A Review of Coronavirus Disease-2019 (COVID-19)

A detailed examination of coronavirus disease 2019 (COVID-19): Covering past and future perspectives

The COVID-19 disease has spread rapidly across the world within just six months, affecting 169 million people and causing 3.5 million deaths globally (2021). The most affected countries include the USA, Brazil, India, and several European countries such as the UK and Russia. Healthcare professionals face new challenges in finding better ways to manage patients and save lives. In this regard, more comprehensive research is needed, including genomic and proteomic studies, personalized medicines and the design of suitable treatments. However, finding novel molecular entities (NME) using a standard or de novo strategy to drug development is a time-consuming and costly process. Another alternate strategy is discovering new therapeutic uses for old/existing/available medications, known as drug repurposing. There are a variety of computational repurposing methodologies, and some of them have been used to counter the coronavirus disease pandemic of 2019 (COVID-19). This review article compiles recently published data on the origin, transmission, pathogenesis, diagnosis, and management of the coronavirus by drug repurposing and vaccine development approach. We have attempted to screen probable drugs in clinical trials by using literature survey. This systematic review aims to create priorities for future research of drugs repurposed and vaccine development for COVID-19.

Experiences of critical care nurses infected with COVID-19 in a Saudi Academic Hospital

BACKGROUND

 Coronavirus disease 2019 (COVID-19) has severely impacted nursing services, with thousands of ICU nurses infected with potentially fatal respiratory infections. Saudi Arabian studies suggest psychological implications, with loneliness and social isolation linked to higher depression and anxiety levels. Pandemic preparedness should focus on workforce protection and mental well-being promotion.

OBJECTIVES

 This study aimed to understand the experiences of critical care nurses in Saudi Arabia who contracted COVID-19, with the goal of formulating recommendations to empower them, increase resilience, and help the profession thrive post-pandemic.

METHOD

 This study used an exploratory, descriptive, and contextual approach, conducting unstructured interviews with 11 Critical Care Unit (CCU) Registered Nurse (RN) who contracted COVID-19, and analysing the data using Colaizzi's seven-step method.

RESULTS

 Three themes emerged from the data: (1) physical isolation led to loneliness and psychological separation, lacking emotional support and freedom of choice; (2) reintegration into the work environment increased stress and loneliness and (3) Coronavirus disease 2019 exposure provided essential insight into patient care and increased awareness of adaptive skills. These themes highlight the challenges participants faced during the pandemic.

CONCLUSION

 This research study indicated the experiences of ICU nurses who contracted COVID-19, revealing feelings of loneliness, depression and stress. Despite reintegration into their work environment, these feelings persist.Contribution: The study indicates that nurses in social isolation or quarantine also require open communication, social interaction, personal autonomy and emotional support to boost their resilience and mental health, and to increase their job satisfaction.

A multilevel analysis of basic water availability in Ethiopia using 2016 demographic health survey

Drinking water is one of life's most basic need, and people all around the developing world confront irregular water supplies. Still, more than one billion people globally do not have secure water supply and these leads to increasing the risk of death and incurring large costs in the prevention of water-borne diseases. There are limited knowledge on actual water availability in Ethiopia. Therefore, this study was aimed determining basic water availability and its associated factors in Ethiopia. This research used 2016 Ethiopian demographic health survey data. Because of the hierarchical and clustering nature of the data, a mixed effect multilevel logistic regression model was used. In this study, the prevalence of basic drinking water availability in Ethiopia is 51.16% (95% CI 50.04-52.27%). Based on the analysis result, the household head age between 46 and 65 [AOR = 4.08, 95% CI 1.64-10.17], household heads having middle-income level (AOR = 1.22, 95% CI 1.00-1.50), being rural communities [AOR = 4.32, 95% CI 3.07-9.57] and large central regions (AOR = 2.08, 95% CI 1.17-3.68) were significant factors. The magnitude of basic drinking water availability among households in Ethiopia is low. Exploring alternative water sources is important to reduce water interruptions.

Respiratory virus circulation during pandemic: Why were some viruses still circulating?

A few months after the beginning of the coronavirus disease 2019 (COVID-19) pandemic in March 2020, several non-pharmacological measures were adopted worldwide, with varying degrees of strictness, to contain the transmission of the virus and mitigate its impacts. These measures, in addition to effectively reducing the circulation of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), these measures also appeared to impact the circulation of other respiratory viruses. Therefore, this study aims to discuss the most relevant data available regarding the circulation of the major respiratory viruses during the COVID-19 pandemic, exploring the factors that allowed some viruses to continue circulating while others experienced a decline. Several authors report that the detection of influenza, respiratory syncytial virus (RSV), human coronaviruses (hCoVs), human parainfluenza viruses (HPIVs), and human metapneumovirus (hMPV) dropped significantly. However, non-enveloped viruses such as adenovirus, and especially human rhinovirus (HRV), did not seem to be as affected. Hypotheses for this scenario include adopting of non-pharmacological measures to curb the spread of COVID-19, behavioral changes in hygiene habits, intrinsic characteristics of each virus such as transmission mode, the presence or absence of a viral envelope and viral interference. Rhinovirus is particularly intriguing, as it maintained a high prevalence during the years of the pandemic. Further investigation into the possible explanations for this phenomenon may be worthwhile.

Dysphonia Severity Index and Consensus Auditory-Perceptual Evaluation of Voice Outcomes, and Their Relation in Hospitalized Patients with COVID-19

OBJECTIVES

This study aimed to compare the results of the Dysphonia Severity Index (DSI) and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) between patients hospitalized with COVID-19 and healthy subjects, as well as to investigate the correlation between DSI and CAPE-V.

STUDY DESIGN

Cross-sectional survey.

MATERIAL AND METHODS

Eighty subjects, 40 COVID-19 patients (with a mean age of 41.2± 5.41) and 40 healthy subjects (with a mean age of 44.50± 3.50) participated in this study. Assessments included the DSI for aerodynamic-acoustic measurement and the Persian version of Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) for evaluating auditory-perceptual voice quality. Data were analyzed by means of the independent t-test and Pearson correlation at the 5% significance level.

RESULTS

The results showed COVID-19 patients got significantly lower score in DSI compared to healthy subjects (P < 0.05). Moreover, the patients with COVID-19 had higher scores in all categories of voice production (severity, roughness, loudness, pitch, strain and breathiness) than the healthy group (P < 0.05). Comparing the result of the two voice assessments in each group revealed that there was a greater negative significant correlation in the diseased group (r p: -0.68, P: 0.001) than in the healthy group (r p: -0.37,P: 0.049).

CONCLUSIONS

Hospitalized COVID-19 patients experience deviations in the voice quality and acoustic-aerodynamic features of their voice. Also, the results of this study showed the patient group had higher perceptual dysphonia and lower voice quality compared to the healthy group. Further studies are recommended to determine the relationship between objective and subjective voice evaluation in patients with COVID-19 after recovery.

Novel drug discovery strategies for chronic obstructive pulmonary disease: the latest developments

INTRODUCTION

The journey from initial drug discovery to approval for respiratory diseases typically spans approximately 10.4 years and cost over $2.8 billion. This intricate process involves five stages: target identification, therapeutic molecule discovery, preclinical testing, clinical trials, and regulatory approval.

AREAS COVERED

This review examines novel drug discovery strategies for chronic obstructive pulmonary disease (COPD), focusing on advanced in vitro models that replicate human lung conditions for accurate drug testing according to the following search string: discovery AND strategy AND COPD. It explores targeted molecular therapies, structure-based drug design, and drug repurposing approaches facilitated by computational analysis. The significance of personalized medicine in tailoring treatments for diverse COPDs is emphasized, highlighting the complexity of the disease and the necessity of these innovative methodologies to improve therapeutic outcomes.

EXPERT OPINION

COPD remains a challenging area, with a significant unmet medical need. Despite previous efforts, few effective therapies exist. Innovative in vitro models, targeted molecular therapies, and drug repurposing strategies are showing promise. Emphasizing advanced preclinical models and repurposing existing drugs could transform treatment paradigms, promoting more effective therapies for complex diseases like COPD. These innovations hold potential for enhancing drug discovery efficiency, leading to personalized and precision medicine approaches.

Effectiveness screening of SARS-CoV-2 (COVID-19) in the municipality of Andratx (Balearic Islands, Spain)

Background

The coronavirus disease 2019 (COVID-19) pandemic was a global health emergency that significantly affected both the wellbeing of individuals and the global economy.

Objective

The aim of this study was to evaluate the degree of SARS-CoV-2 involvement, viral load, and immunological response in adults aged 18-65 who performed essential tasks in the municipality of Andratx (Balearic Islands, Spain) compared to those who did not. Additionally, the study examined these factors in children aged 2-18 years from both groups, if there were any.

Materials

Both groups were monitored between July 2020 and February 2021, in which the degree of involvement, the viral load, and the immunological response to the SARS-CoV-2 were analyzed using questionnaires, polymerase chain reaction (PCR) tests, and ELISA serology tests.

