), followed by case reports 179 (15.41%), photo assays 157 (13.52%), and commentaries 141 (12.14%). The least were three (0.25%) consensus criteria and two (0.17%) each of current ophthalmology and innovations. The lockdown issue with 223 articles, postlockdown phase 1 had 267, postlockdown phase 2 had 321, and postlockdown phase 3 with 316 (1127 articles) articles in IJO showed a rising trend in a number of published articles compared with the prelockdown issues (216 articles). Conclusion: The quality and quantity of articles published in IJO increased and improved significantly. The results were seen with progressive improvement in citations and impact factors of the journal.

We aimed to contribute to increase the efficiency of the Cardiopulmonary Resusitation (CPR) interventions by comparing the code blue applications activated for patients with and without COVID 19 during the pandemic process. The code blue registration forms who were diagnosed with and without COVID-19 and underwent resuscitation, between March 15-November 30, 2020 were examined retrospectively through the hospital information processing system. Demographic data, time of code blue activation, COVID-19 status, call accuracy, initial heart rhythm, respiratory arrest, survival in the first 24 hours, 30-day survival, discharge, time to reach unit. CPR durations were recorded. 79% of patients with code blue were covid-19. İnitial asystolic rhythm was present 16.7%, VF arrest was present in 34.8% and respiratory arrest was present in 71.7% patients and 53.6% of the patients died in the first 24 hours. The average time the team reaches the unit was aproximately 3 minutes, and the mean CPR duration was apoximately 30 minute. The rate initial asystolic rhythm was found higher in COVID-patients. The rate being declared exitus was higher in COVID-19 patients. The time to reach the place of activation and the duration of CPR were found higher in COVID-19 patients. The time to reach the place was found to be delayed for about 1 minute in our study. To develop strategies for minimizing the time between wearing the protective equipment properly and the response to the blue code without delay should be our first goal for the success of resuscitation. [ABSTRACT FROM AUTHOR]

Non-SARS-CoV-2 respiratory viral infections, such as influenza virus (FluV) and human respiratory syncytial virus (RSV), have contributed considerably to the burden of infectious diseases in the non-COVID-19 era. While the rates of co-infection in SARS-CoV-2-positive group (SCPG) patients have been determined, the burden of other respiratory viruses in the SARS-CoV-2-negative group (SCNG) remains unclear. Here, we conducted a cross-sectional study (São José do Rio Preto county, Brazil), and we collected our data using a meta-analysis to evaluate the pooled prevalence of FluV and RSV among SCNG patients. Out of the 901 patients suspected of COVID-19, our molecular results showed positivity of FluV and RSV in the SCNG was 2% (15/733) and 0.27% (2/733), respectively. Co-infection with SARS-CoV-2 and FluV, or RSV, was identified in 1.7% of the patients (3/168). Following our meta-analysis, 28 studies were selected (n = 114,318 suspected COVID-19 patients), with a pooled prevalence of 4% (95% CI: 3–6) for FluV and 2% (95% CI: 1–3) for RSV among SCNG patients were observed. Interestingly, FluV positivity in the SCNG was four times higher (OR = 4, 95% CI: 3.6–5.4, p < 0.01) than in the SCPG. Similarly, RSV positivity was significantly associated with SCNG patients (OR = 2.9, 95% CI: 2–4, p < 0.01). For subgroup analysis, cold-like symptoms, including fever, cough, sore throat, headache, myalgia, diarrhea, and nausea/vomiting, were positively associated (p < 0.05) with the SCPG. In conclusion, these results show that the pooled prevalence of FluV and RSV were significantly higher in the SCNG than in the SCPG during the early phase of the COVID-19 pandemic.

