The Extent of Transmission of Novel Coronavirus in Wuhan, China, 2020

Post-traumatic Stress Disorder and Associated Factors 1 Year After the Beginning of the COVID-19 Pandemic Among Chinese Residents

Background: By investigating the incidence of post-traumatic stress disorder (PTSD) among residents during a period of low transmission, this study reflects the long-term impact of coronavirus disease 2019 (COVID-19) and identify which categories of residents are more likely to develop PTSD due to an acute infectious disease crisis, facilitating the development of targeted strategies to protect mental health after outbreaks of similar acute infectious diseases in the future. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. A convenience sampling strategy was adopted to recruit participants. Participants were asked to complete the PTSD Checklist for DSM-5 (PCL-5). A multivariable linear stepwise regression analysis model was used to identify which factors were associated with PTSD in residents of China. Results: A total of 2,361 Chinese residents completed the questionnaire. The mean PCL-5 score for the respondents was 13.65 (SD = 8.66), with 219 (9.28%) patients having probable PTSD symptoms. Respondents who were female (β = 0.038), had a relative or friend who had contracted COVID-19 (β = 0.041), and had poor health (β = 0.184) had higher PCL-5 scores, while the population aged over 60 years (β = -0.063), who agreed that COVID-19 information was released in a timely manner (β = -0.347), who had experienced a relatively limited impact of COVID-19 on their life (β = -0.069), and who agreed that the local prevention initiatives were sophisticated (β = -0.165) had lower PTSD scores. Conclusions: Outbreaks of acute infectious diseases can have long-term psychological health effects in the general population. In addition, health policy makers need to be concerned about and implement measures to support the mental health of vulnerable groups.

Estimating the Continuously Evolving COVID-19 Case-Fatality Ratio in the United States using a Time-Delay Correcting Algorithm

The COVID-19 pandemic has placed an extreme healthcare burden across the global community, and new population-based analyses are needed to identify successful mitigation and treatment efforts. The objective of this study was to design a computational algorithm to estimate the time-delay between a peak infection and associated death rate, and to estimate a measurement of the daily case-fatality ratio (D-CFR). Daily infection and death rates from January 22, 2020 through April 15, 2021 for the United States (US) were downloaded from the US Center for Disease Control COVID-19 website. A Savitzky-Golay filter estimated the moving time average of each data sequence with 5 different window-sizes. A locally-designed inflection point identification algorithm with a variable length line-fitting sub-routine identified peak infection and death rates, and quantified the time-delay between a peak infection and subsequent death rate. Although filter window-size did not affect the time-delay calculation (p = 0.99), there was a significant effect of fitting-line length (p < 0.001). A significant effect of time-delay length was found among three infection outbreaks (p < 0.001), and there was a significant difference between time-delay lengths (p < 0.01). A maximum D-CFR of approximately 7% occurred during the first infection outbreak; however, starting approximately 2.5 months after the first peak, a significant negative linear trend (p < 0.001) in the D-CFR continued until the end of the analyzed data. In conclusion, this research demonstrated a new method to quantify the time-delay between peak daily COVID-19 infection and death rates, and a new metric to approximate the continuous case-fatality ratio for the ongoing pandemic.

Artificial Intelligence Systems for Diagnosis and Clinical Classification of COVID-19

Objectives: COVID-19 is highly infectious and has been widely spread worldwide, with more than 159 million confirmed cases and more than 3 million deaths as of May 11, 2021. It has become a serious public health event threatening people's lives and safety. Due to the rapid transmission and long incubation period, shortage of medical resources would easily occur in the short term of discovering disease cases. Therefore, we aimed to construct an artificial intelligent framework to rapidly distinguish patients with COVID-19 from common pneumonia and non-pneumonia populations based on computed tomography (CT) images. Furthermore, we explored artificial intelligence (AI) algorithms to integrate CT features and laboratory findings on admission to predict the clinical classification of COVID-19. This will ease the burden of doctors in this emergency period and aid them to perform timely and appropriate treatment on patients. Methods: We collected all CT images and clinical data of novel coronavirus pneumonia cases in Inner Mongolia, including domestic cases and those imported from abroad; then, three models based on transfer learning to distinguish COVID-19 from other pneumonia and non-pneumonia population were developed. In addition, CT features and laboratory findings on admission were combined to predict clinical types of COVID-19 using AI algorithms. Lastly, Spearman's correlation test was applied to study correlations of CT characteristics and laboratory findings. Results: Among three models to distinguish COVID-19 based on CT, vgg19 showed excellent diagnostic performance, with area under the curve (AUC) of the receiver operating characteristic (ROC) curve at 95%. Together with laboratory findings, we were able to predict clinical types of COVID-19 with AUC of the ROC curve at 90%. Furthermore, biochemical markers, such as C-reactive protein (CRP), LYM, and lactic dehydrogenase (LDH) were identified and correlated with CT features. Conclusion: We developed an AI model to identify patients who were positive for COVID-19 according to the results of the first CT examination after admission and predict the progression combined with laboratory findings. In addition, we obtained important clinical characteristics that correlated with the CT image features. Together, our AI system could rapidly diagnose COVID-19 and predict clinical types to assist clinicians perform appropriate clinical management.

Current Status and Associated Factors of Depression and Anxiety Among the Chinese Residents During the Period of Low Transmission of COVID-19

Background: The outbreak of coronavirus disease 2019 (COVID-19) has contributed to depression and anxiety among the general population in China. The purpose of this study is to investigate the prevalence and associated factors of these psychological problems among Chinese adults during the period of low transmission, which could reflect the long-term depression and anxiety of the COVID-19 outbreak. Methods: A cross-sectional survey was conducted in China from 4 to 26 February 2021. Convenient sampling strategy was adopted to recruit participators. Participants were asked to filled out the questions that assessed questionnaire on the residents' depression and anxiety. Results: A total of 2,361 residents filled out the questionnaire. The mean age was 29.72 years (SD = 6.94) and majority of respondents were female (60.10%). Among the respondents, 421 (17.83%), 1470 (62.26%), and 470 (19.91%) were from eastern, central, and western China, respectively. 1704 (72.17%) consented COVID-19 information has been disclosed timely. 142 (6.01%) and 130 (5.51%) patients suffered from depression and anxiety symptoms. Furthermore, some influencing factors were found, including marital status, place of residence, employment status. Conclusion: This study revealed that anxiety and depression still are potential depression and anxiety for some residents, which suggested early recognition and initiation of interventions during the period of low transmission is still indispensable.

Exploring health impact and safety measures against transmission of COVID-19 pandemic in Saudi Arabia

The pandemic of Covid-19 at the global level cannot be underestimated. Arab world including Saudi Arabia is affected with the pandemic of Covid-19. More importantly, the surge of the numbers of infected individuals in Iran has brought fear and anxiety in the whole region in general and Saudi Arabia in particular. Several studies have investigated the prevalence of the virus in different countries from various perspectives. Nonetheless, little focus is given to academic research on health challenge of the virus resulting to fear and anxiety in the recent time in the context of Saudi Arabia. This study primarily aims at exploring the health effect of Covid-19 in Saudi Arabia despite the fact that, the World Health Organization (WHO) has clamored for preventive measures in addressing global health effect of the virus. The methodology of the study is systematic literature review (SLR) and content analysis of the secondary data on health impact of Covid-19 and preventive measures against its transmission in the country are critically analyzed. The results of secondary data of the study indicated that a number of confirmed cases, active cases and deaths in Saudi Arabia manifested negative impact of Covid-19 on citizens' health especially fear and anxiety despite the fact that records have showed steady recovered cases in the country. More specifically, the findings indicated that, health impact of Covid-19 are as follows namely: fear or anxiety, negative attitude among health workers and women in health workforce. Similarly, Saudi Arabia has put in place various preventive measures such as: preventive measures against transmission of Covid-19 which are as follows: institutional preparedness and strengthening mechanism, curfews and lockdowns and suspension of activities and order of social distancing. In conclusion, this paper has lucidly highlighted the health effect of Covid-19 and safety measures against the transmission of Covid-19 have been elaborated in the context of Saudi Arabia. It is thereby suggested that, the outcome of this study can be helpful to the health workers and policymakers in the country to be acquainted with the magnanimity of the novel coronavirus as well as putting effective safety mechanisms in place in curtailing the spread of Covid-19 in Saudi Arabia.

