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Background: Cytokine storm in severe Covid-19 disease is one of the leading causes of death in these patients. Hemoperfusion is a method used to purify the blood from toxins and inflammatory factors. The aim of this study was to evaluate the effect of hemoperfusion on mortality and morbidity in patients with severe Covid - 19 disease. Methods: This was a retrospective study which performed by reviewing the files of 30 patients with severe Covid-19 disease referred to Sina Hospital affiliated to Tehran University of Medical Sciences in 2020. Thirty patients with severe covid-19 disease and positive PCR participated in the study. All patients received routine treatment protocol for covid-19. Hemoperfusion was used for 15 patients in addition to receiving routine care. The remaining 15 patients were included in the control group. Patients in the hemoperfusion group underwent four sessions of hemoperfusion using continuous renal replacement therapy with continuous venovenous hemofiltration. Results: the ICU length of stay in the control and hemoperfusion groups was 3.40 ± 11.40 and 9.65 ± 16.33 days, respectively (P= 0.075). 8 patients died and 7 patients were discharged in the control group, but 11 patients died and 4 patients were discharged in the hemoperfusion group (P= 0.256). The respiratory rate of patients in the control and hemoperfusion groups decreased from 7.43 ± 29.40 to 4.03 ± 24.60 and from 6.11 ± 31.60 to 5.04 ± 24.46, respectively (P < 0.001). The percentage of arterial blood oxygen saturation in the control and hemoperfusion groups increased from 90.86 ± 5.61 to 93.06 30 4.30 and from 92.33 26 3.26 to 92.06 31 5.31, respectively (P= 0.456). Conclusion: Hemoperfusion could not prevent the mortality of patients and finally out of 15 patients, 11 patients died and 4 patients were discharged. Also, no significant difference was observed between the two groups in terms of arterial blood oxygen saturation.

In response to the COVID?19 pandemic, Australia went into a nationwide lockdown that began on 22 March 2020 with stage one restrictions. These initial restrictions included closing non?essential businesses as [...], : Objective: Examine the changes in service delivery Australian public sexual health clinics made to remain open during lockdown. Methods: A cross?sectional survey designed and delivered on Qualtrics was emailed to 21 directors of public sexual health clinics across Australia from July?August 2020 and asked about a variety of changes to service delivery. Descriptive statistics were calculated. Results: Twenty clinics participated, all remained open and reported service changes, including suspension of walk?in services in eight clinics. Some clinics stopped offering asymptomatic screening for varying patient populations. Most clinics transitioned to a mix of telehealth and face?to?face consultations. Nineteen clinics reported delays in testing and 13 reported limitations in testing. Most clinics changed to phone consultations for HIV medication refills (n=15) and eleven clinics prescribed longer repeat prescriptions. Fourteen clinics had staff redeployed to assist the COVID?19 response. Conclusion: Public sexual health clinics pivoted service delivery to reduce risk of COVID?19 transmission in clinical settings, managed staffing reductions and delays in molecular testing, and maintained a focus on urgent and symptomatic STI presentations and those at higher risk of HIV/STI acquisition. Implications for public health: Further research is warranted to understand what impact reduced asymptomatic screening may have had on community STI transmission.

