COVID-19: A Review on the Novel Coronavirus Disease Evolution, Transmission, Detection, Control and Prevention

Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection

BACKGROUND

The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer.

METHODS

We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using a retrospective observational mono-centric study conducted between January 2020 and August 2022. Postoperative complications and 90-day mortality were reported. We compared lung cancer patients with a recent history of COVID-19 infection prior to thoracoscopic lobectomy to those without recent COVID-19 infection. Univariable and multivariable analyses were performed.

RESULTS

One hundred and fifty-three consecutive lung cancer patients were enrolled. Of these 30 (19%), had a history of recent COVID-19 infection prior to surgery. COVID-19 was not associated with a higher complication rate or 90-day mortality. Patients with recent COVID-19 infection had more frequent pleural adhesions (p = 0.006). There were no differences between groups regarding postoperative complications, conversion, drain removal time, total drainage output, and length of hospital stay.

CONCLUSIONS

COVID-19 infection did not affect the outcomes of thoracoscopic lobectomy for lung cancer. The treatment of these patients should not be delayed in case of recent COVID-19 infection and should not differ from that of the general population.

Management of SARS-CoV-2 Omicron Variant Community Screenings in Shanghai, China: A Cross-Sectional Study

Background

Community screening for SARS-CoV-2 Omicron variant plays a significant role in controlling the spread of infection. However, loopholes may exist in the current management of community screening in Shanghai, China. The objective of this study was to discover loopholes in the management of community screening for SARS-CoV-2 Omicron variant in Shanghai, China and provide targeted solutions.

Methods

The cross-sectional study was carried out April 4 to April 30, 2021, among residential committee directors from the Putuo District, Pudong District, and Minhang District of Shanghai, China. Data were collected using a self-designed questionnaire about the management of nucleic acid testing (NAT) sampling in communities through the network platform powered by www.wjx.cn.

Results

A total of 203 residential committee directors responded to the survey. Of them, 47.3% were not accepted training and 40.4% were not aware of cross-infection. Comparison among sampling sites and communities, high-risk group contained lower proportion of community training (P = 0.093~0.200), higher awareness of cross-infection (P = 0.039~0.777), more medical workers (P = 0.007~0.724) and more tests performed (P = 0.001~0.992). Larger communities had more medical workers, sampling sites, sampling tables (P = 0.000) and higher awareness of cross-infection (P = 0.009), but lower proportion of community training (P = 0.051).

Conclusion

Overall, community training and awareness of infection control were inadequate. Government or institutions should organize the community training and raise the awareness of infection control. Significant differences exist in NAT management patterns between sampling sites, as well as communities of different sizes. Residential community directors minimize high-risk sampling point settings in the future. Special personnel designated by the government or institutions should tour to guide each sampling site.

SARS-CoV-2 Omicron (B.1.1.529) Variant: A Challenge with COVID-19

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, there have been multiple peaks of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus virus 2) infection, mainly due to the emergence of new variants, each with a new set of mutations in the viral genome, which have led to changes in the pathogenicity, transmissibility, and morbidity. The Omicron variant is the most recent variant of concern (VOC) to emerge and was recognized by the World Health Organization (WHO) on 26 November 2021. The Omicron lineage is phylogenetically distinct from earlier variants, including the previously dominant Delta SARS-CoV-2 variant. The reverse transcription-polymerase chain reaction (RT-PCR) test, rapid antigen assays, and chest computed tomography (CT) scans can help diagnose the Omicron variant. Furthermore, many agents are expected to have therapeutic benefits for those infected with the Omicron variant, including TriSb92, molnupiravir, nirmatrelvir, and their combination, corticosteroids, and interleukin-6 (IL-6) receptor blockers. Despite being milder than previous variants, the Omicron variant threatens many lives, particularly among the unvaccinated, due to its higher transmissibility, pathogenicity, and infectivity. Mounting evidence has reported the most common clinical manifestations of the Omicron variant to be fever, runny nose, sore throat, severe headache, and fatigue. This review summarizes the essential features of the Omicron variant, including its history, genome, transmissibility, clinical manifestations, diagnosis, management, and the effectiveness of existing vaccines against this VOC.

Procalcitonin and Adrenomedullin in Infectious Diseases

Calcitonin (CT) and adrenomedullin (ADM) are members of the CT family. Procalcitonin (PCT) is a prohormone of CT. Elevations in serum PCT and ADM levels are associated with severe sepsis and coronavirus disease 2019 (COVID-19). PCT enhances sepsis mortality and it binds to the CGRP receptor, which is a heterodimer of CT receptor-like receptor and receptor activity-modifying protein 1. The N-terminal truncated form of PCT, PCT3-116, is produced by the cleavage of PCT by dipeptidyl peptidase 4 (DPP-4) and is the main form of PCT in serum during sepsis, inducing microvascular permeability. Mid-regional pro-adrenomedullin (MR-proADM) is used instead of ADM as a biological indicator because ADM is rapidly degraded, and MR-proADM is released at the same rate as ADM. ADM reduces endothelial permeability and promotes endothelial stability. Endothelial dysfunction is responsible for multiple organ failure in sepsis and COVID-19 patients. Therefore, ADM may be an important molecule for improving the severity associated with sepsis and COVID-19. This review focuses on the current knowledge of PCT and ADM in sepsis and COVID-19.

COVID-19 and ocular complications: A review of ocular manifestations, diagnostic tools, and prevention strategies

Background

The novel severe acute respiratory syndrome coronavins 2 (SARS-CoV-2) led to the severe Corona Virus Disease 2019 (COVID-19) outbreak that started in December 2019 in China and caused enormous health and economic problems worldwide. Over time, SARS-CoV-2 has demonstrated the capacity for mutation. As the most prevalent new coronavirus variety worldwide, the Omicron variant has supplanted the Delta variant. The COVID-19 primarily damages the immune system and the lungs, but it can also harm other organs secondarily, depending on the patients' co-existing conditions.

Main Text

COVID-19 is associated with ophthalmic manifestations such as conjunctival congestion, tear overflow, and conjunctival edema, with the majority of eye complications occurring in patients with severe infection. The virus may make a patient more susceptible to thrombotic conditions that affect venous and arterial circulation. Meanwhile, it can lead to efferent complications and mucormycosis which is more common in patients with diabetes or who have critical or severe SARS-CoV-2 infection. Significantly, there are a number of ocular side effects following the COVID-19 vaccination, such as herpetic keratitis and facial nerve palsy, which have been reported. These side effects may be caused by the vaccinations' propensity to trigger autoimmune symptoms or thromboembolic events. At present, large-scale nucleic acid testing mainly relies on nasopharyngeal swabs and throat swabs. Tear samples and conjunctival swabs may be helpful samples for the diagnosis of ocular SARS-CoV-2 infection. The eye could be a new route of infection, and finding ways such as effective environmental disinfection, scientific administrative control management, qualified personal protection and other measures to protect the eyes could further reduce the risk of infection.

Conclusions

This review aims to sum up the ocular complications of COVID-19, the possible pathogenesis, and preventive strategies to protect ophthalmology practitioners and patients by reviewing the currently available literature on the topic.

Clinical Investigation of Leukocyte DNA Damage in COVID-19 Patients

This prospective cross-sectional study aimed to evaluate leukocyte DNA damage in coronavirus disease (COVID-19) patients. In this study, 50 COVID-19-positive patients attending the Erzurum City Hospital Internal Medicine Outpatient Clinic and 42 control group patients were included. DNA damage was detected in living cells through leukocyte isolation in 50 COVID-19-positive patients using the comet assay method. DNA tail/head (olive) moments were evaluated and compared. White blood cells (WBC), red blood cells (RBC), hemoglobin (HGB), neutrophils (NEU), lymphocytes (LYM), eosinophils (EO), monocytes (MONO), basophils (BASO), platelets (PLT), and the neutrophil/lymphocyte ratio (NLR) were analyzed. The RBC, lymphocyte, eosinophil, and monocyte means were significantly higher in the control group (p < 0.05), whereas the HGB and neutrophile means were significantly higher in the study group (p < 0.05). There were significant negative correlations between COVID-19 and RBC (r = -0.863), LYM (r = -0.542), EO (r = -0.686), and MONO (r = -0.385). Meanwhile, there were significant positive correlations between COVID-19 and HGB (r = 0.863), NEU (r = 0.307), tail moment (r = 0.598), and olive moment (r = 0.582). Both the tail and olive moment mean differences were significantly higher in the study group, with higher ranges (p < 0.05). COVID-19 infection caused statistically significant increases in both the tail and olive damage percentage in patients, causing DNA damage. Lastly, the NLR rate was associated with the presence and progression of COVID-19.