Emotional impact of COVID-19 lockdown and mitigation options: A cross-sectional survey of households in Ebonyi State, Nigeria

Background:

Coronavirus disease 19 (COVID-19) has continued to plague households, leading to lockdown problems. Adopting appropriate mitigation strategies can reduce the impact on family members.

Purpose:

To assess the emotional impact of COVID-19 epidemic lockdown and mitigation measures among households in Ebonyi State.

Methods:

Cross-sectional survey design was used to study 516 participants. Emotional impact of COVID-19 lockdown (r = 0.73) and mitigation options (r = 0.92) questionnaire was used for data collection. Of the 516 copies of the questionnaire distributed, 493 copies (95.5% return rate) were used for data analysis. Data were analysed using descriptive statistics, standard deviations, and t-tests.

Results:

The data showed the emotional impact of the COVID-19 epidemic was high (2.97 ± 0.48) on households. They embraced friendly communication and communication with their partners, maintaining regular contact with their loved ones by phone, email, social media, or video conference to alleviate the COVID-19 lockdown. No significant differences were found in the emotional impact for location (p > 0.05). Significant differences were not observed in many gender-based mitigation options. Conversely, a significant difference existed in the mitigation options based on location (t = 3.143, p < 0.05). However, there was no significant difference in friendly interactions and communication with partners (t = 0.354, p > 0.05), finding opportunities to develop excellent and promising news and images (t = 0.770, p > 0.05) and maintaining regular communication with loved ones via phone, email, social media, and video conference (t = 0.448, p > 0.05).

Conclusion:

The emotional impact of COVID-19 confinement was significant on family life and was more prevalent among men and urban dwellers. There is need to organise an awareness campaign on fundamental ways to overcome emotional distress using media targeting family members to promote emotional health.

The impact of the COVID-19 pandemic on the quality of life and depression, anxiety, and stress levels of individuals above the age of eighteen

PURPOSE

The aim of this study is to analyze the impact of the COVID-19 pandemic on the quality of life and the depression, anxiety, and stress levels of individuals above the age of eighteen.

DESIGN AND METHODS

This study used the snowball method. Data were collected using the sociodemographic question form, the Depression, Anxiety, Stress Scale-21, and the SF-12 Life Quality Scale.

FINDINGS

A statistically significant relationship (p < .05) was measured between age, gender, health condition, concomitant chronic and mental disease, fear of the COVID-19 pandemic, home confinement in this particular period, and the need for psychological support as well as mean scores of Depression, Anxiety, Stress Scale-21, and SF-12 Life Quality Scale.

PRACTICE IMPLICATIONS

Against the likelihood of facing new pandemics in the future, a guideline could be planned to protect and improve prospective the psychosocial wellness of individuals and society.

Neurological complications of COVID-19: from pathophysiology to rehabilitation. An overview

OBJECTIVE

To evaluate how the SARS-COV2 is able to affect the nervous system, the main neurological manifestation, and the treatment used, including neurorehabilitation.

METHODS

Studies performed during the current year that fulfilled inclusion criteria were selected from PubMed, Scopus, Cochrane, and Web of Sciences databases. The search combined the terms "Covid 19," "rehabilitation/treatment," and "neurological complications."

RESULTS

The exact route by which SARS-CoV-2 can penetrate the CNS is still unknown, although a possible retrograde transynaptic pathway from peripheral nerve endings, and/or through the olfactory bulb, have been suggested. An early management of COVID-19 by a multiprofessional team is fundamental to avoid long term sequaele. Rehabilitation is recommended to improve respiratory and cardiac function, as well as to avoid long term neurological complications.

CONCLUSIONS

As no specific conclusions in term of prognosis and treatment could be done, research and consensus paper are needed to provide NeuroCovid patients with the best treatment options, including neurorehabilitation.

COVID-19 pandemic spread against countries' non-pharmaceutical interventions responses: a data-mining driven comparative study

Background

The first half of 2020 has been marked as the era of COVID-19 pandemic which affected the world globally in almost every aspect of the daily life from societal to economical. To prevent the spread of COVID-19, countries have implemented diverse policies regarding Non-Pharmaceutical Intervention (NPI) measures. This is because in the first stage countries had limited knowledge about the virus and its contagiousness. Also, there was no effective medication or vaccines. This paper studies the effectiveness of the implemented policies and measures against the deaths attributed to the virus between January and May 2020.

Methods

Data from the European Centre for Disease Prevention and Control regarding the identified cases and deaths of COVID-19 from 48 countries have been used. Additionally, data concerning the NPI measures related policies implemented by the 48 countries and the capacity of their health care systems was collected manually from their national gazettes and official institutes. Data mining, time series analysis, pattern detection, machine learning, clustering methods and visual analytics techniques have been applied to analyze the collected data and discover possible relationships between the implemented NPIs and COVID-19 spread and mortality. Further, we recorded and analyzed the responses of the countries against COVID-19 pandemic, mainly in urban areas which are over-populated and accordingly COVID-19 has the potential to spread easier among humans.

Results

The data mining and clustering analysis of the collected data showed that the implementation of the NPI measures before the first death case seems to be very effective in controlling the spread of the disease. In other words, delaying the implementation of the NPI measures to after the first death case has practically little effect on limiting the spread of the disease. The success of implementing the NPI measures further depends on the way each government monitored their application. Countries with stricter policing of the measures seems to be more effective in controlling the transmission of the disease.

Conclusions

The conducted comparative data mining study provides insights regarding the correlation between the early implementation of the NPI measures and controlling COVID-19 contagiousness and mortality. We reported a number of useful observations that could be very helpful to the decision makers or epidemiologists regarding the rapid implementation and monitoring of the NPI measures in case of a future wave of COVID-19 or to deal with other unknown infectious pandemics. Regardless, after the first wave of COVID-19, most countries have decided to lift the restrictions and return to normal. This has resulted in a severe second wave in some countries, a situation which requires re-evaluating the whole process and inspiring lessons for the future.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11251-4.

Telepharmacy: A Potential Alternative Approach for Diabetic Patients During the COVID-19 Pandemic

The use of telepharmacy technology allows pharmacists to provide clinical pharmaceutical services to patients with diabetes mellitus (DM) who need regular services during the COVID-19 pandemic while maintaining distance and minimizing face-to-face meetings. The purpose of this review article was to identify the impact of telepharmacy intervention by pharmacists in diabetic patients by reviewing clinical outcomes and patient therapy adherences. A literature search was conducted through the PubMed database using the terms "telemedicine", "telepharmacy", "telehealth" and "telephone" in combination with "pharmacist", 'diabetes' and 'COVID-19' or "Pandemic". From a total of 67 articles identified, 14 research articles conform to the inclusion criteria. Telephone is the most widely used communication model (n = 11). All studies had a positive impact on clinical outcomes and three studies did not provide significant result on therapy adherence. The use of telepharmacy can be maximized and used on a vast scale, with the design of devices and technologies making it easier for pharmacists and diabetic patients to provide and receive clinical pharmaceutical services during the COVID-19 pandemic.