Background: Due to the coronavirus disease-2019 (COVID-19) pandemic, there has been a surge of patients requiring mechanical ventilation over a short period of time. The morbidity and mortality outcome in these patients have been variably reported in the published literature. Comparative analyses of ventilated COVID-19 and non-COVID-19 patients during the same time period have been lacking. Materials and methods: Prospective data for each mechanically ventilated patient was collected from both COVID-19 and non-COVID ICU for a period of 8 months. Their demographic details and disease severity scores were included. Risk-adjusted outcomes across two groups were analyzed using multivariable regression methods. Results: Crude ICU and hospital mortality were similar in COVID-19- and non-COVID-19 ventilated groups (43.8 vs 40% and 43.8 vs 41.1%, respectively; p >0.05). After risk adjustment for the severity of illness by APACHE IV, no significant differences were observed in ICU mortality (OR 1.498; 95% CI 0.669-3.327; p = 0.328) and hospital mortality (OR 1.574; 95% CI 0.707-3.504; p = 0.267). However, mechanically ventilated COVID-19 patients had increased ICU stay (OR 6.261; 95% CI 3.778--8.744; p <0.001) as well as prolonged ventilatory support (OR 4.358; 95% CI 2.910-7.424; p <0.001) when compared to non-COVID-19 patients. Conclusion: In mechanically ventilated patients, no significant differences in terms of mortality were noted between COVID-19 and non-COVID-19 patients. Mechanically ventilated COVID-19 patients had longer ICU stay and more number of days on ventilation. [ABSTRACT FROM AUTHOR]

The emergence of Covid-19 has caused a pandemic and is a major public health concern. Covid-19 has fundamentally challenged the global health care system in all aspects. However, there is a growing concern for the subsequent detrimental effects of continuing delays or adjustments on time-dependent treatments for Covid-19 negative patients. Patients arriving to the ED with STEMIs and acute CVA are currently presumed to have delays due to Covid-19 related concerns. The objective of this paper is to evaluate the implications of the Covid-19 pandemic on non-Covid19 patients in emergency care settings. We conducted a retrospective study from February 2020 to April 2020 and compared this to a parallel period in 2019 to assess the impact of the Covid-19 pandemic on three distinct non-Covid-19 ED diagnosis that require immediate intervention. Our primary outcome measures were time to primary PCI in acute STEMI, time to fibrinolysis in acute CVA, and time to femoral hip fracture correction surgery. Our secondary outcome measure included a composite outcome of length of stay in hospital and mortality. From 1 February 2020 to 30 April 2020, the total referrals to ED diagnosed with STEMI, Hip fracture and CVA of which required intervention were 197 within Covid-19 group 2020 compared to 250 in the control group 2019. Mean duration to intervention (PCI, surgery and tPA, respectively) did not differ between COVID-19 group and 2019 group. Among femoral hip fracture patients', the referral numbers to ED were significantly lower in Covid-19 era (p = 0.040) and the hospitalization stay was significantly shorter (p = 0.003). Among CVA patients', we found statistical differences among the number of referrals and the patients' age. Coping with the Covid-19 pandemic presents a challenge for the general healthcare system. Our results suggest that with proper management, despite the obstacles of isolation policies and social distancing, any negative impact on the quality of health care for the non-Covid-19 patients can be minimized in the emergency department setting. [ABSTRACT FROM AUTHOR]

Summary: Background: Isolation precautions are essential prevent spread of COVID-19 infection but may have a negative impact on inpatient care. The impact of these measures on non-COVID-19 patients remains largely unexplored. Aim: This study aimed to investigate diagnostic and treatment delays related to isolation precautions, the associated patient outcome, and the predisposing risk factors for delays. Methods: This observational study was conducted in seven Helsinki region hospitals during the first wave of the COVID-19 pandemic in Finland. The study used data on all non-COVID-19 inpatients, who were initially isolated due to suspected COVID-19, to estimate whether isolation precautions resulted in diagnostic or treatment delays. Results: Out of 683 non-COVID-19 patients, 33 (4.8%) had delays related to isolation precautions. Clinical condition deteriorated non-fatally in seven (1.0%) patients. The following events were associated with an increased risk of treatment or a diagnostic delay: more than three ward transfers (P = 0.025); referral to an incorrect speciality in the emergency department (P = 0.004); more than three SARS-CoV-2 RT-PCR tests performed (P = 0.022); and where cancer was the final diagnosis (P = 0.018). In contrast, lower respiratory tract symptoms (P = 0.013) decreased the risk. Conclusions: The use of isolation precautions for patients who did not have COVID-19 had minor negative effects on patient outcomes. The present study underlines the importance of targeting diagnostic efforts to patients with unspecified symptoms and to those with a negative SARS-CoV-2 test result. Thorough investigations to achieve an accurate diagnosis improves the prognosis of patients and facilitates appropriate targeting of hospital resources.