Biobran/MGN-3, an Arabinoxylan Rice Bran, Protects against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): An In Vitro and In Silico Study

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus Disease 2019 (COVID-19), poses a serious global public health threat for which there is currently no satisfactory treatment. This study examines the efficacy of Biobran/MGN-3 against SARS-CoV-2. Biobran is an arabinoxylan rice bran that has been shown to significantly inhibit the related influenza virus in geriatric subjects. Here, Biobran's anti-SARS-CoV-2 activity was assessed using MTT and plaque reduction assays, RT-PCR, ELISA techniques, and measurements of SARS-CoV-2-related gene expression and protein levels. For Vero E6 cells infected with SARS-CoV-2, Biobran reduced the viral load by 91.9% at a dose of 100 μg/mL, it reduced viral counts (PFU/mL) by 90.6% at 50 μg/mL, and it exhibited a significant selectivity index (EC₅₀/IC₅₀) of 22.5. In addition, Biobran at 10 μg/mL inhibited papain-like proteinase (PLpro) by 87% and ACE2 SARS-CoV-2 S-protein RBD by 90.5%, and it significantly suppressed SARS-CoV-2 gene expression, down-regulating E-gene and RdRp gene expression by 93% each at a dose of 50 μg/mL and inhibiting the E-protein by 91.3%. An in silico docking study was also performed to examine the protein-protein interaction (PPI) between SARS-CoV-2 RBD and DC-SIGN as well as between serine carboxypeptidase and papain-like protease PLpro. Serine carboxypeptidase, an active ingredient in Biobran, was found to interfere with the binding of SARS-CoV-2 to its receptor DC-SIGN on Vero cells, thus preventing the cell entry of SARS-CoV-2. In addition, it impairs the viral replication cycle by binding to PLpro. We conclude that Biobran possesses potent antiviral activity against SARS-CoV-2 in vitro and suggest that Biobran may be able to prevent SARS-CoV-2 infection. This warrants further investigation in clinical trials.

COVID-19 epidemic and public health interventions in Shanghai, China: Statistical analysis of transmission, correlation and conversion

Background

The Shanghai COVID-19 epidemic is an important example of a local outbreak and of the implementation of normalized prevention and disease control strategies. The precise impact of public health interventions on epidemic prevention and control is unknown.

Methods

We collected information on COVID-19 patients reported in Shanghai, China, from January 30 to May 31, 2022. These newly added cases were classified as local confirmed cases, local asymptomatic infections, imported confirmed cases and imported asymptomatic infections. We used polynomial fitting correlation analysis and illustrated the time lag plot in the correlation analysis of local and imported cases. Analyzing the conversion of asymptomatic infections to confirmed cases, we proposed a new measure of the conversion rate (C _r ). In the evolution of epidemic transmission and the analysis of intervention effects, we calculated the effective reproduction number (R _t ). Additionally, we used simulated predictions of public health interventions in transmission, correlation, and conversion analyses.

Results

(1) The overall level of R _t in the first three stages was higher than the epidemic threshold. After the implementation of public health intervention measures in the third stage, R _t decreased rapidly, and the overall R _t level in the last three stages was lower than the epidemic threshold. The longer the public health interventions were delayed, the more cases that were expected and the later the epidemic was expected to end. (2) In the correlation analysis, the outbreak in Shanghai was characterized by double peaks. (3) In the conversion analysis, when the incubation period was short (3 or 7 days), the conversion rate fluctuated smoothly and did not reflect the effect of the intervention. When the incubation period was extended (10 and 14 days), the conversion rate fluctuated in each period, being higher in the first five stages and lower in the sixth stage.

Conclusion

Effective public health interventions helped slow the spread of COVID-19 in Shanghai, shorten the outbreak duration, and protect the healthcare system from stress. Our research can serve as a positive guideline for addressing infectious disease prevention and control in China and other countries and regions.

Human iPS cell-derived sensory neurons can be infected by SARS-CoV-2 strain WA1/2020 as well as variants delta and omicron

COVID-19 has impacted billions of people in the world since 2019 and unfolded a major healthcare crisis. With an increasing number of deaths and the emergence of more transmissible variants, it is crucial to better understand the biology of the disease-causing virus, the SARS-CoV-2. Peripheral neuropathies appeared as a specific COVID-19 symptom occurring at later stages of the disease. In order to understand the impact of SARS-CoV-2 on the peripheral nervous system, we generated human sensory neurons from induced pluripotent stem cells that we infected with the SARS-CoV-2 strain WA1/2020 and the variants delta and omicron. Using single cell RNA sequencing, we found that human sensory neurons can be infected by SARS-CoV-2 but are unable to produce new viruses. Our data suggests that sensory neurons can be infected by the original WA1/2020 strain of SARS-CoV-2 as well as the delta and omicron variants.

Leukocyte surface expression of the endoplasmic reticulum chaperone GRP78 is increased in severe COVID-19

Hyperinflammation present in individuals with severe COVID-19 has been associated with an exacerbated cytokine production and hyperactivated immune cells. Endoplasmic reticulum stress leading to the unfolded protein response has been recently reported as an active player in inducing inflammatory responses. Once unfolded protein response is activated, GRP78, an endoplasmic reticulum-resident chaperone, is translocated to the cell surface (sGRP78), where it is considered a cell stress marker; however, its presence has not been evaluated in immune cells during disease. Here we assessed the presence of sGRP78 on different cell subsets in blood samples from severe or convalescent COVID-19 patients. The frequency of CD45+sGRP78+ cells was higher in patients with the disease compared to convalescent patients. The latter showed similar frequencies to healthy controls. In patients with COVID-19, the lymphoid compartment showed the highest presence of sGRP78+ cells versus the myeloid compartment. CCL2, TNF-α, C-reactive protein, and international normalized ratio measurements showed a positive correlation with the frequency of CD45+sGRP78+ cells. Finally, gene expression microarray data showed that activated T and B cells increased the expression of GRP78, and peripheral blood mononuclear cells from healthy donors acquired sGRP78 upon activation with ionomycin and PMA. Thus, our data highlight the association of sGRP78 on immune cells in patients with severe COVID-19.

COVID-19 and Thymoquinone: Clinical Benefits, Cure, and Challenges

In today’s world, the outbreak of the coronavirus disease 2019 (COVID-19) has spread throughout the world, causing severe acute respiratory syndrome (SARS) and several associated complications in various organs (heart, liver, kidney, and gastrointestinal tract), as well as significant multiple organ dysfunction, shock, and even death. In order to overcome the serious complications associated with this pandemic virus and to prevent SARS-CoV-2 entry into the host cell, it is necessary to repurpose currently available drugs with a broad medicinal application as soon as they become available. There are several therapeutics under investigation for improving the overall prognosis of COVID-19 patients, but none of them has demonstrated clinical efficacy to date, which is disappointing. It is in this pattern that Nigella sativa seeds manifest their extensive therapeutic effects, which have been reported to be particularly effective in the treatment of skin diseases, jaundice, and gastrointestinal problems. One important component of these seeds is thymoquinone (TQ), which has a wide range of beneficial properties, including antioxidant and anti-inflammatory properties, as well as antibacterial and parasitic properties, in addition to anticarcinogenic, antiallergic, and antiviral properties. This comprehensive review discussed the possibility of an emerging natural drug with a wide range of medical applications; the use of TQ to overcome the complications of COVID-19 infection; and the challenges that are impeding the commercialization of this promising phytochemical compound. TQ is recommended as a highly effective weapon in the fight against the novel coronavirus because of its dual antiviral action, in addition to its capacity to lessen the possibility of SARS-CoV-2 penetration into cells. However, future clinical trials are required to confirm the role of TQ in overcoming the complications of COVID-19 infection.

Characteristics of the Severe Acute Respiratory Syndrome Coronavirus 2 Omicron BA.2 Subvariant in Jilin, China from March to May 2022

Background and Objectives

In the midst of the pandemic, new coronavirus mutants continue to emerge; the most relevant variant worldwide is omicron. Here, patients who recovered from the disease living in Jilin Province were analyzed to identify factors affecting the severity of omicron infection and to provide insights into its spread and early indication.