Results

A positive case of RT-PCR test was found in screening the general population. The highest 2019-nCoV(N)-Ig antibody levels in plasma were measured from 1 to 17 February 2021, with the following percentage of positives: 6.8% of essential workers, 9.5% of essential workers' sons, 7.3% of non-essential workers, and 2.2% of non-essential workers' sons. However, an increase in levels of anti-SARS-CoV-2 (N) immunoglobulin G (IgG) and anti-SARS-CoV-2 (N) immunoglobulin M (IgM) were produced in session 3, from 9 to 25 November 2020, in both cases in non-essential workers, with a mean of 218.1 ng/mL of anti-SARS-CoV-2 (N) IgG and 31.3 ng/mL of anti-SARS-CoV-2 (N) IgM.

Conclusion

The control measures taken to manage the COVID-19 pandemic in the municipality of Andratx, Mallorca, Spain, were effective.

Functional foods and immune system: A sustainable inhibitory approach against SARS-COV-2

Background: COVID-19 has become the center of attention since its outbreak in December 2019. Despite the discovery of its preventive vaccine, role of healthy immune system is undebatable. Functional foods are continuously hunted as a promising option for a safe natural therapeutic treatment.Purpose: This review demonstrates how functional foods can boost host immune system, promote antiviral operation, and synthesize biologically effective molecules against SARS-COV-2.Research Methodology: For current review, online search was conducted for nature-based functional immune boosters against SARS-COV-2.Conclusion: Functional foods, alongside a healthy lifestyle, fortifies the human immune system and could all help to dramatically lower the cost burden of COVID-19, the suffering of the patients, and the mortality rates worldwide.

Repeated detection of SARS-CoV-2 in pet dogs in Ibadan, Oyo State, Nigeria: a cause for vigilance

BACKGROUND

The COVID-19 pandemic of 2020 was unprecedented in its devastating impact on the global economy, public health, travel and tourism, education, sports, religion, and social lives. Studies conducted thereafter on the disease and its causative agent, SARS-CoV-2, have highlighted the need for effective and sustainable public health interventions.

METHODS

This study investigated the prevalence and endemicity of SARS-CoV-2 infection in pet dogs using immunochromatography assay (IC) and quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) of their blood, rectal swabs, and nasal swabs in Ibadan, Oyo State, Nigeria between 2022 and 2024.

KEY FINDINGS

For the IC, positivity rates of 11.7% (23/197), 85.7% (6/7), and 100% (3/3) were recorded for 2022, 2023 and 2024 while for the RT-qPCR, positivity rates of 37.9% (11/29), 33.3% (2/6) and 100% (3/3) were recorded for 2022, 2023 and 2024. This repeated detection of SARS-CoV-2 in three of the dogs tested over the three-year period suggests continuous shedding of the virus by these animals and indicates endemicity of the virus in the study area. Findings highlight the urgent need for optimized SARS-CoV-2 rapid diagnostic tools tailored for veterinary applications to ensure rapid and reliable detection of the virus, especially in resource-constrained settings.

CONCLUSION

Considering the zoonotic nature of SARS-CoV-2 and its potential for mutation into more virulent strains that can be transmissible to humans, the findings of this study have significant implications for public health and implementation of One Health strategies by policymakers, and highlight the need for robust SARS-CoV-2 surveillance in domestic animals to mitigate potential zoonotic risks.

COVID-19 vaccines side effects among the general population during the pandemic: a cross-sectional study

Background and aims

The general population have depicted concern about the safety and efficacy of the vaccine and its long-term effects on human health. Pakistan being on the verge of the pandemic is in more demand for vaccination and immunization. Therefore, this study aimed to evaluate the COVID-19 vaccines side effects among the general population.

Methods

A cross-sectional face-to-face study was carried out among individuals who received either the first dosage or both doses of vaccination in twin cities (Islamabad and Rawalpindi) of Pakistan. Data was collected through a self-administered questionnaire. The questionnaire included three sections (socio-demographic, medical history, vaccine, and immunization) with 20 questions. The collected data was analyzed in SPSS (version 25) using descriptive statistics, the chi-square test, and the odd ratio.

Results

A total of 2,618 participants were included and of them, females (55.3%; n = 1,449) were more than males. The majority of the participants reported the use of precautionary medicines including vitamin C (1,319; 50.4%) followed by paracetamol (n = 1,249; 47.7%) and mineral supplements (n = 616; 23.5%) for COVID-19. In this study, 3.8% (n = 99) were unvaccinated and the first and second doses of the vaccine was received by 2,519 and 2,239 of the participants, respectively. Different types of side effects were highlighted in the current study. The most frequently reported side effects after the first dose of COVID-19 were fever (n = 997), pain at the injection site (n = 994), muscle pain (n = 620), and fatigue (n = 482). Additionally, pain at the injection site (n = 852), fever (n = 815), and muscle pain (n = 601) were commonly reported after the 2nd dose of COVID-19. The lowest reported side effects were swollen lymph nodes and anaphylactic shock. In the current study, people who were previously immunized with the flu and pneumonia vaccine had a lower risk of developing side effects (p < 0.05).

Conclusion

This study highlights important information about side effects reported due to the COVID-19 vaccinations. Moreover, the use of precautionary medications was also highlighted. These findings could have a valuable impact on designing future comparative studies and developing policies/guidelines for pandemic preparedness.

Demographic, epidemiological and clinical profile of patients with post-COVID syndrome followed at a teaching hospital in Brazil

INTRODUCTION

Post-COVID Syndrome (PCS), occurs several weeks after Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2 infection), has a frequency of 10 %‒35 % of cases, presents a wide range of symptoms that can persist for months or years and markedly reduces the quality of life of patients.

OBJECTIVE

To describe clinical, epidemiological and evolutionary aspects of a cohort of patients diagnosed with PCS followed on an outpatient basis.

METHODOLOGY

Individuals of both sexes, > 18-years old who presented symptoms suggestive of PCS and had previously confirmed SARS-CoV-2 infection were included. Clinical evaluation was carried out monthly by a multidisciplinary team, and if necessary laboratorial exams were performed.

RESULTS

From June 2021 to June 2022, 92 cases of PCS were diagnosed, of which 60 (65.2 %) were female and the average age was 49.1 years. In 61 (66.3 %) of the cases, SARS-CoV-2 infection occurred between January and November 2021. In 55 (59.7 %) of the cases the symptoms were mild, while 31 (36.0 %) were moderate or severe cases. Most cases of PCS occurred in individuals with the mild form of COVID-19. The predominant symptoms were chronic fatigue in 59 (68.6 %) cases, brain fog in 68 (73.4 %), myalgias and arthralgias in 44 (47.8 %), cramps and paresthesia's in 40 (46.5 %). The main comorbidities observed were high blood pressure, obesity and diabetes mellitus. The persistence of symptoms was greater in those cases who presented severe forms of COVID-19. Most patients experienced gradual and progressive improvement over the months.

DISCUSSION

The profile of patients with PCS in this cohort is similar to other reports. A great number of symptoms is remarkable with variable presentation and evolution and their frequency exceeds that previously described in a large meta-analysis. Inflammatory phenomena mediated by the virus, autoimmunity and direct organic damage have been implicated in the genesis of this syndrome.

Nanoparticles of natural product-derived medicines: Beyond the pandemic

This review explores the synergistic potential of natural products and nanotechnology for viral infections, highlighting key antiviral, immunomodulatory, and antioxidant properties to combat pandemics caused by highly infectious viruses. These pandemics often result in severe public health crises, particularly affecting vulnerable populations due to respiratory complications and increased mortality rates. A cytokine storm is initiated when an overload of pro-inflammatory cytokines and chemokines is released, leading to a systemic inflammatory response. Viral mutations and the limited availability of effective drugs, vaccines, and therapies contribute to the continuous transmission of the virus. The coronavirus disease-19 (COVID-19) pandemic has sparked renewed interest in natural product-derived antivirals. The efficacy of traditional medicines against pandemic viral infections is examined. Their antiviral, immunomodulatory, anti-inflammatory, and antioxidant properties are highlighted. This review discusses how nanotechnology enhances the efficacy of herbal medicines in combating viral infections.

Depression levels of the general public increases during the COVID-19 pandemic in China: A web-based cross-sectional survey

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak lasted several months, having started in December 2019. This study aimed to report the impacts of various factors on the depression levels of the general public and ascertain how emotional measures could be affected by psychosocial factors during the COVID-19 pandemic.

AIM

To investigate the depression levels of the general public in China during the COVID-19 pandemic.

METHODS

A total of 2001 self-reported questionnaires about Beck Depression Inventory (BDI) were collected on August 22, 2022 via the website. Each questionnaire included four levels of depression and other demographic information. The BDI scores and incidences of different depression levels were compared between various groups of respondents. χ 2 analysis and the two-tailed t-test were used to assess categorical and continuous data, respectively. Multiple linear regressions and logistic regressions were employed for correlation analysis.

RESULTS

The averaged BDI score in this study was higher than that for the non-epidemic periods, as reported in previous studies. Even higher BDI scores and incidences of moderate and severe depression were recorded for people who were quarantined for suspected COVID-19 infection, compared to the respondents who were not quarantined. The participants who did not take protective measures were associated with higher BDI scores than those who made efforts to keep themselves relatively safer. Similarly, the people who did not return to work had higher BDI scores compared to those managed to. A significant association existed between the depression levels of the subgroups and each of the factors, except gender and location of residence. However, quarantine was the most relative predictor for depression levels, followed by failure to take preventive measures and losing a partner, either through divorce or death.

CONCLUSION

Based on these data, psychological interventions for the various subpopulations in the general public can be implemented during and after the COVID-19 pandemic. Other countries can also use the data as a reference.

