Outbreak of COVID-19: An emerging global pandemic threat

A study on the siting of emergency medical facilities under uncertain demand-A case study of Wuhan country parks

Introduction

At the beginning of 2020, the novel coronavirus broke out as a sudden public health emergency worldwide, with the number of confirmed patients constantly rising, which brought huge pressure to the medical system. Many countries and regions have noticed the positive role of emergency medical facilities in combating the COVID-19 pandemic. Therefore, the analysis of the location and construction of emergency medical facilities for public health emergencies has practical significance.

Objective

This paper mainly discusses the use of urban suburban parks as the construction sites for emergency medical facilities and builds a maximum service quality level model for emergency medical facilities in response to public health emergencies.

Method

Considering the suddenness and unpredictability of public health emergencies, this study introduces polyhedral uncertainty sets to describe the uncertainty of the number of confirmed patients and transforms the model into an easily solvable mixed-integer programming model through the Bertsimas and Sim robust optimization method. The GAMS software is used for programming and the CPLEX solver is called to solve the model. Taking 13 urban suburban parks in Wuhan as an example, the optimal location plan and patient allocation of emergency medical facilities are determined, verifying the feasibility and effectiveness of the model.

Discussion

The results show that the model effectively promotes the determination of location plans and patient transfer routes. It is expected that in the event of a sudden public health emergency in a city, it can provide reference and basis for decision-makers to deal with public health emergencies.

The Trend in Suicide Risk Among People with HIV Before, During, and After the COVID-19 Pandemic Lockdown

Suicide Risk (SR) and the COVID-19 pandemic affected People with HIV (PWH) disproportionately in comparison with the general population, but little information on SR during and after the COVID-19 lockdown on the Latino PWH has been described, therefore, this study aimed to describe SR in PWH attended the HIV clinic before (2018-2019), during (2020), and after (2021-2022) the COVID-19 lockdown, the trend of SR, and the factors associated. Three standardized questions from the "Columbia-Suicide Severity Rating Scale" (C-SSRS) were routinely applied as screening for suicide risk to all PWH attending their clinical visits during 2018-2022. We estimated suicidality risk and rate. We compared sociodemographic characteristics in those with and without SR. We evaluated the potential association of SR with the calendar year before, during, and after the COVID-19 lockdown using a mixed-effects logistic regression. A total of 2330 patients were seen during the study period; 2157 (93%) were evaluated for suicidality at least once, of those, 75 (3.5%) had SR. Those with SR compared with non-SR were more frequently women (20% vs 10%) and with a heterosexual HIV transmission route (29% vs 23%). SR rates per 1000 patients-day among those evaluated were 0.03 in 2018, 0.25 in 2019, 3.16 in 2020, 7.0 in 2021 and 11.98 in 2022. Throughout the model, independently of covariables, a significant increase in the OR of SR was observed in these years compared to 2018: 1.07 in 2019; 2.74 in 2021; and 4.82 in 2022, except in 2020, OR = 0.18.

Analysis of equity in the distribution of human resources and hospital beds and its association with the COVID-19 mortality rate: a case of Iran

BACKGROUND AND OBJECTIVE

Equitable distribution of health resources is important to achieving equity, guaranteeing access to healthcare services, and improving societies' health status. This study aimed to examine equity in the distribution of health resources and its association with the mortality caused by COVID-19 in South Khorasan province, east Iran.

METHOD

This was a secondary analysis of data from a cross-sectional study conducted in South Khorasan province in 2022. Data were drawn from an existing online database (Farabar) provided by the Public Health Department of the Ministry of Health in Iran. Data related to the number of hospital beds, medical specialists and practitioners, nurses, paramedical workers, health watch, community health workers (Behvarz), healthcare financial resources, and COVID-19 mortality rate were extracted from the Farabar system for each city separately. The equity in the distribution of resources was analyzed by calculating the Gini Coefficient index and using EXCEL software. The Gini Coefficient was used to measure the distribution of health resources and services (i.e. financial resources, human resources, hospital beds, ICU beds) against population size and geographic size. Data were analyzed using SPSS software, version 25.

RESULTS

The Gini Coefficient ranged between 0.006 and 0.320. The Gini Coefficient of health care system financial (0.006) resources distribution was more equitable, while that of hospital beds (0.229) and intensive care beds (0.320) was more inequitable. The Gini Coefficient of the distribution of human resources was estimated at less than 0.3, which is relatively equitable. The COVID-19 mortality rate per 100,000 population was estimated at 113.6, lower than the national average. After controlling the confounding variable (rural population (as % of the total population)), there was no significant correlation between COVID-19 mortality and the distribution of human resources, hospital beds, and healthcare financial resources.

CONCLUSION

According to the results, the distribution of resources relative to the province's population was relatively equitable, and there was no significant correlation between the COVID-19 mortality rate and the distribution of human resources, hospital beds, and healthcare financial resources. This can be due to the equitable distribution of health resources. Having a better and deeper understanding of the regions and populations disproportionately impacted by COVID-19 can help with intervention and resource allocation.

A β-Thalassemia Cell Biobank: Updates, Further Validation in Genetic and Therapeutic Research and Opportunities During (and After) the COVID-19 Pandemic

Background: Cellular biobanks are of great interest for performing studies finalized in the development of personalized approaches for genetic diseases, including β-thalassemia and sickle cell disease (SCD), important diseases affecting the hematopoietic system. These inherited genetic diseases are characterized by a global distribution and the need for intensive health care. The aim of this report is to present an update on the composition of a cellular Thal-Biobank, to describe its utilization since 2016, to present data on its application in studies on fetal hemoglobin induction and on gene editing, and to discuss its employment as a "unique tool" during and after the COVID-19 pandemic. Methods: The methods were as follows: freezing, cryopreservation, long-term storage, and thawing of erythroid precursor cells from β-thalassemia patients; fetal hemoglobin (HbF) induction; CRISPR-Cas9 gene editing; HPLC analysis of the hemoglobin pattern. Results: The updated version of the Thal-Biobank is a cellular repository constituted of 990 cryovials from 221 β-thalassemia patients; the phenotype (pattern of hemoglobin production) is maintained after long-term storage; fetal hemoglobin induction and CRISPR-Cas9 gene editing can be performed using biobanked cells. In representative experiments using an isoxazole derivative as HbF inducer, the HbF increased from 13.36% to more than 60%. Furthermore, in CRIPR/Cas9 gene editing, de novo production of HbA was obtained (42.7% with respect to the trace amounts found in untreated cells). Conclusions: The implemented Thal-Biobank was developed before the COVID-19 outbreak and should be considered a tool of great interest for researchers working on β-thalassemia, with the aim of developing innovative therapeutic protocols and verifying the impact of the COVID-19 pandemic on erythroid precursor cells.

Does the COVID-19 XBB Omicron subvariant signal the beginning of the end of the pandemic?

ABSTRACT

All pandemic viruses have eventually adapted to human hosts so that they become more transmissible and less virulent. The XBB Omicron subvariant is rapidly becoming the dominant strain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Singapore from October 2022 and is one of several variants circulating globally with the potential to dominate autumn/winter waves in different countries. The XBB Omicron subvariant has demonstrated increased transmissibility through an apparent propensity for immune evasion. This is to be expected in the natural evolution of a virus in a population highly vaccinated with a vaccine targeting the spike protein of the original Wuhan strain of the virus. This review explores the important implications of the rising prevalence of the SARS-CoV-2 Omicron subvariant for public health in Singapore and beyond.

Clinical and Epidemiological Features of Pediatric COVID-19: A Retrospective Study

Background and Aims

There is a demand for additional data regarding the impact of coronavirus disease 2019 (COVID-19) on the pediatric population. This study sought to determine the clinical and epidemiological features of pediatric COVID-19 in Iran.

