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Background: With limited pharmacological interventions, post-COVID-19 condition is a clinical challenge, and supplementary therapies are essential for symptom relief and enhancing quality of life (QoL). In our prospective observational study, we aimed to evaluate the impact of Salus per aquam (Spa) therapy on post-COVID-19 symptoms and QoL in individuals who suffer from chronic joint, musculoskeletal, skin, and/or respiratory conditions. Methods: A total of 159 individuals undergoing Spa therapy were enrolled, and 78 of them had post-COVID-19 symptoms, assessed using Visual Analogue Scale (VAS) and modified British Medical Research Council Questionnaire (mMRC-DS scales), as well as the Short Form 36 Health Status Survey (SF-36) questionnaire for QoL. Results: Spa therapy significantly reduced most post-COVID-19 symptoms, especially chronic fatigue, pain, brain fog, and persistent cough (all p < 0.05), as well as physical (+72%) and emotional (+66%) limitations. When stratified by sex, males showed a greater improvement from baseline, while females consistently displayed a higher amelioration in all QoL dimensions. Moreover, full vaccination with 3–4 doses significantly protected against SARS-CoV-2 re-infections and post-COVID-19 development (p < 0.05). Conclusions: Spa therapy demonstrated effectiveness in mitigating post-COVID-19 symptoms and enhancing QoL in patients suffering from chronic diseases. [ABSTRACT FROM AUTHOR]

The global impact of Severe Acute Respiratory Syndrome Coronavirus-2 (SARSCOV2) is profound, with Coronavirus Disease 2019 (COVID-19) presenting a clinical spectrum that leads to multi-systemic failure, particularly affecting the pancreas and resulting in diabetes and cardiovascular co-morbidities. Diabetes, the more life-threatening manifestation of COVID-19, is associated with a 30% higher fatality rate. This review aims to explore the intricate relationship between Hyperglycaemia and hyper inflammation in individuals with post-COVID diabetes, emphasizing the risks of recurring hyperglycaemia and distinguishing it from conventional diabetes. Methodologically, data synthesis and extraction were conducted based on diabetes mellitus and recent studies on the impact of coronavirus, especially SARS, on the pancreas, utilizing articles from the Pubmed search engine. Hospitalized COVID-19 patients show a higher likelihood of concurrent conditions, including diabetes mellitus and cardiovascular diseases. Factors contributing to post-COVID diabetes include age, co-morbidities, pre-diabetic status, pre-existing micro-angiopathic disease burden, stress and direct links to elevated blood levels induced by cytokine storms or hyperinflammation from the diabetogenic virus. In conclusion, this study highlights the potential disruptions in glucose production and metabolism following COVID-19 infection. The recommendation is for individuals who have experienced COVID-19 to undergo rigorous glycemic screening approximately a month post-infection. The findings underscore the importance of monitoring and addressing alterations in glucose homeostasis as part of post-COVID-19 care. Further research and clinical observation are essential to enhance our understanding of the intricate relationship between COVID-19 and glycemic control. The key message emphasizes the comprehensive review of the interplay between SARS-CoV-2 infection and the heightened risk of diabetes, advocating for vigilant post-infection glycemic screening and revealing potential disruptions in glucose metabolism. [ABSTRACT FROM AUTHOR]

Abstract Background Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic. Methods We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics. Results Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent. Conclusions While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices.

Background: Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged as a potential solution. To date, however, there has been little examination of U.S. patient experiences with Long COVID clinics and how patients may or may not have come to access care at a Long COVID clinic. Methods: We conducted semi-structured interviews with 30 U.S. women aged 18 or older who had experienced Long COVID symptoms for at least 3 months, who had not been hospitalized for acute COVID-19, and who had seen at least one medical provider about their symptoms. Participants were asked about experiences seeking medical care for Long COVID. Long COVID clinic-related responses were analyzed using qualitative framework analysis to identify key themes in experiences with Long COVID clinics. Results: Of the 30 women, 43.3% (n = 13) had been seen at a Long COVID clinic or by a provider affiliated with a Long COVID clinic and 30.0% (n = 9) had explored or attempted to see a Long COVID clinic but had not been seen at time of interview. Participants expressed five key themes concerning their experiences with seeking care from Long COVID clinics: (1) Access to clinics remains an issue, (2) Clinics are not a one stop shop, (3) Not all clinic providers have sufficient Long COVID knowledge, (4) Clinics can offer validation and care, and (5) Treatment options are critical and urgent. Conclusions: While the potential for Long COVID clinics is significant, findings indicate that ongoing barriers to care and challenges related to quality and coordination of care hamper that potential and contribute to distress among women seeking Long COVID care. Since Long COVID clinics are uniquely positioned and framed as being the place to go to manage complex symptoms, it is critical to patient wellbeing that they be properly resourced to provide a level of care that complies with emerging best practices. [ABSTRACT FROM AUTHOR]

Background: Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID‐19‐designated hospitals in Bangladesh, a matched case‒control study was conducted on post‐SARS‐CoV‐2 fatigue. Method: In this study, 105 physicians diagnosed with COVID‐19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age‐ and designation‐matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID‐19 infection was confirmed by detection of SARS CoV‐2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. Result: Approximately two‐thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID‐19‐positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of <3. Conclusion: Physicians who had a previous history of COVID‐19 infection had significantly higher total and mean FSS scores, signifying a more severe level of fatigue than physicians who had never been COVID‐19 positive while working in the same hospital irrespective of their age and sex. [ABSTRACT FROM AUTHOR]

Abstract Background Post COVID-19 syndrome is characterized by several cardiorespiratory symptoms but the origin of patients’ reported symptomatology is still unclear. Methods Consecutive post COVID-19 patients were included. Patients underwent full clinical evaluation, symptoms dedicated questionnaires, blood tests, echocardiography, thoracic computer tomography (CT), spirometry including alveolar capillary membrane diffusion (DM) and capillary volume (Vcap) assessment by combined carbon dioxide and nitric oxide lung diffusion (DLCO/DLNO) and cardiopulmonary exercise test. We measured surfactant derive protein B (immature form) as blood marker of alveolar cell function. Results We evaluated 204 consecutive post COVID-19 patients (56.5 ± 14.5 years, 89 females) 171 ± 85 days after the end of acute COVID-19 infection. We measured: forced expiratory volume (FEV1) 99 ± 17%pred, FVC 99 ± 17%pred, DLCO 82 ± 19%, DM 47.6 ± 14.8 mL/min/mmHg, Vcap 59 ± 17 mL, residual parenchymal damage at CT 7.2 ± 3.2% of lung tissue, peakVO2 84 ± 18%pred, VE/VCO2 slope 112 [102–123]%pred. Major reported symptoms were: dyspnea 45% of cases, tiredness 60% and fatigability 77%. Low FEV1, Vcap and high VE/VCO2 slope were associated with persistence of dyspnea. Tiredness was associated with high VE/VCO2 slope and low PeakVO2 and FEV1 while fatigability with high VE/VCO2 slope. SPB was fivefold higher in post COVID-19 than in normal subjects, but not associated to any of the referred symptoms. SPB was negatively associated to Vcap. Conclusions In patients with post COVID-19, cardiorespiratory symptoms are linked to VE/VCO2 slope. In these patients the alveolar cells are dysregulated as shown by the very high SPB. The Vcap is low likely due to post COVID-19 pulmonary endothelial/vasculature damage but DLCO is only minimally impaired being DM preserved.