Cayley-Purser secured communication and jackknife correlative classification for COVID patient data analysis

Internet of Medical Things (IoMT) is a group of medical devices that connect the healthcare information technology to minimize the redundant hospital visit and healthcare system troubles. IoMT connect the patients to the doctor and transmit the medical data over the network. The spread of corona virus has put the people at high risk. Due to increasing number of cases and its stress on health professionals, IoMT technology is used in many healthcare centers. But, the security level and data classification accuracy was not improved by existing methods during the data communication. In order to solve these issues, Cayley-Purser Cryptographic Secured Communication based Jackknife Correlative Data Classification (CPCSC-JCDC) method is designed. The key objective of CPCSC-JCDC method is to collect the patient information through IoMT devices and send to the doctor in more secured manner. Initially in CPCSC-JCDC method, the patient data is collected. After the data collection process, the data gets encrypted with help of public key of the patient by using cayley-purser cryptosystem. After the encryption process, the data is sent to the doctor. The doctor receives and decrypts the patient data by using their private key. After decryption process, the doctor analyses the patient data and classifies the data as emergency case or normal case by using jackknife correlation function. This helps to minimize the patient readmission rate and increase the patient satisfaction level. Experimental evaluation is carried out by Novel Corona Virus 2019 dataset using different metrics like data classification accuracy, data classification time and security level. The evaluation result shows that CPCSC-JCDC method improves the security level as well as accuracy and minimizes the time consumption during data communication than existing works.

A prospective study of the effect of COVID-19 on psychiatric symptoms and sleep problems from infection to 9-month follow-up

Diverse psychological consequences of the COVID-19 pandemic have been reported for 6 months after infection. We conducted a prospective study to evaluate the psychological impact of COVID-19 infection in newly diagnosed cases that were followed up at 1, 6, and 9 months after infection. 137 people were recruited and divided into four groups based on the COVID-19 Treatment Guidelines. They were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Post-traumatic stress disorder Checklist for DSM-5 (PCL-5), and Symptom Checklist 90 (SCL-90). We found that 9 months after infection, patients continued to report poor sleep (74.5%), PTSD (78.3%), somatization (17%), anxiety (17%), aggression (5.7%), phobic anxiety (4.7%), psychoticism (1.9%), paranoid (3.8%), and obsessive-compulsive (9.4%) symptoms, as well as depression and interpersonal sensitivity. The most significant risk factors for psychiatric complications were older age, level of education, smoking, hospitalization duration, hypertension, and critical severity. The negative mental health effects of COVID-19 persist after hospital discharge, and many patients continue to experience moderate-to-severe issues that may endure for 9 months. Notably, there was a progressive improvement in these symptoms over that time.

Antihypertensive Drug Use and COVID-19 Disease Severity in Hospitalized US Veterans: A Retrospective Cohort Study

This research investigated associations between hypertensive patients with COVID-19 who did and did not use specific antihypertensive medications and had incurred hospital ventilation/death in the US Veterans Hospital System. This study included de-identified medical records of 572 994 hypertensive US veterans who were diagnosed with COVID-19 and hospitalized between March 1, 2020, and February 28, 2022, with a 60-day follow-up period. Mechanical ventilation and/or death within 60 days of COVID-19 hospitalization served as the outcome variables. On multivariable analysis, CCB use was associated with a 9% increased risk of mechanical ventilation, while ACE inhibitors (HR: 0.90), alpha blockers (HR: 0.92), and CCB (HR: 0.93) users were associated with a significantly decreased risk of death. Additional multivariable analysis on those with and without additional comorbidities, such as chronic kidney disease (CKD), heart failure, and diabetes, revealed that in those with at least one additional comorbidity, CCB uses led to a 9% increased deleterious risk for ventilation. In contrast, the use of ACE inhibitors (HR: 0.86), alpha blockers (HR: 0.92), and CCB (HR: 0.93) demonstrated a moderate protective effect against mortality. Lastly, in hypertensive veterans without any additional comorbidities, there was a lack of significant association between hypertensive medication usage and mechanical ventilation and/or death. In summary, although CCB use was associated with an increased risk of requiring mechanical ventilation, it also demonstrated a protective effect against mortality. At the same time, ACEI, alpha blocker, and CCB usage led to a significantly decreased risk for death within all hypertensive hospitalized COVID-19 veteran cohorts.

Committed care in the shadow of fear: The experiences of emergency medical services staff encountering with COVID-19 patients

BACKGROUND

By the beginning of the coronavirus disease 2019 (COVID-19) pandemic, emergency medical services (EMSs) played a key first-line role in patients affected by this disease care. In Iran, EMSs is a main part of health system that has a substantial role in managing emerging crisis and disasters. This study aimed to investigate the experience of the EMSs staff encountering with COVID-19 patients.

MATERIALS AND METHODS

This was a descriptive qualitative study conducted on 14 EMSs staff selected by purposive sampling from August 2021 to September 2022. This study was conducted in the southern part of Iran. Data were collected using a semi-structured interview, and Graneheim, U.H. and Lundman, B. (2004) conventional content analysis method applied for their analysis MAXQDATA 2020 was used to store the interview data and codes. Till reaching data saturation, sampling was continued.

RESULTS

Data analysis contributed to the extraction of 783 primary codes, 15 subclasses, 4 classes, and 2 main themes, including "committed care" (with two classes of "respect to the personal identity of the patient" and "facilitators to adhere to care") and "the bottleneck of care in the shadow of fear" (with two classes of "the fine line between fear and responsibility" and "the sacrifice in care").

CONCLUSIONS

Although there was a fear of encountering COVID-19 patients among the EMSs staff, they provided devotional and committed care to patients considering moral values and human principles. Health policymakers should minimize the challenges of EMSs staff encountering with emerging infectious diseases with effective planning.

Evaluation of Genomic Surveillance of SARS-CoV-2 Virus Isolates and Comparison of Mutational Spectrum of Variants in Bangladesh

The SARS-CoV-2-induced disease, COVID-19, remains a worldwide public health concern due to its high rate of transmission, even in vaccinated and previously infected people. In the endemic state, it continues to cause significant pathology. To elu- cidate the viral mutational changes and screen the emergence of new variants of concern, we conducted this study in Bangladesh. The viral RNA genomes extracted from 25 ran- domly collected samples of COVID-19-positive patients from March 2021 to February 2022 were sequenced using Illumina COVID Seq protocol and genomic data processing, as well as evaluations performed in DRAGEN COVID Lineage software. In this study, the percentage of Delta, Omicron, and Mauritius variants identified were 88%, 8%, and 4%, respectively. All of the 25 samples had 23,403 A>G (D614G, S gene), 3037 C>T (nsp3), and 14,408 C>T (nsp12) mutations, where 23,403 A>G was responsible for increased transmis- sion. Omicron had the highest number of unique mutations in the spike protein (i.e., sub- stitutions, deletions, and insertions), which may explain its higher transmissibility and immune-evading ability than Delta. A total of 779 mutations were identified, where 691 substitutions, 85 deletions, and 3 insertion mutations were observed. To sum up, our study will enrich the genomic database of SARS-CoV-2, aiding in treatment strategies along with understanding the virus's preferences in both mutation type and mutation site for predicting newly emerged viruses' survival strategies and thus for preparing to coun- teract them.

Sleep and cardiorespiratory function assessed by a smart bed over 10 weeks post COVID-19 infection

Inadequate information exists regarding physiological changes post-COVID-19 infection. We used smart beds to record biometric data following COVID-19 infection in nonhospitalized patients. Recordings of daily biometric signals over 14 weeks in 59 COVID-positive participants' homes in 2020 were compared with the same participants' data from 2019. Participants completed a survey of demographic information, health conditions, COVID exposure and testing, and symptom prevalence/subjective severity. Mean age was 47.5 years (standard deviation [SD] 9.5), mean body mass index was 30.1 kg/m2 (SD 7.1), and 46% were men. During acute infection, 64% exhibited 5-6 h increased sleep duration, 51% had increased movement, and 64% had increased breathing rate (BR). Nearly 34% had paradoxical bradycardia (decreased heart rate by ~ 10 BPM concomitant with elevated BR and/or fever), with more-severe symptoms. Smart beds can detect physiological changes during COVID-19. A subtype of acute response (paradoxical bradycardia) may predict delay recovery from COVID-19.

Unlocking the Potential of RNA Sequencing in COVID-19: Toward Accurate Diagnosis and Personalized Medicine

COVID-19 has caused widespread morbidity and mortality, with its effects extending to multiple organ systems. Despite known risk factors for severe disease, including advanced age and underlying comorbidities, patient outcomes can vary significantly. This variability complicates efforts to predict disease progression and tailor treatment strategies. While diagnostic and therapeutic approaches are still under debate, RNA sequencing (RNAseq) has emerged as a promising tool to provide deeper insights into the pathophysiology of COVID-19 and guide personalized treatment. A comprehensive literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar. We employed Medical Subject Headings (MeSH) terms and relevant keywords to identify studies that explored the role of RNAseq in COVID-19 diagnostics, prognostics, and therapeutics. RNAseq has proven instrumental in identifying molecular biomarkers associated with disease severity in patients with COVID-19. It allows for the differentiation between asymptomatic and symptomatic individuals and sheds light on the immune response mechanisms that contribute to disease progression. In critically ill patients, RNAseq has been crucial for identifying key genes that may predict patient outcomes, guiding therapeutic decisions, and assessing the long-term effects of the virus. Additionally, RNAseq has helped in understanding the persistence of viral RNA after recovery, offering new insights into the management of post-acute sequelae, including long COVID. RNA sequencing significantly improves COVID-19 management, particularly for critically ill patients, by enhancing diagnostic accuracy, personalizing treatment, and predicting therapeutic responses. It refines patient stratification, improving outcomes, and holds promise for targeted interventions in both acute and long COVID.