Methods

In this study, 311 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were divided into two groups. Data on the patients' demographic characteristics and laboratory tests, including platelet count (PLT), neutrophil count (NE), C-reactive protein (CRP), serum creatinine (SCR), and neutrophil-to-lymphocyte ratio (NLR), were collected. The biomarkers for moderate and severe coronavirus disease 2019 (COVID-19) and factors affecting the incubation period and time to subsequent negative nucleic acid amplification test (NAAT) were also investigated.

Results

Age, gender, vaccination, hypertension, stroke, chronic obstructive pulmonary disease (COPD)/chronic bronchitis/asthma, and some laboratory tests were statistically different between the two groups. In the receiver operating characteristic (ROC) analysis, PLT and CRP had higher area under the ROC curve values. In the multivariate analysis, age, hypertension, COPD/chronic bronchitis/asthma, and CRP were correlated with moderate and severe COVID-19. Moreover, age was correlated with longer incubation. In the Kaplan-Meier curve analysis, gender (male), CRP, and NLR were associated with longer time to subsequent negative NAAT.

Conclusions

Older patients with hypertension and lung diseases were likely to have moderate or severe COVID-19, and younger patients might have a shorter incubation. A male patient with high CRP and NLR levels might take more time to turn back negative in the NAAT.

The COVID-19 Impact on Oral Healthcare Demand and Performance: The Experience of a Clinical and Academic Centre in Portugal (EU)

INTRODUCTION

The SARS-CoV-2 pandemic has reshaped the global landscape as we know it and had a tremendous effect on healthcare systems around the world. However, its impact on oral healthcare is still to be fully assessed. The aim of this study was to understand if and how COVID-19 affected the demand and performance of oral healthcare, taking the Clinical and Academic Centre of Coimbra as an example, more specifically, the Department of Stomatology of the Coimbra Hospital and University Centre and the Dentistry Department of the Faculty of Medicine of the University of Coimbra.

MATERIAL AND METHODS

An observational study was designed for collecting the data of a series of key oral healthcare indicators: number of appointments; referrals from primary healthcare; missed appointments; number of surgeries performed in the operating room; number of biopsies; number of patients admitted through the emergency department and epidemiologic parameters over two 18-month periods between September 2018 and August 2021: pre-COVID-19 and during the COVID-19 pandemic, with the latter divided in four stages. A statistical analysis which included descriptive and inferential procedures was then performed, with an established significance level of 5% and the application of parametric tests, t-Student test for a sample and for independent samples and One-Way ANOVA for the variance analysis.

RESULTS

There was a general decline in all indicators comparing the pre-COVID-19 with the COVID-19 period, with a reduction of 50.61% in the number of appointments, 44.06% in referrals, 24.41% in surgeries, 26.30% in biopsies and 32.33% in patients seen in the Emergency Room. The number of missed appointments also increased by 181.82%. All variations revealed statistically significant differences (p < 0.05). The individual COVID-19 stage analysis, when compared with the pre-COVID-19 reference, and variance analysis of these different stages also showed statistically significant differences (p < 0.05 and p < 0.001), except for the number of biopsies during the third and fourth stages.

CONCLUSION

The results of this study suggest that the SARS-CoV-2 pandemic has had a considerable impact on oral healthcare demand and performance. However, results also show a remarkable adjustment and improvement in the provided care, with a positive evolution throughout the COVID-19 period.

Exploration and verification of COVID-19-related hub genes in liver physiological and pathological regeneration

Objectives An acute injury is often accompanied by tissue regeneration. In this process, epithelial cells show a tendency of cell proliferation under the induction of injury stress, inflammatory factors, and other factors, accompanied by a temporary decline of cellular function. Regulating this regenerative process and avoiding chronic injury is a concern of regenerative medicine. The severe coronavirus disease 2019 (COVID-19) has posed a significant threat to people's health caused by the coronavirus. Acute liver failure (ALF) is a clinical syndrome resulting from rapid liver dysfunction with a fatal outcome. We hope to analyze the two diseases together to find a way for acute failure treatment. Methods COVID-19 dataset (GSE180226) and ALF dataset (GSE38941) were downloaded from the Gene Expression Omnibus (GEO) database, and the "Deseq2" package and "limma" package were used to identify differentially expressed genes (DEGs). Common DEGs were used for hub genes exploration, Protein-Protein Interaction (PPI) network construction, Gene Ontology (GO) functional enrichment, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) was used to verify the role of hub genes in liver regeneration during in vitro expansion of liver cells and a CCl4-induced ALF mice model. Results: The common gene analysis of the COVID-19 and ALF databases revealed 15 hub genes from 418 common DEGs. These hub genes, including CDC20, were related to cell proliferation and mitosis regulation, reflecting the consistent tissue regeneration change after the injury. Furthermore, hub genes were verified in vitro expansion of liver cells and in vivo ALF model. On this basis, the potential therapeutic small molecule of ALF was found by targeting the hub gene CDC20. Conclusion We have identified hub genes for epithelial cell regeneration under acute injury conditions and explored a new small molecule Apcin for liver function maintenance and ALF treatment. These findings may provide new approaches and ideas for treating COVID-19 patients with ALF.

Nasal Microbiome in COVID-19: A Potential Role of Corynebacterium in Anosmia

The evolution and the development of the symptoms of Coronavirus disease 19 (COVID-19) are due to different factors, where the microbiome plays a relevant role. The possible relationships between the gut, lung, nasopharyngeal, and oral microbiome with COVID-19 have been investigated. We analyzed the nasal microbiome of both positive and negative SARS-CoV-2 individuals, showing differences in terms of bacterial composition in this niche of respiratory tract. The microbiota solution A (Arrow Diagnostics) was used to cover the hypervariable V1-V3 regions of the bacterial 16S rRNA gene. MicrobAT Suite and MicrobiomeAnalyst program were used to identify the operational taxonomic units (OTUs) and to perform the statistical analysis, respectively. The main taxa identified in nasal microbiome of COVID-19 patients and in Healthy Control subjects belonged to three distinct phyla: Proteobacteria (HC = 14%, Cov19 = 35.8%), Firmicutes (HC = 28.8%, Cov19 = 30.6%), and Actinobacteria (HC = 56.7%, Cov19 = 14.4%) with a relative abundance > 1% in all groups. A significant reduction of Actinobacteria in Cov19 group compared to controls (P < 0.001, FDR = 0.01) was found. The significant reduction of Actinobacteria was identified in all taxonomic levels down to the genus (P < 0.01) using the ANOVA test. Indeed, a significantly reduced relative abundance of Corynebacterium was found in the patients compared to healthy controls (P = 0.001). Reduced abundance of Corynebacterium has been widely associated with anosmia, a common symptom of COVID-19 as suffered from our patients. Contrastingly, the Corynebacterium genus was highly represented in the nasal mucosa of healthy subjects. Further investigations on larger cohorts are necessary to establish functional relationships between nasal microbiota content and clinical features of COVID-19.

Trend of Academic Productivity in Plastic Surgery and the Impact of COVID-19: A Bibliometric Analysis

BACKGROUND

Plastic surgery has grown rapidly over the past decade, with increasing scientific output. The emergence of coronavirus disease 2019 (COVID-19) has a considerable impact on plastic surgery.

OBJECTIVE

To identify trends in published literature in plastic surgery from 2011 to 2021. To explore the impact of COVID-19 on scientific research output through bibliometric analysis methods.

METHODS

Web of Science was searched by authors on December 23, 2021. Published papers about plastic surgery over the last decade were analyzed. The search output was imported into VOSviewer for science mapping.

RESULTS

The actual number of papers related to plastic surgery during the COVID-19 period was higher than expected one. For scientific outputs in plastic surgery, keywords about surgical practice had a high frequency. "Reconstruction," "effect," "flap," "tissue," "defect," "model" maintained a high level of heat before and after COVID-19. The heat of "risk," "complication," "review," "infection," "cohort," and "meta-analysis" increased after the outbreak of COVID-19. The international collaboration showed an upward trend despite the impact of COVID-19. From the perspective of the volume of plastic surgery publications, some journals had a more positive performance compared to the pre-epidemic period. The proportion of original articles decreased after the spread of COVID-19 from 70.26% to 63.84%.