Objective: The aims of the study are to assess the quality of sleep in recently recovered COVID-19 and long-COVID cases and to determine its associations with fatigue and pain. Methods: Post–COVID-19 cases (n = 201) and controls (n = 206) were assessed using the Pittsburgh Sleep Quality Index questionnaire for sleep quality, Fatigue Severity Scale for fatigue, and Numeric Pain Rating Scale for pain in this observational study. Results: Global Pittsburgh Sleep Quality Index score was higher (P ≤ 0.001) among cases (5.7 ± 5.1; 95% confidence interval, 5.0–6.4) than controls (2.1 ± 2.0; 95% confidence interval, 1.8–2.4). Normal sleep latency was observed in 56 (27.9%) patients and 164 (79.6%) controls (P < 0.001). Fatigue Severity Scale score was higher (P ≤ 0.001) among cases (16.8 ± 10.2; 95% confidence interval, 15.4, 18.2) against controls (10.9 ± 4.1; 95% confidence interval, 10.3–11.4). The Fatigue Severity Scale scores in mild, moderate, and severe COVID-19 were 14.3 ± 8.1, 22.1 ± 10.8, and 22.8 ± 13, respectively (P < 0.001) and higher in the older (20.7 ± 12.1) and middle-aged (19.6 ± 10.3) than in younger (13.9 ± 8.3) (P ≤ 0.001) cases. The global Pittsburgh Sleep Quality Index score was positively correlated with the Fatigue Severity Scale (r = 0.755, P < 0.001) and Numeric Pain Rating Scale scores (r = 0.657, P < 0.001). Numeric Pain Rating Scale score correlated with Fatigue Severity Scale score (r = 0.710, P < 0.001). Fatigue Severity Scale and global Pittsburgh Sleep Quality Index scores were higher in the long-COVID group (P < 0.001). Conclusions: Significantly poor sleep quality was observed in post–COVID-19 individuals including long COVID being positively associated with fatigue and pain. [ABSTRACT FROM AUTHOR]

Background and purpose: Infection with COVID‐19 can lead to persistent sequelae, such as fatigue, daytime sleepiness or disturbed sleep, that can remain for more than 12 weeks and that are summarized as post‐COVID syndrome. The causes remain unclear. The present study investigated the presence of sleep disorders in patients with post‐COVID syndrome using polysomnography. Methods: Thirty‐four patients with post‐COVID syndrome and new‐onset fatigue and sleepiness after a SARS‐CoV2 infection underwent polysomnography in accordance with American Association of Sleep Medicine (AASM) standards as part of their clinical workup. Analysis was performed visually based on AASM criteria (scoring manual version 2.6, 2020). Results: Polysomnography revealed a sleep efficiency of <80% in 50% of patients and a mean respiratory disturbance index (RDI) of 9.9 ± 15.4/h. Excluding central apneas, 12 patients (35%) had an RDI of ≥5/h, pointing to obstructive sleep apnea syndrome (OSAS; AASM 2014). Patients with a high RDI were significantly older (p = 0.01) and showed a trend towards a higher body mass index (p = 0.08) than patients with a normal RDI but had no other risk factors for OSAS. Six patients agreed to long‐term treatment of their OSAS and all reported discontinuation of daytime symptoms. Conclusions: Post‐COVID symptoms such as daytime sleepiness, fatigue and memory and concentration problems may in part be a result of reduced sleep efficiency and sleep apnea in a relevant percentage of patients. This possibly treatable cause of the symptoms should be kept in mind in patients presenting with post‐COVID syndrome. [ABSTRACT FROM AUTHOR]

Background: Post COVID-19 syndrome is characterized by several cardiorespiratory symptoms but the origin of patients’ reported symptomatology is still unclear. Methods: Consecutive post COVID-19 patients were included. Patients underwent full clinical evaluation, symptoms dedicated questionnaires, blood tests, echocardiography, thoracic computer tomography (CT), spirometry including alveolar capillary membrane diffusion (DM) and capillary volume (Vcap) assessment by combined carbon dioxide and nitric oxide lung diffusion (DLCO/DLNO) and cardiopulmonary exercise test. We measured surfactant derive protein B (immature form) as blood marker of alveolar cell function. Results: We evaluated 204 consecutive post COVID-19 patients (56.5 ± 14.5 years, 89 females) 171 ± 85 days after the end of acute COVID-19 infection. We measured: forced expiratory volume (FEV1) 99 ± 17%pred, FVC 99 ± 17%pred, DLCO 82 ± 19%, DM 47.6 ± 14.8 mL/min/mmHg, Vcap 59 ± 17 mL, residual parenchymal damage at CT 7.2 ± 3.2% of lung tissue, peakVO2 84 ± 18%pred, VE/VCO2 slope 112 [102–123]%pred. Major reported symptoms were: dyspnea 45% of cases, tiredness 60% and fatigability 77%. Low FEV1, Vcap and high VE/VCO2 slope were associated with persistence of dyspnea. Tiredness was associated with high VE/VCO2 slope and low PeakVO2 and FEV1 while fatigability with high VE/VCO2 slope. SPB was fivefold higher in post COVID-19 than in normal subjects, but not associated to any of the referred symptoms. SPB was negatively associated to Vcap. Conclusions: In patients with post COVID-19, cardiorespiratory symptoms are linked to VE/VCO2 slope. In these patients the alveolar cells are dysregulated as shown by the very high SPB. The Vcap is low likely due to post COVID-19 pulmonary endothelial/vasculature damage but DLCO is only minimally impaired being DM preserved. [ABSTRACT FROM AUTHOR]