Objectives: To assess the effect of the COVID-19 Pandemic on hospital visits and admissions of non-COVID-19 patients in 2020 compared to 2019. Material and Methods: This retrospective study was conducted in 2021 at the Department of Pediatrics, Benazir Bhutto Hospital, Rawalpindi comparing the data of non-COVID-19 patients visits and admissions from January to December 2019 with non-COVID-19 patients visits and admissions from January to December 2020. The relevant data was retrieved from the Pediatric Department record on a pre-designed study questionnaire. Data was entered and analyzed in SPSS version-24 for descriptive statistics and analysis. Results: The total OPD visits in 2019 were 112682 patients compared to 63859 patients in 2020 showing a 43.33% reduction. The total number of patients who visited pediatric emergency were 80274 in 2019 and 41182 in 2020, showing a decline of 48.65%. There were a total of 6151 admissions in the paediatric ward in 2019 compared to 2778 admissions in 2020 recording a decline of 54.84%. The admissions in the Neonatal Unit were 5544 in 2019 and 3528 in 2020 with a reduction of 36.36%. The admissions in PICU in 2019 were 2685 and in 2020 the admissions decline to 2011 which is a 25.1% reduction. Conclusion: There was a significant decline in both hospital visits and admissions in 2020 compared to those in 2019. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the trend of COVID-19-related and non-COVID-19-related articles published in the Indian Journal of Ophthalmology (IJO) during the COVID-19 pandemic.Methods: A retrospective analysis of all COVID-19 and non-COVID-19-related articles published in all the issues of IJO from January 2020 to March 2021 was performed. The data were obtained from the official website of IJO, Editor IJO monthly email, and PubMed. The monthly data were analyzed and a comparative analysis was done. The articles were segregated as Original, Review, Case Report/Series, Letter to the Editor/Commentary, Guest Editorial, Research methodology, Point-Counterpoint, Consensus Criteria, Ophthalmic Images, Photo Essay, Surgical Techniques, and AIOS Meeting Papers.Results: Out of 1343 articles published in IJO during the pandemic, 182 (13.55%) were COVID-19-related and 1161 (86.45%) were non-COVID-19-related articles. Among COVID-19 articles (182), majority were letter to the editors 66 (36.26%), followed by original articles 39 (21.42%), commentaries 24 (13.18%), editorials 18 (9.89%), and preferred practices 13 (7.14%). The least were case reports five (2.74%), current ophthalmology and innovation three (1.64%) each, and one (0.54%) each of consensus criteria, images, and photo assays. In the non-COVID-19-related articles (1161), maximum were original articles 276 (23.77%), followed by case reports 179 (15.41%), photo assays 157 (13.52%), and commentaries 141 (12.14%). The least were three (0.25%) consensus criteria and two (0.17%) each of current ophthalmology and innovations. The lockdown issue with 223 articles, postlockdown phase 1 had 267, postlockdown phase 2 had 321, and postlockdown phase 3 with 316 (1127 articles) articles in IJO showed a rising trend in a number of published articles compared with the prelockdown issues (216 articles).Conclusion: The quality and quantity of articles published in IJO increased and improved significantly. The results were seen with progressive improvement in citations and impact factors of the journal. [ABSTRACT FROM AUTHOR]