Aim: To delineate and analyze the mortality from COVID -19 in our institute during the devastating second wave of pandemic. Settings and Design: A retrospective cohort analysis. Methods and Materials: A comprehensive mortality analysis of 142 laboratory-confirmed severe acute respiratory syndrome coronavirus 2-infected deceased patients from our hospital's medical records was done. These patients presented with severe disease at the time of admission and were managed in intensive care units. Statistical Analysis Used: Statistical Package for Social Sciences software, IBM manufacturer, Chicago, USA, version 21.0 was used. Results: The number of deceased males (82, 62.6%) was higher than females (53, 37.3%). Median age of deceased patient was 57 (44.25–69.75) years. Most frequent comorbidities were diabetes mellitus (42, 29.6%) and hypertension (41, 28.9%). Most common symptoms being shortness of breath (137, 96.5%), fever (94, 66.2%) and cough (73, 51.4%). Median peripheral capillary oxygen saturation (SpO2) at time of admission was 86% (77.25–90). Median time interval from symptom onset to admission in hospital was 3 (2.25–5) days. Neutrophil lymphocyte ratio was more than 5 in 117 (90.7%) patients. Complications seen were acute respiratory distress syndrome in 82.3%, acute liver injury in 58.4%, acute kidney injury in 26.7%, sepsis in 13.3% and acute cardiac injury in 12% patients. The median high-resolution computed tomography score was 20 (17–22). Conclusions: Male and elderly patients with underlying comorbidities had poorer outcome and involvement of multiple organ systems was common. A short time interval between symptom onset and admission/mortality, particularly encountered was worrisome.

Background: Sars-CoV2 can cause severe pneumonia and acute respiratory distress syndrome (ARDS). In COVID-19-associated respiratory failure, lung transplantation might be an option (Bharat A). Case report: A previously healthy 63-year-old man with a nasopharyngeal swab positive for SarsCoV2 and radiological evidence of interstitial lung consolidations developed acute respiratory distress that required intubation and veno-venous extracorporeal membrane oxygenation support (VV ECMO). Because of no recovery of his lung function, he underwent a bilateral lung transplant. ICU stay was complicated by several episodes of bacterial superinfections and an increase of liver function tests (LFTs). Afterward, he faced a progressive clinical worsening associated to severe anemia, further rise of indices of cholestasis, hypertriglyceridemia and hyperferritinemia. Bone marrow smear showed a picture compatible with haemophagocytic lymphohistocytosis (HLH) and first and second line therapy were started. In addition, a transjugular hepatic biopsy was performed with histopathological evidence of portal and periportal fibrosis, compatible with Covid 19-related cholangiopathy. During the hospital stay, he developed several MDR opportunistic infections. The patient died few months later from multiorgan failure secondary to septic shock. A post-mortem confirmed a diagnosis of cholangiopathy, and medullary erythro-haemophagocytosis. Conclusion: Post Covid19 syndrome is a clinical entity that includes novel and old sequelae following recovery from Sars-CoV2 infections. Early identification of these diseases is crucial for adequate management and might influence the long term prognosis of these patients.

Objective:This study aims to evaluate information on the website of the Ministry of Health about the COVID-19 pandemic, the social media accounts of health authorities, and the COVID-19 cases.Methods:In this descriptive ecological research, the content analysis of the posts about COVID-19, which were shared for health professionals and the public on the official website of the Ministry of Health, was conducted. The content traffic of the social media accounts of the health authorities about the pandemic and the daily number of cases along with recovery and death rates related to the pandemic were analyzed.Results:The first COVID-19 post was sent on 22 January 2020 through the official Twitter account of the Minister of Health. After the first tweet about COVID-19, the first positive case was seen in the 50th day, while the first death was seen in the 57th day and the first recovery case was seen in the 67th day. There is a significant positive correlation between the number of days passed and the number of cases, deaths, recoveries, comments, retweets and likes that the tweets of the Minister received; between the number of cases and the number of deaths and recovery cases; between fatal cases and recovery cases.Conclusion:A correlation was found between the tweet traffic of the health authorities’ twitter accounts and the number of COVID-19 cases, deaths, recoveries and days passed. Therefore, social platforms can be an important risk communication tool for public health in informing and managing the community in disasters like pandemics.