Methods

A retrospective study was performed to assess medical records of children with COVID-19 admitted to Abuzar Hospital in Ahvaz (Iran). Their clinical and demographic data were recorded.

Results

In this study, 600 medical records of pediatric COVID-19 patients were evaluated. Over 50% of them were boys. Mild, moderate, and severe manifestations of COVID-19 were identified in 250, 200, and 150 children, respectively. Patients with severe or moderate COVID-19 had substantially higher levels of various inflammatory markers (C-reactive protein (CRP), fibrinogen, and d-dimer), alanine transaminase (ALT), creatine kinase (CPK), blood urea nitrogen (BUN), neutrophils, lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatinine (Cr), bilirubin, and gamma-glutamyl transferase (GGT) compared to children with mild COVID-19 (p < 0.001); they also had lower levels of lymphocytes, hemoglobin (Hb), and vitamin D than patients with mild COVID-19 (p < 0.001). In addition, children with severe or moderate COVID-19 had a notably higher incidence of fever or dry cough and longer hospital stays than those with mild COVID-19 (p < 0.001). The prevalence of malnutrition and anemia in patients was 50.6% and 31.5%, respectively. A significant proportion of children who were underweight and stunted experienced moderate to severe COVID-19. Furthermore, there was a considerably higher prevalence of malnutrition, anemia, and vitamin D insufficiency, or deficiency in children with moderate-to-severe COVID-19 compared to patients with mild COVID-19 (p < 0.001).

Conclusion

The outcomes of this study revealed a significantly higher prevalence of malnutrition, anemia, vitamin D insufficiency or deficiency, elevated liver and kidney function test results, and increased inflammatory markers in children with moderate to severe COVID-19 compared to those with mild COVID-19.

The effect of hypochlorous acid inhalation on the activity of antioxidant system enzymes in rats of different ages

Hypochlorous acid HOCl is an effective disinfectant with a broad spectrum and high rate of microbicidal action. Its use for air treatment can be an effective tool for the prevention and therapy of infectious diseases. In this work, the in vivo study was conducted on 110 Wistar Han rats (12 and 72 weeks old) on the effect of a single inhalation of air containing gaseous HOCl on the activity of antioxidant system enzymes. For this, a special installation was designed to uniformly maintain the concentration of HOCl in the air and regulate it over a wide range. Inhalation exposure was carried out for 4 h at total chlorine concentrations in the air of approximately 2.0 mg/m3 and 5.0 mg/m3, after which the animals were observed for 14 days. The effect of inhalation on the antioxidant system activity varied significantly in animals of different ages. Catalase activity in young rats increased approximately 2-fold on days 1-2 after inhalation, regardless of the HOCl concentration, while in old animals a sharp dose-dependent decrease was initially observed. The glutathione peroxidase activity in animals of both ages increased upon inhalation of air with 5.0 mg/m3 HOCl, and in old animals this was more pronounced; when the HOCl concentration decreased to 2.0 mg/m3, this indicator increased slightly in old rats and remained virtually unchanged in young ones. The glutathione reductase activity when exposed to 2.0 mg/m3 HOCl did not change for both age groups, and with increasing HOCl concentration it increased by 1.5-2.0 times in all animals.

A COMPREHENSIVE REVIEW ON THE MULTIFACETED INTERACTIONS BETWEEN HOST IMMUNITY AND VIRAL PATHOGENESIS IN COVID-19

The Corona Virus Disease (COVID-19) pandemic has presented unparalleled challenges, marked by a wide array of clinical presentations spanning from asymptomatic carriage to severe respiratory compromise and multi-organ dysfunction. It is crucial to comprehend the intricate interplay between host immunity and viral pathogenesis to elucidate disease mechanisms and guide therapeutic strategies. This review delves into the multifaceted interactions between host immunity and viral pathogenesis in COVID-19, with a particular focus on the impact of host factors such as age, sex, comorbidities, and genetic predisposition on disease severity. Utilizing state-of-the-art methodologies, including multiomics approaches, has yielded an expansive molecular portrayal of COVID-19, furnishing innovative perspectives on host immune reactions, viral pathogenicity, and disease advancement. Establishing standardized methodologies for data analysis and interpretation while concurrently addressing ethical considerations and promoting interdisciplinary collaboration are crucial steps in advancing our comprehension of COVID-19 pathogenesis. Despite obstacles like complexities in data integration, this review highlights the imperative of persistent endeavors in deciphering the complex interactions between hosts and pathogens to alleviate the global health ramifications of COVID-19.

The burden and impact of COVID-19 among newborns in African countries: a study protocol for a systematic review and meta-analysis

The WHO, on 30 January 2020, declared the Chinese outbreak of coronavirus disease 2019 (COVID-19) a global community health emergency that poses a serious threat to vulnerable healthcare systems. This review protocol will be conducted to systematically review and to perform a meta-analysis on the impact of COVID-19 among newborns in Africa. All observational studies on the impact of COVID-19 among newborns in Africa will be included. A standard quest strategy to retrieve studies was conducted on several databases (Google Scholar, PubMed/MEDLINE, EMBASE, HINARI, Cochrane Library, WHO COVID-19 database, Africa Wide Knowledge and Web of Science). Two independent authors were tasked to extract key data and to assess the risk of bias. To assess possible publication bias, funnel plot test and Egger's test methods will be used. The description will be used to show the COVID-19 distribution data by interest variables such as residence, setting and person-level characteristics. The findings of this review will notify healthcare professionals about the burden and impact of COVID-19 and provide evidence to bring about the requisite improvements in clinical practice.

Assessment of the hematological profiles among COVID-19 patients during the first and second waves in Ethiopia: A multicenter retrospective cohort study

Background

The coronavirus disease 2019 is highly infectious and patients with coronavirus diseases demonstrated a series of clinical symptoms caused by severe acute respiratory syndrome coronavirus-2. Without a break of the wave's hematological profile of the patients is still ambiguous and differs from wave to wave.

Objective

This study aimed to assess the hematological profile among coronavirus disease 2019 patients during the first and the second waves in Ethiopia.

Methods

A multi-centered facility-based retrospective cohort study design was conducted at six coronavirus disease 2019 treatment centers. A total of 538 study participants were enrolled in the selected coronavirus disease 2019 treatment centers during the first and second waves of the pandemic. The demographic characteristics, underlying diseases, symptoms, and hematological parameters of patients were recorded. Data were entered into Epi-Data Manager 4.6 and analyzed using STATA 14.2. An independent sample t-test was used to assess the mean differences in hematological parameters across waves. Associations between categorical variables across waves were also determined using Chi-square and Fisher exact tests.

Results

Among the total study participants, 240 (44.6%) and 298 (55.4%) patients were taken from wave-1 and wave-2, respectively. The average age of the study participants was 56.44 ± 16.25 years. The most frequent comorbidities in this study were hypertension, diabetes mellitus, ischemic heart disease, and asthma. The most presenting symptoms of COVID-19 infection across the two waves were presented. In the first wave, dry cough 166 (69.2%), fatigue 153 (63.75%), shortness of breath 148 (61.67%), and fever accounted 116 (48.33%), while during the second wave, dry cough 242 (81.2%), fatigue 244 (81.88%) shortness of breath 204 (68.47%) and fever account 180 (60.40%). White blood cells (WBC), neutrophils, and lymphocytes had shown increment during the first wave. Platelet count and platelet distribution width (p < 0.001) had significant mean differences across the two waves, while the other had no significant mean difference.