CONCLUSION

Although the COVID-19 has a profound impact on the healthcare industry, the bibliographic data reveals an increasing scientific output in the field of plastic surgery over time. For plastic surgery, high-frequency terms, research hotspots, popular journals, article types, and international collaboration have changed under the influence of COVID-19.

Potential Targets and Mechanisms of Bitter Almond-Licorice for COVID-19 Treatment Based on Network Pharmacology and Molecular Docking

BACKGROUND

The outbreak of Corona Virus Disease 2019 (COVID-19) has resulted in millions of infections and raised global attention. Bitter almonds and licorice are both Traditional Chinese Medicines (TCM), often used in combination to treat lung diseases. Several prescriptions in the guidelines for the diagnosis and treatment of coronavirus disease 2019 (trial version ninth) contained bitter almond-licorice, which was effective in the treatment of COVID-19. However, the active ingredients, drug targets and therapeutic mechanisms of bitter almonds-licorice for the treatment of COVID-19 remain to be elucidated.

METHODS

The active ingredients and targets were derived from the Traditional Chinese Medicine Systems Pharmacology (TCMSP). Meanwhile, targets associated with COVID-19 were obtained from the GeneCards database, PharmGkb database and DrugBank database. Then, the potential targets of bitter almond-licorice against COVID-19 were screened out. Protein-protein interaction (PPI) networks and core targets were analyzed through the String database and Cytoscape software. In addition, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed based on potential targets using R statistical software. Finally, molecular docking was used to validate the binding of the active ingredients to the core targets.

RESULTS

The results of the TCMSP database showed that the bitter almond-licorice had 89 active components against COVID-19, involving 102 targets. PPI network and core target analysis indicated that IL-6, TNF, MAPK1, and IL1B were the key targets against COVID-19. In addition, GO and KEGG enrichment analysis showed that the bitter almond-licorice were involved in various biological processes through inflammation-related pathways such as TNF signaling pathway and IL-17 signaling pathway. Finally, molecular docking approaches confirmed the affinity between the active components of the bitter almond-licorice and the therapeutic targets.

CONCLUSION

The bitter almond-licorice could be used to treat COVID-19 by inhibiting inflammatory responses and regulating cellular stress. This work is based on data mining and molecular docking, and the findings need to be interpreted with caution.

Molecular evolution of SARS-CoV-2 from December 2019 to August 2022

Severe acute respiratorysyndrome coronavirus-2 (SARS-CoV-2) pandemic spread rapidly and this scenario is concerning worldwide, presenting more than 590 million coronavirus disease 2019 cases and 6.4 million deaths. The emergence of novel lineages carrying several mutations in the spike protein has raised additional public health concerns worldwide during the pandemic. The present study review and summarizes the temporal spreading and molecular evolution of SARS-CoV-2 clades and variants worldwide. The evaluation of these data is important for understanding the evolutionary histories of SARSCoV-2 lineages, allowing us to identify the origins of each lineage of this virus responsible for one of the biggest pandemics in history. A total of 2897 SARS-CoV-2 whole-genome sequences with available information from the country and sampling date (December 2019 to August 2022), were obtained and were evaluated by Bayesian approach. The results demonstrated that the SARS-CoV-2 the time to the most recent common ancestor (tMRCA) in Asia was 2019-12-26 (highest posterior density 95% [HPD95%]: 2019-12-18; 2019-12-29), in Oceania 2020-01-24 (HPD95%: 2020-01-15; 2020-01-30), in Africa 2020-02-27 (HPD95%: 2020-02-21; 2020-03-04), in Europe 2020-02-27 (HPD95%: 2020-02-20; 2020-03-06), in North America 2020-03-12 (HPD95%: 2020-03-05; 2020-03-18), and in South America 2020-03-15 (HPD95%: 2020-03-09; 2020-03-28). Between December 2019 and June 2020, 11 clades were detected (20I [Alpha] and 19A, 19B, 20B, 20C, 20A, 20D, 20E [EU1], 20F, 20H [Beta]). From July to December 2020, 4 clades were identified (20J [Gamma, V3], 21 C [Epsilon], 21D [Eta], and 21G [Lambda]). Between January and June 2021, 3 clades of the Delta variant were detected (21A, 21I, and 21J). Between July and December 2021, two variants were detected, Delta (21A, 21I, and 21J) and Omicron (21K, 21L, 22B, and 22C). Between January and June 2022, the Delta (21I and 21J) and Omicron (21K, 21L, and 22A) variants were detected. Finally, between July and August 2022, 3 clades of Omicron were detected (22B, 22C, and 22D). Clade 19A was first detected in the SARS-CoV-2 pandemic (Wuhan strain) with origin in 2019-12-16 (HPD95%: 2019-12-15; 2019-12-25); 20I (Alpha) in 2020-11-24 (HPD95%: 2020-11-15; 2021-12-02); 20H (Beta) in 2020-11-25 (HPD95%: 2020-11-13; 2020-11-29); 20J (Gamma) was 2020-12-21 (HPD95%: 2020-11-05; 2021-01-15); 21A (Delta) in 2020-09-20 (HPD95%: 2020-05-17; 2021-02-03); 21J (Delta) in 2021-02-26 (2020-11-02; 2021-04-24); 21M (Omicron) in 2021-01-25 (HPD95%: 2020-09-16; 2021-08-08); 21K (Omicron) in 2021-07-30 (HPD95%: 2021-05-30; 2021-10-19); 21L (Omicron) in 2021-10-03 (HPD95%: 2021-04-16; 2021-12-23); 22B (Omicron) in 2022-01-25 (HPD95%: 2022-01-10; 2022-02-05); 21L in 2021-12-20 (HPD95%: 2021-05-16; 2021-12-31). Currently, the Omicron variant predominates worldwide, with the 21L clade branching into 3 (22A, 22B, and 22C). Phylogeographic data showed that Alpha variant originated in the United Kingdom, Beta in South Africa, Gamma in Brazil, Delta in India, Omicron in South Africa, Mu in Colombia, Epsilon in the United States of America, and Lambda in Peru. The COVID-19 pandemic has had a significant impact on global health worldwide and the present study provides an overview of the molecular evolution of SARS-CoV-2 lineage clades (from the Wuhan strain to the currently circulating lineages of the Omicron).

Change in hospital admissions in dental diseases before and during the COVID-19 pandemic

In this retrospective cross-sectional study, it was aimed to evaluate the negative effects of the pandemic process in the field of oral health by revealing the characteristics of applications made to a hospital related to oral health before and during the pandemic. Patient records who applied to Cyprus Science University Dentistry Hospital between October 2019 and March 2021 were included in the study. Gender, age, applied unit, applying frequency and procedure records were evaluated. Ethical approval was taken from Cyprus Science University. Patient records were divided into two groups as before pandemic (n = 338) and during pandemic (n = 1517). Results of the study showed that gender, age and applied unit distributions were not significantly different between before and during pandemic (p > 0.05). Female and prosthesis applied patients were more common before and after COVID-19 pandemic. Detertrage, tooth extraction, night plaque, temporary cron, metal supported porcelain crown on implant, compomer filler and orthodontic diagnosis rates were decreased during pandemic, compared to before pandemic. Panaromic X-ray was the most common process before and during the pandemic. The differences between before and during pandemic were statistically significant (p < 0.05). The results of the research show that the pandemic process in terms of oral health caused significant differences in the reasons for application, even in the population aged 34-36, the majority of whom are women.

Evaluation of SARS-CoV-2 antibody persistence and viral spread in stool: a long-term care experience before COVID-19 vaccination

BACKGROUND

Due to elderly residents, nursing homes/assisted living facilities were the most affected places in COVID-19 pandemic. Besides symptomatic patients, asymptomatic patients were detected during routine screening.

AIM

This study aims to determine the factors that affect antibody response and viral shedding in stool samples after natural exposure to the virus in residents and staff who recovered from COVID-19 before the vaccine was available.

METHODS

This prospective cross-sectional study was conducted at the nation's highest-capacity Residential and Nursing Home. Blood samples were collected between December 15, 2020 and January 15, 2021 from participating residents and staff for anti-SARS-CoV-2 antibody testing. Stool samples were obtained for SARS-CoV-2 PCR testing 2 months after COVID-19. The Social Sciences (SPSS) program version 15.0 was used for statistical analysis. The Mann-Whitney U test compared SARS-CoV-2 antibody concentration between two groups.