Incorrect Facemask-Wearing Detection Using Convolutional Neural Networks with Transfer Learning

The COVID-19 pandemic has been a worldwide catastrophe. Its impact, not only economically, but also socially and in terms of human lives, was unexpected. Each of the many mechanisms to fight the contagiousness of the illness has been proven to be extremely important. One of the most important mechanisms is the use of facemasks. However, the wearing the facemasks incorrectly makes this prevention method useless. Artificial Intelligence (AI) and especially facial recognition techniques can be used to detect misuses and reduce virus transmission, especially indoors. In this paper, we present an intelligent method to automatically detect when facemasks are being worn incorrectly in real-time scenarios. Our proposal uses Convolutional Neural Networks (CNN) with transfer learning to detect not only if a mask is used or not, but also other errors that are usually not taken into account but that may contribute to the virus spreading. The main problem that we have detected is that there is currently no training set for this task. It is for this reason that we have requested the participation of citizens by taking different selfies through an app and placing the mask in different positions. Thus, we have been able to solve this problem. The results show that the accuracy achieved with transfer learning slightly improves the accuracy achieved with convolutional neural networks. Finally, we have also developed an Android-app demo that validates the proposal in real scenarios.

Environmental contamination with SARS-CoV-2 in COVID-19 hospitals in Wuhan, China, 2020

Coronavirus disease 2019 (COVID-19) pandemic has caused high number of infections and deaths of healthcare workers globally. Distribution and possible transmission route of SARS-CoV-2 in hospital environment should be clarified. We herein collected 431 environmental (391 surface and 40 air) samples in the intensive care unit (ICU) and general wards (GWs) of three hospitals in Wuhan, China from February 21 to March 4, 2020, and detected SARS-CoV-2 RNA by real-time quantitative PCR. The viral positive rate in the contaminated areas was 17.8% (28/157), whereas there was no virus detected in the clean areas. Higher positive rate (22/59, 37.3%) was found in ICU than that in GWs (3/63, 4.8%). The surfaces of computer keyboards and mouse in the ICU were the most contaminated (8/10, 80.0%), followed by the ground (6/9, 66.7%) and outer glove (2/5, 40.0%). From 17 air samples in the contaminated areas, only one sample collected at a distance of around 30 cm from the patient was positive. Enhanced surface disinfection and hand hygiene effectively decontaminated the virus from the environment. This finding might help understand the transmission route and contamination risk of SARS-CoV-2 and evaluate the effectiveness of infection prevention and control measures in healthcare facilities.

Immunoinformatics study to search epitopes of spike glycoprotein from SARS-CoV-2 as potential vaccine

The Coronavirus disease named COVID-19 is caused by the virus reported in 2019 first identified in China. The cases of this disease have increased and as of June 1st, 2020 there are more than 216 countries affected. Pharmacological treatments have been proposed based on the resemblance of the HIV virus. With regard to prevention there is no vaccine, thus, we proposed to explore the spike protein due to its presence on the viral surface, and it also contains the putative viral entry receptor as well as the fusion peptide (important in the genome release). In this work we have employed In Silico techniques such as immunoinformatics tools which permit the identification of potential immunogenic regions on the viral surface (spike glycoprotein). From these analyses, we identified four epitopes E332-370, E627-651, E440-464 and E694-715 that accomplish essential features such as promiscuity, conservation grade, exposure and universality, and they also form stable complexes with MHCII molecule. We suggest that these epitopes could generate a specific immune response, and thus, they could be used for future applications such as the design of new epitope vaccines against the SARS-CoV-2.Communicated by Ramaswamy H. Sarma.

Comparative report of compliance to precautionary measures against COVID-19 in Nigeria and Jordan

PURPOSE OF THE STUDY

The purpose of this study is to comparatively report the strategies for implementation of safety measures against the transmission of Covid-19 in Nigeria as the heart of Africa and Jordan as the nexus of Arab world.

METHODOLOGY

The methodology used in this study is systematic literature review (SLR) and content analysis of report of the secondary data on Covid-19 which was obtained from Nigerian Centre for Disease Control & Presidential Task Force in Nigeria and Jordanian National Committee for Epidemic.

MAIN FINDINGS

The report showed indicators of compliance to precautionary measures against the spread of Covid-19 in both Nigeria and Jordan. There was an imposition total lockdown in major citizens like Lagos & Abuja in Nigeria and Irbid in Jordan while partial lockdown in other parts of the countries. Also, both countries tried to comply with the safety measures provided by World Health Organization (WHO) against Covid-19 such as: the use of facemask, social distancing, hand sanitizers and school activities were suspended. However, there is no specific fine against the violators of precautionary measures in Nigeria as compared to what is obtainable in Jordan where fines of Jordanian Dinars of 20-50 was imposed.

APPLICATIONS OF THIS STUDY

The report can be useful to Nigeria Centre for Disease Control & Presidential Task Force in Nigeria, Jordanian National Committee for Epidemic, health workers and policymakers towards strengthening compliance with safety measures that are put in place in curtailing further transmission of the virus.

NOVELTY/ORIGINALITY OF THIS STUDY

Most studies on Covid-19 assessed the rate of the spread of the pandemic but this study attempts to comparatively examine the compliance of precautionary measures in combatting the spread of Covid-19 in both Nigeria and Jordan. The readers would benefit from the study by galvanizing efforts in ensuring the compliance to the safety measures against the transmission of Covid-19 in both Nigeria and Jordan.

Deep Transfer Learning-Based Framework for COVID-19 Diagnosis Using Chest CT Scans and Clinical Information

The Coronavirus Disease 2019 (COVID-19) which first emerged in Wuhan, China in late December, 2019, has now spread to all the countries in the world. Conventional testing methods such as the antigen test, serology tests, and polymerase chain reaction tests are widely used. However, the test results can take anything from a few hours to a few days to reach the patient. Chest CT scan images have been used as alternatives for the detection of COVID-19 infection. Use of CT scan images alone might have limited capabilities, which calls attention to incorporating clinical features. In this paper, deep learning algorithms have been utilized to integrate the chest CT scan images obtained from patients with their clinical characteristics for fast and accurate diagnosis of COVID-19 patients. The framework uses an ANN to obtain the probability of the patient being infected with COVID-19 using their clinical information. Beyond a certain threshold, the chest CT scan of the patient is classified using a deep learning model which has been trained to classify the CT scan with 99% accuracy.

Risk Factors of Psychological Responses of Chinese University Students During the COVID-19 Outbreak: Cross-sectional Web-Based Survey Study

BACKGROUND

COVID-19 is a highly contagious and highly pathogenic disease caused by a novel coronavirus, SARS-CoV-2, and it has become a pandemic. As a vulnerable population, university students are at high risk during the epidemic, as they have high mobility and often overlook the severity of the disease because they receive incomplete information about the epidemic. In addition to the risk of death from infection, the epidemic has placed substantial psychological pressure on the public. In this respect, university students are more prone to psychological problems induced by the epidemic compared to the general population because for most students, university life is their first time outside the structure of the family, and their mental development is still immature. Internal and external expectations and academic stress lead to excessive pressure on students, and unhealthy lifestyles also deteriorate their mental health. The outbreak of COVID-19 was a significant social event, and it could potentially have a great impact on the life and the mental health of university students. Therefore, it is of importance to investigate university students' mental health status during the outbreak of COVID-19.

OBJECTIVE

The principal objective of this study was to investigate the influencing factors of the psychological responses of Chinese university students during the COVID-19 outbreak.

METHODS

This study used data from a survey conducted in China between February 21 and 24, 2020, and the data set contains demographic information and psychological measures including the Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the compulsive behaviors portion of the Yale-Brown Obsessive-Compulsive Scale. A total of 2284 questionnaires were returned, and 2270 of them were valid and were used for analysis. The Mann-Whitney U test for two independent samples and binary logistic regression models were used for statistical analysis.