Background: Post COVID-19 syndrome is characterized by several cardiorespiratory symptoms but the origin of patients’ reported symptomatology is still unclear. Methods: Consecutive post COVID-19 patients were included. Patients underwent full clinical evaluation, symptoms dedicated questionnaires, blood tests, echocardiography, thoracic computer tomography (CT), spirometry including alveolar capillary membrane diffusion (DM) and capillary volume (Vcap) assessment by combined carbon dioxide and nitric oxide lung diffusion (DLCO/DLNO) and cardiopulmonary exercise test. We measured surfactant derive protein B (immature form) as blood marker of alveolar cell function. Results: We evaluated 204 consecutive post COVID-19 patients (56.5 ± 14.5 years, 89 females) 171 ± 85 days after the end of acute COVID-19 infection. We measured: forced expiratory volume (FEV1) 99 ± 17%pred, FVC 99 ± 17%pred, DLCO 82 ± 19%, DM 47.6 ± 14.8 mL/min/mmHg, Vcap 59 ± 17 mL, residual parenchymal damage at CT 7.2 ± 3.2% of lung tissue, peakVO2 84 ± 18%pred, VE/VCO2 slope 112 [102–123]%pred. Major reported symptoms were: dyspnea 45% of cases, tiredness 60% and fatigability 77%. Low FEV1, Vcap and high VE/VCO2 slope were associated with persistence of dyspnea. Tiredness was associated with high VE/VCO2 slope and low PeakVO2 and FEV1 while fatigability with high VE/VCO2 slope. SPB was fivefold higher in post COVID-19 than in normal subjects, but not associated to any of the referred symptoms. SPB was negatively associated to Vcap. Conclusions: In patients with post COVID-19, cardiorespiratory symptoms are linked to VE/VCO2 slope. In these patients the alveolar cells are dysregulated as shown by the very high SPB. The Vcap is low likely due to post COVID-19 pulmonary endothelial/vasculature damage but DLCO is only minimally impaired being DM preserved. [ABSTRACT FROM AUTHOR]

Arterial hypertension is one of the most common and significant cardiovascular risk factors. There are many well-known and identified risk factors for its development. In recent times, there has been growing concern about the potential impact of COVID-19 on the cardiovascular system and its relation to arterial hypertension. Various theories have been developed that suggest a connection between COVID-19 and elevated blood pressure. However, the precise link between SARS-CoV-2 infection and the long-term risk of developing hypertension remains insufficiently explored. Therefore, the primary objective of our study was to investigate the influence of COVID-19 infection on blood pressure elevation and the subsequent risk of developing arterial hypertension over an extended period. To accomplish this, we conducted a thorough search review of relevant papers in the PubMed and SCOPUS databases up to 3 September 2023. Our analysis encompassed a total of 30 eligible articles. Out of the 30 papers we reviewed, 19 of them provided substantial evidence showing a heightened risk of developing arterial hypertension following COVID-19 infection. Eight of the studies showed that blood pressure values increased after the infection, while three of the qualified studies did not report any notable impact of COVID-19 on blood pressure levels. The precise mechanism behind the development of hypertension after COVID-19 remains unclear, but it is suggested that endothelial injury and dysfunction of the renin–angiotensin–aldosterone system may be contributory. Additionally, changes in blood pressure following COVID-19 infection could be linked to lifestyle alterations that often occur alongside the illness. Our findings emphasize the pressing requirement for thorough research into the relationship between COVID-19 and hypertension. These insights are essential for the development of effective prevention and management approaches for individuals who have experienced COVID-19 infection. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Coronavirus disease 2019 (COVID-19) can cause hypoxic respiratory failure; long-term oxygen therapy (LTOT) duration is unknown. MATERIAL AND METHODS: The aim was to investigate which patients would need LTOT after COVID-19 pneumonia. This single-center, prospective study was conducted at the Ankara University Faculty of Medicine, Department of Chest Diseases, between May 2021 and December 2021. The 70 patients hospitalized for COVID-19 pneumonia and discharged with LTOT due to hypoxemic respiratory failure were included. Patients were divided into 2 groups as group I (LTOT requirement <3 months) and group II (LTOT requirement continued =3 months). RESULTS: The mean age was 64.4 ± 13.5 years, and 44 (62.9%) of them were male. The most frequently encountered comorbidities were cardiovascular disease (57.1%) and lung disease (22.9%). While PaO2 levels increased in both groups during the follow-up period, this increment was significantly higher in group I (PaO2: 66.6 ± 9.9 mm Hg, P < .001). The factors affecting the LTOT requirement were evaluated using binary logistic regression. On multivariate analyses of lymphocytes, ferritin, C-reactive protein, PaO2, SaO2, subpleural reticulation, and number of lobes affected (=3 lobes), the SaO2 level and presence of subpleural reticulation were significantly different between the 2 groups [odds ratio (OR) (95% CI): 0.853 (0.749-0.971), P = .016] and [OR (95% CI): 0.171 (0.042-0.733), P = .017], respectively. CONCLUSION: A significant proportion of patients who develop respiratory failure due to COVID-19 recover within the first 3 months. Factors determining the LTOT requirement for more than 3 months were SaO2 and the presence of subpleural reticulation. [ABSTRACT FROM AUTHOR]

Background: Tooth carving exercise is fundamental in rendering the dental practitioner capable of identification of deciduous and permanent teeth, recognition and treatment of dental pathology and other rehabilitation procedures. The present study was aimed to determine the perception of the tooth carving exercise in the dental curriculum and its clinical implications amongst dental students (interns and post graduates), dental practitioners, and dental academicians all over India. Material and Methods: The questionnaire consisted of 14 questions related to tooth carving and dental anatomy which was validated by two senior pathologists. The questionnaire was circulated via Google forms and the responses were collected through WhatsApp and emails over a period of 3 months. The Mann-Whitney U test was performed to find out the correlation between different groups Result and Conclusion: The Response Rate of our study was 99.3 %, reflecting the positive attitude of participants towards the tooth carving exercises. According to our survey, majority of the subjects believed that tooth carving on wax blocks is quite valid and effective in future practice. 80% of the students (interns and postgraduates) and 91% of academicians and clinicians believed that tooth carving on wax blocks helped them forge and fortify their knowledge of tooth morphology and thereby identify associated pathologies. The study outcome indicates that carving on wax blocks is essential in terms of acquiring a basic understanding of the morphology of the teeth and its applications in clinical dentistry and thereby, reiterating its necessity to continue in the dental curriculum. [ABSTRACT FROM AUTHOR]

Abstract Background Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID‐19‐designated hospitals in Bangladesh, a matched case‒control study was conducted on post‐SARS‐CoV‐2 fatigue. Method In this study, 105 physicians diagnosed with COVID‐19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age‐ and designation‐matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID‐19 infection was confirmed by detection of SARS CoV‐2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. Result Approximately two‐thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID‐19‐positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of

Long COVID is a condition that develops in a subset of patients after COVID-19 infection comprising of symptoms of varying severity encompassing multiple organ systems. Currently, long COVID is without consensus on a formal definition, identifiable biomarkers, and validated treatment. Long COVID is expected to be a long-term chronic condition for a subset of patients and is associated with suffering and incapacity. There is an urgent need for clear management guidelines for the primary care provider, who is essential in bridging the gap with more specialized care to improve quality of life and functionality in their patients living with long COVID. The purpose of this mini review is to provide primary care providers with the latest highlights from existing literature regarding the most common long COVID symptoms and current management recommendations. This review also highlights the underutilized interventions of stellate ganglion blocks and low-dose naltrexone, both with well-established safety profiles demonstrated to improve quality of life and functionality for patients suffering with some symptoms of long COVID, and encourages prompt referral to interventional pain management.