Knowledge, Awareness, and Influence of the COVID-19 Pandemic on Students of Biomedical Faculties: A Cross-Sectional Study

Background/Objectives: The COVID-19 pandemic has had a profound impact on physical, mental, and social aspects of life worldwide. This study aimed to explore and compare differences in knowledge, awareness, behavior, and the psychological impact of the pandemic among students of biomedical faculties at the University of Zagreb. Methods: A cross-sectional study was conducted between 27 November 2020 and 19 January 2021 involving 518 students from the School of Dental Medicine, School of Medicine, Faculty of Pharmacy and Biochemistry, and Faculty of Veterinary Medicine. An anonymous online questionnaire was distributed, assessing participants' knowledge about SARS-CoV-2, information sources, attitudes, and psychological responses. Data were analyzed using descriptive statistics and appropriate statistical tests. Results: The median knowledge score was 61.54%, with senior and female students demonstrating significantly more knowledge (p < 0.001 and p = 0.044, respectively). Students who consulted the scientific literature and official websites had higher knowledge levels (p < 0.001). Most participants used media and social networks for pandemic information, while scientific sources were underutilized. Psychological impacts were evident, with 46.3% expressing fear about the future and 25% reporting anxiety if they were to be infected. Additionally, those who engaged with the scientific literature were more likely to accept vaccination and showed lower levels of COVID-19 stigma. A majority (64.5%) believed that the media exaggerated the pandemic's risks. Conclusions: Biomedical students demonstrated moderate knowledge about COVID-19, with a clear link between scientific literacy and more informed, less stigmatizing attitudes. This study underscores the importance of reliable information sources in shaping public health awareness and highlights the need for further education on COVID-19 symptoms and preventive measures.

Anxiety and burnout in infectious disease nurses: the role of perceived stress and resilience

BACKGROUND

Nurses serving in infectious disease ward represent a distinct occupational group that has attracted considerable attention following epidemic outbreaks. However, prior to this study, no research had delved into the underlying mechanism linking anxiety to burnout symptoms among infectious disease nurses. This study aimed to explore investigate the association between anxiety and burnout among nurses working in such environments and scrutinized the mediating role of perceived stress and the moderating influence of resilience on the principal relationship.

METHODS

Employing a cross-sectional study using a web-based design, data were collected from 1,579 clinical nurses working in infectious disease ward across 50 hospitals in China. Participants responded to questionnaires assessing anxiety, perceived stress, resilience and burnout. Statistical analyses encompassed descriptive statistics, one-way analyses of variance, independent-samples t-tests, Pearson correlations, and bootstrapping techniques to evaluate the indirect and moderating effects.

RESULTS

The study revealed that 62.13% of the respondents reported high levels of burnout, and 55.92% experienced moderate to high degrees of emotional exhaustion among infectious disease nurses. Significant correlations were observed between anxiety, perceived stress, resilience, and each component of burnout (P < 0.05). Notably, the mediating effect of perceived stress was accounting for 30.61% of the relationship between anxiety and burnout. Simple slope analysis demonstrated that perceived stress significantly predicted emotional exhaustion at both low (B = 0.854, t = 16.586, and P < 0.001) and high (B = 0.498, t = 9.503, and P < 0.001) levels of resilience. The perceived stress and emotional exhaustion were more serious when resilience levels were lower.

CONCLUSION

Anxiety was identified as a critical risk factor for burnout among nurses in infectious disease units. The relationship between anxiety and burnout was markedly affected by the levels of perceived stress and resilience. Specifically, the deleterious impact of perceived stress on burnout was amplified in nurses with diminished resilience relative to those with heightened resilience. Based on these findings, it is imperative to allocate resources for stress management programs and resilience training. Such initiatives would bolster support for nurses in infectious disease wards, ultimately enhancing their job satisfaction and well-being.

Medicinal plants for the management of post-COVID-19 fatigue: A literature review on the role and mechanisms

Background

COVID-19 infection has a lasting impact on human health, which is known as post-COVID-19 conditions. Fatigue is one of the most commonly reported post-COVID-19 conditions. Management of fatigue in the post-COVID-19 era is necessary and emerging. The use of medicinal plants may provide a strategy for the management of post-COVID-19 fatigue.

Methods

A literature search has been conducted by using PubMed, Embase and Cochrane library databases is performed for studies published up to March 2024. Keywords, such as "post-COVID-19 conditions, persistent COVID-19 symptoms, chronic COVID-19, long-term sequelae, fatigue, post-COVID-19 fatigue, herbal plants, medicinal herbs, traditional Chinese medicine, pharmacological mechanisms, pharmacological actions" are thoroughly searched in Englsih and Chinese. This study reviews the pathophysiology of post-COVID-19 fatigue and potential herbal plants for managing post-COVID-19 fatigue.

Results and conclusion

Representative medicinal plants that have been extensively investigated by previous studies are presented in the study. Three common mechanisms among the most extensively studied for post-COVID-19 fatigue, with each mechanism having medicinal plants as an example. The latest clinical studies concerning the management of post-COVID-19 fatigue using medicinal plants have also been summarized. The study shows the potential for improving post-COVID-19 fatigue by consuming medicinal plants.

Association of SARS-CoV-2 Infection during pregnancy with placental weight and histopathologic lesions

INTRODUCTION

The reported gross and histopathologic changes in the placenta associated with SARS-CoV-2 infection are heterogeneous. We sought to summarize placental histopathologic findings from pregnancies affected by SARS-CoV-2 infection according to timing of infection and symptom severity.

METHODS

We conducted a retrospective cohort study of patients with SARS-CoV-2 infection during pregnancy who had deliveries at Mayo Clinic, Rochester, Minnesota, from April 2020 through June 2021. Placental histopathologic findings and clinical characteristics were compared for infections before vs after 28 weeks' gestation and according to COVID-19 symptom severity.

RESULTS

We analyzed 93 cases of SARS-CoV-2 infection during pregnancy, with 51 % of infections occurring before 28 weeks' gestation. Infections were categorized as asymptomatic (14 %), mild (77 %), moderate (6 %), and severe (3 %) according to World Health Organization criteria. An increased risk of small placental weight (<10th percentile) was associated with maternal infection at all gestational ages (30 %, P < .001). Histopathologic lesions consistent with maternal vascular malperfusion occurred more often for infections before than after 28 weeks' gestation (18/46, 38 % vs 9/47, 19 %; P = .047) and did not differ in frequency according to symptom severity. Inflammatory changes were present in 50 % of the placentas examined but did not differ by group, except that acute fetal vasculitis occurred more frequently after asymptomatic vs symptomatic maternal infection (23 % vs 5 %; risk ratio, 4.62; 95 % CI, 1.16-18.30).

DISCUSSION

COVID-19 at any gestational age or severity increases the risk of small placental weight and the presence of placental inflammatory lesions.

Correlation of the cycle threshold value of SARS-CoV-2 by RT-PCR with biomarker levels in the prognosis of patients hospitalized with COVID-19

Background and Objective

The COVID-19 disease caused by SARS-CoV-2 was declared as pandemic by WHO soon after its emergence in 2019. This virus was known to cause serious clinical symptoms and severe illness. By using RT-PCR, which reports the cycle threshold value, the disease is diagnosed, whereas for the severity of the disease, biomarker levels, like IL-6, CRP, D-dimer, serum ferritin and serum procalcitonin, can be measured. We, thus, aimed to explore any potential correlation of the cycle threshold value and biomarker level with the outcome of COVID-19-positive hospitalized patients.

Method

Patients with the cycle threshold (Ct) value <35 were included in the study and their initial Ct values were noted. Different biochemical parameters, such as C-reactive protein (CRP), serum ferritin, D-dimer, Interleukin-6 and serum procalcitonin, were assessed for severity. They were classified according to Ct value into three groups: Group 1 >30.0, Group 2 20.0-30.0 and Group 3 <20.0.

Results

The study included 370 hospitalized COVID-19 patients with a mean age (mean ± SD) of 51.08 (16.58%) years and 250 (67.5%) males and 120 (32.4%) females. Comparison of data with outcome shows that IL-6, CRP amongst the biomarker and Ct value (deduced by RT-PCR test) were significantly correlated with the mortality (P value < 0.05). The ROC curve was also plotted for these parameters, which shows that IL-6, CRP, PCT and Ct value were better prognostic marker. Poor prognosis was found in Group 2 (Ct value 20.0-30.0) patients compared to Group 1 and Group 3. There was significant correlation (P value < 0.05) between Ct value and outcome of the patient.

Interpretation and Conclusion

This study depicts that low Ct value and elevated levels of IL-6 and CRP can be used as a screening tool to detect the mortality in COVID-19 patients as they are significantly correlated with the mortality.