Background: Chest CT scan has a great sensitivity with rapid diagnoses of COVID-19 infection in the community. Nevertheless,the specificity of this test for diagnosis of this disease are believed to be low. Objective: To evaluate role, effectiveness and diagnostic accuracy of chest CT scan with main imaging manifestations and hematological appearances for screening COVID-19 cases through comparing results of those with other NON-COVID-19 pneumonia. Patients and Method: Twenty COVID--19 & 28NON--COVID--19pneumoniaIraqi patients in Yarmouk teaching hospital, Baghdad, Iraq from 1 march to 1 may 2020, at the beginning of the outbreak in Iraq COVID--19 had been included in current research. Confirmed COVID--19 together with NON--COVID-19 patients to be infected or not with SARS-CoV-2 using RT-PCR were included in current research. Socio- demographic,hematological and chest CT scan finding were examined to compare the variance between COVID-19 and NON-COVID-19 patients. Result: "COVID-19" patients mean age was 62.10 ±14.308SDrangedbetween 35- 90 years whereas "non-COVID-19" patients mean was 61.07± 13.638 SD.There was a significant difference between WBC average number of COVID-19 compared to its average number of "NON-COVID-19" patients (P<0.001). A significant differences between Neutrophils, lymphocytes, Monocytes, Eosinophil and Basophils low counts and MCV, MCH, PDW of COVID-19 compared to its counts or levels in "NON-COVID-19" patients (P<0.001). A significantly different of CT scanImages 'Ground glass opacity, Crazy paving alteration', 'Vascular dilatations, Traction Bronchiectasis alteration', 'Sub pleural --bands' & Architectura) between "COVID-19" & "NON-COVID-19 cases (P less than 0.001), whereas Consolidation was non-significant. Conclusion: A chest CT scan might be a dependabletool for COVID-19 cases diagnosis. Hematological features that include WBC, Neutrophils, Lymphocytes, Monocytes, Eosinophil, Basophils, MCV, MCH, PDW might be substantial indications for COVID-19 appraisal. [ABSTRACT FROM AUTHOR]

Background: High mobility group box 1 (HMGB1) and interleukin-18 (IL-18) are involved in various non-coronavirus disease pathogenesis and are reported as potential biomarkers for coronavirus disease (COVID-19). However, their association with COVID-19 pathogenesis has not yet been explored., Aim: This study aimed to investigate the association between HMGB1 and IL-18 concentrations in the sera of COVID-19 patients versus non-COVID-19 patients., Material and Methods: We used stored serum samples obtained from 30 COVID-19 patients and 30 non-COVID-19 patients. We collected data on age, gender, treatment status, principal diagnosis, and comorbidity from patient medical records. HMGB1 and IL-18 concentrations were analyzed in the serum by enzyme-linked immunosorbent assay (ELISA). The swab samples' RT-PCR cycle threshold (CT) values were obtained from the laboratory database., Results: HMGB1 concentrations were increased in the COVID-19 inpatients and non-COVID-19 inpatients compared to non-COVID-19 outpatients (COVID-19 inpatients vs. non-COVID-19 outpatients: 151.33 (90.27-192.38) vs. 80.75 (54.16-128.72) ng/ml; p = 0.0316; non-COVID-19 inpatients vs. non-COVID-19 outpatients: 152.66 (104.04-288.51) vs. 80.75 (54.16-128.72) ng/ml; p = 0.0199). IL-18 concentrations were also higher in the COVID-19 inpatients and non-COVID-19 inpatients compared to non-COVID-19 outpatients (COVID-19 inpatients vs. non-COVID-19 outpatients: 620.00 (461.50-849.6) vs. 403.10 (372.70-556.90) pg/ml; p = 0.0376; non-COVID-19 inpatients vs. non-COVID-19 outpatients: 835.70 (558.30-1602.00) vs. 403.10 (372.70-556.90) pg/ml; p = 0.0026). Moreover, HMGB1 was associated with IL-18 concentrations in the sera of COVID-19 inpatients (p = 0.0337; r = 0.5500)., Conclusion: The association of HMGB1 and IL-18 in COVID-19 might indicate the potential for a dangerous cycle leading to a cytokine storm to occur., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Isolation precautions are essential prevent spread of COVID-19 infection but may have a negative impact on inpatient care. The impact of these measures on non-COVID-19 patients remains largely unexplored., Aim: This study aimed to investigate diagnostic and treatment delays related to isolation precautions, the associated patient outcome, and the predisposing risk factors for delays., Methods: This observational study was conducted in seven Helsinki region hospitals during the first wave of the COVID-19 pandemic in Finland. The study used data on all non-COVID-19 inpatients, who were initially isolated due to suspected COVID-19, to estimate whether isolation precautions resulted in diagnostic or treatment delays., Results: Out of 683 non-COVID-19 patients, 33 (4.8%) had delays related to isolation precautions. Clinical condition deteriorated non-fatally in seven (1.0%) patients. The following events were associated with an increased risk of treatment or a diagnostic delay: more than three ward transfers ( P  = 0.025); referral to an incorrect speciality in the emergency department ( P  = 0.004); more than three SARS-CoV-2 RT-PCR tests performed ( P  = 0.022); and where cancer was the final diagnosis ( P  = 0.018). In contrast, lower respiratory tract symptoms ( P  = 0.013) decreased the risk., Conclusions: The use of isolation precautions for patients who did not have COVID-19 had minor negative effects on patient outcomes. The present study underlines the importance of targeting diagnostic efforts to patients with unspecified symptoms and to those with a negative SARS-CoV-2 test result. Thorough investigations to achieve an accurate diagnosis improves the prognosis of patients and facilitates appropriate targeting of hospital resources., (© 2021 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.)