Abstract Background The infection caused by the SARS-CoV-2 virus has led to the emergence of a novel diagnostic entity known as “post-COVID syndrome” (PCS). It is characterized by a constellation of medical and psychiatric symptoms that occur and persist for variable duration following the COVID infection. Among these post-COVID psychiatric symptoms are depressive and anxiety disorders, which were found to be the highest prevalence in the post-COVID period. The frequency and severity of post-COVID symptoms are correlated with the severity of the infection. Many inflammatory and coagulation markers have been involved in the severity of post-COVID symptoms and hence the development of post-COVID psychiatric symptoms/disorders. Limited research has been conducted to examine the psychological challenges experienced by individuals in the early stages of post-COVID recovery in Egypt, specifically within a timeframe of 1 to 3 months. The current study aims to estimate the occurrence rate of early post-COVID psychiatric symptoms/disorders such as depression and anxiety and to detect its association with clinical and severity parameters of COVID-19 infection. Methods The current study was a comparative cross-sectional approach, from the chest department’s “post-COVID-19 follow-up” outpatient clinic at Kobri ElKoba Medical Complex in Cairo, Egypt. A convenient sample of adult Egyptian patients were recruited between October 2021 and June 2022. They were subjected to the following: a pre-designed questionnaire to collect the patients’ demographic characteristics, Arabic version of General Health Questionnaire (GHQ) to identify potential cases, Arabic version of Structured Clinical Interview for DSM-IV (SCID I) Clinician Version (SCID-CV) and retrieval of essential related clinical and laboratory data like C-reactive protein (CRP), systemic immune-inflammation index (SII): (neutrophils × platelets)/lymphocytes), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), and D-dimer and COVID-19 treatment lines together with a liker scale questionnaire to assess the severity of COVID-19 infection. Results Depression was found to be the most prevalent psychiatric disorder (45.6%) among the study participants, followed by generalized anxiety disorder (42.1%). Subthreshold GAD and depression were found in 17.5% and 14% of patients respectively. COVID was a major predictor of GAD (p 0.000), while being on antibiotics (p = 0.033), having cardiac illnesses (p = 0.007), and an increased D dimer (p = 0.022) were the most predictive factors for depression. Conclusion COVID-19 infection has demonstrated an increased risk of mental health problems in multiple domains. It was evident that depression was the most presenting psychiatric illness among the studied sample (45.6%), while generalized anxiety disorder was the second most prevalent disorder (42.1%). And suicide was found in 9.6% of the study sample. It is worth noting that our results displayed a high prevalence of subthreshold psychiatric symptoms. These findings emphasize the utmost need for mental health assessments for all survivors.

Background: The infection caused by the SARS-CoV-2 virus has led to the emergence of a novel diagnostic entity known as "post-COVID syndrome" (PCS). It is characterized by a constellation of medical and psychiatric symptoms that occur and persist for variable duration following the COVID infection. Among these post-COVID psychiatric symptoms are depressive and anxiety disorders, which were found to be the highest prevalence in the post-COVID period. The frequency and severity of post-COVID symptoms are correlated with the severity of the infection. Many inflammatory and coagulation markers have been involved in the severity of post-COVID symptoms and hence the development of post-COVID psychiatric symptoms/disorders. Limited research has been conducted to examine the psychological challenges experienced by individuals in the early stages of post-COVID recovery in Egypt, specifically within a timeframe of 1 to 3 months. The current study aims to estimate the occurrence rate of early post-COVID psychiatric symptoms/disorders such as depression and anxiety and to detect its association with clinical and severity parameters of COVID-19 infection. Methods: The current study was a comparative cross-sectional approach, from the chest department's "post-COVID-19 follow-up" outpatient clinic at Kobri ElKoba Medical Complex in Cairo, Egypt. A convenient sample of adult Egyptian patients were recruited between October 2021 and June 2022. They were subjected to the following: a pre-designed questionnaire to collect the patients' demographic characteristics, Arabic version of General Health Questionnaire (GHQ) to identify potential cases, Arabic version of Structured Clinical Interview for DSM-IV (SCID I) Clinician Version (SCID-CV) and retrieval of essential related clinical and laboratory data like C-reactive protein (CRP), systemic immune-inflammation index (SII): (neutrophils × platelets)/lymphocytes), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), and D-dimer and COVID-19 treatment lines together with a liker scale questionnaire to assess the severity of COVID-19 infection. Results: Depression was found to be the most prevalent psychiatric disorder (45.6%) among the study participants, followed by generalized anxiety disorder (42.1%). Subthreshold GAD and depression were found in 17.5% and 14% of patients respectively. COVID was a major predictor of GAD (p 0.000), while being on antibiotics (p = 0.033), having cardiac illnesses (p = 0.007), and an increased D dimer (p = 0.022) were the most predictive factors for depression. Conclusion: COVID-19 infection has demonstrated an increased risk of mental health problems in multiple domains. It was evident that depression was the most presenting psychiatric illness among the studied sample (45.6%), while generalized anxiety disorder was the second most prevalent disorder (42.1%). And suicide was found in 9.6% of the study sample. It is worth noting that our results displayed a high prevalence of subthreshold psychiatric symptoms. These findings emphasize the utmost need for mental health assessments for all survivors. [ABSTRACT FROM AUTHOR]