Conclusion

In the present study, dry cough, fatigue, shortness of breath, and fever were found to be the most presenting symptoms of COVID-19 infection across the two waves. Only the platelet count and platelet distribution width had significant mean differences across the two waves, while the other had no significant mean difference across waves.

Clinical Trials of Mesenchymal Stem Cells for the Treatment of COVID 19

Mesenchymal Stem Cells (MSCs) are being investigated as a treatment for a novel viral disease owing to their immunomodulatory, anti-inflammatory, tissue repair and regeneration characteristics, however, the exact processes are unknown. MSC therapy was found to be effective in lowering immune system overactivation and increasing endogenous healing after SARS-CoV-2 infection by improving the pulmonary microenvironment. Many studies on mesenchymal stem cells have been undertaken concurrently, and we may help speed up the effectiveness of these studies by collecting and statistically analyzing data from them. Based on clinical trial information found on clinicaltrials. gov and on 16 November 2020, which includes 63 clinical trials in the field of patient treatment with COVID-19 using MSCs, according to the trend of increasing studies in this field, and with the help of meta-analysis studies, it is possible to hope that the promise of MSCs will one day be realized. The potential therapeutic applications of MSCs for COVID-19 are investigated in this study.

Effects of SARS-CoV-2 infection on hypothyroidism and subclinical hypothyroidism: a meta-analysis

Background

In recent years, the outbreak of COVID-19 caused by SARS-CoV-2 has been witnessed globally. However, the impact of SARS-CoV-2 infection on thyroid dysfunction and subclinical thyroid dysfunction remains unclear. Therefore, this meta-analysis aimed to assess the effects of SARS-CoV-2 infection on thyroid dysfunction and its relationship with the severity of COVID-19.

Methods

We systematically searched databases including PubMed, Willey Library, Embase, Web of Science, CNKI, Wanfang, and VIP. We focused on randomized controlled trials, case-control studies, and cohort studies published between December 2019 and August 2023, examining the association between SARS-CoV-2 infection and hypothyroidism, with a specific emphasis on the severity of the infection. The quality of the research was assessed using the Newcastle-Ottawa Scale (NOS), while statistical analysis was conducted using the meta and metafor packages in R 4.2.1 software.

Results

For the meta-analysis, a total of eight articles were identified based on strict inclusion and exclusion criteria. For the association between SARS-CoV-2 infection and hypothyroidism, three studies (266 samples) comparing TSH levels of COVID-19 and control groups showed no difference in TSH levels [SMD=-0.04,95%CI(-1.22,1.15),P=0.95]. Additionally, two studies examining TT3 (a sample of 176 cases) and two studies examining TT4 (a sample of 176 cases) also showed no difference in TT3 and TT4 between the COVID-19 group and the control group, respectively. However, when evaluating the severity of COVID-19, six studies (565 samples) showed that TSH in the severe group was significantly lower than in the mild group [SMD = -0.55, 95% CI (-0.96, -0.14)], while FT3 was also lower in the severe group [SMD = -0.96, 95% CI (-1.24, -0.67)]. No noticeable differences were observed between the severe and mild groups in their TT3, FT4, and TT4 levels.

Conclusion

SARS-CoV-2 infection may have detrimental effects on thyroid function in individuals with severe symptoms. More research is needed to confirm and explore this relationship.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023486042.

Research on the site selection of emergency medical facilities from the perspective of country parks

Post-epidemic era, human society entered the stage of epidemic prevention and control normalized, emergency medical facilities are an important means of epidemic prevention and control, attention-needed can provide construction sites for emergency medical facilities. Disaster prevention and green space can provide construction sites for emergency medical facilities. In comparison, it was found that the site selection conditions of country parks and emergency medical facilities were more compatible. Based on the requirement of the latter's location, using the Delphi method and analytic hierarchy process, through to the country park type, effective safety area, space fragmentation, distance away from the water, in the wind, away from the city center distance, hydrogeology, eight factors such as traffic is quantitative, construct the evaluation system of emergency medical facility location. Taking Nanjing as an example, the Nanjing city region within the scope of the 43 country parks comprehensive comparison. Results show that green hill forest park, the highest scores in addition to the traffic time factor, the remaining seven factor score the highest, the most balanced distribution, security, scalability, rehabilitation, convenience, pollution prevention, and evacuation. It can be preferred as the site selection and construction target of emergency medical facilities. Besides, the Youzishan Forest Park and Dongkeng Country Park comprehensive scores and each factor score is higher, can be used as emergency preplan alternative goals. The score results indicate that the evaluation method for severity exhibits higher levels of differentiation, significant validity, and highly consistent assignment of impact factor weights. In view of the different regional land, impact factor weights assignment can be adjusted adjust measures to local conditions, to effectively make use of the existing conditions, avoid adverse factors.

Design, synthesis, and computational studies of novel imidazo[1,2-a]pyrimidine derivatives as potential dual inhibitors of hACE2 and spike protein for blocking SARS-CoV-2 cell entry

In the present work, a new series of imidazo[1,2-a]pyrimidine Schiff base derivatives have been obtained using an easy and conventional synthetic route. The synthesized compounds were spectroscopically characterized using ¹H, ¹³C NMR, LC-MS(ESI), and FT-IR techniques. Green metric calculations indicate adherence to several green chemistry principles. The energy of Frontier Molecular Orbitals (FMO), Molecular Electrostatic Potential (MEP), Quantum Theory of Atoms in Molecules (QTAIM), and Reduced Density Gradient (RDG) were determined by the Density Functional Theory (DFT) method at B3LYP/6-31 G (d, p) as the basis set. Moreover, molecular docking studies targeting the human ACE2 and the spike, key entrance proteins of the severe acute respiratory syndrome coronavirus-2 were carried out along with hACE2 natural ligand Angiotensin II, the MLN-4760 inhibitor as well as the Cannabidiolic Acid CBDA which has been demonstrated to bind to the spike protein and block cell entry. The molecular modeling results showed auspicious results in terms of binding affinity as the top-scoring compound exhibited a remarkable affinity (-9.1 and -7.3 kcal/mol) to the ACE2 and spike protein respectively compared to CBDA (-5.7 kcal/mol), the MLN-4760 inhibitor (-7.3 kcal/mol), and angiotensin II (-9.2 kcal/mol). These findings suggest that the synthesized compounds may potentially act as effective entrance inhibitors, preventing the SARS-CoV-2 infection of human cells. Furthermore, in silico, ADMET, and drug-likeness prediction expressed promising drug-like characteristics.

COVID-19 vaccine hesitancy among women planning for pregnancy, pregnant or breastfeeding mothers in Jordan: A cross-sectional study

BACKGROUND

Women planning to become pregnant, who are pregnant, and who are breastfeeding are more hesitant to take COVID-19 vaccines compared to other women globally.

AIM

This study investigates COVID-19 vaccine hesitancy among women, who are planning for pregnancy, currently pregnant, and breastfeeding women in Jordan.

METHODS

An online cross-sectional study was conducted in the biggest three cities in Jordan, including 874 women.

RESULTS

Women who were planning for pregnancy, pregnant, or breastfeeding reported statistically significant lower levels of perception of the seriousness of COVID-19 (7.12 ± 0.72, 7.53 ± 1.80, 7.2439 ± 7296, respectively), significant lower levels of perceived benefits of the vaccine (8.92 ± 2.15, 8.73 ± 1.93, 9.09 ± 2.10, respectively), significant lower levels of motivation and causes of action (7.15 ± 1.71, 6.7524 ± 1.40, 7.27 ± 1.68, respectively), and significantly higher levels of COVID-19 vaccination hesitancy (31.32 ± 6.40, 30.11 ± 4.49, 30.27 ± 6.29, respectively) than other women. Married women, those whoe were previously infected with COVID-19, and those who had chronic diseases reported statistically significant lower levels of perception of COVID-19 seriousness, perceived benefits of COVID-19 vaccine, motivation to take COVID-19 vaccine, and causes of action, and significantly higher levels of hesitancy to take COVID-19 vaccine than unmarried women, those who have not been infected with COVID-19, and those who were medically healthy (p<0.001). There were statistically significant positive correlations between perception, perceived benefits, motivation, and cause of action with years of education; and statistically significant negative correlations between perception, perceived benefits, motivation, and cause of action with age (p<0.001).