RESULTS

Four hundred sixty-four (52.3%) residents and 424 (47.7%) staff participated. Entirely 259 (29.2%) participants were anti-SARS-CoV-2 IgG (+) and 255 (28.7%) were SARS-CoV-2 PCR (+). Both antibody and PCR positivity was detected in 196 (76.9%). In PCR (-) group, 63 (10.0%) participants were SARS-CoV-2 IgG (+). Antibody titers were found highest in SARS-CoV-2 PCR (+) male residents. SARS-CoV-2 IgG titers were significantly high in SARS-CoV-2 PCR (+) and hospitalized participants regardless of age. Stool samples were obtained from 61(23.9%) participants and were found negative.

CONCLUSION

A durable SARS-CoV-2 IgG antibody response was monitored at least 9 months after the participants were diagnosed with COVID-19. SARS-CoV-2 antibody positivity was detected 76.9% in PCR (+) and 10.0% in PCR (-) participants. Knowing the duration of detectable antibodies is an important finding for developing disease prevention and public health strategies.

Safety and Efficacy of Covid-19 Vaccination in Patients Undergoing Biological Treatments for Psoriasis

The introduction of biologic drugs revolutionized the treatment of psoriasis, shifting treatment goals to higher treatment outcomes and less frequent safety issues. The outbreak of Coronavirus disease 2019 (COVID-19) represented a worldwide challenge, strongly affecting lifestyle, global economy, and overall health. Among the strategies adopted to contain the spreading of the infection, vaccination is the main one. In this context, the introduction of COVID-19 vaccines raised several doubts about their effectiveness and safety in patients undergoing therapy with biological for psoriasis. Even if molecular and cellular mechanisms by which COVID-19 vaccines lead to psoriasis development have not yet been fully elucidated, vaccination itself can trigger the release of interleukin (IL)-6, interferon (IFN) and tumor necrosis factor (TNF) α by T-helper (Th)1/Th17 cells. All these cytokines are involved in psoriasis pathogenesis. Thus, the aim of this manuscript is to review current literature on the safety and effectiveness of COVID-19 vaccination in psoriasis patients undergoing treatment with biologics, in order to clarify any concerns.

Broadly neutralizing antibodies to SARS-CoV-2 and other human coronaviruses

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently emerged pathogenic human coronavirus that belongs to the sarbecovirus lineage of the genus Betacoronavirus. The ancestor strain has evolved into a number of variants of concern, with the Omicron variant of concern now having many distinct sublineages. The ongoing COVID-19 pandemic caused by SARS-CoV-2 has caused serious damage to public health and the global economy, and one strategy to combat COVID-19 has been the development of broadly neutralizing antibodies for prophylactic and therapeutic use. Many are in preclinical and clinical development, and a few have been approved for emergency use. Here we summarize neutralizing antibodies that target four key regions within the SARS-CoV-2 spike (S) protein, namely the N-terminal domain and the receptor-binding domain in the S1 subunit, and the stem helix region and the fusion peptide region in the S2 subunit. Understanding the characteristics of these broadly neutralizing antibodies will accelerate the development of new antibody therapeutics and provide guidance for the rational design of next-generation vaccines.

Impacts of the novel coronavirus SARS-CoV-2 on wildlife behaviour via human activities

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the pandemic of the coronavirus disease 2019 (COVID-19), resulting in a global lockdown in 2020. This stagnation in human activities ('anthropause') has been reported to affect the behaviour of wildlife in various ways. The sika deer Cervus nippon in Nara Park, central Japan, has had a unique relationship with humans, especially tourists, in which the deer bow to receive food and sometimes attack if they do not receive it. We investigated how a decrease and subsequent increase in the number of tourists visiting Nara Park affects the number of deer observed in the park and their behaviour (bows and attacks against humans). Compared with the pre-pandemic years, the number of deer in the study site decreased from an average of 167 deer in 2019 to 65 (39%) in 2020 during the pandemic period. Likewise, the number of deer bows decreased from 10.2 per deer in 2016-2017 to 6.4 (62%) in 2020-2021, whereas the proportion of deer showing aggressive behaviour did not change significantly. Moreover, the monthly numbers of deer and their bows both corresponded with the fluctuation in the number of tourists during the pandemic period of 2020 and 2021, whereas the number of attacks did not. Thus, the anthropause caused by the coronavirus altered the habitat use and behaviour of deer that have continuous interactions with humans.

Factors Affecting the Outcomes of COVID-19 in Diabetes Patients at Haji Adam Malik General Hospital Medan, Indonesia

Background

COVID-19 is a virulent viral infection by SARS-CoV-2 which caused pandemic and high mortality. One of the numerous risk factors for worse clinical outcomes in COVID-19 patients is the presence of comorbidity. Diabetes Mellitus is a chronic metabolic disease frequently in COVID-19 patients. Insulin resistance, causes chronic inflammation in the body, may aggravate the clinical outcome COVID-19 patients.

Objective

The aim of the study was to examine factors that impact clinical outcomes in COVID-19 T2DM patients.

Methods

The method used an analytical method with cross sectional design. Population is inpatients in Haji Adam Malik Hospital diagnosed with COVID-19 and Diabetes Mellitus Type 2 with 99 inpatients as sample. The data used are secondary data obtained through medical records from a hospital covering patients characteristics and laboratory result The data was analyzed using t-independent and chi square test with SPSS program.

Results

Clinical outcomes for 99 patients are 60 patients are cured and 39 patients are dead. analytical study found a significant correlation between factors impacting clinical outcomes on COVID-19 patients with T2DM that are HbA1c level, D-dimer, cholesterol total and COVID-19 degree of severity and the clinical outcomes (p<0,05).

Conclusion

HbA1c level, D-dimer, total cholesterol and the infection degree of severity affects the clinical outcomes on COVID-19 with T2DM (p<0,05).

Covid-19 and its relation to the human eye: transmission, infection, and ocular manifestations

BACKGROUND

The world is suffering from a new strain of the coronavirus family-Covid-19. This virus strain affected different organs in the human body with a wide range of mild symptoms and moderate signs to severe and deadly ones. Multiple organs can be infected, and one of these organs is the eye. The eye is a vital organ that consists of vascular tissues and is connected to the respiratory tract through the tears and the nasolacrimal duct.

METHODS

Recent papers and research from PubMed, Researchgate, and Google Scholar were cited and thoroughly discussed. These papers were chosen based on their relevancy, reliability, publication year, published journal, and ease of accessibility to the paper itself.

RESULTS

The theory concluded that the ocular surface might consider a pathway for the virus attack and infection causation through the tears and the angiotensin-converting enzyme 2 located in the eye. This article thoroughly reviewed the history, the existing aspects of Covid-19, the ocular system features, and the claims about the possible involvement of the eye in the virus transmission along with the eye infection. There was no consensus on the eye's involvement theory.

CONCLUSION

The authors highlighted the extra work and research needed to be conducted to prove or deny these claims to provide a better understanding of the immune response of the eye to Covid-19 infection.

Mask-Wearing and Handwashing Behaviors of Chinese Rural Residents during the Pandemic of COVID-19: A Cross-Sectional Survey

OBJECTIVE

To understand mask-wearing and handwashing behaviors of Chinese rural residents during the COVID-19 pandemic and to analyze the associated factors.

METHODS

This study used a multi-stage random sampling method to conduct a cross-sectional questionnaire survey during the period of July to December of 2021, in six counties located in Shandong, Shanxi, and Yunnan provinces representing the eastern, central, and western regions of China, respectively. A total of 3864 villagers were surveyed with a questionnaire, and 3832 valid questionnaires were finally analyzed. Descriptive statistics and logistic regression analysis were used for statistical analysis.

RESULTS

Around ninety-four percent (93.6%) of rural residents reported mask-wearing during the COVID-19 pandemic, but only 44.5% of them could replace masks in time. Multivariate logistic regression analysis showed that those who were female, aged 15-59, had an education level of high school and above, were divorced/widowed, worked as farmers (workers), or were rural residents in Shandong Province were more likely to wear masks. Furthermore, those who were female, aged 15-59, had an education level of high school and above, were unmarried and married, were business and service workers, or were rural residents in Shandong and Shanxi Province replaced masks more timely. Around seventy percent (69.7%) of rural residents reported using soap when washing their hands, but only 38.0% of rural residents could wash their hands properly. Multivariate logistic regression analysis showed that rural residents who were aged 35-59, had an education of high school and above, or lived in Shandong Province and Shanxi Province were more likely to wash their hands with soap. Those who were aged 15-59, had an education of high school and above, worked as farmers (workers), were employees of governmental departments and retirees, were business and service workers, or were students had higher proper handwashing rates.