Background COVID-19 patients have encountered either central or peripheral nervous system affliction. However, there was no connection discovered between the COVID-19 very severe variant and neurological system disease, particularly neuropathy. Abnormalities in the biochemical markers of sepsis, neuroinflammation, and cytokine storm may be used to explain nervous system affection in COVID-19. Aim of the work This research aims to evaluate the relationship between the biochemical and radiological severity of COVID-19 and the peripheral neuropathy experienced by some COVID-19 patients. Patient and methods A comparative cross-sectional study was carried out on a sample of 175 adult patients who had positive COVID-19 PCR results. Patients were selected from records of those who have previously visited Ain Shams University hospitals with documented COVID-19 affection in the past two years (2020 and 2021). All patients underwent to baseline evaluations that include a complete medical history, a neurological examination, laboratory investigation, and a chest CT scan while being treated for acute COVID-19. Then nerve conduction study done for all patient have the inclusion criteria. Result Eighty-seven patients (50%) were female and 87 patients (50%) were male,with age range from 17 to 75 years (42.95 ± 12.12). The patient were divided to 4 groups according to COVID-19 affection, asymptomatic group 29 patient with 14 (48.3%) female and 15 (51.7%) male with age range from 20 to 63 year (43.1 ± 12.05), 49 patient mild COVID-19 with 30 (61.2%) female and 19 (38.8%) male with age 21–64 year (42.53 ± 11.31), 59 moderate COVID-19 with 26 female (44.1%) and 33 (55.9%) male with age range 23–75 year (44.51 ± 12.51), 37 severe COVID-19 with 17 female (45.9%), and 20 male (54.1%) with age 17–69 year (40.59 ± 12.71). There was no significant statistical difference between all groups regarding age (P value 0.492) and sex (P value 0.311) Regarding axonal peripheral neuropathy, there was 29 patient (100%) for asymptomatic group, 49 (100%) for the mild group, 55 (93.2%) for moderate group and 34 (91.9%) for the severe group having negative study and 0 (0%) for asymptomatic group, 0 (0%) for mild group, 4 (6.8%) for moderate group and 3 (8.1%) for severe groups having positive affection for axonal peripheral neuropathy with nonsignificant statistical difference between all groups(P value 0.110). For peripheral neuropathy there was 28 (96.6%) for asymptomatic group,44(89.8%) mild group, 50 (84.7%) moderate group and 26 (70.3%) severe group having negative study for peripheral neuropathy and 1 (3.4%) for asymptomatic group,5 (10.2%) mild group, 9 (15.3%) moderate group and 11 (29.7%) severe group having positive study for peripheral neuropathy with significant statistical difference between all groups(P value 0.017). Conclusion In our study, the peripheral neuropathy affection following COVID-19 infection was not statistically significant, with peripheral neuropathy being more prevalent than axonal peripheral neuropathy, borderline demyelinating LL, UL sensory motor being more frequent, and peripheral nerve affection being more prevalent in cases with a history of moderate and severe COVID-19 affection. [ABSTRACT FROM AUTHOR]

Fatigue in children and young people is common yet often under-recognised and sub-optimally managed. It is a major contributor to school absenteeism and frequently causes a decline in the mental and physical health of the sufferer if not managed appropriately. Fatigue is present in a many medical conditions but is frequently associated with a diagnosis of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and more recently, Post COVID Syndrome, commonly known as Long COVID. Regardless of the cause of fatigue, the principles in management are the same. A multidisciplinary team (MDT) approach is recommended and input from healthcare professionals such as occupational therapists, physiotherapists and psychologists is valuable but access to such professionals varies across different Clinical Commissioning Groups. Although an MDT approach is advised, simply understanding the key principles of activity management empowers the young person and their families to make lifestyle changes that enable energy levels to be optimised whilst avoiding the phenomenon of "boom and bust" where over-exertion is followed by extreme exhaustion. This review article provides a framework on how to investigate fatigue and subsequently support young people and their families with their symptoms with the aim of enhancing quality of life and improving access to education. [ABSTRACT FROM AUTHOR]

Abstract Background Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected. Methods The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time. Results Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected. Conclusion Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health.

Romana Ulbrichtova,1 Peter Vysehradsky,1 Alica Bencova,2 Maria Tatarkova,1 Oto Osina,3 Viera Svihrova,1 Henrieta Hudeckova1 1Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, 036 01, Slovakia; 2Outpatient Clinic of Pneumology, Senium Medica, Martin, 036 01, Slovakia; 3Clinic of Occupational Medicine and Toxicology, Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, 036 59, SlovakiaCorrespondence: Romana Ulbrichtova, Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Mala Hora 11149/4B, Martin, 036 01, Slovakia, Tel +421904450571, Email romana.ulbrichtova@uniba.skPurpose: The aim of our study was to validate a Slovakian translation of the PAC‑19QoL instrument among Slovakian patients with post COVID-19 syndrome.Patients and Methods: The PAC-19QoL instrument was translated into the Slovakian language and administrated to patients with post COVID-19 syndrome. Cronbach’s alpha coefficient was used to analyse the internal consistency of the instrument. Construction validity was evaluated by using Pearson’s correlation coefficient and Spearman’s rank correlation. Scores of patients and controls were compared using Mann–Whitney U-test.Results: Forty-five asymptomatic and forty-one symptomatic participants were included. Forty-one patients with post COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach alpha greater than 0.7. There was a significant correlation between all domains on the test (p < 0.001), with the highest correlation of Total (r = 0.994) and Domain 1 (r = 0.991). Spearman’s rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings.Conclusion: The Slovakian version of the instrument is valid, reliable and can be a suitable tool for research and daily clinical practice among patients with post COVID-19 syndrome.Keywords: PAC-19QoL, EQ-5D-5L, validation, post COVID, quality of live

An increasing number of patients experiences prolonged symptoms, whose profile and timeline remain uncertain, a condition that has been defined as post COVID. The majority of recovered hospitalized patients manifests at least one persistent symptom even sixty days after the first clinical manifestation's onset. Particularly, in light of the COVID-19-related symptomatology, it has been hypothesized that SARS-CoV-2 might affect the dopamine pathway. However, no scientific evidence has been produced so far.To this end, human iPSC-derived dopaminergic neurons were infected with EU, Delta and Omicron SARS-CoV-2 variants. The infection with EU and Delta variants, but not with Omicron, results in a reduced intracellular content and extracellular release of dopamine. Indeed, the tyrosine hydroxylase was found to be significantly upregulated at the mRNA level, while being greatly reduced at the protein level. The major downstream synthetic enzyme DOPA-decarboxylase and the dopamine transporter were significantly downregulated both at the mRNA and protein level. Notably, in vitro SARS-CoV-2 infection was also associated with an altered MAP2 and TAU expression and with an increased presence of neuronal stress markers.These preliminary observations suggest that the dopamine metabolism and production are affected by SARS-CoV-2, partially explaining some of the neurological symptoms manifested.

AbstractBackground Fear of coronavirus disease (COVID-19) has been associated with significant health effects.Objectives To assess COVID-19 fear and investigate factors associated with higher fear among COVID-19 survivors over 6 months after infection.Methods Cross-sectional study using multistage sampling (family practices within the highest 5th percentile of numbers of SARS-CoV-2 infected patients and random sample of patients within these practices) performed from March 15 to 17 July 2021. Adult patients with a laboratory-confirmed history of COVID-19 were recruited for a self-administered 79-item questionnaire including demographics, self-rated health, physical activity, COVID-19 characteristics, severity and the fear of COVID-19 Scale (FCV-19S). Comorbidity data were extracted from Estonian Health Insurance Fund. Logistic regression models were used to evaluate factors associated with COVID-19 fear.Results Of 341 participants included, 60% were women, 24.2% were hospitalised due to COVID-19 and 22.2% had long COVID, 143 (42%) participants reported high levels of fear (cut-off FCV-19S >17.8). Higher fear was associated with being female (aOR 2.12, 95% CI 1.14–3.95), age ≥61 years (aOR 3.23, 95% CI 1.28–8.16), two-member-households (aOR 3.70, 95% CI 1.40–9.77) physical inactivity 6 months prior to COVID-19 (aOR 3.53, 95% CI 1.26–9.95), and symptom severity during acute COVID-19. Long COVID was not associated with higher COVID-19 fear (aOR 1.82 95% CI 0.91–3.63).Conclusion Almost half of participants reported COVID-19 fear more than 6 months after infection. Greater fear was associated with sociodemographic factors, physical activity prior to COVID-19 and COVID-19 symptom severity. There is a need to target this population to develop appropriate interventions.