CONCLUSIONS

Women who were planning for pregnancy, pregnant, or breastfeeding in Jordan showed miderate scores in COVID-19 vaccine hesitancy despite the current international recommendations for its safety for women and their foetuses or neonates.

Human-to-AI Interrater Agreement for Lung Ultrasound Scoring in COVID-19 Patients

OBJECTIVES

Lung ultrasound (LUS) has sparked significant interest during COVID-19. LUS is based on the detection and analysis of imaging patterns. Vertical artifacts and consolidations are some of the recognized patterns in COVID-19. However, the interrater reliability (IRR) of these findings has not been yet thoroughly investigated. The goal of this study is to assess IRR in LUS COVID-19 data and determine how many LUS videos and operators are required to obtain a reliable result.

METHODS

A total of 1035 LUS videos from 59 COVID-19 patients were included. Videos were randomly selected from a dataset of 1807 videos and scored by six human operators (HOs). The videos were also analyzed by artificial intelligence (AI) algorithms. Fleiss' kappa coefficient results are presented, evaluated at both the video and prognostic levels.

RESULTS

Findings show a stable agreement when evaluating a minimum of 500 videos. The statistical analysis illustrates that, at a video level, a Fleiss' kappa coefficient of 0.464 (95% confidence interval [CI] = 0.455-0.473) and 0.404 (95% CI = 0.396-0.412) is obtained for pairs of HOs and for AI versus HOs, respectively. At prognostic level, a Fleiss' kappa coefficient of 0.505 (95% CI = 0.448-0.562) and 0.506 (95% CI = 0.458-0.555) is obtained for pairs of HOs and for AI versus HOs, respectively.

CONCLUSIONS

To examine IRR and obtain a reliable evaluation, a minimum of 500 videos are recommended. Moreover, the employed AI algorithms achieve results that are comparable with HOs. This research further provides a methodology that can be useful to benchmark future LUS studies.

Antiviral activity of marine sulfated glycans against pathogenic human coronaviruses

Great interest exists towards the discovery and development of broad-spectrum antivirals. This occurs due to the frequent emergence of new viruses which can also eventually lead to pandemics. A reasonable and efficient strategy to develop new broad-spectrum antivirals relies on targeting a common molecular player of various viruses. Heparan sulfate is a sulfated glycosaminoglycan present on the surface of cells which plays a key role as co-receptor in many virus infections. In previous work, marine sulfated glycans (MSGs) were identified as having antiviral activities. Their mechanism of action relies primarily on competitive inhibition of virion binding to heparan sulfate, preventing virus attachment to the cell surface prior to entry. In the current work we used pseudotyped lentivirus particles to investigate in a comparative fashion the inhibitory properties of five structurally defined MSGs against SARS-CoV-1, SARS-CoV-2, MERS-CoV, and influenza A virus (IAV). MSGs include the disaccharide-repeating sulfated galactan from the red alga Botryocladia occidentalis, the tetrasaccharide-repeating sulfated fucans from the sea urchin Lytechinus variegatus and from the sea cucumber Isostichopus badionotus, and the two marine fucosylated chondroitin sulfates from the sea cucumbers I. badionotus and Pentacta pygmaea. Results indicate specificity of action against SARS-CoV-1 and SARS-CoV-2. Curiously, the MSGs showed decreased inhibitory potencies against MERS-CoV and negligible action against IAV. Among the five MSGs, the two sulfated fucans here studied deserve further attention since they have the lowest anticoagulant effects but still present potent and selective antiviral properties.

The impact of lockdown on symptoms and health status of patients with chronic airway diseases: An appraisal of patient perceived impressions

Background

The pandemic-specific lockdown may influence the health status of patients with chronic airflow obstruction (CAO) as COPD, COPD-PH, and chronic asthma.

Objectives

To find the impact of the lockdown on symptoms, and the degree of perceived change in physical activity and emotional health with possible reasons including the indicators of ambient air pollution.

Methods

A cohort of CAO patients was telephonically enquired regarding their perceived well-being in symptom status, physical activity, and emotional health with the perceived contribution from plausible reasons (regular medication, simple food, no pollution, and family attention) for the change; all being expressed in percentages. The change in symptom scores as 0-39, 40-79, and 80-100 were regarded as 'low', 'medium', and 'high' respectively. The impact of the individual contributing factor was calculated statistically. The assessment of the CAT (COPD assessment test) score and the ambient air pollution (PM2.5 and PM10) was also done for their association with well-being.

Results

There was a universal improvement (p < 0.5) in COPD (n = 113), COPD-PH, (n = 40), and chronic asthma, (n = 19) as regards symptoms, physical activity, and emotional health that tallies to overall and individual change in CAT score. There were concomitant reductions in PM10 and PM2.5 levels during the lockdown compared to the same period of the previous year. All the four listed factors contributed with the 'no/low pollution' and 'simple food being the most important; on acting together, they reduced the moderate and severe symptoms impressively.

Conclusion

Reduced air pollution and simple food appear most important for the improvement of CAO patients during the lockdown period.

Retrospective Modeling of the Omicron Epidemic in Shanghai, China: Exploring the Timing and Performance of Control Measures

BACKGROUND

In late February 2022, the Omicron epidemic swept through Shanghai, and the Shanghai government responded to it by adhering to a dynamic zero-COVID strategy. In this study, we conducted a retrospective analysis of the Omicron epidemic in Shanghai to explore the timing and performance of control measures based on the eventual size and duration of the outbreak.

METHODS

We constructed an age-structured and vaccination-stratified SEPASHRD model by considering populations that had been detected or controlled before symptom onset. In addition, we retrospectively modeled the epidemic in Shanghai from 26 February 2022 to 31 May 2022 across four periods defined by events and interventions, on the basis of officially reported confirmed (58,084) and asymptomatic (591,346) cases.

RESULTS

According to our model fitting, there were about 785,123 positive infections, of which about 57,585 positive infections were symptomatic infections. Our counterfactual assessment found that precise control by grid management was not so effective and that citywide static management was still needed. Universal and enforced control by citywide static management contained 87.65% and 96.29% of transmission opportunities, respectively. The number of daily new and cumulative infections could be significantly reduced if we implemented static management in advance. Moreover, if static management was implemented in the first 14 days of the epidemic, the number of daily new infections would be less than 10.

CONCLUSIONS

The above research suggests that dynamic zeroing can only be achieved when strict prevention and control measures are implemented as early as possible. In addition, a lot of preparation is still needed if China wants to change its strategy in the future.

Speech phoneme and spectral smearing based non-invasive COVID-19 detection

COVID-19 is a deadly viral infection that mainly affects the nasopharyngeal and oropharyngeal cavities before the lung in the human body. Early detection followed by immediate treatment can potentially reduce lung invasion and decrease fatality. Recently, several COVID-19 detections methods have been proposed using cough and breath sounds. However, very little study has been done on the use of phoneme analysis and the smearing of the audio signal in COVID-19 detection. In this paper, this problem has been addressed and the classification of speech samples has been carried out in COVID-19-positive and healthy audio samples. Additionally, the grouping of the phonemes based on reference classification accuracies have been proposed for effectiveness and faster detection of the disease at a primary stage. The Mel and Gammatone Cepstral coefficients and their derivatives are used as the features for five standard machine learning-based classifiers. It is observed that the generalized additive model provides the highest accuracy of 97.22% for the phoneme grouping "/t//r//n//g//l/." This smearing-based phoneme classification technique can also be used in the future to classify other speech-related disease detections.