Objective: Coronavirus disease 2019 (COVID-19) has spread worldwide, including Japan. However, little is known about the clinical symptoms which discriminate between COVID-19 and non-COVID-19 among outpatients in general practitioner clinics, which is important for efficient case detection. The aim of this study was to investigate the clinical symptoms to discriminate between COVID-19 and non-COVID-19 cases among outpatients in general practitioner clinics during the second wave of the COVID-19 pandemic in Japan in August 2020. Methods: The records of 360 patients who visited a clinic with suspicion of infectious disease and underwent COVID-19 PCR test between 1 and 14 August 2020 were used. The patients filled out a questionnaire on possible clinical symptoms and transmission routes. Multivariate logistic regression was used to investigate the association between clinical symptoms and COVID-19 status. Results: COVID-19-positive patients were 17 (4.7%). Multiple logistic regression analyses showed that anosmia (odds ratio (OR), 25.94 95% confidence interval (CI), 7.15–94.14; p < 0.001), headache (OR, 3.31 95% confidence interval (CI), 0.98–11.20; p = 0.054), sputum production (OR, 3.32 CI, 1.01–10.90; p = 0.048) and history of visiting an izakaya or bar (OR, 4.23 CI, 0.99–18.03; p = 0.051) were marginally significantly associated withbeing COVID-19 positive. This model showed moderate predictive power (area under receiver operating characteristic curve = 0.870 CI, 0.761 to 0.971). Conclusions: We found that anosmia, headache, sputum production, history of visiting an izakaya or bar were associated with COVID-19, which can be used to detect patients with COVID-19 in out-patient clinics in Japan. The findings of this study need to be verified in other clinics and hospitals in Japan and other countries with universal healthcare coverages. [ABSTRACT FROM AUTHOR]