Background: The coronavirus disease 2019 (COVID-19) reporting and data system (CO-RADS) grade of high-resolution computed tomography (HRCT)-thorax scan investigation is an innovative tool for the diagnosis of COVID-19 patients. By this tool, majority of moderate-to-severe COVID-19 patients are screened to detect lung pathologies. Hardly any study has explored its use vis-a-vis reverse transcriptase-polymerase chain reaction (RT-PCR) in asymptomatic patients., Objectives: (1) The objective of the study is to assess the frequency COVID-19 patients among asymptomatic subjects who were admitted in the hospital for planned surgery, (2) estimate the sensitivity and specificity of CO-RADS grade of HRCT-thorax investigation for the diagnosis of COVID-19 patients where RT-PCR test was considered as "Gold Standard" test., Methodology: A descriptive retrospective study was conducted by studying the records in the case files of 150 patients who were admitted in the Department of General Surgery, Man Mohini Health Clinic, Murshidabad, West Bengal for minor surgical procedures between September 1 and December 31, 2020. Data were collected from hospital records. The CO-RADS grade of HRCT-thorax investigation and RT-PCR test were performed for the diagnosis of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) virus. The MS-excel application was applied for data analysis., Results: The mean age of the participants was 42.58 ± 14.29 years. A total of 17 (11%) and 39 (26%) of the patients were diagnosed with COVID-19 by HRCT-thorax and RT-PCR test, respectively. The sensitivity and specificity of CO-RADS grade of HRCT-thorax investigation for diagnosis of COVID-19 patients were 43.58% and 100%, respectively. The positive and negative predictive values of CO-RADS grade of HRCT-thorax investigation were 100% and 83.45%, respectively., Conclusions: The frequency of asymptomatic patients with COVID-19 that was missed by HRCT thorax was high, compared to the gold standard RT-PCR, reflecting its low sensitivity and low negative predictive value in the diagnosis of SARS-CoV-2 virus infection. Hence, it is difficult to conclude in favor of HRCT thorax as first-line screening modality in all individuals., Competing Interests: None

Coronavirus disease 2019 (COVID 19), which originated in December 2019, on January 30, 2020 was declared by the World Health Organization as the sixth public health emergency from international concerns [1]. Since the onset of the disease in late 2019 to mid-June 2020, more than 8.5 million people around the world have been infected with COVID 19. Of these, more than 450,000 have died [2]. So far, six species of human coronavirus have been identified, most of which , like SARS in 2002 and MERS in 2012, cause mild respiratory illness [3]. During the spread of COVID 19 worldwide, people use social media to receive and exchange information [4]. With the advent of smartphones, widespread access to the Internet, and the availability of instant messaging applications, it has become clear that these communications can have numerous benefits for healthcare providers as well. WhatsApp is one of the instant messaging applications that is widely used in healthcare and is, therefore, a popular app [5]; it has about 1.5 billion users worldwide [6]. WhatsApp is compatible with all smartphone operating systems such as iPhone, Android, Windows phone [7]. This messenger allows its users to easily share text and video messages as well as media files and content with other users. A,lso group chats and the participation of several users in calls for conversation are easily available in this messenger. WhatsApp communications can be done easily and internationally. WhatsApp is available for everyone for an annual subscription fee of $0.99 [6, 8]. In addition to major changes in people's daily lifestyles, social media has improved communication between patients and professionals by establishing fast multimedia communication, health education, social support, and better health decisions, so that WhatsApp has been used in cases such as drug therapy problems, drug and dietary supplements, emotional changes, lifestyle habits, social rights, physical symptoms, commitment to treatment, medical emergencies, oral health promotion and issues of dentistry [9]. According to a study by Kurubaran Ganasegeran et al., most health system employees understand the use of WhatsApp in health and clinical matters, and it has been observed that these messengers in clinical departments (approximately 61% of employees), clinics (about 60%), operating room (56%) and when calling the treatment staff (approximately 55%) have been used [8]. The World Health Organization also defines mobile (wireless) health as public health, supported by wireless devices such as mobile phones, monitoring devices, personal digital assistants (PDAs), and other wireless devices [10]. Given the prevalence of COVID 19 worldwide and the risk to all individuals, the use of WhatsApp Messenger to inform the latest announcements of the World Health Organization, public and regional health centers, health professionals, and researchers can have a significant impact on public health. The messenger can also be used to effectively communicate with members of the medical staff to resolve the questions and rumors, and avoid frequent visits to health centers that are high-risk areas. WhatsApp can also be contacted by friends and acquaintances using voice and video calls, which can probably reduce the psychological pressure of the quarantine and isolation to some extent.