RESULTS

Our study surveyed 563 medical students and 1707 nonmedical students. Among them, 251/2270 students (11.06%) had mental health issues. The results showed that contact history of similar infectious disease (odds ratio [OR] 3.363, P=.02), past medical history (OR 3.282, P<.001), and compulsive behaviors (OR 3.525, P<.001) contributed to the risk of mental health issues. Older students (OR 0.928, P=.02), regular daily life during the epidemic outbreak (OR 0.410, P<.001), exercise during the epidemic outbreak (OR 0.456, P<.001), and concern related to COVID-19 (OR 0.638, P=.002) were protective factors for mental health issues.

CONCLUSIONS

According to the study results, mental health issues have seriously affected university students, and our results are beneficial for identifying groups of university students who are at risk for possible mental health issues so that universities and families can prevent or intervene in the development of potential mental health issues at the early stage of their development.

Fear of COVID-19 and its Impact on Job Satisfaction and Turnover Intention among Egyptian Physicians

Introduction

The risk of experiencing psychiatric symptoms related to the COVID-19 pandemic is high among healthcare workers whose occupations are in public health, emergency medicine, and intensive or critical care.

Materials and methods

A cross-sectional study aimed to assess the prevalence of fear of COVID-19 among 411 frontline Egyptian physicians during the COVID-19 pandemic; identify determinants and predictors for fear of COVID-19; determine the impact of fear of COVID-19 on job satisfaction; and detect the impact of fear of COVID-19 on turnover intention. Three standardized scales (fear of COVID-19, job satisfaction, and turnover intention scores) were used for data collection via online Google Form.

Results

Regarding fear relating to the COVID-19 pandemic, 16.5% of the study subjects were classified as experiencing a severe fear level, while 78.1% experienced a moderate degree. A significant association between the level of fear relating to COVID-19 and the work department. The highest degree of fear is in a general-educational-university facility. Regarding job satisfaction, 42% of those having a severe level of fear are dissatisfied. Fear of COVID-19 is negatively associated with job satisfaction while positively significant correlated with turnover scores, a positive significant predictor of turnover intention. Job satisfaction is negatively associated with turnover intention; a negative significant predictor of turnover intention.

Conclusions

Frontline Egyptian physicians reported higher levels of fear relating to the COVID-19 pandemic (moderate to severe). Increased fear levels relating to COVID-19 have a relationship with lower levels of job satisfaction and higher levels of job turnover.

Coronavirus and its terrifying inning around the globe: The pharmaceutical cares at the main frontline

A novel coronavirus (2019-nCoV) is an acute life-threatening disease, emerged in China, which imposed a potentially immense toll in terms of public health emergency due to high infection rate and has a devastating economic impact that attracts the world's attention. After that, on January 30, 2020, it was officially declared as a global pandemic by World Health Organization (WHO). The International Committee on Taxonomy of Viruses (ICTV) recognized it as a Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and the disease named Coronavirus Disease-19 (COVID-19). Several studies have been ameliorated the active role of COVID-19 transmission, etiology, pathogenicity, and mortality rate as serious impact on human life. The symptoms of this disease may include fever, fatigue, cough and some peoples are severely prone to gastrointestinal infection. The elderly and seriously affected peoples are likely concerned with serious outcomes. In this review, we mainly aimed to provide a benchmark summary of the silent characteristics and findings of some candidates for antiviral drugs and immunotherapies such as plasma therapy, cytokine therapy, antibodies, intravenous immunoglobulin, and pharmaceutical health concerns that are related to this disease.

COVID-19 Pandemic Causing Depression in Different Sociodemographic Groups in Saudi Arabia

COVID-19 disease was announced as a global pandemic in March 2020 by the World health organization (WHO). Saudi Arabia was among the first countries to enforce restriction measures such as closing schools, remote working, and a travel ban. We aim to evaluate the impact of the COVID-19 pandemic on people’s depression in Saudi Arabia. A cross-sectional online survey of 1109 participants was conducted during the curfew between 18th of May and 11th of June 2020. An online questionnaire included questions about the commitment to follow the precautionary measures, knowledge on COVID-19, and depression. Depression was assessed with the Impact of Event Scale-Revised method. Females, unmarried individuals, elderly persons, parents of young children, unemployed, and small families were more likely to be depressed. Education level did not explain the differences in depression. However, the more knowledge the participants had about COVID-19 the better they followed the restrictions. A regression analysis revealed that the commitment of a person to follow the restrictions increased his/her depression symptoms. Attention should be paid to different groups of people in future psychiatric planning.

COVID Obesity: A One-Year Narrative Review

On 11 March 2020, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO). This study focuses on a narrative review about the illness during the first year of the pandemic in relation to obesity. Databases were used to search studies published up to 8 December 2020. In total, 4430 articles and other scientific literature were found, and 24 articles were included in this one-year narrative review. The mean BMI value of severe COVID-19 patients ranged from 24.5 to 33.4 kg/m2, versus <18.5 to 24.3 kg/m2 for non-severe patients. Articles using the terms obesity or overweight without indicating the BMI value in these patients were common, but this is not useful, as the anthropometric parameters, when not defined by this index, are confusing due to the classification being different in the West compared to among Asian and Korean criteria-based adults. We proposed a new term, called COVID obesity, to define the importance of this anthropometric parameter, among others, in relation with this pandemic.

Prevalence, Demographic, and Clinical Correlates of Likely PTSD in Subscribers of Text4Hope during the COVID-19 Pandemic

Background: During the COVID-19 pandemic, people may experience increased risk of adverse mental health, particularly post-traumatic stress disorder (PTSD). Methods: A survey measured stress, anxiety, depression, and PTSD symptoms in Text4Hope subscribers using the Perceived Stress Scale, Generalized Anxiety Disorder 7-Item Scale, Patient Health Questionnaire-9, and PTSD Checklist for DSM-5 Part 3, respectively. A Chi-square test and multivariate logistic regression were employed. Results: Most respondents were 41–60 years old (49.5%), Caucasian (83.3%), with post-secondary education (92.1%), employed (70.3%), married/cohabiting/partnered (64.9%), and homeowners (71.7%). Likely PTSD was reported in 46.8% of the respondents. Those who were afraid to contract the coronavirus had a history of depression before the pandemic, and those who received counselling during the pandemic exhibited a high prevalence of likely PTSD (OR (1.7 to 2.2)). Significant lower odds of likely PTSD were observed among subscribers who received absolute support from family/friends. Conclusions: This paper presents findings on the prevalence of likely PTSD and identified vulnerable groups during the COVID-19 pandemic. Our results support the proposal that public health advice should incorporate mental health wellness campaigns aiming to reduce the psychological impact of pandemics.

Predicting the incidence of COVID-19 using data mining

BACKGROUND

The high prevalence of COVID-19 has made it a new pandemic. Predicting both its prevalence and incidence throughout the world is crucial to help health professionals make key decisions. In this study, we aim to predict the incidence of COVID-19 within a two-week period to better manage the disease.

METHODS

The COVID-19 datasets provided by Johns Hopkins University, contain information on COVID-19 cases in different geographic regions since January 22, 2020 and are updated daily. Data from 252 such regions were analyzed as of March 29, 2020, with 17,136 records and 4 variables, namely latitude, longitude, date, and records. In order to design the incidence pattern for each geographic region, the information was utilized on the region and its neighboring areas gathered 2 weeks prior to the designing. Then, a model was developed to predict the incidence rate for the coming 2 weeks via a Least-Square Boosting Classification algorithm.