Objectives: The purpose of this research was to look at the amount of fatigue and physical activity (PA) in individuals after COVID-19 in Poland and the correlation between fatigue and PA. Methods: The online research was carried out among adult Polish residents (122 women and 82 men) who had tested positive for SARS-CoV-2 during the previous year. The level of fatigue was measured using the Modified Fatigue Impact Scale (MFIS). The PA level was assessed using the International Physical Activity Questionnaire (IPAQ). Results: A total of 46.6% of the subjects had been ill with COVID-19 for more than 6 months before the time of the survey response. The MFIS total measure is 77 of the maximum score, and the median is 17. A total of 26% of respondents reported low activity, while 41% of respondents reported high activity. A statistically significant negative relationship was found between PA level and total fatigue score. The best scores for fatigue and PA were obtained by the subjects with mild COVID-19. The time since diagnosis (as opposed to older age and female sex) was not clearly associated with most measures. Conclusions: PA may play an important role in regulating the severity of fatigue; it should be increased, especially in patients after COVID. Further studies are also needed to investigate the mechanism of differences in fatigue and PA. [ABSTRACT FROM AUTHOR]

Background: Isolated frontal sinus involvement in mucormycosis is seen very infrequently. Recent technological advances including image guided navigation and angled endoscopes have shifted paradigm towards minimally invasive surgeries. Open approaches are still relevant for the disease of frontal sinus with lateral extension where effective clearance cannot be obtained if approached endoscopically. Objectives: The objective of this study was to describe the presentation and management of patients of mucormycosis with isolated frontal sinus involvement with help of external approaches. Materials and methods: The available records of the patients were retrieved and analysed. The literature, the associated contributory clinical features and management techniques were reviewed. Results: 4 patients presented with isolated frontal sinus mucor involvement. 3 out of 4 patients had history of diabetes mellitus (75%). All patients had history of covid-19 infection (100%). 3 out of 4 patients had unilateral frontal sinus involvement and were operated by Lynch Howarth approach. Mean age of presentation was 46 years with male predominance. Bicoronal approach was used in one case with bilateral involvement. Conclusion: Although conservative endoscopic surgeries are preferred nowadays for frontal sinus clearance but the extensive bony destruction with lateral extension in our series of patients with isolated frontal sinus mucormycosis warranted the need for open procedures. [ABSTRACT FROM AUTHOR]

The year 2020 was marked by the beginning of the Covid-19 virus pandemic, which manifested its effect at the global level and stopped the affirmative processes of every single country. The consequences of the virus affected the economy, everyday life, the work of institutions, the availability of various goods and services. The Covid-19 pandemic has caused significant changes in the landscape of labor law, which require adaptation in order to protect the rights of employees and respond to new challenges in the world, in the form of appropriate adaptations and needs of workers and employers. This paper includes changes in the field of employment, as well as the psychological characteristics of people and the way they behave after the Covid-19 virus. The author gives an interpretation using the method of observation and comparative analysis and tries to answer the problematic question: "Did the pandemic of the Covid-19 virus affect changes in the labor market and to what extent?" Every social segment is affected, especially the field of jobs, where the previous economic success largely suffers adverse consequences. The focus that is pursued in the pandemic but also in the post-pandemic time is precisely empathy and human solidarity, especially in social and economic terms. Through empirical research, the paper aims to present the devastating character of the Covid-19 virus on the labor market in the Republic of Serbia, as well as the emerging trends consequently caused by the aforementioned virus. [ABSTRACT FROM AUTHOR]

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Background: Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected. Methods: The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time. Results: Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected. Conclusion: Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health. [ABSTRACT FROM AUTHOR]

This study examines the relationship between organizational culture and employee performance in the post-Covid-19 era, with a focus on determining whether employee engagement mediates in the model. The research aims to understand the impact of the pandemic on organizational culture and employee performance, and the role that employee engagement plays in this relationship. Data were collected through surveys and analyzed using statistical techniques to identify patterns and relationships. Data was analyzed using the Smart PLS software version 3.0. The findings of this study will provide insights for organizations on how to effectively manage their culture and performance in the post-Covid-19 era. Furthermore, this research will contribute to the existing literature on the topic by exploring the post-Covid-19 context and the potential mediating role of employee engagement. Overall, the study aims to provide practical recommendations for organizations on how to create a positive culture and enhance employee performance in the post-Covid-19 era. [ABSTRACT FROM AUTHOR]

This study assesses the spiritual's post-covid Asnaf entrepreneur's toward zakat on business. It indicated the new insight of Asnaf entrepreneur's spirituality after covid. After participating in the AEP, Asnaf became the zakat payer and directly will be give the positive effect to zakat collection. However, many small businesses, especially business from Asnaf entrepreneurs are financially fragile because of Covid-19 challenges. To meet the challenges posed by the Covid-19, the Asnaf entrepreneurs had to react in agile and decisive ways by relating the spirituality toward business and able to maintain as the zakat payer soon. This involves conducting an after-action review in spiritual by lessons learned from the pandemic and enhance the business value. Therefore, in this paper, we explore the Spiritual's Asnaf entrepreneurs toward zakat on business after facing the Covid-19. The analysis was performed to examine the reliability and validity of the measurement, and the structural equation modelling techniques (SEM). Spiritual among Asnaf entrepreneur's toward zakat on business after Covid-19. Hence, the study provides an insight to zakat institution that the Covid-19 seek out the opportunities emerging in the recovery and stability return by move to digitalization business. [ABSTRACT FROM AUTHOR]