In December 2019, in Wuhan, China, a group of acute respiratory illnesses was diagnosed with unknown etiology, which today is known as Coronavirus disease 2019 (COVID 19) [1]. Coronavirus is a single-stranded RNA virus that affects both humans and animals. The disease spread rapidly throughout China and other countries [2, 3]. In January 2020, the World Health Organization (WHO) announced the outbreak of the new coronavirus as the sixth public health emergency of international concern [4]. In general, the first step in preventing the spread of infectious diseases is quarantine and isolation; in public health, quarantine means separating and keeping people at risk of contracting an infectious disease, including travel bans, daily commutes, and public gatherings. Isolation also means isolating the infected people [5]. For the first time, China's National Health Commission has implemented quarantine and isolation of people at risk and patients with COVID 19, and other countries have taken action following the outbreak [6]. Usually, people who experience quarantine have unpleasant feeling about it. Cases such as separation from loved ones, loss of freedom, insecurity about illness, and boredom can have many negative psychological burdens, for example disorders such as anxiety, depression, dysfunction, or unwillingness to work [7]. In addition to the fear and anxiety caused by the virus, other factors can negatively affect a person's mental health. One of these factors is Internet addiction [8]. The Internet is an essential and integral part of the new lifestyle. The term Internet addiction refers to the psychological dependence on the use of the Internet, which is a problematic behavior in human interaction with technology that can have significant effects on increasing stress, depression and social communication disorders [9]. In general, it can be said that three personal, social and internet factors play a role in Internet addiction. Personal factors are related to individual characteristics such as introversion, inability to communicate sufficiently, and low self-efficacy. Internet factors also include more time to use the Internet, easier access to the Internet, and superior Internet skills. Social factors also include low family support and sociological problems of the individuals. The important point is that the combination of social and personal factors can have a significant impact on Internet addiction [10]. Due to the prevalence of COVID 19 and home quarantine and lifestyle changes, Internet addiction is one of the disorders that can increase dramatically. On the other hand, Internet addiction can increase the chances of developing other mental disorders such as anxiety and depression. Internet addiction can also endanger a person's physical health and reduce social, occupational, and recreational activities. Applying educational and counseling programs (virtually via the Internet and the media) to help reduce the psychological problems of Internet addiction and provide solutions in this course can be helpful.

Background and Aims: As of November 2020, the Coronavirus Disease 2019 (COVID 19) has infected more than 396,000 people in the Philippines. Although no study has been done on malnutrition among a general cohort of patients with COVID 19, it has long been associated with increased mortality and poor long-term outcomes. We aimed to determine the prevalence of malnutrition among patients with COVID 19 admitted in a tertiary government hospital., Methods: Cross-sectional study on COVID 19-confirmed patients admitted to the COVID 19 wards from July 15 to September 15, 2020. Nutritional status was assessed using the Philippine Society for Parenteral and Enteral Nutrition (PhilSPEN) modified Subjective Global Assessment Grade (SGA) tool. Malnutrition was defined as those with SGA grades B and C. Chi-square test or Fisher exact test of association, as appropriate, was used to identify factors that have a significant association with malnutrition. Furthermore, logistic regression was done on factors with significant association., Results: Among the 355 adult patients in the study, 71.83% (255/355) were malnourished [SGA B: 67.84% (173/255); SGA C: 32.16% (82/255)]. The following were shown to have significant association with malnutrition: community-acquired pneumonia (CAP) [p-value < 0.001], hospital-acquired pneumonia (HAP) [p-value 0.002], and chronic kidney disease (p-value 0.033). Multivariable logistic regression revealed that age [OR 1.02, CI 95% 1.00, 1.04, p-value 0.027] and CAP-Moderate Risk (MR) [OR 3.02, CI 95% 1.73, 5.27, p-value < 0.001] are significant predictors of malnutrition. All