Therapeutic Effects of Cannabinoids and Their Applications in COVID-19 Treatment

Cannabis sativa is one of the first medicinal plants used by humans. Its medical use remains controversial because it is a psychotropic drug whose use has been banned. Recently, however, some countries have approved its use, including for recreational and medical purposes, and have allowed the scientific study of its compounds. Cannabis is characterized by the production of special types of natural products called phytocannabinoids that are synthesized exclusively by this genus. Phytocannabinoids and endocannabinoids are chemically different, but both pharmacologically modulate CB1, CB2, GRP55, GRP119 and TRPV1 receptor activities, involving activities such as memory, sleep, mood, appetite and motor regulation, pain sensation, neuroinflammation, neurogenesis and apoptosis. Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are phytocannabinoids with greater pharmacological potential, including anti-inflammatory, neuroprotective and anticonvulsant activities. Cannabidiol is showing promising results for the treatment of COVID-19, due to its capability of acting on the unleashed cytokine storm, on the proteins necessary for both virus entry and replication and on the neurological consequences of patients who have been infected by the virus. Here, we summarize the latest knowledge regarding the advantages of using cannabinoids in the treatment of COVID-19.

How Has COVID-19 Impacted Our Language Use?

The COVID-19 pandemic has led to severe consequences for people's mental health. The pandemic has also influenced our language use, shaping our word formation habits. The overuse of new metaphorical meanings has received particular attention from the media. Here, we wanted to investigate whether these metaphors have led to the formation of new semantic associations in memory. A sample of 120 university students was asked to decide whether a target word was or was not related to a prime stimulus. Responses for pandemic pairs in which the target referred to the newly acquired metaphorical meaning of the prime (i.e., "trench"-"hospital") were compared to pre-existing semantically related pairs (i.e., "trench"-"soldier") and neutral pairs (i.e., "trench"-"response"). Results revealed greater accuracy and faster response times for pandemic pairs than for semantic pairs and for semantic pairs compared to neutral ones. These findings suggest that the newly learned pandemic associations have created stronger semantic links in our memory compared to the pre-existing ones. Thus, this work confirms the adaptive nature of human language, and it underlines how the overuse of metaphors evoking dramatic images has been, in part, responsible for many psychological disorders still reported among people nowadays.

Establishment of hospital resilience framework in urban China: insight from Wuhan City

Since the Corona Virus Disease 2019 (COVID-19) swept the world, many countries face a problem that is a shortage of medical resources. The role of emergency medical facilities in response to the epidemic is beginning to arouse public attention, and the construction of the urban resilient emergency response framework has become the critical way to resist the epidemic. Today, China has controlled the domestically transmitted COVID-19 cases through multiple emergency medical facilities and inclusive patient admission criteria. Most of the existing literature focuses on case studies or characterizations of individual facilities. This paper constructs an evaluation system to measure urban hospital resilience from the spatial perspective and deciphered the layout patterns and regularities of emergency medical facilities in Wuhan, the city most affected by the epidemic in China. Findings indicate that the pattern of one center and two circles are a more compelling layout structure for urban emergency medical facilities in terms of accessibility and service coverage for residents. Meanwhile, the Fangcang shelter hospital has an extraordinary performance in terms of emergency response time, and it is a sustainable facility utilization approach in the post-epidemic era. This study bolsters areas of the research on the urban resilient emergency response framework. Moreover, the paper summarizes new medical facilities’ planning and location characteristics and hopes to provide policy-makers and urban planners with valuable empirical evidence.

Convalescents' Reports on COVID-19 Experience-A Qualitative Study

BACKGROUND

The dynamic character of the COVID-19 pandemic and its social consequences caused several medical and societal issues and dilemmas. The aim of our qualitative research was to capture and analyze attitudes and beliefs of convalescents who experienced mild symptoms of COVID-19 in the first wave of the pandemic and decided to donate their plasma for therapeutic purposes.

MATERIAL AND METHODS

The article presents results of qualitative research conducted on the basis of grounded theory (GT) methodology. Empirical material includes 10 in-depth interviews conducted with respondents who had mild or asymptomatic disease and, after recovery, voluntarily donated their plasma to the Regional Centre for Blood Donation and Blood Treatment (RCKiK). Data were collected in May and June 2020 in Poland. Qualitative analysis was focused on the experience of convalescents who entered the social role of a sick person in individual, social, and organizational dimensions.

RESULTS

The social role of the patient in the narratives of convalescents was related to three stages: (1) initiation to the role, (2) staying in the COVID-19 patient role, and (3) leaving the role. Research results enabled the distinction of three basic descriptive categories ("ontological uncertainty", "the global and individual dimension", and "being sick in the disease-infected environment"), which became epistemological framework for a detailed description of the roles played by an individual COVID-19 patient during the pandemic.

CONCLUSIONS

The disease, despite its mild course, generated a number of non-medical issues, and the entire process of being ill was burdened with institutional and emotional struggles. The experience of mild COVID-19 is significantly modified by disease institutionalization. These results may contribute to a better understanding of the psychosocial dimension of COVID-19 and convalescents' motivations for plasma donation.

Higher Intake of Dietary Magnesium Is Inversely Associated With COVID-19 Severity and Symptoms in Hospitalized Patients: A Cross-Sectional Study

Background and Aims

Magnesium is an anti-inflammatory mineral that plays a role in the innate immune system, and the relaxation of bronchial smooth muscle warrants additional attention in COVID-19. This study examined the association between magnesium intake and COVID-19 severity and related symptoms in hospitalized patients.

Methods

A cross-sectional study was done enrolling 250 COVID-19 patients aged 18 to 65 years. A validated 168-item online food frequency questionnaire (FFQ) was used to assess dietary magnesium intake. COVID-19 Treatment Guidelines were used to determine COVID-19 severity, and symptoms were evaluated using a standard questionnaire. Crude and adjusted analyses were performed (Model 1: age, sex, and energy intake; Model 2: Model 1 + physical activity, supplements, corticosteroids, and antiviral drugs; Model 3: Model 2 + body mass index).

Results

The mean age of participants was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients at the highest tertile of dietary magnesium intake had lower serum levels of inflammatory biomarkers, including CRP (11.8 ± 2.2 vs. 29.5 ± 2.1 mg/L, p < 0.001) and ESR (15.8 ± 2.4 vs. 34.7 ± 2.4 mm/hr, p < 0.001), than those at the lowest tertile. After controlling for potential confounders, we observed that a higher dietary magnesium intake was associated with a lower odds of severe COVID-19 (OR: 0.32; 95% CI: 0.15–0.70). Also, we found a significant inverse association between dietary magnesium intake and odds of COVID-19 symptoms.

Conclusion

We found that higher intake of dietary magnesium was inversely associated with COVID-19 severity and symptoms.