CONCLUSION

During the COVID-19 pandemic, the proportion of Chinese rural residents wearing masks reached 93.6%, but only 44.5% were able to replace masks in time, gender, age, education level, marital status, occupation, and living place had an impact on mask-wearing. The proportion of Chinese rural residents who could wash hands with soap reached 69.7%, but only 38.0% could wash their hands properly. Age and education level were influencing factors for both washing-hand with soap and proper handwashing.

The Potential of Stilbene Compounds to Inhibit Mpro Protease as a Natural Treatment Strategy for Coronavirus Disease-2019

COVID-19 disease has had a global impact on human health with increased levels of morbidity and mortality. There is an unmet need to design and produce effective antivirals to treat COVID-19. This study aimed to explore the potential ability of natural stilbenes to inhibit the M^pro protease, an acute respiratory syndrome coronavirus-2 (SARS-CoV-2) enzyme involved in viral replication. The binding affinities of stilbene compounds against M^pro were scrutinized using molecular docking, prime molecular mechanics-generalized Born surface area (MM-GBSA) energy calculations, and molecular dynamic simulations. Seven stilbene molecules were docked with M^pro and compared with GC376 and N3, antivirals with demonstrated efficacy against M^pro. Ligand binding efficiencies and polar and non-polar interactions between stilbene compounds and M^pro were analyzed. The binding affinities of astringin, isorhapontin, and piceatannol were -9.319, -8.166, and -6.291 kcal/mol, respectively, and higher than either GC376 or N3 at -6.976 and -6.345 kcal/mol, respectively. Prime MM-GBSA revealed that these stilbene compounds exhibited useful ligand efficacy and binding affinity to M^pro. Molecular dynamic simulation studies of astringin, isorhapontin, and piceatannol showed their stability at 300 K throughout the simulation time. Collectively, these results suggest that stilbenes such as astringin, isorhapontin, and piceatannol could provide useful natural inhibitors of M^pro and thereby act as novel treatments to limit SARS-CoV-2 replication.

An Executed Plan to Combat COVID-19 in the United States

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019. To date, this coronavirus is responsible for greater than 90 million cases in the United States and more than 1 million confirmed deaths. When this virus came to the United States, testing was unorganized, no effective treatments were known, and no vaccines had been discovered. A plan to correct these deficiencies through cooperative science and efficient clinical trials was implemented to combat this novel virus. This plan developed efficient and inexpensive tests, highly effective medicines to treat and prevent disease progression, and vaccines to immunize the population.

Potential use of the S-protein-Angiotensin converting enzyme 2 binding pathway in the treatment of coronavirus disease 2019

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen that causes coronavirus disease 2019 (COVID-19), infects humans through a strong interaction between the viral spike protein (S-protein) and angiotensin converting enzyme 2 (ACE2) receptors on the cell surface. The infection of host lung cells by SARS-CoV-2 leads to clinical symptoms in patients. However, ACE2 expression is not restricted to the lungs; altered receptors have been found in the nasal and oral mucosa, vessel, brain, pancreas, gastrointestinal tract, kidney, and heart. The future of COVID-19 is uncertain, however, new viral variants are likely to emerge. The SARS-CoV-2 Omicron variant has a total of 50 gene mutations compared with the original virus; 15 of which occur in the receptor binding domain (RBD). The RBD of the viral S-protein binds to the human ACE2 receptor for viral entry. Mutations of the ACE2-RBD interface enhance tight binding by increasing hydrogen bond interactions and expanding the accessible surface area. Extracorporeal membrane oxygenation, hyperbaric oxygen, and aggressive dialysis for the treatment of COVID-19 have shown various degrees of clinical success. The use of decoy receptors based on the ACE2 receptor as a broadly potent neutralizer of SARS-CoV-2 variants has potential as a therapeutic mechanism. Drugs such as 3E8 could block binding of the S1-subunit to ACE2 and restrict the infection of ACE2-expressing cells by a variety of coronaviruses. Here, we discuss the development of ACE2-targeted strategies for the treatment and prevention of COVID-19.

Four Waves of the COVID-19 Pandemic: Comparison of Clinical and Pregnancy Outcomes

During the last two and a half years, clinical manifestations, disease severity, and pregnancy outcomes have differed among pregnant patients with SARS-CoV-2 infection. These changes were preceded by the presence of new variants of SARS-CoV-2, known in the literature as variants of concern. The aim of this study is to describe the differences between maternal clinical characteristics and perinatal outcomes among pregnant women with COVID-19 during four waves of the COVID-19 epidemic in Serbia. This retrospective study included a series of 192 pregnant patients who were hospitalized due to the severity of their clinical status of SARS-CoV-2 infection. During four outbreaks of COVID-19 infection in Serbia, we compared and analyzed three sets of variables, including signs, symptoms, and characteristics of COVID-19 infection, clinical endpoints, and maternal and newborn parameters. During the dominance of the Delta variant, the duration of hospitalization was the longest (10.67 ± 1.42 days), the frequency of stillbirths was the highest (17.4%), as well as the frequency of progression of COVID infection (28.9%) and the requirement for non-invasive oxygen support (37%). The dominance of the Delta variant was associated with the highest number of prescribed antibiotics (2.35 ± 0.28), the most common presence of nosocomial infections (21.7%), and the highest frequency of corticosteroid therapy use (34.8%). The observed differences during the dominance of four variants of concern are potential pathways for risk stratification and the establishment of timely and proper treatments for pregnant patients. Early identification of the Delta variant, and possibly some new variants with similar features in the future, should be a priority and, perhaps, even an opportunity to introduce more accurate and predictive clinical algorithms for pregnant patients.

As the SARS-CoV-2 virus evolves, should Omicron subvariant BA.2 be subjected to quarantine, or should we learn to live with it?

It has been nearly 35 months since the COVID-19 outbreak. The pathogen SARS-CoV-2 has evolved into several variants. Among them, Omicron is the fifth variant of concern which have rapidly spread globally during the past 8 months. Omicron variant shows different characteristics from previous variants, which is highly infectious, highly transmissible, minimally pathogenic, vaccine and antibody tolerant; however, it is less likely to cause severe illness, resulting in fewer deaths. Omicron has evolved into five main lineages, including BA.1, BA.2, BA.3, BA.4, and BA.5. Before BA.5, Omicron BA.2 sublineage was the dominant strain all over the world for several months. The experience of prevention and treatment against BA.2 is worth studying and learning for overcoming other Omicron subvariants. Although the Omicron subvariant BA.2 is significantly less severe than that caused by ancestral strains, it is still far more dangerous than influenza, and its long-term sequelae are unknown. Effective treatments are currently limited; therefore, effective defense may be the key to controlling the epidemic today, rather than just "living with" the virus.

A brief review on the validation of biology methods for COVID-19 detection

The COVID-19 global pandemic has been going on for more than two years, and the evolution of SARS-CoV-2 with many variants of concern still poses a risk to public health. Sufficient access to qualified and validated testing plays an important role in detecting and alerting trends of the pandemic and provides evidence for making decisions in preventive strategies and policies. Depending on the method of testing and laboratory conditions, validation parameters (i.e., analytical sensitivity, limit of detection, diagnostic sensitivity, analytical specificity, diagnostic specificity, repeatability, reproducibility, robustness, positive predictive value, negative predictive value, applicability, practicability, and time to results) can be very different. With three main types of COVID-19 detection kits available, comprising nucleic acid, serological, and antigen detection, the kind of validation parameters that should be used becomes a complicated consideration and takes time to assess. Our review provides valuable and comprehensive information for laboratories in the assessment and selection of the optimal parameters to validate new COVID-19 test kits.