RESULTS

The model was presented for three groups based on the incidence rate: less than 200, between 200 and 1000, and above 1000. The mean absolute error of model evaluation were 4.71, 8.54, and 6.13%, respectively. Also, comparing the forecast results with the actual values in the period in question showed that the proposed model predicted the number of globally confirmed cases of COVID-19 with a very high accuracy of 98.45%.

CONCLUSION

Using data from different geographical regions within a country and discovering the pattern of prevalence in a region and its neighboring areas, our boosting-based model was able to accurately predict the incidence of COVID-19 within a two-week period.

Anxiety effects on quality of life during the COVID-19 outbreak: A parallel-serial mediation model among nurses in Turkey

BACKGROUND

Nurses experience loneliness, anxiety, fear, fatigue, sleep disorders, and other physical and mental health problems due to their close contact with patients in cases of epidemic diseases. Among nurses in Turkey, we want to explore how anxiety, psychological health, and social isolation affect nurses' quality of life.

OBJECTIVES

This study aimed to investigate the effects of the COVID-19 pandemic on the quality of life (COVID-19 EQLS), State-Trait Anxiety Inventory (STAI-1 and STAI-2), psychological health, and social isolation among nurses. It also aimed to identify whether the influence of trait anxiety, psychological health, and social isolation are stronger than the direct influence of state anxiety on nurses' quality of life during the pandemic.

METHODS

A cross-sectional study design and STROBE guidelines were implemented. In this study, 638 nurses in Turkey were included using simple random sampling. The participants completed the STAI-1 and STAI-2 and COVID-19 EQLS online-form. The parallel-serial mediation model was used to examine the relationships between the determined variables.

RESULTS

Psychological health, psychological effects of social isolation, and trait anxiety fully mediated the relationship between state anxiety and quality of life of nurses. The total indirect effect of the confidence interval of bootstrapping was statistically different from zero.

CONCLUSIONS

Trait anxiety, psychological health, and social isolation were the main factors with statistically significant indirect effects on the quality of life of Turkish nurses in this study.

Estimation of the Actual Incidence of Coronavirus Disease (COVID-19) in Emergent Hotspots: The Example of Hokkaido, Japan during February-March 2020

Following the first report of the coronavirus disease 2019 (COVID-19) in Sapporo city, Hokkaido Prefecture, Japan, on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized due to having mild or no symptoms during the initial months of the outbreak. We therefore aimed to predict the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo city using data on cases diagnosed outside these areas. Two statistical frameworks involving a balance equation and an extrapolated linear regression model with a negative binomial link were used for deriving both estimates, respectively. The estimated cumulative incidence in Hokkaido as of 27 February was 2,297 cases (95% confidence interval (CI): 382-7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo city as of 28 February was estimated at 2233 cases (95% CI: 0-4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating a higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases helped to inform the public health response at the beginning of the pandemic and provided insight into the possible scope of undetected transmission for future assessments.

COVID - 19 related knowledge and preventive practices early in the outbreak among health care workers in selected public health facilities of Illu aba Bor and Buno Bedelle zones, Southwest Ethiopia

BACKGROUND

Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia.

METHODS

An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of < 0.05.

RESULT

The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5-10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices.

CONCLUSION

The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended.

The estimations of the COVID-19 incubation period: A scoping reviews of the literature

BACKGROUND

A novel coronavirus (COVID-19) has taken the world by storm. The disease has spread very swiftly worldwide. A timely clue which includes the estimation of the incubation period among COVID-19 patients can allow governments and healthcare authorities to act accordingly.

OBJECTIVES

to undertake a review and critical appraisal of all published/preprint reports that offer an estimation of incubation periods for COVID-19.

ELIGIBILITY CRITERIA

This research looked for all relevant published articles between the dates of December 1, 2019, and April 25, 2020, i.e. those that were related to the COVID-19 incubation period. Papers were included if they were written in English, and involved human participants. Papers were excluded if they were not original (e.g. reviews, editorials, letters, commentaries, or duplications).

SOURCES OF EVIDENCE

COVID-19 Open Research Dataset supplied by Georgetown's Centre for Security and Emerging Technology as well as PubMed and Embase via Arxiv, medRxiv, and bioRxiv.

CHARTING METHODS

A data-charting form was jointly developed by the two reviewers (NZ and EA), to determine which variables to extract. The two reviewers independently charted the data, discussed the results, and updated the data-charting form.

RESULTS AND CONCLUSIONS

Screening was undertaken 44,000 articles with a final selection of 25 studies referring to 18 different experimental projects related to the estimation of the incubation period of COVID-19. The majority of extant published estimates offer empirical evidence showing that the incubation period for the virus is a mean of 7.8 days, with a median of 5.01 days, which falls into the ranges proposed by the WHO (0-14 days) and the ECDC (2-12 days). Nevertheless, a number of authors proposed that quarantine time should be a minimum of 14 days and that for estimates of mortality risks a median time delay of 13 days between illness and mortality should be under consideration. It is unclear as to whether any correlation exists between the age of patients and the length of time they incubate the virus.

Deep Convolutional Neural Network-Based Computer-Aided Detection System for COVID-19 Using Multiple Lung Scans: Design and Implementation Study

BACKGROUND

Owing to the COVID-19 pandemic and the imminent collapse of health care systems following the exhaustion of financial, hospital, and medicinal resources, the World Health Organization changed the alert level of the COVID-19 pandemic from high to very high. Meanwhile, more cost-effective and precise COVID-19 detection methods are being preferred worldwide.

OBJECTIVE

Machine vision-based COVID-19 detection methods, especially deep learning as a diagnostic method in the early stages of the pandemic, have been assigned great importance during the pandemic. This study aimed to design a highly efficient computer-aided detection (CAD) system for COVID-19 by using a neural search architecture network (NASNet)-based algorithm.

METHODS

NASNet, a state-of-the-art pretrained convolutional neural network for image feature extraction, was adopted to identify patients with COVID-19 in their early stages of the disease. A local data set, comprising 10,153 computed tomography scans of 190 patients with and 59 without COVID-19 was used.

RESULTS

After fitting on the training data set, hyperparameter tuning, and topological alterations of the classifier block, the proposed NASNet-based model was evaluated on the test data set and yielded remarkable results. The proposed model's performance achieved a detection sensitivity, specificity, and accuracy of 0.999, 0.986, and 0.996, respectively.

CONCLUSIONS

The proposed model achieved acceptable results in the categorization of 2 data classes. Therefore, a CAD system was designed on the basis of this model for COVID-19 detection using multiple lung computed tomography scans. The system differentiated all COVID-19 cases from non-COVID-19 ones without any error in the application phase. Overall, the proposed deep learning-based CAD system can greatly help radiologists detect COVID-19 in its early stages. During the COVID-19 pandemic, the use of a CAD system as a screening tool would accelerate disease detection and prevent the loss of health care resources.

Single-cell analysis of angiotensin-converting enzyme II expression in human kidneys and bladders reveals a potential route of 2019 novel coronavirus infection

BACKGROUND

Since 2019, a novel coronavirus named 2019 novel coronavirus (2019-nCoV) has emerged worldwide. Apart from fever and respiratory complications, acute kidney injury has been observed in a few patients with coronavirus disease 2019. Furthermore, according to recent findings, the virus has been detected in urine. Angiotensin-converting enzyme II (ACE2) has been proposed to serve as the receptor for the entry of 2019-nCoV, which is the same as that for the severe acute respiratory syndrome. This study aimed to investigate the possible cause of kidney damage and the potential route of 2019-nCoV infection in the urinary system.

METHODS

We used both published kidney and bladder cell atlas data and new independent kidney single-cell RNA sequencing data generated in-house to evaluate ACE2 gene expression in all cell types in healthy kidneys and bladders. The Pearson correlation coefficients between ACE2 and all other genes were first generated. Then, genes with r values larger than 0.1 and P values smaller than 0.01 were deemed significant co-expression genes with ACE2.