Evaluation of electropolymerized molecularly imprinted polymers (E-MIPs) on disposable electrodes for detection of SARS-CoV-2 in saliva

We investigate electropolymerized molecularly imprinted polymers (E-MIPs) for the selective recognition of SARS-CoV-2 whole virus. E-MIPs imprinted with SARS-CoV-2 pseudoparticles (pps) were electrochemically deposited onto screen printed electrodes by reductive electropolymerization, using the water-soluble N-hydroxmethylacrylamide (NHMA) as functional monomer and crosslinked with N,N'-methylenebisacrylamide (MBAm). E-MIPs for SARS-CoV-2 showed selectivity for template SARS-CoV-2 pps, with an imprinting factor of 3:1, and specificity (significance = 0.06) when cross-reacted with other respiratory viruses. E-MIPs detected the presence of SARS-CoV-2 pps in <10 min with a limit of detection of 4.9 log10 pfu/mL, suggesting their suitability for detection of SARS-CoV-2 with minimal sample preparation. Using electrochemical impedance spectroscopy (EIS) and principal component analysis (PCA), the capture of SARS-CoV-2 from real patient saliva samples was also evaluated. Fifteen confirmed COVID-19 positive and nine COVID-19 negative saliva samples were compared against the established loop-mediated isothermal nucleic acid amplification (LAMP) technique used by the UK National Health Service. EIS data demonstrated a PCA discrimination between positive and negative LAMP samples. A threshold real impedance signal (ZRe) ≫ 4000 Ω and a corresponding charge transfer resistance (RCT) ≫ 6000 Ω was indicative of absence of virus (COVID-19 negative) in agreement with values obtained for our control non-imprinted polymer control. A ZRe at or below a threshold value of 600 Ω with a corresponding RCT of <1200 Ω was indicative of a COVID-19 positive sample. The presence of virus was confirmed by treatment of E-MIPs with a SARS-CoV-2 specific monoclonal antibody.

Fractionation of sulfated galactan from the red alga Botryocladia occidentalis separates its anticoagulant and anti-SARS-CoV-2 properties

Sulfation pattern and molecular weight (MW) play a key role in the biological actions of sulfated glycans. Besides anticoagulant effects, certain sulfated glycans can also exhibit anti-SARS-CoV-2 properties. To develop a more selective antiviral carbohydrate, an efficient strategy to separate these two actions is required. In this work, low MW fractions derived from the red alga Botryocladia occidentalis sulfated galactan (BoSG) were generated, structurally characterized, and tested for activity against SARS-CoV-2 and blood coagulation. The lowest MW fraction was found to be primarily composed of octasaccharides of monosulfated monosaccharides. Unlike heparin or native BoSG, we found that hydrolyzed BoSG products had weak anticoagulant activities as seen by aPTT and inhibitory assays using purified cofactors. In contrast, lower MW BoSG-derivatives retained anti-SARS-CoV-2 activity using SARS-CoV-2 spike (S)-protein pseudotyped lentivirus vector in HEK-293T-hACE2 cells monitored by GFP. Surface plasmon resonance confirmed that longer chains are necessary for BoSG to interact with coagulation cofactors but is not required for interactions with certain S-protein variants. We observed distinct affinities of BoSG derivatives for the S-proteins of different SARS-CoV-2 strains, including WT, N501Y (Alpha), K417T/E484K/N501Y (Gamma), and L542R (Delta) mutants, and stronger affinity for the N501Y-containing variants. Docking of the four possible monosulfated BoSG disaccharides in interactions with the N501Y mutant S-protein predicted potential binding poses of the BoSG constructs and favorable binding in close proximity to the 501Y residue. Our results demonstrate that depolymerization and fractionation of BoSG are an effective strategy to segregate its anticoagulant property from its anti-SARS-CoV-2 action.

Potential Neuroprotective Effect of Cannabinoids in Covid-19 Patients

The global pandemic caused by the SARS-CoV-2 virus began in early 2020 and is still present. The respiratory symptoms caused by COVID-19 are well established, however, neurological manifestations that may result from direct or indirect neurological damage after SARS-CoV-2 infection have been reported frequently. The main proposed pathophysiological processes leading to neurological damage in COVID-19 are cerebrovascular disease, and indirect mechanisms of inflammatory / autoimmune origin. A growing number of studies confirm that neuroprotective measures should be maintained in COVID-19 patients. On the other hand, cannabinoids have been the subject of various studies that propose them as potential promising drugs in chronic neurodegenerative diseases due to their powerful neuroprotective potential. In this review we address the possible mechanism of action of cannabinoids as a neuroprotective treatment in patients infected by SARS-CoV-2. The endocannabinoid system is found in multiple systems within the body, including the immune system. Its activation can lead to beneficial results, such as a decrease in viral entry, a decrease in viral replication, and a decrease in pro-inflammatory cytokines such as IL-2, IL-4, IL-6, IL-12, TNF-α or IFN-c through CB2R expression induced during inflammation by SARS-CoV-2 infection in the central nervous system.

Severity of coronavirus disease 19: Profile of inflammatory markers and ACE (rs4646994) and ACE2 (rs2285666) gene polymorphisms in Iraqi patients

Susceptibility to coronavirus disease 2019 (COVID-19) and disease severity has recently been associated with inflammatory markers and genetic polymorphisms of ACE (angiotensin-converting enzyme) and ACE2 genes, but the evidence has been inconclusive. This case-control study (99 COVID-19 patients and 96 controls) sought to assess the significance of age, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and SARS-CoV-2 RT-PCR cycle threshold (Ct) in severity of COVID-19. Besides, two variants of ACE and ACE2 genes (rs4646994 and rs2285666, respectively) were analyzed to determine their role in COVID-19 susceptibility and/or disease severity. Results revealed that age, CRP and NLR were significantly elevated in severe cases compared to moderate cases, while RT-PCR Ct value was significantly decreased. Allele and genotypes of both variants were not associated with COVID-19 risk, with the exception of rs2285666 A allele. It showed a significantly higher frequency in female patients than in female controls (probability = 0.041). In conclusion, the study indicated the role of age, CRP, NLR and SARS-CoV-2 RT-PCR Ct in susceptibility to COVID-19 severity. However, analysis of the ACE and ACE2 gene variants (rs4646994 and rs2285666, respectively) showed that the two variants were not associated with the risk of developing COVID-19.

General vaccination knowledge influences nurses’ and midwives’ COVID-19 vaccination intention in Cyprus: a nationwide cross-sectional study

This cross-sectional study was conducted during the period between 08 and 28 December 2020 to investigate the association of nurses’ and midwives’ level of vaccination knowledge and the COVID-19 vaccine acceptance for themselves during the COVID-19 pandemic era in Cyprus. Participants included registered nurses and midwives working in public or private service provision. Data collection was achieved using a self-administered questionnaire with questions on socio-demographic characteristics, questions assessing participants’ general vaccination knowledge, and questions related to COVID-19 vaccination. A total of 437 responders answered the survey, with 93% being nurses and 7% midwives. The results indicate that as the vaccination knowledge score increases (higher knowledge) the probability of accepting the COVID-19 vaccination increases too (OR = 1.30, 95% CI: 1.13–1.48). The association between vaccination knowledge and the intention to be vaccinated against COVID-19 remained statistically significant, even after adjusting for age and gender (OR = 1.28, 95% CI: 1.12–1.47), socioeconomic (OR = 1.29, 95% CI: 1.12–1.48), and demographic characteristics (OR = 1.29, 95% CI: 1.11–1.49). Also, as age increases, the probability of accepting the COVID-19 vaccination increases, while female respondents had a lower probability of accepting the COVID-19 vaccination than male respondents. This study demonstrated that COVID-19 vaccination acceptance is related to the vaccination knowledge of the nurses and midwives in Cyprus. Targeted vaccination campaigns are needed to improve nurses’ and midwives’ level of vaccination knowledge in order to achieve a better coverage among them, as well as to influence their patients’ ultimate positive vaccine decision.