patients with CAP- High Risk and HAP were malnourished., Conclusion: The prevalence of malnutrition was high (71.83%) in a general cohort of COVID 19 patients as measured by the modified SGA tool. The following are risk factors of malnutrition among patients with COVID 19: age, CAP, and HAP. Nutritional support and management of comorbidities are of paramount importance in the care of patients with COVID 19., Competing Interests: Declaration of competing interest The principal investigators and co-investigators have no relevant conflicts of interest., (Copyright © 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Since SARS-CoV-2, the novel coronavirus that causes coronavirus disease 2019 (COVID-19), was first detected in December 2019 (1), approximately 1.3 million cases have been reported worldwide (2), including approximately 330,000 in the United States (3). To conduct population-based surveillance for laboratory-confirmed COVID-19-associated hospitalizations in the United States, the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) was created using the existing infrastructure of the Influenza Hospitalization Surveillance Network (FluSurv-NET) (4) and the Respiratory Syncytial Virus Hospitalization Surveillance Network (RSV-NET). This report presents age-stratified COVID-19-associated hospitalization rates for patients admitted during March 1-28, 2020, and clinical data on patients admitted during March 1-30, 2020, the first month of U.S. surveillance. Among 1,482 patients hospitalized with COVID-19, 74.5% were aged ≥50 years, and 54.4% were male. The hospitalization rate among patients identified through COVID-NET during this 4-week period was 4.6 per 100,000 population. Rates were highest (13.8) among adults aged ≥65 years. Among 178 (12%) adult patients with data on underlying conditions as of March 30, 2020, 89.3% had one or more underlying conditions; the most common were hypertension (49.7%), obesity (48.3%), chronic lung disease (34.6%), diabetes mellitus (28.3%), and cardiovascular disease (27.8%). These findings suggest that older adults have elevated rates of COVID-19-associated hospitalization and the majority of persons hospitalized with COVID-19 have underlying medical conditions. These findings underscore the importance of preventive measures (e.g., social distancing, respiratory hygiene, and wearing face coverings in public settings where social distancing measures are difficult to maintain) † to protect older adults and persons with underlying medical conditions, as well as the general public. In addition, older adults and persons with serious underlying medical conditions should avoid contact with persons who are ill and immediately contact their health care provider(s) if they have symptoms consistent with COVID-19 (https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html) (5). Ongoing monitoring of hospitalization rates, clinical characteristics, and outcomes of hospitalized patients will be important to better understand the evolving epidemiology of COVID-19 in the United States and the clinical spectrum of disease, and to help guide planning and prioritization of health care system resources., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Linda Niccolai reports personal fees from Merck outside the submitted work; Evan Anderson reports personal fees from AbbVie and Pfizer, and grants from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Novavax, Sanofi-Pasteur, and Micron, outside the submitted work; Andrew Weigel reports grants from the Council of State and Territorial Epidemiologists during the conduct of the study; Ruth Lynfield reports that she is the coeditor for a book on public health and an associate editor for American Academy of Pediatrics Report of the Committee of Infectious Diseases (Red Book); Laurie Billing reports a grant from the Council of State and Territorial Epidemiologists during the conduct of the study; William Schaffner reports personal fees from Pfizer, Roche Diagnostics, and Pepsico outside the submitted work; H. Keipp Talbot reports compensation from Seqiris outside the submitted work; Andrea George reports a grant from the Council of State and Territorial Epidemiologists during the conduct of the study; Sue Kim reports a grant from the Council of State and Territorial Epidemiologists during the conduct of the study; Justin Henderson reports a grant from the Council of State and Territorial Epidemiologists during the conduct of the study; and Clarissa Aquino reports a grant from the Council of State and Territorial Epidemiologists during the conduct of the study. No other potential conflicts of interest were disclosed.