Background: The occupancy of healthcare resources by the COVID-19 outbreak had led to the unmet health needs of non-COVID-19 diseases. We aimed to explore whether the social media information could help surveil and understand the characteristics of unmet non-COVID-19 health needs during the COVID-19 outbreak in Wuhan city., Methods: This was an observational study based on social media data. The study period was set during the 3 months of the COVID-19 outbreak. Non-COVID-19 urgent and emergent health needs in Wuhan city were derived from Sina Weibo-one of China's largest social media platforms. Lag Spearman correlation was used to investigate the epidemiological relationship between the COVID-19 outbreak and non-COVID-19 health needs. Patient's primary diseases and needed care were annotated and categorized according to the International Classification of Diseases 11th Revision. The delay time in seeking help was calculated and compared., Results: After screening 114,795 Weibo posts, a total of 229 patients with non-COVID-19 health needs were included in our study. There were significant correlations between the daily number of COVID-19 cases at a 10-day lag, deaths at a 5-day lag, and non-COVID-19 Weibo. The actual number of non-COVID-19 patients with urgent and emergent health needs was estimated to be about 6,966. Patients with non-COVID-19 health needs were skewed to those aged 50 to 70 years. The non-COVID-19 diseases were diverse, with 46.3% as non-neoplastic diseases and 53.7% as neoplasms. The most needed cares were palliative cancer care (22.7%), chemotherapy (18.8%), and critical care (17.0%). The median delay in seeking help was 3 days [interquartile range (IQR), 1 to 15 days] for acute care, and 18.5 days (IQR, 6 to 30 days) for cancer care., Conclusions: Our preliminary findings in Wuhan city indicated that the social media data might provide a viable option to surveil and understand the unmet health needs during an outbreak. Those heterogeneous health needs derived from the social media data might inspire a more resilient healthcare system to address the unmet needs promptly., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://dx.doi.org/10.21037/atm-21-1769). The authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)

Beta cell dysfunction is suggested in patients with COVID-19 infections. Poor glycemic control in ICU is associated with poor patient outcomes. This is a single center, retrospective analysis of 562 patients in an intensive care unit from 1 March to 30 April 2020. We review the time in range (70–150 mg/dL) spent by critically ill COVID-19 patients and non-COVID-19 patients, along with the daily insulin use. Ninety-three in the COVID-19 cohort and 469 in the non-COVID-19 cohort were compared for percentage of blood glucose TIR (70–150 mg/dL) and average daily insulin use. The COVID-19 cohort spent significantly less TIR (70–150 mg/dL) compared to the non-COVID-19 cohort (44.4% vs. 68.5%). Daily average insulin use in the COVID-19 cohort was higher (8.37 units versus 6.17 units). ICU COVID-19 patients spent less time in range (70–150 mg/dL) and required higher daily insulin dose. A higher requirement for ventilator and days on ventilator was associated with a lower TIR. Mortality was lower for COVID-19 patients who achieved a higher TIR. [ABSTRACT FROM AUTHOR]

Background: Since there are reports of cases of 2019-coronavirus disease (COVID-19) asymptomatic carriers in China recently and fever is one of the main symptoms, we aimed to distinguish COVID-19 cases from other febrile patients with clinical examinations in this study., Methods: A total of 134 suspected COVID-19 patients in the isolation ward of the First Affiliated Hospital of Guangzhou Medical University were recruited from January 23 to May 23, 2020. We analyze the pathogenic form and clinical characteristics., Results: Among them, pathogens were identified in only 84 patients (62.7%), including 23 (17.1%) with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), 30 (22.3%) with other viruses, 31 (25.0%) with other pathogens and 3 (3.5%) with mixed infections. The commonly observed symptoms of COVID-19 patients were cough, fever, fatigue, and muscle aches, which were significantly different than the symptoms of nonviral infections (P<0.05) but from those of other viral infections (P>0.05). Furthermore, lactate dehydrogenase and the neutrophil/lymphocyte were found significantly high in COVID-19 patients compared to non-COVID-19 patients (P<0.05). The most common manifestations of COVID-19 patients were ground-glass opacities (100%) with or without lung consolidation, however, they also often showed involvement of several lobes of both lungs (P<0.05). Due to the clear differential diagnosis, the overall antibiotic use rate was 35.8% (31/87)., Conclusions: When diagnosing COVID-19, infections with other pathogens should not be ignored. Successful pathogen identification will support accurate treatment., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-6600). NZ serves as an unpaid honorary editor-in-chief of Annals of Translational Medicine from Jan 2019 to Dec 2024. The other authors have no conflicts of interest to declare., (2021 Annals of Translational Medicine. All rights reserved.)