Mitigating COVID-19 Transmission in Schools With Digital Contact Tracing

Precision mitigation of COVID-19 is in pressing need for postpandemic time with the absence of pharmaceutical interventions. In this study, the effectiveness and cost of digital contact tracing (DCT) technology-based on-campus mitigation strategy are studied through epidemic simulations using high-resolution empirical contact networks of teachers and students. Compared with traditional class, grade, and school closure strategies, the DCT-based strategy offers a practical yet much more efficient way of mitigating COVID-19 spreading in the crowded campus. Specifically, the strategy based on DCT can achieve the same level of disease control as rigid school suspensions but with significantly fewer students quarantined. We further explore the necessary conditions to ensure the effectiveness of DCT-based strategy and auxiliary strategies to enhance mitigation effectiveness and make the following recommendation: social distancing should be implemented along with DCT, the adoption rate of DCT devices should be assured, and swift virus tests should be carried out to discover asymptomatic infections and stop their subsequent transmissions. We also argue that primary schools have higher disease transmission risks than high schools and, thereby, should be alerted when considering reopenings.

Transformation Model of Government Policy on Task Force Through Coronavirus Disease 2019 Pandemic Handling Strategy in the COVID Tourism Ambassador Program in South Sulawesi Province, Indonesia

BACKGROUND: Various policies have been issued by the government regarding task force to accelerate coronavirus disease 2019 (COVID-19) handling, ranging from presidential decrees, ministerial decrees, governor decrees, followed by decisions from the implementing agencies regarding the policy outputs, and compliance of the target groups. AIM: This study aimed to identify and analyze changes in task force policies as well as strategies used in handling the COVID-19 pandemic through the Tourism Ambassador program in South Sulawesi which is considered as an effective model for handling COVID-19. METHODS: This research was conducted by applying qualitative method that emphasizes interpretation and phenomena holistically. The analysis used was the model of government policy transformation in the task force through the COVID-19 pandemic handling strategy in the COVID tourism ambassador program in South Sulawesi. This study was participated by informants (participants) who were involved in the COVID Ambassador Tourism Program in South Sulawesi. RESULTS: The Provincial Government of South Sulawesi has made policy changes, especially regarding the COVID-19 handling acceleration task force. There were various changes in the government regulatory policies related to the Regulation of the Minister of Health (Permenkes) of the Republic of Indonesia No. 09 of 2020 to Presidential Decree (Kepres) No. 11 of 2020 regarding regulations for Large-Scale Social Restrictions to accelerate the handling of COVID-19 in South Sulawesi. CONCLUSION: Changes in policy related to the acceleration of COVID-19 control and handling in South Sulawesi resulted in a policy output that showed a decrease in the number of COVID-19 positive cases. Implementing the strategy through the COVID-19 Tourism Ambassador program as a model for handling COVID-19 in South Sulawesi is the right strategy.

A Lower 25(OH)D Level in COVID-19 Patients is Associated with Increased Mortality: An Observational Study

Background: Recent studies have shown that insufficient vitamin D supply is correlated with increase in COVID-19 cases and its mortality. Potentially, it may play an important role in controlling virus proliferation. Objectives: This study aimed to evaluate the association between serum vitamin D levels and clinical findings, and mortality rate in patients with COVID-19. Methods: This cross-sectional study was conducted on 200 COVID-19 patients referred or admitted to Loghman-e-Hakim Hospital of Tehran, Iran, from February to June 2020. After patient selection, demographic information of all patients was recorded. Eventually, the relationship between basic demographic and clinical findings with vitamin D levels in all patients was evaluated. Results: The mean Vit-D levels in intubated and non-intubated patients were 22.95 ± 22.23 ng/mL and 21.64 ± 29.20 ng/mL, respectively (P = 0.018). In most of the outpatients (46.7%), Vit-D levels were between 21 - 30 ng/mL, and 47.6% of admitted patients had Vit-D ≤ 20 ng/mL. The mean Vit-D level in survived patients was significantly higher than patients who died (28.2 ± 21.18 ng/mL vs. 19.91 ± 14.18 ng/mL, respectively; P = 0.021). While 34.2% (55 cases) of survived patients had Vit-D level ≥ 31 ng/mL, about 70% of death cases had Vit-D ≤ 20 ng/mL (P < 0.001). Conclusions: According to our results, vitamin D supplementation could be beneficial in COVID-19 patients. However, further comprehensive clinical trials are needed to confirm these findings.

Neutrophil Maturation, Reactivity and Granularity Research Parameters to Characterize and Differentiate Convalescent Patients from Active SARS-CoV-2 Infection

Studying the dynamics changes of neutrophils during innate immune response in coronavirus 2019 (COVID-19) can help understand the pathogenesis of this disease. The aim of the study was to assess the usefulness of new neutrophil activation parameters: Immature Granulocyte (IG), Neutrophil Reactivity Intensity (NEUT-RI), Neutrophil Granularity Intensity (NEUT-GI), and data relating to granularity, activity, and neutrophil volume (NE-WX, NE-WY, NE-WZ) available in hematology analyzers to distinguish convalescent patients from patients with active SARS-CoV-2 infection and healthy controls (HC). The study group consisted of 79 patients with a confirmed positive RT-PCR test for SARS-CoV2 infection, 71 convalescent patients, and 20 HC. We observed leukopenia with neutrophilia in patients with active infection compared to convalescents and HC. The IG median absolute count was higher in convalescent patients than in COVID-19 and HC (respectively, 0.08 vs. 0.03 vs. 0.02, p < 0.0001). The value of the NEUT-RI parameter was the highest in HC and the lowest in convalescents (48.3 vs. 43.7, p < 0.0001). We observed the highest proportion of NE-WX, NE-WY, and NE-WZ parameters in HC, without differences between the COVID-19 and convalescent groups. New neutrophil parameters can be useful tools to assess neutrophils’ activity and functionalities in the immune response during infection and recovery from COVID-19 disease.

A Standardized Prospective Memory Evaluation of the Effects of COVID-19 Confinement on Young Students

The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory (PM), which are pivotal for the ability to plan and perform future activities. Although the number of studies documenting the COVID-19 effects has recently blossomed, most of them employed self-reported questionnaires as the assessment method. The main aim of our study was to use standardized tests to evaluate WM and PM in a population of young students. A sample of 150 female psychology students was recruited online for the administration of two self-reported questionnaires that investigated psychological wellbeing (DASS-21), prospective, and retrospective memory (PRMQ). Subjects were also administered two standardized tests for WM (PASAT) and PM (MIST). We found increased anxiety, depression, and stress and decreased PM as measured by self-reports. The perceived memory failures agreed with the results from the standardized tests, which demonstrated a decrease in both WM and PM. Thus, COVID-19 restriction has strongly impacted on students’ mental health and memory abilities, leaving an urgent need for psychological and cognitive recovery plans.

Chloroquine attenuates thymic stromal lymphopoietin production via suppressing caspase-1 signaling in mast cells

Thymic stromal lymphopoietin (TSLP) produced by mast cells is involved in allergic inflammation pathogenesis. Chloroquine (CQ) is known to be an anti-malarial drug; however, additional protective functions of CQ have been discovered. This study aims to clarify an anti-inflammatory effect of CQ through modulating TSLP levels using an in vitro model of phorbol myristate acetate (PMA) + A23187-activated human mast cell line (HMC-1) and an in vivo model of PMA-irritated ear edema. CQ treatment reduced the production and mRNA expression levels of TSLP in activated HMC-1 cells. CQ down-regulated caspase-1 (CASP1), MAPKs, and NF-κB levels enhanced by stimulation with PMA + A23187. Moreover, ear thickness in ear edema was suppressed following CQ treatment. CQ decreased CASP1 and NF-κB levels in the ear tissue. TSLP levels in the ear tissue and serum were reduced following CQ treatment. Collectively, the above findings elucidate that CQ inhibits the pro-inflammatory mechanisms of TSLP via the down-regulation of distinct intracellular signaling cascade in mast cells. Therefore, CQ may have protective roles against TSLP-mediated inflammatory disorders.