Background: Few studies have assessed the differences of patterns of Long COVID (L-COVID) with regards to the pathogenetic SARS-CoV-2 strains. Objectives: To investigate the relationship between demographic and clinical characteristics of acute phase of infection and the persistence of L-COVID symptoms and clinical presentation across different SARS-CoV-2 strains. Methods: In this observational-multicenter study we recorded all demographic and clinical characteristics, severity of infection, presence/persistence of symptoms of fatigue, dyspnoea and altered quality of life (QoL) at baseline and after 6 months, in a sample of Italian patients from Liguria between March 2020 and March 2022. Results: 308 patients (mean age 63.2 years; 55.5% men) with previous COVID were enrolled. Obese patients were 21.2% with a significant difference in obesity prevalence across the second and third wave (p = 0.012). Treatment strategies differed between waves (p < 0.001): more patients required invasive mechanical ventilation in the first wave, more patients were treated with high-flow nasal cannula/non-invasive ventilation in the in the second and more patients were treated with oxygen-therapy in the fourth wave. At baseline, a high proportion of patients were symptomatic (dyspnoea and fatigue), with impairment in some QoL indicators. A higher prevalence of patients with pain, were seen in the first wave compared to later infections (p = 0.01). At follow-up, we observed improvement of dyspnoea, fatigue and some dimensions of QoL scale evaluation such as mobility, usual activities, pain evaluations; instead there was no improvement in remaining QoL scale indicators (usual care and anxiety-depression). Conclusions: There were no significant differences in the prevalence of the most frequent L-COVID symptoms, except for QoL pain domain that was especially associated with classical variant. Our results show substantial impact on social and professional life and usual care activities. These findings highlight the importance of multidisciplinary post COVID follow-up care including mental health support and rehabilitation program. [ABSTRACT FROM AUTHOR]

Background: With the sudden rise in Corona cases over a short period of 5 to 6 months all around the globe, governments had to impose lockdowns to reduce the spread of virus but nobody was sure about how long this will continue. The solution was the formation of vaccine on which scientists started working quickly. Within a year different vaccines came in the market to use in humans on emergency basis. But as the time was short to properly evaluate the efficacy and side effects of these vaccines, public started having some undesirable effects after vaccination along with the immunity against virus. A few studies in this regard have highlighted some issues with the administration of different vaccines. Objective: The aim of our study conducted on students and faculty of Ayub Medical College (AMC) was to determine the frequency and intensity of undesirable effects after vaccination. Methodology: It was a descriptive cross-sectional study conducted on 113 students from 1st March 2021 to 31st October 2021. Study population was undergraduate students and faculty of AMC, Abbottabad who are partially or fully vaccinated against Covid-19. A structured questionnaire was developed for data collection after reviewing of literature. After taking informed consent students were approached in lecture halls and hostels and faculty members were approached in their offices for recording the answers to questions. Data was recorded on a proforma and was analyzed by using statistical package for social sciences. Results: In this study the participants belonged to the age group 18-59 years and mean age was 23.15±5.6years among the students and faculty of AMC. Out of the total 113 participants 85(75.2%) were males and 28(24.8%) females. Out of 85 male participants, 52 (61.17%) experienced undesirable effects after vaccination and 33(38.82%) didn't have any of these effects. Out of 28 female participants, 12(42.85%) felt undesirable effects after vaccination while 16(57.14%) didn't face any effects. The most common undesirable effect faced by the majority of the participants 46(22.7%) was fatigue. No significant association of undesirable effects was found with socio-demographic or other factors in the research. Conclusion: The analysis showed that majority of the participants experienced undesirable effects after getting either first or second dose of Covid vaccination which mostly resolved in a day or two without use of any medication. There is still need to work on the vaccines to minimize their undesirable effects. [ABSTRACT FROM AUTHOR]

Background COVID-19 patients have encountered either central or peripheral nervous system affliction. However, there was no connection discovered between the COVID-19 very severe variant and neurological system disease, particularly neuropathy. Abnormalities in the biochemical markers of sepsis, neuroinflammation, and cytokine storm may be used to explain nervous system affection in COVID-19. Aim of the work This research aims to evaluate the relationship between the biochemical and radiological severity of COVID-19 and the peripheral neuropathy experienced by some COVID-19 patients. Patient and methods A comparative cross-sectional study was carried out on a sample of 175 adult patients who had positive COVID-19 PCR results. Patients were selected from records of those who have previously visited Ain Shams University hospitals with documented COVID-19 affection in the past two years (2020 and 2021). All patients underwent to baseline evaluations that include a complete medical history, a neurological examination, laboratory investigation, and a chest CT scan while being treated for acute COVID-19. Then nerve conduction study done for all patient have the inclusion criteria. Result Eighty-seven patients (50%) were female and 87 patients (50%) were male,with age range from 17 to 75 years (42.95 ± 12.12). The patient were divided to 4 groups according to COVID-19 affection, asymptomatic group 29 patient with 14 (48.3%) female and 15 (51.7%) male with age range from 20 to 63 year (43.1 ± 12.05), 49 patient mild COVID-19 with 30 (61.2%) female and 19 (38.8%) male with age 21–64 year (42.53 ± 11.31), 59 moderate COVID-19 with 26 female (44.1%) and 33 (55.9%) male with age range 23–75 year (44.51 ± 12.51), 37 severe COVID-19 with 17 female (45.9%), and 20 male (54.1%) with age 17–69 year (40.59 ± 12.71). There was no significant statistical difference between all groups regarding age (P value 0.492) and sex (P value 0.311) Regarding axonal peripheral neuropathy, there was 29 patient (100%) for asymptomatic group, 49 (100%) for the mild group, 55 (93.2%) for moderate group and 34 (91.9%) for the severe group having negative study and 0 (0%) for asymptomatic group, 0 (0%) for mild group, 4 (6.8%) for moderate group and 3 (8.1%) for severe groups having positive affection for axonal peripheral neuropathy with nonsignificant statistical difference between all groups(P value 0.110). For peripheral neuropathy there was 28 (96.6%) for asymptomatic group,44(89.8%) mild group, 50 (84.7%) moderate group and 26 (70.3%) severe group having negative study for peripheral neuropathy and 1 (3.4%) for asymptomatic group,5 (10.2%) mild group, 9 (15.3%) moderate group and 11 (29.7%) severe group having positive study for peripheral neuropathy with significant statistical difference between all groups(P value 0.017). Conclusion In our study, the peripheral neuropathy affection following COVID-19 infection was not statistically significant, with peripheral neuropathy being more prevalent than axonal peripheral neuropathy, borderline demyelinating LL, UL sensory motor being more frequent, and peripheral nerve affection being more prevalent in cases with a history of moderate and severe COVID-19 affection.

Background: One of the most dreaded complications of COVID pneumonia is post-COVID residual lung fibrosis and lung function impairment. Objectives: To find out the extent and type of pulmonary function abnormality using spirometry, diffusion capacity, and 6-minute walk test and to co-relate with the clinical severity at the time of infection, in patients who have recovered from COVID19 pneumonia, in a tertiary care hospital in India. Materials and Methods: This is a prospective, cross-sectional study with a total 100 patients. Patients who have recovered from COVID pneumonia after one month of onset of symptoms and before 3 months who come for follow-up and have respiratory complaints undergo pulmonary function test will be recruited in the study. Results: In our study, the most common lung function abnormality detected was restrictive pattern in 55% of the patients (N = 55) followed by mixed pattern in 9% of patients (N = 9), obstructive in 5% of patients (N = 5), and normal in 31% of patients (N = 31). In our study, total lung capacity was reduced in 62% of the patients and normal in 38% of the patients and diffusion capacity of lung was reduced in 52% of the patients recovered from 52% of the individuals. Also, a 6-minute walk test was reduced in 15% of the patients and normal in 85% of the patients. Conclusion: Pulmonary function test can serve as an important tool in both diagnosis and follow-up of post-COVID lung fibrosis and pulmonary sequalae.