RESULTS

Our results showed the enriched expression of ACE2 in all subtypes of proximal tubule (PT) cells of the kidney. ACE2 expression was found in 5.12%, 5.80%, and 14.38% of the proximal convoluted tubule cells, PT cells, and proximal straight tubule cells, respectively, in three published kidney cell atlas datasets. In addition, ACE2 expression was also confirmed in 12.05%, 6.80%, and 10.20% of cells of the proximal convoluted tubule, PT, and proximal straight tubule, respectively, in our own two healthy kidney samples. For the analysis of public data from three bladder samples, ACE2 expression was low but detectable in bladder epithelial cells. Only 0.25% and 1.28% of intermediate cells and umbrella cells, respectively, had ACE2 expression.

CONCLUSION

This study has provided bioinformatics evidence of the potential route of 2019-nCoV infection in the urinary system.

COVID-19 Lockdown and the Behavior Change on Physical Exercise, Pain and Psychological Well-Being: An International Multicentric Study

Objective: To evaluate the impact of the COVID-19 pandemic and the following lockdown on physical exercise (PEx) practice, pain, and psychological well-being. Methods: A cross-sectional multicentric study was performed using a nonrandom convenience sampling from the general population (≥18 years-old) of 6 countries (Brazil, Italy, France, Portugal, Germany, and Spain) adopting social isolation (SI). The validated self-administered online survey (PEF-COVID19) was used. The tests T-test and Chi-square with Bonferroni correction were used for statistical analysis and a multivariate logistic regression model (p ˂ 0.05). Results: We included 3194 replies and ~80% of the respondents were in SI. Brazilian sample was highly influenced by the pandemic considering PEx practice and habits, pain, anxiety, and stress (p ˂ 0.05). Among the European countries, Italy presented the major changes. The model to predict the non-practice of PEx during SI showed that the variables countries, smoking, SI, and PEx level were significant predictors (p ˂ 0.001). Conclusion: The pandemic changed the PEx practice and habits, and the psychological well-being of populations in different manners. Countries, smoking, SI, and PEx level were predictors for the non-practice of PEx. Public health strategies are suggested to avoid sedentary lifestyles and quality of life decrease.

Mental health symptoms among the nurses of Bangladesh during the COVID-19 pandemic

Background

The coronavirus disease-19 (COVID-19) pandemic has wreaked havoc on healthcare staff and caused serious psychological distress. We aimed to determine the effects of the COVID-19 pandemic on the mental health of Bangladeshi nurses, as well as the relationship between occupational factors and mental health symptoms. We conducted a cross-sectional study among registered nurses in Bangladesh. We used the Depression, Anxiety and Stress Scale-21 (DASS-21) and the Impact of Event Scale-Revised (IES-R) to assess mental health symptoms.

Results

Among the 547 nurses included in the study, the prevalence of mild to extremely severe depression, anxiety, and stress was 50.5%, 51.8%, and 41.7% respectively, and 61.9% of the respondents reported mild to severe psychological impact for COVID-19. Psychological symptoms were more prevalent among female nurses than male nurses (p <0.05). Linear regression revealed that having complete personal protective equipment (PPE) during working was significantly associated with lower levels of depression, anxiety, and stress (p <0.05). Facing any emotional abuse working in the COVID-19 pandemic situation was significantly associated with higher levels of depression, anxiety, and stress and greater psychological impact of the outbreak (p <0.05).

Conclusions

A high prevalence of mental health symptoms was observed in nurses. We recommend the implementation of mental well-being interventions and ensuring a proper work environment for nurses during the pandemic.

Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults

BACKGROUND

The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health.

AIM

To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular.

METHODS

A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates.

RESULTS

Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β = -.33). Loss of meaningful activities was strongly related to mental health (β = -.36) and explained 9% incremental variance (R2 change = .092, p < .001) above control variables.

CONCLUSIONS

The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.

Acceptance and Intake of COVID-19 Vaccines among Older Germans

The main aim of this study was to investigate the various factors influencing COVID-19 vaccination acceptance and actual intake among older Germans aged over 75 years old (n = 1037). We found that the intention to get vaccinated or intake of the COVID-19 vaccine were positively related to the perceptions of becoming infected, perceptions of the severity of the potential long-term effects, the vaccine's efficacy, and the benefits of vaccination. Meanwhile, the intention to get the vaccine or vaccine intake were decreased by perceptions of the negative side-effects and the general impediments to vaccination.

SARS-CoV 2 Infection (Covid-19) and Cardiovascular Disease in Africa: Health Care and Socio-Economic Implications

The current pandemic of SARS-COV 2 infection (Covid-19) is challenging health systems and communities worldwide. At the individual level, the main biological system involved in Covid-19 is the respiratory system. Respiratory complications range from mild flu-like illness symptoms to a fatal respiratory distress syndrome or a severe and fulminant pneumonia. Critically, the presence of a pre-existing cardiovascular disease or its risk factors, such as hypertension or type II diabetes mellitus, increases the chance of having severe complications (including death) if infected by the virus. In addition, the infection can worsen an existing cardiovascular disease or precipitate new ones. This paper presents a contemporary review of cardiovascular complications of Covid-19. It also specifically examines the impact of the disease on those already vulnerable and on the poorly resourced health systems of Africa as well as the potential broader consequences on the socio-economic health of this region.

Factores psicosociales en estudiantes universitarios de Loreto, Ancash, Moquegua y Puno durante el confinamiento por el Covid-19, Perú

The study was carried out with the objective of comparing and analyzing psychosocial factors such as stress, depression and anxiety in undergraduate university students from Loreto, Ancash, Moquegua and Puno during confinement by Covid-19, Peru. The study was based on a non-experimental, quantitative-descriptive, cross-sectional and correlational design with non-probability and intentional sampling, an online survey was applied to a sample of 665 undergraduate students using validated instruments such as the List of Indicators of Vulnerability to stress, the Zung Depression Scale, and the Hamilton Anxiety Scale. The study reports vulnerability to stress in 50.8%, 46.3%, 36.4% and 37.5% in Loreto, Ancash, Moquegua and Puno. The prevalence of depression was 100.0%, 97.6%, 96.9% and 95.2% between mild, moderate and severe; likewise, 100.0% presented anxiety symptoms. It was concluded that a situation of obligatory social confinement is directly related to the presence of stress, depression and anxiety, particularly in undergraduate university students, affecting a greater proportion of women; of these between 19 and 22 years, and with a higher incidence in regions with a greater number of confirmed cases; where insomnia, worry and irritability are the most significant symptoms.

Exploring stress coping strategies of frontline emergency health workers dealing Covid-19 in Pakistan: A qualitative inquiry

Background

The COVID-19 outbreak has gravely impacted the physical and psychological health of people. As the outbreak is ongoing, it is crucial to equip the emergency healthcare workers (HCWs) to be medically and psychologically prepared.

Objective

To examine the psychological impact of COVID-19 on emergency HCWs and to understand how they are dealing with COVID-19 pandemic, their stress coping strategies or protective factors, and challenges while dealing with COVID-19 patients.

Methods

Using a framework thematic analysis approach, 15 frontline emergency HCWs directly dealing with COVID-19 patients from April 2, 2020 to April 25, 2020. The semi-structured interviews were conducted face-to-face or by telephone. Data were analyzed using thematic analysis.

Results

Findings highlighted first major theme of stress coping, including, limiting media exposure, limited sharing of Covid-19 duty details, religious coping, just another emergency approach, altruism, and second major theme of Challenges includes, psychological response and noncompliance of public/denial by religious scholar.