The application of machine learning algorithms for predicting length of stay before and during the COVID-19 pandemic: evidence from Wuhan-area hospitals

Objective

The COVID-19 pandemic has placed unprecedented strain on healthcare systems, mainly due to the highly variable and challenging to predict patient length of stay (LOS). This study aims to identify the primary factors impacting LOS for patients before and during the COVID-19 pandemic.

Methods

This study collected electronic medical record data from Zhongnan Hospital of Wuhan University. We employed six machine learning algorithms to predict the probability of LOS.

Results

After implementing variable selection, we identified 35 variables affecting the LOS for COVID-19 patients to establish the model. The top three predictive factors were out-of-pocket amount, medical insurance, and admission deplanement. The experiments conducted showed that XGBoost (XGB) achieved the best performance. The MAE, RMSE, and MAPE errors before and during the COVID-19 pandemic are lower than 3% on average for household registration in Wuhan and non-household registration in Wuhan.

Conclusions

Research finds machine learning is reasonable in predicting LOS before and during the COVID-19 pandemic. This study offers valuable guidance to hospital administrators for planning resource allocation strategies that can effectively meet the demand. Consequently, these insights contribute to improved quality of care and wiser utilization of scarce resources.

Uptake of COVID-19 vaccine and associated factors among Health Care Workers at Queen Elizabeth Central Hospital in Malawi: A cross-section study

Globally, the introduction of the Coronavirus Disease of 2019 (COVID-19) vaccine within one year of the pandemic brought doubts to the general population including health professionals. Even though Health Care Workers (HCWs) are at a high risk of contracting and transmitting the coronavirus due to their work, their COVID-19 vaccine uptake is unknown. This study aimed to determine the uptake of the COVID-19 vaccine and identify factors associated with uptake among HCWs at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. We conducted a quantitative cross-sectional study at QECH. HCWs over 18 years, and with at least one year working experience at QECH were recruited using a simple random sampling technique between December 2021 and February 2022. Data were collected on sociodemographic characteristics, medical history, COVID-19 and COVID-19 vaccine perspectives. The study was informed by Behavioral and Social Drivers of COVID-19 Vaccination framework. We computed vaccine uptake as number of HCWs fully vaccinated divided by total number of participants recruited in the study. Bivariate and multivariable logistic regression models were used to identify factors associated with vaccine uptake. Of the 273 HCWs enrolled into the study 71% were fully vaccinated. Gender (Adjusted Odds Ratio (AOR) = 0.54, 95% CI: 0.30-0.96), ownership of medical insurance schemes (AOR = 2.90, 95% CI: 1.36-6.18) and history of vaccine refusal (AOR = 0.29, 95% CI: 0.12-0.70) were significantly related to vaccine uptake. Age and work experience were statistically significant. The level of education, the income of HCWs and occupation did not determine whether HCWs got vaccinated against COVID-19. There was high vaccine uptake among HCWs at QECH. Some risk factors for severe COVID-19 such as advancing in age and work experience are persuasive to COVID-19 vaccination. We recommend intensified COVID-19 vaccination campaigns for subgroups such as young adults and female HCWs.

The Association of Physical Symptoms and Psychological Problems in the Indonesian Community During the COVID-19 Outbreak

Introduction

Changes in health status and adjustments to new lifestyles during the pandemic have triggered societal psychological problems in society. This study aimed to explore the correlation between physical symptoms and psychological problems in Indonesian society during the COVID-19 outbreak.

Methods

This cross-sectional study employed an online survey to gather data from 9425 participants in Indonesia between June and July 2020, which was selected using convenience sampling. The Self-Reporting Questionnaire (SRQ) instrument was employed to investigate psychological problems, the utilization of psychoactive substances, psychotic symptoms, and post-traumatic stress disorder (PTSD). Physical symptoms were assessed through self-reports indicating the presence or absence of experienced COVID-19 symptoms. The statistical analyses were conducted using Spearman-rank and Cramer's V correlation.

Results

The findings suggest that the perceived physical symptoms during the COVID-19 outbreak are significantly associated with psychological problems, (including decreased energy, somatic symptoms, depressive moods, and depressive thoughts, the use of psychoactive substances, psychotic symptoms, and PTSD.

Conclusion

Our study concluded that physical health is significantly associated with psychological problems. It is essential to eliminate factors that cause psychological problems by promoting the physical condition of the general population. Through promotive and preventive efforts, physical and psychological conditions should be improved in COVID-19 outbreaks.

Memory inflation: Beyond the acute phase of viral infection

Memory inflation is confirmed as the most commonly dysregulation of host immunity with antigen-independent manner in mammals after viral infection. By generating large numbers of effector/memory and terminal differentiated effector memory CD8+ T cells with diminished naïve subsets, memory inflation is believed to play critical roles in connecting the viral infection and the onset of multiple diseases. Here, we reviewed the current understanding of memory inflated CD8+ T cells in their distinct phenotypic features that different from exhausted subsets; the intrinsic and extrinsic roles in regulating the formation of memory inflation; and the key proteins in maintaining the expansion and proliferation of inflationary populations. More importantly, based on the evidences from both clinic and animal models, we summarized the potential mechanisms of memory inflation to trigger autoimmune neuropathies, such as Guillain-Barré syndrome and multiple sclerosis; the correlations of memory inflation between tumorigenesis and resistance of tumour immunotherapies; as well as the effects of memory inflation to facilitate vascular disease progression. To sum up, better understanding of memory inflation could provide us an opportunity to beyond the acute phase of viral infection, and shed a light on the long-term influences of CD8+ T cell heterogeneity in dampen host immune homeostasis.

Evaluation of the mental health of COVID-19 patients discharged from the intensive care unit

In this editorial, I address the mental health status of patients who have been discharged from intensive care units (ICUs) after battling coronavirus disease 2019 (COVID-19). An ICU admission is generally a stressful experience, and for severe COVID-19 survivors prolonged treatment in the ICU can lead to significant psychological consequences. These individuals may experience psychiatric distress, including symptoms such as insomnia, anxiety, depression, and even post-traumatic psychological issues. Research indicates that during the first 6 months to 1 year following an ICU stay, nearly one-third of survivors exhibit symptoms similar to those of depression and post-traumatic stress disorder. Several factors may have contributed to the development of depressive and anxious symptoms during the COVID-19 pandemic, particularly for those who underwent an ICU stay. The ICU environment itself is inherently stressful, filled with the constant noise of various medical devices. Studies have provided strong evidence that the prolonged need for ventilation support and the loss of freedom of movement are key factors in the development of psychological problems among COVID-19 patients who had been treated in the ICU.

A novel nucleic acid extraction system integrating a switching valve-assisted microfluidic cartridge and a constant pressure pump

BACKGROUND

Nucleic acid extraction (NAE) is essential in molecular diagnostics, genetic engineering, and DNA sequencing. While advances in switching valve-assisted, self-contained microfluidic (S2M) cartridges have improved the NAE processes, challenges persist in streamlining workflows, reducing processing times, and enhancing multi-target detection. Achieving these objectives requires precise control of on-chip fluid dynamics and efficient transfer of nucleic acid solutions (NAS) to detection areas. However, research on novel S2M cartridge designs and compatible fluid control systems is still limited.

RESULT

This study presented an innovative NAE system that integrated an S2M cartridge, a constant pressure (CP) pump, a metal heating bath, a rotating lever, and a magnet. The S2M cartridge contained the reagents for both NAE and detection, while the CP pump provided stable, precise, and rapid fluid delivery, outperforming traditional peristaltic and injection pumps, especially for handling small volumes and reducing pulsation. A custom rotating lever connects reagent chambers, facilitating mixing, cleaning, elution, and NAS transfer. This system showed advantages over manual methods, achieving all processes in 20 min. The CP pump-assisted S2M cartridge enabled rapid MBs re-suspension with a recovery rate of 80 %. The system's sensitivity, repeatability, and ease of use were also confirmed. The NAE system can extract Escherichia coli DNA (50 CFU mL^-1) from food and serum samples and viral DNA (HBV, HCV, HIV) at 200 copies mL^-1 from serum samples.

SIGNIFICANCE

This study highlighted the need for an efficient fluid system in the S2M cartridge for stable NAE. By streamlining NAE and facilitating on-chip reagent preparation, the system enhanced point-of-care diagnostics. Although manual steps remain, the CP pump effectively managed fluid processes, paving the way for automated pathogen detection. Moreover, when combined with visual detection reagents, the NAE system showed promise as a direct molecular diagnostic tool.

Association of iron deficiency anaemia with the hospitalization and mortality rate of patients with COVID‑19

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) illness led to the coronavirus disease 2019 (COVID-19) pandemic, which has caused enormous health and financial losses, as well as challenges to global health. Iron deficiency anaemia (IDA) has been linked to adverse outcomes in patients infected with SARS-COV-2. The present study aimed to assess the association between IDA and the severity of COVID-19 in hospitalized patients. For this purpose, a retrospective data analysis of 100 patients with COVID-19 was conducted. Data of patients hospitalized with SARS-COV-2 infection confirmed by RT-PCR were collected between June, 2021 and March, 2022. The collected data included patient demographics, comorbidities, clinical signs, symptoms and IDA medical laboratory findings, including complete blood count and iron profiles. The results revealed that patients with COVID-19 admitted to the isolation unit represented 61.0% of the study sample, whereas 39.0% were admitted to the intensive care unit (ICU). No patients had stage I IDA, whereas 4 patients (4%) had stage II IDA. Furthermore, 19 patients (19.0%) had stage III IDA. A significantly higher proportion of patients with IDA (69.6%) were admitted to the ICU compared with those without IDA (29.9%, P<0.001). Additionally, patients with IDA had a higher proportion of a history of stroke compared with those without IDA (17.4 vs. 2.6%, respectively, P=0.024). The most common comorbidities identified were hypertension (29%), diabetes (23%) and heart problems (17%). On the whole, the present study demonstrates significant associations between IDA and a longer hospitalization period. A greater incidence of complications was observed in the hospitalized patients who were SARS-COV-2-positive. Although further studies with larger sample sizes are required to confirm these findings, the results presented herein may provide insight for physicians as regards the prevention and treatment of patients with IDA who are infected with coronavirus.