Body Mass Index, Multi-Morbidity, and COVID-19 Risk Factors as Predictors of Severe COVID-19 Outcomes

Purpose

The purpose of the present study was to investigate body mass index, multi-morbidity, and COVID-19 Risk Score as predictors of severe COVID-19 outcomes.

Patients

Patients from this study are from a well-characterized patient cohort collected at Mayo Clinic between January 1, 2020 and May 23, 2020; with confirmed COVID-19 diagnosis defined as a positive result on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assays from nasopharyngeal swab specimens.

Measures

Demographic and clinical data were extracted from the electronic medical record. The data included: date of birth, gender, ethnicity, race, marital status, medications (active COVID-19 agents), weight and height (from which the Body Mass Index (BMI) was calculated, history of smoking, and comorbid conditions to calculate the Charlson Comorbidity Index (CCI) and the U.S Department of Health and Human Services (DHHS) multi-morbidity score. An additional COVID-19 Risk Score was also included. Outcomes included hospital admission, ICU admission, and death.

Results

Cox proportional hazards models were used to determine the impact on mortality or hospital admission. Age, sex, and race (white/Latino, white/non-Latino, other, did not disclose) were adjusted for in the model. Patients with higher COVID-19 Risk Scores had a significantly higher likelihood of being at least admitted to the hospital (HR = 1.80; 95% CI = 1.30, 2.50; P < .001), or experiencing death or inpatient admission (includes ICU admissions) (HR = 1.20; 95% CI = 1.02, 1.42; P = .028). Age was the only statistically significant demographic predictor, but obesity was not a significant predictor of any of the outcomes.

Conclusion

Age and COVID-19 Risk Scores were significant predictors of severe COVID-19 outcomes. Further work should examine the properties of the COVID-19 Risk Factors Scale.

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to coronavirus disease 2019 (COVID-19) which, in turn, may be associated with multiple organ dysfunction. In this review, we present advantages and disadvantages of cannabidiol (CBD), a non-intoxicating phytocannabinoid from the cannabis plant, as a potential agent for the treatment of COVID-19. CBD has been shown to downregulate proteins responsible for viral entry and to inhibit SARS-CoV-2 replication. Preclinical studies have demonstrated its effectiveness against diseases of the respiratory system as well as its cardioprotective, nephroprotective, hepatoprotective, neuroprotective and anti-convulsant properties, that is, effects that may be beneficial for COVID-19. Only the latter two properties have been demonstrated in clinical studies, which also revealed anxiolytic and antinociceptive effects of CBD (given alone or together with Δ9-tetrahydrocannabinol), which may be important for an adjuvant treatment to improve the quality of life in patients with COVID-19 and to limit post-traumatic stress symptoms. However, one should be aware of side effects of CBD (which are rarely serious), drug interactions (also extending to drugs acting against COVID-19) and the proper route of its administration (vaping may be dangerous). Clearly, further clinical studies are necessary to prove the suitability of CBD for the treatment of COVID-19.

No impact of confinement during COVID-19 pandemic on anxiety and depression in Parkinsonian patients

BACKGROUND

Governments around the world have imposed varied containment measures to curb the spread of the COVID-19 infection. The psychological impact could be highly negative in patients with neurologic condition like Parkinson's Disease (PD).

METHODS

We prospectively evaluated symptoms of depression and anxiety in 50 (26 females; mean age at 60.4) non demented Moroccan PD patients, using Hospital Anxiety and Depression Scale (HADS), at the beginning and after 6 weeks of a full confinement.

RESULTS

At the first evaluation, 28% of patients had depression while 32% had anxiety. After 6 weeks of confinement, some patients got worse and others got better scores but no significant statistical difference for both troubles was seen.

CONCLUSION

Our results show that there is no significant impact of 6 weeks of confinement on overall anxiety and depression scores. However, confinement could have an unexpected positive psychological impact on a significant number of PD patients.

COVID-19 Patient with Severe Comorbidity in Multimodal Acute Care Setting with Non-Invasive Medical Ventilation: A Clinical Outcome Report

The virus that causes COVID-19 is rapidly spreading across the globe. Elderly patients with multiple pre-existing conditions are at a higher risk. This case study describes acute inpatient treatment of a COVID-19 patient with uncontrolled diabetes mellitus, kidney complications, heart failure, chronic pain, depression, and other comorbidities in an isolation ward without mechanical ventilation.

Relationship between the dynamic changes of serum 2019-nCoV IgM/IgG and patient immunity after 6 month hospital discharge

Objectives

To investigate the relationship between the dynamic changes of serum 2019-nCoV IgM/IgG and immunity alteration for patients after 6-month hospital discharge.

Methods

One IgM(+) and IgG(−), 32 IgM(+) and IgG(+), 38 IgM(−) and IgG(+), and 40 IgM(−) and IgG(−) patients were included. Demographic data were collected. IgM and IgG antibodies, hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and lymphocyte subsets in serum were determined at weeks 0, 2 and 4.

Results

The hs-CRP and IL-6 levels of all patients were within the normal ranges. The number of patients with all lymphocyte subset testing items within normal ranges was 12/110 (10.9%) at week 0, 15/110 (13.6%) at week 2 and 18/110 (16.4%) at week 4. The percentages of CD8 + cells, NK cells and B lymphocytes in the IgM(+) and IgG(+) group were quite different from those in the IgM(−) and IgG(+) group and the IgM(−) and IgG(−) group, with much higher percentages of CD8 + cells and much lower percentages of NK cells and B lymphocytes at weeks 0, 2 and 4. Twelve IgM(+) patients in the IgM(+) and IgG(+) group converted to IgM(−), and the percentages of NK cells and B lymphocytes in these patients were significantly increased at week 4.

Conclusions

The changes of serum IgM and IgG are closely related to immunity in patients in the recovery stage. However, immunity does not recover when the patients test negative for these antibodies.

Mortality Rate and Predictors of Mortality in Hospitalized COVID-19 Patients with Diabetes

Studies have confirmed COVID-19 patients with diabetes are at higher risk of mortality than their non-diabetic counterparts. However, data-driven evidence of factors associated with increased mortality risk among hospitalized COVID-19 patients with diabetes is scarce in South Korea. This study was conducted to determine the mortality rate and identify risk factors of mortality among hospitalized COVID-19 patients with type 2 diabetes in Gyeongsangbuk-do province, South Korea. In this hospital-based, cross-sectional study, we enrolled a total of 324 patients with confirmed COVID-19, hospitalized at two of the tertiary level healthcare facilitates of Gyeongsangbuk-do, South Korea from 18 February to 30 June 2020. Demographic and clinical data and laboratory profiles were analyzed and multivariate logistic regression analysis was used to identify risk factors of mortality among diabetic patients with COVID-19. Of the 324 patients, 55 (16.97%) had diabetes mellitus. The mean age of all study subjects was 55 years, and the mean age of those with diabetes was greater than that of those without (69.8 years vs. 51.9 years). Remarkably, the mortality rate was much higher among those with diabetes (20.0% vs. 4.8%). Multivariate logistic regression analysis revealed that an older age (≥70 years) and a high serum lactate dehydrogenase (LDH) levels significantly predicted mortality among hospitalized COVID-19 patients with diabetes. Our study cautions more attention to be paid to patients with diabetes mellitus hospitalized for COVID-19, especially those aged ≥ 70 years and those with a high serum LDH level, to reduce the risk of mortality.