Conclusions

Participants practiced and recommended various coping strategies to deal with stress and anxiety emerging from COVID-19 pandemic. Media was reported to be a principal source of raising stress and anxiety among the public. Religious coping as well as their passion to serve humanity and country were the commonly employed coping strategies.

Anxiety and Depression Among Health Sciences Students in Home Quarantine During the COVID-19 Pandemic in Selected Provinces of Nepal

Aim: This study aimed to assess anxiety and depression among health sciences students at home quarantine during the COVID-19 pandemic in selected provinces of Nepal. Methods: A web-based cross-sectional study was conducted among 409 health science students enrolled at graduate and post-graduate levels in selected universities and their affiliated colleges. Students from selected colleges were asked to fill out a survey, that was made available through email and social media outlets such as Facebook and Viber. The data were downloaded in Excel and imported to SPSS version 16 for analysis. Results : The prevalence of anxiety and depression was 15.7 and 10.7%, respectively. The study showed significant associations between (i) place of province and anxiety; (ii) sleep per day and depression; (iii) hours spent on the internet per day for education and depression; (iv) postponement of final exams and depression. There were no significant associations with the socio-demographic variables. Conclusion: Anxiety and depression in health science students showed correlation with the province, internet use for education, and postponement of exams. These correlations could be common among students in other fields as well. A large-scale study covering a wider geographical area and various fields of education is necessary to further evaluate the impact of COVID-19 on (health sciences) students. The integration of mental health programs both as an intervention and a curriculum level among students is critical to ensure the health of the students.

The Coronavirus Disease Pandemic: Assessment of Perceived Barriers and Threats among Undergraduate University Students in Saudi Arabia

Communities play an important and active role in preventing and controlling the spread of coronavirus disease (COVID-19). Reduction of COVID-19-related barriers and threats perceived by the public should be the top priority in promoting positive preventive behaviors among people. This cross-sectional study aimed at identifying the barriers and threats perceived by public university students in the southwestern part of Saudi Arabia during the COVID-19 pandemic. The students were recruited through a snowball sampling technique, and data were collected using a web-based questionnaire. Data on socio-demographic aspects, perceived barriers, and perceived threats were collected. Perceived barriers were estimated using the Health Belief Model (HBM) questionnaire, and perceived threats were estimated using the patient threat perceptions in the emergency department scale. This study was conducted between March and June 2020. Approximately 50% of the study participants had a high level of perceived barriers and a moderate level of total perceived threats. Notable factors associated with participants’ perceived barriers and threats were age, college type, and monthly income. Perceived barriers, participants’ residence location, and sex were also significantly related to each other. Moreover, perceived barriers were significantly correlated with perceived threats. COVID-19-related perceived barriers and threats ranged from a moderate level to a high level among most of the participating students. Perceived barriers were associated with some of the demographic variables. The findings from this study may help the government in formulating strategies for planning interventions to reduce COVID-19 pandemic propagation.

The Effect of COVID-19 Lockdown Measures on Physical Activity Levels and Sedentary Behaviour in a Relatively Young Population Living in Kosovo

To abate the spread of the COVID-19 virus, different restriction measures were imperative, limiting the possibility to be engaged in physical activity. Therefore, this study aimed to evaluate the effect of COVID-19 lockdown on physical activity (PA) levels expressed as energy expenditure (MET-min/week) and sedentary behaviour in Kosovo. The possible association between PA levels and other factors was analyzed. 1633 participants (age range: 13 to 63 years; mean: 24.70 ± 9.33 years; body height: 172 ± 10.57 cm; body mass: 69.10 ± 13.80 kg; BMI: 23.09 ± 3.63 kg/m2) participated in the study, categorized by age, gender, BMI, and living area. An online survey, including an adapted version of the IPAQ-SF, was administered once during lockdown to assess PA levels and sedentary behaviour both before and during COVID-19 lockdown. The Wilcoxon signed-rank, Mann-Whitney U and Kruskal-Wallis rank of sum tests were used for statistical analysis. COVID-19 restrictions had a negative impact on the types of and overall PA levels MET-min/week (p < 0.001). Sedentary behaviour significantly increased during COVID-19 restrictions (p < 0.001). Higher decreases in MET-min/week during lockdown were observed among males, young and young adults, overweight, and urban-living participants. Finally, COVID-19 restrictions decreased the PA levels and MET-min/week, and increased sedentary behaviour also in a relatively young cohort. Such differences were dependent on several factors.

The state of latency in microbial pathogenesis

The state of latency occurs when a microbe's persistence in a host produces host damage without perturbing homeostasis sufficiently to cause clinical symptoms or disease. The mechanisms contributing to latency are diverse and depend on the nature of both the microbe and the host. Latency has advantages for both host and microbe. The host avoids progressive damage caused by interaction with the microbe that may translate into disease, and the microbe secures a stable niche in which to survive. Latency is clinically important because some latent microbes can be transmitted to other hosts, and it is associated with a risk for recrudescent microbial growth and development of disease. In addition, it can predispose the host to other diseases, such as malignancies. Hence, latency is a temporally unstable state with an eventual outcome that mainly depends on host immunity. Latency is an integral part of the pathogenic strategies of microbes that require human (and/or mammalian) hosts, including herpesviruses, retroviruses, Mycobacterium tuberculosis, and Toxoplasma gondii. However, latency is also an outcome of infection with environmental organisms such as Cryptococcus neoformans, which require no host in their replicative cycles. For most microbes that achieve latency, there is a need for a better understanding and more investigation of host and microbial mechanisms that result in this state.

Threshold conditions for global stability of disease free state of COVID-19

This article focus the elimination and control of the infection caused by COVID-19. Mathematical model of the disease is formulated. With help of sensitivity analysis of the reproduction number the most sensitive parameters regarding transmission of infection are found. Consequently strategies for the control of infection are proposed. Threshold condition for global stability of the disease free state is investigated. Finally, using Matlab numerical simulations are produced for validation of theocratical results.

Geographical and Epidemiological Characteristics of 3,487 Confirmed Cases With COVID-19 Among Healthcare Workers in China

As the first area to report the outbreak, China used to be the front line of the battle against the novel coronavirus SARS-CoV-2. The present descriptive analysis of 3,487 COVID-19-confirmed cases with health workers reported through April 30, 2020 offers important new information to the international community on the epidemic in China. These data showed that Chinese measures including the high-grade protective gear used, mask wearing, and social distancing, are effective in reducing transmission in hospitals.

Information management in the early stages of the COVID-19 pandemic

Purpose

This paper aims to review the information management aspects of the early months of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus 19 outbreak. It shows that the transition from epidemic to the pandemic was caused partly by poor management of information that was publicly available in January 2020.

Design/methodology/approach

The approach combines public domain epidemic data with economic, demographic, health, social and political data and investigates how information was managed by governments. It includes case studies of early-stage information management, from countries with high and low coronavirus disease 2019 impacts (as measured by deaths per million).

Findings

The reasons why the information was not acted upon appropriately include “dark side” information behaviours (Stone et al., 2019). Many errors and misjudgements could have been avoided by using learnings from previous epidemics, particularly the 1918-1919 flu epidemic when international travel (mainly of troops in First World War) was a prime mode of spreading. It concludes that if similar outbreaks are not to turn into pandemics, much earlier action is needed, mainly closing borders and locking-down.

Research limitations/implications

The research is based on what was known at the time of writing, when the pandemic’s exact origin was uncertain, when some statistics about actions and results were unavailable and when final results were unknown.

Practical implications

Governments faced with early warning signs or pandemics must act much faster.

Social implications

If the next virus is as infectious as SARS-CoV-2 but much more fatal, the world faces disastrous consequences if most governments act as slowly as this time.

Originality/value

This is one of the first analyses of information management practices relating to the pandemic’s early stages.