ROTEM and von Willebrand Factor in COVID patients presenting with acute ischemic stroke: A case series: ROTEM and von Willebrand Factor in COVID-19 Related Stroke

OBJECTIVES

SARS-CoV-2 (COVID) induces systemic thrombotic complications including acute ischemic stroke. In this case series, we report markers of inflammation, coagulation factors including von Willebrand factor antigen, and rotational thromboelastometry (ROTEM) data.

MATERIALS AND METHODS

Retrospective case series of COVID patients seen at a single comprehensive stroke center between 2020-2022. For patients undergoing mechanical thrombectomy (MT), ROTEM data was collected during the procedure and analyzed on ROTEM delta system.

RESULTS

Fifteen patients (33.3% female) median age 65-years-old presented with COVID and acute ischemic stroke. Thirteen had LVO. The mean NIHSS was 15 (range 0-35) on admission and 18 (0-42) at discharge. Most were cryptogenic (N=7, 46.7%), followed by cardioembolic (N=6, 40%) and large artery-to-artery embolization (N=2, 13.3%). mRS was < 3 in 8 (53%) patients at discharge. None of the patients were on anticoagulation, and five were on antiplatelet therapy pre-hospitalization. Seven received thrombolytics with alteplase (tPA), and 10 had MT. Baseline platelet count was 102 K/uL (range 102-291 K/uL). vWF was measured in 12 patients, all elevated, with seven having levels >400 (180%). ROTEM data was collected in six patients. Three who received tPA had abnormal EXTEM and FIBTEM data (CT extem > 85secs, A10 EXTEM < 45mm, and A10 FIBTEM < 10mm). Notably, INTEM (CT INTEM >208secs) was abnormal in five of the six patients, two of whom did not receive tPA.

CONCLUSIONS

Elevated vWF antigen levels with abnormal ROTEM data suggests that COVID induces changes in the clotting cascade. More robust research is needed to investigate these findings. Thrombolytics, MT, and antiplatelet agents should be utilized to treat COVID-related ischemic stroke based on current clinical guidelines.

Brazilian Teachers' Voices: The Impact of the First Two Years of the Pandemic

OBJECTIVES

To compare vocal symptoms, stress, overall fatigue, and self-reported vocal quality in teachers between pre pandemic, emergency remote teaching (ERT), and hybrid teaching (simultaneous in-person and online teaching), evaluate their voices during hybrid teaching, and correlate it with self-reported vocal quality.

STUDY DESIGN

Hybrid cross-sectional study with longitudinal cohort characteristics.

METHOD

The sample comprised 70 teachers of both sexes, aged 24 to 68years (mean of 42.5years). Everyone filled out a recall questionnaire on pre-pandemic and ERT and another one on hybrid teaching. The voices were recorded and then submitted to judges for auditory-perceptual evaluation. The statistical analysis compared the three moments, verifying a correlation between the variables.

RESULTS

The auditory-perceptual evaluation carried out during hybrid teaching revealed that 74.3% of teachers in the sample had mild vocal deviations according to the overall severity in the CAPE-V. Changes in self-reported vocal quality were associated with hoarseness, dry throat, vocal fatigue, voice failures, loud speaking, stress, and overall fatigue. Also, 61.4% of participants reported that during ERT, their voices were better than before the pandemic and during hybrid teaching. Voice roughness and strain observed in the auditory-perceptual evaluation were associated with vocal symptoms.

CONCLUSION

Remote teaching has transformed teachers' communication in class, highlighting the need for monitoring by them. Teachers reported improved vocal quality during ERT compared with before the pandemic, but it worsened slightly in hybrid teaching. Public school teachers perceived greater vocal improvement than those in private schools. The most common symptoms were hoarseness, dry throat, sore throat, and overall fatigue, regardless of the time of analysis. During hybrid teaching, most of the sample had mildly deviant voices, especially due to roughness and strain, which are related to the most frequent symptoms.

Pre-trained quantum convolutional neural network for COVID-19 disease classification using computed tomography images

Background

The COVID-19 pandemic has had a significant influence on economies and healthcare systems around the globe. One of the most important strategies that has proven to be effective in limiting the disease and reducing its rapid spread is early detection and quick isolation of infections. Several diagnostic tools are currently being used for COVID-19 detection using computed tomography (CT) scan and chest X-ray (CXR) images.

Methods

In this study, a novel deep learning-based model is proposed for rapid detection of COVID-19 using CT-scan images. The model, called pre-trained quantum convolutional neural network (QCNN), seamlessly combines the strength of quantum computing with the feature extraction capabilities of a pre-trained convolutional neural network (CNN), particularly VGG16. By combining the robust feature learning of classical models with the complex data handling of quantum computing, the combination of QCNN and the pre-trained VGG16 model improves the accuracy of feature extraction and classification, which is the significance of the proposed model compared to classical and quantum-based models in previous works.

Results

The QCNN model was tested on a SARS-CoV-2 CT dataset, initially without any pre-trained models and then with a variety of pre-trained models, such as ResNet50, ResNet18, VGG16, VGG19, and EfficientNetV2L. The results showed the VGG16 model performs the best. The proposed model achieved 96.78% accuracy, 0.9837 precision, 0.9528 recall, 0.9835 specificity, 0.9678 F1-Score and 0.1373 loss.

Conclusion

Our study presents pre-trained QCNN models as a viable technique for COVID-19 disease detection, showcasing their effectiveness in reaching higher accuracy and specificity. The current paper adds to the continuous efforts to utilize artificial intelligence to aid healthcare professionals in the diagnosis of COVID-19 patients.

Severity Profile of COVID-19 in Hospitalized Pediatric Patients

OBJECTIVE

We aimed to describe the clinical characteristics associated with severity in children hospitalized with COVID-19.

METHOD

This was an epidemiological cohort study conducted in two hospitals, one of which was a reference center for the treatment of COVID-19 cases. Data were collected from the reports generated by the hospital epidemiology centers and the medical records of patients aged between 0 and 14 years with a diagnosis of COVID-19, hospitalized between March 2020 and June 2021. To analyze the association between the clinical profile and severity, the cases were classified as severe (severe and critical) and non-severe (asymptomatic, mild, and moderate).

RESULTS

Of the 191 children followed up in the cohort, 73.3% developed the severe form. The percentage of children with oxygen saturation below 95% was 46.6%. In the multivariate analysis, a higher risk of severity was estimated among children with uncontrolled asthma (RR = 13.2), who were overweight or obese (RR = 3.21), who had cough symptoms (RR = 2.72), and those aged under one year (RR = 3.23).

CONCLUSIONS

This result underscores the need to improve healthcare at every level for children and for the management of asthma and nutrition when considering children with this clinical profile who are diagnosed with COVID-19.

Use of NIR in COVID-19 Screening: Proof of Principles for Future Application

The COVID-19 pandemic that affected the world between 2019 and 2022 showed the need for new tools to be tested and developed to be applied in global emergencies. Although standard diagnostic tools exist, such as the reverse-transcription polymerase chain reaction (RT-PCR), these tools have shown severe limitations when mass application is required. Consequently, a pressing need remains to develop a rapid and efficient screening test to deliver reliable results. In this context, near-infrared spectroscopy (NIRS) is a fast and noninvasive vibrational technique capable of identifying the chemical composition of biofluids. This study aimed to develop a rapid NIRS testing methodology to identify individuals with COVID-19 through the spectral analysis of swabs collected from the oral cavity. Swab samples from 67 hospitalized individuals were analyzed using NIR equipment. The spectra were preprocessed, outliers were removed, and classification models were constructed using partial least-squares for discriminant analysis (PLS-DA). Two models were developed: one with all the original variables and another with a limited number of variables selected using ordered predictors selection (OPS-DA). The OPS-DA model effectively reduced the number of redundant variables, thereby improving the diagnostic metrics. The model achieved a sensitivity of 92%, a specificity of 100%, an accuracy of 95%, and an AUROC of 94% for positive samples. These preliminary results suggest that NIRS could be a potential tool for future clinical application. A fast methodology for COVID-19 detection would facilitate medical diagnoses and laboratory routines, helping to ensure appropriate treatment.