Aim: The study aims to determine persistent symptoms and effects of COVID-19 infection on the quality of life (QOL) at 1 and 3 months after the acute phase of the disease in mild, moderate and severe cases. Methods: The prospective observational study was conducted among patients with confirmed COVID-19 who had been treated and discharged after hospitalization from February 2021 to June 2021. All patients were interviewed at 1 and 3 months post discharge to assess persisting symptoms and health-related QOL. QOL was assessed using European Quality Of Life 5-Dimensions 3-Levels (EQ-5D-3L) and EuroQol-visual analogue scales (EQ-VAS). Results: In total, 388 out of 479 discharged following COVID-19 infection were included. The median age of patients was 48 years, with 62.6% male predominance. Most of the COVID-19 cases were mild (67.01%). Most common presenting symptom was fever (69.8%). EQ-5D-3L showed that the problems reported at 3-month follow-up were significantly less when compared to 1-month follow-up (p < 0.001), and QOL significantly improved after 3 months in non-intensive care unit (ICU) patients when compared to ICU patients (p = 0.007). The mean EQ-VAS score significantly improved at 3 months when compared to 1 month (80.34 ± 12.77 vs. 91.69 ± 12.34; P < 0.001). The severity of illness was correlated with QOL (p < 0.007). Conclusion: The study results demonstrate ongoing improvement in the QOL and persistent symptoms, while a minority still were symptomatic after 3 months post-COVID-19 illness.

To evaluate the Quality of Life in Mucormycosis patients in our hospital using a new MQOL36 questionnaire post discharge. 37 cases between Apr 2021 to July 2021 were included in the study with a minimum follow up period of 4 weeks. They were administered Mucormycosis quality-of-life questionnaire (MQOL-36) either in person or via telephonic interview and answers were recorded into digital questionnaire modulated by us using a digital data recording app—KoBoCollect. Their demographic, clinical, imaging, histopathological and treatment data was retrieved and analysed. Most of the patients reported their health to be good with only 1 patient who had extensive cranial involvement reporting as poor and still undergoing repeated surgeries. 46.67% had no nasal complaints, 20% had nasal obstruction, 13.33% had nasal discharge with 2 patients complaining of crusting and 1 of whistling sound at quiet respiration. Most worrying factor was financial condition with 33.33% patients financially distraught and 43.33% being affected but barely managing at present. Only 2 patients reported no economic impact. Mucormycosis in COVID-19 has changed the face of otorhinolaryngology as we know it—while treating the disease is important, treating the post operative aftermath also becomes equally important. The MQOL-36 produces a quality-of-life profile scoring an individual's perception of quality of life in the following domains: Physical, Psychological, Level of Independence, Social Relationships and Environment. Monitoring the quality of life in patients post discharge could help us manage the enormous morbidity associated with the disease. [ABSTRACT FROM AUTHOR]

Background: One of the most dreaded complications of COVID pneumonia is post‑COVID residual lung fibrosis and lung function impairment. Objectives: To find out the extent and type of pulmonary function abnormality using spirometry, diffusion capacity, and 6‑minute walk test and to co‑relate with the clinical severity at the time of infection, in patients who have recovered from COVID19 pneumonia, in a tertiary care hospital in India. Materials and Methods: This is a prospective, cross‑sectional study with a total 100 patients. Patients who have recovered from COVID pneumonia after one month of onset of symptoms and before 3 months who come for follow‑up and have respiratory complaints undergo pulmonary function test will be recruited in the study. Results: In our study, the most common lung function abnormality detected was restrictive pattern in 55% of the patients (N = 55) followed by mixed pattern in 9% of patients (N = 9), obstructive in 5% of patients (N = 5), and normal in 31% of patients (N = 31). In our study, total lung capacity was reduced in 62% of the patients and normal in 38% of the patients and diffusion capacity of lung was reduced in 52% of the patients recovered from 52% of the individuals. Also, a 6‑minute walk test was reduced in 15% of the patients and normal in 85% of the patients. Conclusion: Pulmonary function test can serve as an important tool in both diagnosis and follow‑up of post‑COVID lung fibrosis and pulmonary sequalae. [ABSTRACT FROM AUTHOR]

Rhino-Orbital cerebral Mucormycosis (ROCM) an angioinvasive fungal infection commonly seen in diabetic and immunocompromised patients. In recent days, due to COVID 19 pandemic mucormycosis has been significantly increased (Smith et al. in Radiol Cardiothorac Imaging 2(5):e200280, 2020). In this study we evaluate the involvement, clinical features, contributing risk factors and outcome of post covid Rhino orbital cerebral mucormycosis. A cross sectional descriptive study was conducted on post covid rhino orbital cerebral mucormycosis patients from May 2021 to October 2021 in Otorhinolaryngology department of Stanley Medical college Chennai. We collected detailed history of Covid-19 hospital stay, treatment taken, co morbidities, Endoscopic findings, management and outcome. 243 cases analysed with median age 51 years (range 28–75 years) and male predominance with M:F ratio 1.6. The median time interval between covid and ROCM was 20 (15–35) days. Based on involvement 111 (46%) Stage-II, 87 (36%) Stage-I, 37 (15%) stage III and 8 (3%) stage IV disease observed. with overall mortality of 5.7%. Among which 230 (94.6%) patients had diabetes mellitus, 111 (45.8%) patients received steroid and 134 (54.3%) had immunomodulators during covid management. Despite of surgical debridement and antifungal therapy 14 (5.8%) patients died from mucormycosis. we conclude that covid be the predisposing factor for mucormycosis especially in patients with diabetes and increased usage of steroids. Treatment needs multimodality approach with antifungals and surgical debridement with surveillance fir good outcome. [ABSTRACT FROM AUTHOR]

Understanding what learning style preferences exist in international business classrooms is important for the overall design of learning objectives and learning outcomes in business education. This is especially important as 94% of the global learner population moved online in the wake of the COVID-19 pandemic, including the majority of business learners. The study used the Felder-Silverman Model of learning styles to investigate business learners in a hospitality discipline in the United States (n = 365) and in Singapore (n = 154). Findings revealed that two learning styles of business learners were significantly different between the two data sets. The results of this study contribute to the understanding of learning preferences of business students and how learning styles across these two cultures may assist instructors in the overall design of their international business classes. [ABSTRACT FROM AUTHOR]