COVID-19–induced anxiety and protective behaviour among nursing students: A survey from western India

Introduction:

The COVID-19 Pandemic has caused anxiety and stress among people. Nursing students, being an important link in the delivery of health care services, are always exposed to stressful situations which in turn put a great toll on their mental health. Moreover, the perceived risk of pandemics motivates people to embrace different protective measures so as to reduce any potential threats of an emerging health concern.

Objective:

The aim of this study was to assess the COVID-induced anxiety and protective behaviors among nursing students.

Methods:

Nursing students studying at 02 nursing institutes of Jodhpur, Rajasthan, India were enrolled for the study. The data were collected using COVID-induced anxiety scale and protective behaviors towards COVID-19 Scale. These scales were converted to online google forms, and the link was circulated among 370 nursing students through emails and WhatsApp. A total of 229 students submitted their responses within stipulated time and were included in the final data analysis.

Results:

The response rate of the survey was 62%. Evidently, nursing students had a moderate level of anxiety (mean score 31.28 ± 5.29) due to the COVID-19 outbreak. Overall protective behavior mean score was 56.63 ± 6.4 which reflects that students were following higher quality of protective behaviors. There is a negative linear correlation between anxiety score and protective behavior score.

Conclusion:

The nursing students exhibited a moderate level of anxiety, and routing protective behaviors were frequently performed by these students. There is a timely need to plan and implement interventions for nursing students so as to make them self-capable to resolve psychosocial issues, especially during disease outbreaks.

Assessment of community psycho-behavioral responses during the outbreak of novel coronavirus (2019-nCoV): a cross-sectional study

<abstract> <p>The novel coronavirus 2019 (2019-nCoV) is a public health emergency of international concern resulting in adverse psychological impacts during the epidemic.</p> <sec> <title>Methods</title> <p>From 1 to 10 April 2020, we conducted an online survey. The online survey collected information on demographic data, precautionary measures against (2019-nCoV), self-health evaluation, knowledge, and concerns about (2019-nCoV), and appraisal of crisis management. The psychological impact was assessed by the General Anxiety Disorder 7-item (GAD-7) scale. The designed questionnaire was answered by participants, and collected data were statistically analyzed.</p> </sec><sec> <title>Results</title> <p>This study included 1200 respondents. In total, 80% of respondents rated the psychological impact; 18% reported minimal anxiety; 34% reported mild anxiety, and 48% with moderate anxiety symptoms. A large proportion (74%) believed that they were very or somewhat likely to contract (2019-nCoV) while only (35%) believed they were unlikely to survive if they contracted the disease. (58%) of the respondents, practiced the precautionary measures directed against person-to-person droplet spread. Respondents with a moderate level of anxiety were most likely to take comprehensive precautionary measures against the infection. Also, older, female, more educated people as well as those who are more likely to contract the infection.</p> </sec><sec> <title>Conclusions</title> <p>During the outbreak, more than half of the respondents rated the psychological impact as moderate anxiety. Thus, the psychological needs during the outbreak should be addressed appropriately. Our results highlight the need to promote protective personal health practices to interrupt the transmission of the (2019-nCoV) in the community. Therefore, educational public programs about preventive measures should be targeted at the identified groups with low current uptake of precautions.</p> </sec></abstract>

SARS-COV-2 (COVID-19): Cellular and biochemical properties and pharmacological insights into new therapeutic developments

COVID-19 caused by SARS-COV-2 first appeared in the Wuhan City of China and began to spread rapidly among people. Rapid progression of the outbreak has led to a major global public health problem of a potentially fatal disease. On January 30, 2020, WHO declared the pandemic as the sixth public health emergency of the world. Upon this, the whole country has started to take the necessary precautions. The new coronavirus uses membrane-bound angiotensin-converting enzyme 2 (ACE2) to enter into the cells, such as SARS-CoV, and mostly affects the respiratory tract. Symptoms of COVID-19 patients include fever (93%), fatigue (70%), cough (70%), anorexia (40%) and dyspnoea (34.5%). The elderly and people with underlying chronic diseases are more susceptible to infection and higher mortality. Currently, a large number of drugs and vaccines studies are ongoing. In this review, we discussed the virology, epidemiological data, the replication of the virus, and its relationship with cardiovascular diseases on COVID-19 pandemics, treatment and vaccines. Thereby, this study aims to neatly present scientific data in light of many regarding literature that can be a clue for readers who research this disease prevention and treatment. SIGNIFICANCE OF THE STUDY: This review summarized current information on COVID-19 (epidemiology, pathophysiology, clinical, laboratory, cardiovascular diseases, ACE2 and pharmacological agents) for researchers and reveals guiding data for researchers, especially in the field of cardiovascular system, pharmacology, dysregulation of cellular function in disease, molecular and cell biology and physiology in the regulation of tissue function in health and disease.

Evolution of computed tomography manifestations of eleven patients with severe coronavirus disease 2019 (COVID-19) pneumonia

PURPOSE

Severe coronavirus disease 2019 (COVID-19) pneumonia is associated with high mortality. However, the evolution of computed tomography (CT) manifestations of severe COVID-19 pneumonia remains unclear, more evidence regarding its evolution process is urgently needed.

METHOD

The clinical, laboratory and imaging data of eleven patients with severe COVID-19 pneumonia were collected to investigate the evolution process of severe COVID-19 cases.

RESULTS

The main initial CT manifestations of severe COVID-19 pneumonia were multiple ground-glass opacities and/or consolidation. The evolution of CT manifestations showed that acute exudative lesions of severe COVID-19 pneumonia could be gradually resolved after the active intervention.

CONCLUSIONS

Most of patients with severe COVID-19 pneumonia showed marked improvement of acute exudative lesions on chest imagings and satisfactory prognosis of severe COVID-19 pneumonia could be achieved after active treatment.

Mental Symptoms and Stress of Hospitalized Schizophrenia Patients With 2019 Novel Coronavirus Disease: An Observation Study

Background: The 2019 novel coronavirus disease (COVID-19) is an extremely rapidly spreading respiratory infection caused by SARS-CoV-2. Many schizophrenic patients were infected with COVID-19 in Wuhan City, Hubei Province. This study took hospitalized schizophrenia patients with COVID-19 as the research subjects and observed the changes in psychopathology and stress of patients with COVID-19 and the accompanying social isolation. Methods: To sort and isolate potential COVID-19-infected patients, an isolated ward was set up from January 30, 2020, to March 30, 2020. Schizophrenia patients with COVID-19 were referred to this ward, and long-term hospitalized cases were included in this study. The Positive and Negative Syndrome Scale and Perceived Stress Scale were used to evaluate the severity of mental symptoms and psychological stress in the early stage of the outbreak of COVID-19, after the diagnosis of COVID-19 and after recovery. At the time of diagnosis, we also extracted the patient's routine blood, biochemical and other indicators and asked the patient's perception of COVID-19. Results: 21 hospitalized schizophrenia patients with COVID-19 were recruited in this study. The changes in PANSS scores were not significant (p = 0.225 baseline vs. diagnosed, p = 0.399 cured vs. diagnosed). The CPSS scores increased significantly after diagnosis and transfer to the isolation ward (p < 0.001 baseline vs. diagnosed, p < 0.001 cured vs. diagnosed). The course of schizophrenia was a protective factor of stress levels to cases (t = -3.25, p = 0.006), and patients' perception of COVID-19 was a risk factor (t = 2.48, p = 0.038). The final multiple linear regression model was statistically significant (F = 8.16, p < 0.001). Conclusion: Hospitalized schizophrenia patients with COVID-19 had increased stress levels and negative symptoms but alleviated positive symptoms after medical isolated treatment. This reminds us that in the face of major epidemics, we must specifically alleviate the psychological burden at the peak of the epidemic and improve the prognosis of patients after the epidemic.