The Effect of Angiotensin-Converting Enzyme Insertion/Deletion Polymorphism on the Severity and Death Rate of COVID-19 in Iranian Patients

The study was designed to assess the association of ACE I/D polymorphism with the severity and prognosis of COVID-19 in the Iranian population. Hence, 186 adult patients were categorized into three clinical groups based on the severity of COVID-19: 1) Outpatients or mildly symptomatic patients as control (n = 71); 2) Hospitalized patients or severe symptomatic cases (n = 53); 3) Inpatients led to ICU/death or critically ill patients needed mechanical ventilation (n = 62). The possible association of ACE I/D polymorphism with the risk of comorbidities and serum level of C-reactive protein was evaluated in two severe cases. The results showed that the frequency of D and I alleles are 69.35% and 30.65%, respectively, in the total population. The analysis of allelic frequencies via Fisher's exact test confirmed significantly higher frequency of D allele in both severe groups than that in the mild one, 78.31% in Hospitalized patients (OR = 2.56; 95% CI 1.46 to 4.46; p-value = 0.0011) and 74.19% in Inpatients led to ICU/death (OR = 2.04; 95% CI = 1.22 to 3.43; p-value = 0.0094) compared to 58.45% in Outpatients. The results of genotype proportions displayed an association between COVID-19 severity and DD genotype. Overall, our findings in Iranian patients supported the undeniable role of the DD genotype in the intensity of the disease, comparable to other populations. Furthermore, there is no definite evidence regarding the protective effect of the I allele in our inquiry.

Prevalence of anti-HLA antibodies in COVID-19 convalescent plasma donors: an Indian experience

BACKGROUND

COVID-19 convalescent plasma is one of the experimental therapies used widely in moderately sick COVID-19 patients. However, there are a few risks involved in plasma transfusion; notably, transfusion-related acute lung injury (TRALI) caused by antibodies against human leukocyte antigens (HLA). This study was designed to assess the prevalence of anti-HLA antibodies in convalescent plasma donors using the single antigen bead method.

STUDY DESIGN AND METHODS

This was a hospital-based observational study of consecutive plasma donors. A total of 252 samples were screened for anti-HLA Class I and Class II antibodies using the microbead assay with the identification of anti-HLA Ab in positive samples being performed using a single antigen bead assay. Luminex-based normalized background cutoff ratios of 10.8 for Class I and 6.9 for Class II and mean fluorescence intensity cutoffs of 2500 for Class I and 1500 for Class II were used for screening and the single bead assay, respectively.

RESULTS

Of 252 screened samples, 28 (11.1 %) were positive for Class I, Class II or both Class I and Class II anti-HLA antibodies in donors with no history of a previous immunizing event. Moreover, 20/252 (7.9%) donors without any history of prior immunization had specific anti-HLA antibodies of Class I or Class II or both by the single bead assay.

CONCLUSIONS

The high prevalence of anti-HLA antibodies in our cohort of donors raises an urgent and immediate need for anti-HLA antibody screening in all convalescent plasma donors for safe therapy of COVID-19 patients.

The cumulative impact of trauma, chronic illness, and COVID-19 stress on mental health in a case-control study of adults with psychotic disorders in Ethiopia

BACKGROUND

The COVID-19 pandemic has profoundly impacted the economic, psychological, and social well-being of people in Ethiopia. Pandemic-related fears can exacerbate anxiety and depression symptoms among those with pre-existing physical and mental health conditions as well as those with prior exposure to traumatic events.

METHODS

We used data from the Ethiopia NeuroGAP-Psychosis study (898 cases and 941 controls with and without a diagnosis of psychosis respectively, 66% male, mean age = 37 years). Data was collected between November 2021 and June 2022 during the COVID-19 pandemic from four hospitals in Ethiopia (three in Addis Ababa and one in Jimma city). Structural equation modeling analysis was conducted to examine the associations between trauma exposure, physical health conditions (like arthristis, neurological disorders, diabetes), COVID-19 stress, and psychological distress (depression and anxiety symptoms). We assessed direct and indirect effects for mediation, and conducted multigroup analysis to examine moderation by case control status.

RESULTS

We found evidence that the impact of greater trauma exposure and physical health conditions on higher psychological distress was mediated through higher COVID-19 stress. Sociodemographic characteristics (older age and being maried) were associated with higher psychological distress, with these associations mediated through greater trauma, physical health conditions, and COVID-19 stress. Case-control status also moderated the associations between these variables, with the mediation effects being stronger in cases and weaker in controls. Further, cases reported greater trauma and psychological distress, while controls reported more physical health conditions and COVID-19 stress.

IMPLICATIONS

Our findings uniquely assess the interaction of health and emergency related factors in understudied settings like Ethiopia. They underscore the importance of including daily hardships and environmental stressors, along with prior trauma exposure, as risk factors for the assessment of mental health symptoms. This study has key implications for mental health screening and intervention research in response to complex emergency contexts like Ethiopia with a history of armed conflict in addition to the COVID-19 pandemic. Our findings can aid the development of targeted services that address the mental health of at-risk groups with pre-existing mental and physical health conditions.

Navel orange peel ethanolic extract and naringin ameliorate CFA-induced arthritis in Wistar rats through their modulatory effects on Th1/Th2/Th17 cytokines and oxidative stress

Rheumatoid arthritis (RA) is an autoimmune illness affecting joint articulations, leading to a disability state. Currently, there is no satisfying optimal therapy except for immunosuppressants, which have variable and bad effects after long-term use. Hence, researchers have attempted to develop other alternative, safer, and more effective natural treatment agents that are effective and without undesirable effects. The objective of this research is to assess the antiarthritic properties of navel orange peel ethanolic extract (NOPEE) and naringin (NAR) in experimentally induced RA in male Wistar rats. RA was induced via two successive subcutaneous injections of 0.1 mL complete Freund's adjuvant (CFA) into a footpad of the right hind leg. The arthritic rats were orally treated with 100 mg/kg body weight (b.w.)/day of NOPEE or with 25 mg/kg b.w./day of NAR for 14 days. Results showed that treatment with NOPEE or NAR obviously counteracted the increased ankle joint circumference, inflammatory cell infiltration, pannus development, cartilage degradation, and synovial hyperplasia that developed in CFA-induced arthritic rats. Additionally, the elevation of serum rheumatoid factor (RF), prostaglandin E2 (PGE-2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-17 (IL-17) were significantly declined in parallel to enhanced level of serum interleukin-4 (IL-4). Furthermore, NOPEE and NAR supplementation, reversed the negative oxidative effects of lipid peroxidation (LPO), nitric oxide (NO), as well as improved the antioxidant glutathione level (GSH), glutathione reductase (GR) and superoxide dismutase (SOD) activities. Overall, the anti-arthritic effects of NOPEE and NAR may be mediated through their modulatory effects on T helper (Th)1/Th2/Th17 cytokines, oxidative stress, and the antioxidant defense system.

Racial Attitudes and Perceptions of Government Response during the COVID-19 Pandemic: Implications for Public Health Strategies

BACKGROUND

This study explored whether opinions about the government's role in addressing the COVID-19 pandemic vary based on demographic characteristics and racial beliefs. We hypothesized that opinions about the United States (U.S.) government's response to COVID-19 would differ based on an individual's characteristics such as age, race, and racial beliefs.

METHODS

We utilized an Inter-University Consortium for Political and Social Research dataset to examine differences in opinion regarding the government's pandemic response, considering personal characteristics and racial beliefs. Descriptive statistics depicted respondents' characteristics, and a Chi-square test for independence assessed whether differences emerged based on racial attitude, self-reported racial identity, sex, income, education, and age. Logistic regression analyses were conducted to independently determine which characteristics were associated with differences in evaluating the government's pandemic response.

RESULTS

The sample consisted of 1028 respondents: 47.5% male and 52.5% female. Overall, the group viewed the government unfavorably, with only 40% reporting that the government responded correctly and 54% believing the government is almost always wasteful and inefficient. Hispanics or Latinos were more likely to view the government as wasteful or inefficient, while more Whites rated the government's pandemic response as appropriate. Individuals who believed that racial discrimination is the main reason why many Black people cannot get ahead generally regarded the government's pandemic response more favorably. Only 5% deemed the government's response excessive. Being Black, younger, and female was associated with the view that racial discrimination is the main reason why many Black people cannot get ahead. Individuals who felt this way viewed the government unfavorably by almost a 2:1 ratio.

CONCLUSIONS

A majority of U.S. residents do not believe the government responded correctly to the pandemic and more than half viewed the government as wasteful and inefficient. Differences emerged by ethnicity and racial attitudes, with individuals of color holding more negative views of the government's response. Understanding this perspective can help develop messaging and strategies that resonate with communities where racial and minority groups live.

COVID-19 among Physically Active and Physically Inactive Individuals

INTRODUCTION

COVID-19 was first reported in Wuhan, China, and subsequently spread worldwide. There were numerous restrictions on daily life activities, including lifestyles, social distancing, isolation and access to many forms of exercise and home confinement. All these activities have health benefits, as they enhance the immune system, which is the need of the hour during the COVID-19 pandemic. There is little data regarding the occurrence of COVID-19 among marathon runners, cyclists and yoga practitioners. The aim of the present study was to find the prevalence of COVID-19 among physically active and physically inactive individuals and to compare it among those groups.

MATERIAL AND METHODS

Physically active individuals were selected as per the Global Recommendations on Physical Activity for Health 2010, in the age group of 18-60 years, and included runners, yoga practitioners and cyclists from the Hyderabad club. A prevalidated questionnaire was circulated among the study groups through Google form. The data was analyzed statistically.

RESULTS

There was a high proportion of persons affected by COVID-19 in the physically inactive group (75.75%) when compared to the active group (17.17%). The percentages of subjects who tested positive for COVID-19 were as follows: 16.16% cyclists, 29.29% runners and 27.27% yoga practitioners among the physically active individuals, and 51.51% of physically inactive subjects.