A tale of two stories: COVID-19 and disability. A critical scoping review of the literature on the effects of the pandemic among athletes with disabilities and para-athletes

The still ongoing COVID-19 pandemic has dramatically impacted athletes, and, in particular, para-athletes and athletes with disabilities. However, there is no scholarly appraisal on this topic. Therefore, a critical scoping review of the literature was conducted. We were able to retrieve sixteen relevant studies. The sample size ranged from 4 to 183. Most studies were observational, cross-sectional, and questionnaire-based surveys, two studies were interventional, and two were longitudinal. One study was a technical feasibility study. Almost all studies were conducted as single-country studies, with the exception of one multi-country investigation. Five major topics/themes could be identified: namely, 1) impact of COVID-19-induced confinement on training and lifestyles in athletes with disabilities/para-athletes; 2) impact of COVID-19-induced confinement on mental health in athletes with disabilities/para-athletes; 3) impact of COVID-19-induced confinement on performance outcomes in athletes with disabilities/para-athletes; 4) risk of contracting COVID-19 among athletes with disabilities/para-athletes; and, finally, 5) impact of COVID-19 infection on athletes with disabilities/para-athletes. The scholarly literature assessed was highly heterogeneous, with contrasting findings, and various methodological limitations. Based on our considerations, we recommend that standardized, reliable tools should be utilized and new, specific questionnaires should be created, tested for reliability, and validated. High-quality, multi-center, cross-countries, longitudinal surveys should be conducted to overcome current shortcomings. Involving all relevant actors and stakeholders, including various national and international Paralympic Committees, as a few studies have done, is fundamental: community-led, participatory research can help identify gaps in the current knowledge about sports-related practices among the population of athletes with disabilities during an unprecedented period of measures undertaken that have significantly affected everyday life. Moreover, this could advance the field, by capturing the needs of para-athletes and athletes with disabilities and enabling the design of a truly "disability-inclusive response" to COVID-19 and similar future conditions/situations. Furthermore, follow-up studies on COVID-19-infected para-athletes and athletes with disabilities should be conducted. Evidence of long-term effects of COVID-19 is available only for able-bodied athletes, for whom cardiorespiratory residual alterations and mental health issues a long time after COVID-19 have been described.

Nurse scheduling in COVID-19-designated hospitals in China: A nationwide cross-sectional survey

AIM

This study aimed to investigate scheduling in COVID-19-designated hospitals, including working hours, rest days, adverse nursing outcomes and their relationship.

BACKGROUND

Hospitals are at the forefront of COVID-19 prevention and control, and nurses are the main force on the frontline of the epidemic. Nursing shift is one of the most relevant and pressing issues for frontline nurses. However, there is a lack of national, large-sample surveys on scheduling and adverse nursing outcomes in COVID-19-designated hospitals.

METHODS

Using a cross-sectional online survey, we used nurse-reported data to measure the characteristics of the work setting, samples and work schedule. A descriptive analysis was performed to assess the shift status and adverse outcomes of designated hospitals and frontline nurses. Logistic regression analysis was performed to determine the association between them.

RESULTS

Basic data were collected from 217 departments of 69 COVID-19-designated hospitals in 31 provinces in China. Nurses in the severe isolation ward worked mainly for 4 h per shift, whereas those in the fever clinic and observation ward worked mainly for 6-8 h. Half of the nurses had only 1 day of rest per week. Long working hours, lack of adequate rest time and overtime can seriously affect the quality and safety of nurses' work, resulting in adverse outcomes. Frontline nurses hope that scheduling guarantees the time to rest while ensuring fairness.

CONCLUSIONS

The current evidence showed that frontline nurses were faced with long working hours, insufficient rest and overtime, which has a negative impact on nurse satisfaction, physical and mental health and quality of care. The government, hospitals and administrators still face many problems to overcome in their nursing schedules.

IMPLICATIONS FOR NURSING MANAGEMENT

Governments and hospitals should take these factors, such as the work setting characteristics and demographic features of the frontline nurses, into account when selecting nurses to fight COVID-19. Nurses have different working hours in different types of coronavirus unit; therefore, nursing managers should consider the working environment and nursing schedule needs, and in the future, we should pay attention to the fairness of nurses while ensuring their rest.

Construction and Validation of Mortality Risk Nomograph Model for Severe/Critical Patients with COVID-19

Objective: A nomograph model of mortality risk for patients with coronavirus disease 2019 (COVID-19) was established and validated. Methods: We collected the clinical medical records of patients with severe/critical COVID-19 admitted to the eastern campus of Renmin Hospital of Wuhan University from January 2020 to May 2020 and to the north campus of Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, from April 2022 to June 2022. We assigned 254 patients to the former group, which served as the training set, and 113 patients were assigned to the latter group, which served as the validation set. The least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression were used to select the variables and build the mortality risk prediction model. Results: The nomogram model was constructed with four risk factors for patient mortality following severe/critical COVID-19 (≥3 basic diseases, APACHE II score, urea nitrogen (Urea), and lactic acid (Lac)) and two protective factors (percentage of lymphocyte (L%) and neutrophil-to-platelets ratio (NPR)). The area under the curve (AUC) of the training set was 0.880 (95% confidence interval (95%CI), 0.837~0.923) and the AUC of the validation set was 0.814 (95%CI, 0.705~0.923). The decision curve analysis (DCA) showed that the nomogram model had high clinical value. Conclusion: The nomogram model for predicting the death risk of patients with severe/critical COVID-19 showed good prediction performance, and may be helpful in making appropriate clinical decisions for high-risk patients.

Iran's Struggling Health System in the Policy of Managing the COVID-19 Pandemic

BACKGROUND

Infectious diseases are one of the most important problems that affect the whole world. The World Health Organization (WHO), an active health organization, has identified coronavirus disease 19 (COVID-19) as a public health emergency and advises governments not to waste time on effective measures and interventions to attack and suppress the virus. In Iran, so far, the total number of screening tests has exceeded 21 million tests and more than 5 million doses of vaccine have been injected. However, we are still far from controlling the epidemic wave. Given the current situation, it is necessary to identify the challenges of managing the new coronavirus epidemic (COVID-19) in the country's medical universities.

METHODS

This qualitative study was conducted from January 2020 to January 2021 to explore the views of a group of service providers and staff managers of medical universities who were selected via purposeful sampling (n = 47). Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis methods. The trial version of MAXQDA 16 software was used to manage the coding process.

RESULTS

Upon analysis of data by service providers and staff managers of medical universities, five main themes including governance and leadership, service delivery, human resources, medicine and technology, and financing and 15 sub-themes including management and leadership, culture and society, process, infrastructure, manpower, training and skills, mental pressure, work pressure, nutrition, safety, employee motivation, medical equipment, medicine, payment, and funds were found.

CONCLUSIONS

Identification of the most important challenges of service providers and staff managers can play an important role in improving the management of the new coronavirus epidemic (COVID-19). It seems that in order to solve some of these challenges, coordination is needed outside the field of health, and considering the formation of the National Corona Headquarters at the national level, it is possible to use this infrastructure to provide the necessary policies and strategies.

Knowledge, attitudes, and practices related to COVID-19 infection, related behavior, antibiotics usage, and resistance among Syrian population: A cross-sectional study

BACKGROUND AND AIMS

Antibiotic resistance is seen as a worldwide health risk as a result of the overuse of antibiotics. Many countries noted that antibiotic usage was high during the COVID-19 pandemic. The purpose of this study is to evaluate Syrians' knowledge, attitudes, and practice about the use of antibiotics and antibiotic resistance during the COVID-19 epidemic.

METHODS

A cross-sectional study was conducted using an online questionnaire to collect the data from the Syrian population from February 5 to March 4, 2022. Syrians 18 years or older all over the world were able to participate in this study. A convenience snowball sampling method was used. SPSS version 20.0 was used to analyze the data. To examine the results, binominal logistic regression was used. Statistical significance was defined as a p < 0.05.

RESULTS

Out of 2406 respondents, 60.2% knew that transmission of COVID-19 could occur even if the patient has not developed any symptoms, and 91.6% were able to recognize the main clinical symptoms of COVID-19. There was a statistically significant difference between male and female knowledge of COVID-19 (p = 0.002), with males having 3.78 ± 2.1 (2.7-3.87) and females scoring 3.93 ± 2.3 (3.7-4.1). Newly graduated students have more knowledge of COVID-19 than other subtypes of Job (p = 0.0001), and those with medical practice are more knowledgeable than those without (p = 0.0001). Only 16.6% answered that taking antibiotics would not speed up the recovery from all the infections. 65.3% answered correctly that misuse of antibiotics could cause antibiotic resistance.