CONCLUSION

Physical activity acts as a barrier against COVID-19 infections and enhances the immune system. Therefore, it has to be prioritized by public health agencies and incorporated into routine medical care.

SARS-CoV-2 Research in Dogs (Canis lupus familiaris) and Felines (Felis silvestris catus) Domiciled in an International Border Region (Paraguay and Brazil)

Introduction: COVID-19 is an infectious disease caused by SARS-CoV-2 that has become a serious threat to public health owing to its rapid spread from aerosols from infected people. Despite being considered a strictly human disease, there are reports in the literature about animals with confirmed presence of the virus. Aim: Owing to the scarcity of scientific literature on the potential for infection of animals and their importance for One Health, the objective of this work was to research SARS-CoV-2 RNA in felines (Felis silvestris catus) and dogs (Canis lupus familiaris) domiciled. Materials and Methods: Oropharyngeal swabs were collected from domestic dogs and cats belonging to patients diagnosed with COVID-19 from August to October 2021 and residents of the northwest and west regions of Paraná, Brazil. Results: Of the 34 samples collected, 14 were from dogs and 20 from cats. Three of these samples tested positive in real-time PCR, and two of them were also positive in the immunochromatographic test. After testing positive in real-time PCR, the samples underwent genetic sequencing using the Illumina COVIDSeq test. Of the 34 samples collected, three (9%), all of them female and from the feline species, tested positive in real-time PCR, with two of these (67%) also testing positive in the immunochromatographic test. Regarding sequencing, it was possible to sequence the three samples aligned with the AY.101 lineage, corresponding to the Delta variant. Conclusion: The occurrence of SARS-CoV-2 infection in dogs and cats is seen as an unintended event with significant implications for public health, including its potential transmission to other animal species. Further research is required to enhance our understanding of how this disease spreads among these animals and its broader impact on One Health initiatives.

Predictive Factors for Poor Outcomes Associated with COVID-19 in a Retrospective Cohort of Myasthenia Gravis Patients

Purpose

To investigate the predictors for poor outcomes (including disease exacerbation, hospitalization and myasthenic crisis) in patients with pre-existing myasthenia gravis (MG) following Coronavirus disease 2019 (COVID-19), and to explore the potential effects of COVID-19 on inflammatory and immune responses in MG patients.

Patients and Methods

This retrospective cohort study analyzed medical records of 845 MG patients who were diagnosed with COVID-19 between January 2020 to March 2023 at a single medical center.

Results

Generalized MG at onset and comorbidities (chronic kidney disease and malignancy) were independent risk factors of poor outcomes. Patients achieving minimal manifestation or better status before COVID-19 had a significantly reduced risk for poor outcomes. Furthermore, patients with older onset age or anti-acetylcholine receptor antibody had a higher risk of exacerbation and hospitalization than those without. Prednisone or immunosuppressant treatment had the potential to reduce the occurrence of poor outcomes, while the duration of prednisone or immunosuppressant usage was associated with a higher risk of poor outcomes. Of the 376 MG patients with blood results available, patients with COVID-19 tended to have higher levels of leukocyte counts, neutrophil-lymphocyte-ratio, hypersensitive C-reactive protein, and Interleukin-6, as well as lower percentages of lymphocytes and regulatory T cells compared to patients without COVID-19.

Conclusion

Disease severity at onset, comorbidities, and unsatisfactory control of myasthenic symptoms predicted the occurrence of poor outcomes in MG patients following COVID-19. The risk of poor outcomes was reduced in patients controlled by short-term immunosuppressive therapy. Novel coronavirus might affect inflammatory and immune responses in MG patients, particularly in altering interleukin-6 and regulatory T cell levels.

3-chymotrypsin-like protease in SARS-CoV-2

Coronaviruses constitute a significant threat to the human population. Severe acute respiratory syndrome coronavirus-2, SARS-CoV-2, is a highly pathogenic human coronavirus that has caused the coronavirus disease 2019 (COVID-19) pandemic. It has led to a global viral outbreak with an exceptional spread and a high death toll, highlighting the need for effective antiviral strategies. 3-Chymotrypsin-like protease (3CLpro), the main protease in SARS-CoV-2, plays an indispensable role in the SARS-CoV-2 viral life cycle by cleaving the viral polyprotein to produce 11 individual non-structural proteins necessary for viral replication. 3CLpro is one of two proteases that function to produce new viral particles. It is a highly conserved cysteine protease with identical structural folds in all known human coronaviruses. Inhibitors binding with high affinity to 3CLpro will prevent the cleavage of viral polyproteins, thus impeding viral replication. Multiple strategies have been implemented to screen for inhibitors against 3CLpro, including peptide-like and small molecule inhibitors that covalently and non-covalently bind the active site, respectively. In addition, allosteric sites of 3CLpro have been identified to screen for small molecules that could make non-competitive inhibitors of 3CLpro. In essence, this review serves as a comprehensive guide to understanding the structural intricacies and functional dynamics of 3CLpro, emphasizing key findings that elucidate its role as the main protease of SARS-CoV-2. Notably, the review is a critical resource in recognizing the advancements in identifying and developing 3CLpro inhibitors as effective antiviral strategies against COVID-19, some of which are already approved for clinical use in COVID-19 patients.

DeepCSFusion: Deep Compressive Sensing Fusion for Efficient COVID-19 Classification

Worldwide, the COVID-19 epidemic, which started in 2019, has resulted in millions of deaths. The medical research community has widely used computer analysis of medical data during the pandemic, specifically deep learning models. Deploying models on devices with constrained resources is a significant challenge due to the increased storage demands associated with larger deep learning models. Accordingly, in this paper, we propose a novel compression strategy that compresses deep features with a compression ratio of 10 to 90% to accurately classify the COVID-19 and non-COVID-19 computed tomography scans. Additionally, we extensively validated the compression using various available deep learning methods to extract the most suitable features from different models. Finally, the suggested DeepCSFusion model compresses the extracted features and applies fusion to achieve the highest classification accuracy with fewer features. The proposed DeepCSFusion model was validated on the publicly available dataset "SARS-CoV-2 CT" scans composed of 1252 CT. This study demonstrates that the proposed DeepCSFusion reduced the computational time with an overall accuracy of 99.3%. Also, it outperforms state-of-the-art pipelines in terms of various classification measures.

The 100 most-cited articles in COVID-19: a bibliometric analysis

Corona virus disease 2019 (COVID-19) pandemic, sparked by the emergence of a novel coronavirus in early 2020, has prompted a surge in published articles. This study aims to systematically analyse the characteristics and trends of impactful research in the field. The 100 most-cited publications associated with COVID-19 were identified by two independent reviewers using the 'Web of Science' database across all available journals up to the year 2023. Data collected include country, citation count, subject, level of evidence (using Oxford Centre for Evidence-Based Medicine System 2011), impact factor, funding, and study design. We identified 394 038 publications, and the 100 most-cited publications were ranked. These were cited by a total of 283 034 articles (median citation = 767), median impact factor of 66.9 and 72 articles with fundings. China (n = 44), USA (n = 19), and UK (n = 13) were the three highest contributors (n = 220 505). Most articles were level 5 evidence (n = 48), followed by level 3 (n = 28), 4 (n = 14), 2 (n = 7), and 1 (n = 3). The main subjects were mechanism of action and structures of SARS-CoV-2 virus (n = 18) and impact of COVID-19 on public health (n = 18). Publications in 2022 and 2023 predominantly focused on the impact of COVID-19. Majority of the highly cited studies were of low-to-moderate quality, with only 10 consisting of randomized controlled trials or systematic reviews with or without meta-analysis. These findings reflect a growing interest in understanding the impact of COVID-19 pandemic on public and mental health. This analysis found the potential for future double-blinded randomized controlled trials to validate existing findings.

Predictive Value and Diagnostic Potential of IL-10, IL-17A, IL1-β, IL-6, CXCL, and MCP for Severe COVID-19 and COVID-19 Mortality

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) necessitates advanced prognostic tools to anticipate disease progression and optimize patient outcomes. This study evaluates the predictive value and diagnostic potential of interleukins interleukin (IL) IL-10, IL-17A, IL1-β, IL-6, chemokine ligand (CXCL), and Monocyte Chemotactic Protein (MCP) for severe coronavirus disease 2019 (COVID-19) and COVID-19 mortality, aiming to correlate cytokine levels with disease severity. Conducted from January 2023 to January 2024, this prospective cohort study involved patients hospitalized with moderate and severe COVID-19 from Romania. This study analyzed statistically significant predictors of severe COVID-19 outcomes. IL-6 and MCP emerged as significant, with hazard ratios (HRs) of 2.35 (95% confidence interval (CI): 1.54-3.59, p = 0.014) and 2.05 (95% CI: 1.22-3.45, p = 0.007), respectively. Compound scores integrating multiple inflammatory markers also demonstrated predictive value; Compound Score 2 had an HR of 2.23 (95% CI: 1.35-3.68, p = 0.002), surpassing most single markers in association with severe disease. Notably, interleukins IL-10 and IL-1β did not show significant associations with disease severity. This study underscores the importance of IL-6 and MCP as robust predictors of severe COVID-19, substantiating their role in clinical assessments to foresee patient deterioration. The utility of compound scores in enhancing predictive accuracy suggests a composite approach may be more effective in clinical settings.