CONCLUSION

Our study concluded that the Syrian population demonstrated good knowledge of COVID-19 and moderate acceptance of the new norm. Knowledge regarding antibiotic use and resistance and practice of preventive measures was poor, which can encourage the health authorities to develop community education programs to increase public awareness of the usage of antibiotics and safety protocols during the COVID-19 pandemic.

COVID-19 systematic screening of asymptomatic haematopoietic stem cell donors: Less if often more

From COVID pandemic spread until now, many HSCT unrelated donor registries recommend as a precaution a systematic COVID-19 testing for all donors during the precollection time. Literature is quite poor to support this systematic attitude. We report one sibling allogeneic HSCT which we proceeded despite a positive COVID test on related asymptomatic donor and summarize the all seven cases reported until now. We suggest to question this systematic COVID testing, two years after pandemic began, when there is no systematic testing on other blood products received during all the haematological malignancies treatment process.

A Review of Corneal Transplantation: An Insight on the Overall Global Post-COVID-19 Impact

The coronavirus disease 2019 (COVID-19) pandemic made us reframe a lot of the strategies followed in medical practice and ophthalmological services and procedures were also not spared, including corneal transplantation or keratoplasty, the most routine procedure performed worldwide. The prevalence of viral presence in the ocular tissue necessitates a focus on the handling of donor ocular tissue and the functioning of eye banks, ensuring it doesn't risk the patient and the doctor's safety. Restrictions in the movement of people during the pandemic limited the number of donations, causing a shortage of tissues, with a large number of people already waitlisted for tissue needs. The lesson from the COVID-19 pandemic directs us to look for long-term corneal storage techniques taking into consideration the tissue viability time and the possibility of post-pandemic shortages. Although there is not a significant number of reports, the cases of corneal graft rejection post-vaccination against COVID-19 are highlighted and thus should form a part of the lookout while evaluating the possible cause of rejection of grafts. This article summarises the overall impact of the pandemic on corneal transplantation and the possible future of storage techniques, which need to evolve and be adapted.

SARS-CoV-2 Non-Structural Proteins and Their Roles in Host Immune Evasion

Coronavirus disease 2019 (COVID-19) has caused an unprecedented global crisis and continues to threaten public health. The etiological agent of this devastating pandemic outbreak is the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). COVID-19 is characterized by delayed immune responses, followed by exaggerated inflammatory responses. It is well-established that the interferon (IFN) and JAK/STAT signaling pathways constitute the first line of defense against viral and bacterial infections. To achieve viral replication, numerous viruses are able to antagonize or hijack these signaling pathways to attain productive infection, including SARS-CoV-2. Multiple studies document the roles of several non-structural proteins (NSPs) of SARS-CoV-2 that facilitate the establishment of viral replication in host cells via immune escape. In this review, we summarize and highlight the functions and characteristics of SARS-CoV-2 NSPs that confer host immune evasion. The molecular mechanisms mediating immune evasion and the related potential therapeutic strategies for controlling the COVID-19 pandemic are also discussed.

Incidence of Bacterial and Fungal Secondary Infections in COVID-19 Patients Admitted to the ICU

Purpose

Secondary infections have been observed among coronavirus disease 2019 (COVID-19) patients, especially in the intensive care unit (ICU) setting, which is associated with worse clinical outcomes. The current study aimed to investigate the incidence, common pathogens, and outcome of bacterial and fungal secondary infections among ICU patients with COVID-19.

Methods

A retrospective chart review of all patients admitted to the ICU at King Fahd Hospital of the University in Saudi Arabia. All adult patients aged ≥18 admitted in the ICU for ≥48 hours with positive COVID-19 reverse transcription-polymerase chain reaction test during the period between March 2020 till September 2021 were included.

Results

Out of 314 critically ill patients, 133 (42.4%) developed secondary infections. The incidence of secondary bacterial infection was 32.5% with Pseudomonas aeruginosa (n = 34), Acinetobacter baumannii (n = 33), and Klebsiella pneumoniae (n = 17) being the predominant pathogens, while secondary fungal infection was 25.2% mainly caused by Candida albicans (n = 43). Invasive mechanical ventilation was significantly associated with the development of secondary bacterial infections (odds ratio [OR] = 17.702, 95% confidence interval [CI] 7.842–39.961, p < 0.001) and secondary fungal infections (OR = 12.914, 95% CI 5.406–30.849, p < 0.001). Mortality among patients with secondary infections was 69.2% (n = 92). Secondary infections were associated with longer hospital and ICU stays with a median of 25 days (interquartile range [IQR] 17–42) and 19 days (IQR 13–32), respectively.

Conclusion

Bacterial and fungal secondary infections are common among COVID-19 patients admitted to the ICU with a predominance of gram-negative bacteria and Candida species. The development of secondary infections was significantly associated with invasive mechanical ventilation. Poor clinical outcomes have been observed, demonstrated with a prolonged hospital and ICU stays and higher mortality.

COVID-19: Ramifications and Effects on University Healthcare Students

AIM

This study was carefully designed to analyze the perceived psychological impact of the COVID-19 pandemic among Roseman dental students. Students assessed their perceived changes in stress, self-esteem, and lifestyle behavior changes based on the impact of the pandemic.

MATERIALS AND METHODS

A self-designed, anonymous, 18-item questionnaire was administered to Roseman dental students after being approved by the Institutional Review Board. Independent samples t-test and one-way ANOVA were utilized for comparison of psychological factors toward gender, as well as year of study. Chi-square correlations between stress and self-esteem, as well as lifestyle behavior, were also reported.

RESULTS

In total, 313 students with a mean age of 28.15 (SD:4.21) completed the survey. Statistically significant differences were shown between students based upon age and year of study, with regard to stress and lifestyle behavior changes. Cross-tabulations of stress with self-esteem and lifestyle behavior changes showed positive relationships, as students with higher levels of stress showed significant self-esteem problems and lifestyle behavior changes. The largest frequency of stress/anxiety and lifestyle behavioral changes was found in the age range of 25-34 years old, particularly in the Class of 2024 and 2025.

CONCLUSION

The COVID-19 pandemic has imposed a significant psychological impact on dental students at Roseman. However, further studies are needed to assess the long-lasting impacts of the pandemic on University healthcare students as a whole.

CLINICAL SIGNIFICANCE

The pandemic has not only affected the way in which dental students progress academically but also as healthcare providers now and into the future.

Utility of Differential White Cell Count and Cell Population Data for Ruling Out COVID-19 Infection in Patients With Community-Acquired Pneumonia

INTRODUCTION

The main aim of this study was to assess the utility of differential white cell count and cell population data (CPD) for the detection of COVID-19 in patients admitted for community-acquired pneumonia (CAP) of different etiologies.

METHODS

This was a multicenter, observational, prospective study of adults aged ≥18 years admitted to three teaching hospitals in Spain from November 2019 to November 2021 with a diagnosis of CAP. At baseline, a Sysmex XN-20 analyzer was used to obtain detailed information related to the activation status and functional activity of white cells.

RESULTS

The sample was split into derivation and validation cohorts of 1065 and 717 patients, respectively. In the derivation cohort, COVID-19 was confirmed in 791 patients and ruled out in 274 patients, with mean ages of 62.13 (14.37) and 65.42 (16.62) years, respectively (p<0.001). There were significant differences in all CPD parameters except MO-Y. The multivariate prediction model showed that lower NE-X, NE-WY, LY-Z, LY-WY, MO-WX, MO-WY, and MO-Z values and neutrophil-to-lymphocyte ratio were related to COVID-19 etiology with an AUC of 0.819 (0.790, 0.846). No significant differences were found comparing this model to another including biomarkers (p=0.18).

CONCLUSIONS

Abnormalities in white blood cell morphology based on a few cell population data values as well as NLR were able to accurately identify COVID-19 etiology. Moreover, systemic inflammation biomarkers currently used were unable to improve the predictive ability. We conclude that new peripheral blood biomarkers can help determine the etiology of CAP fast and inexpensively.

Low risk of environmental contagion by SARS-CoV-2 in non-sanitary spaces

Objective

To study the presence of SARS-CoV-2 on surfaces (high, medium and low contact) and airs in non-sanitary spaces with high public influx to evaluate the risk of environmental contagion.

Methods

Surfaces and airs were analysed by RT-qPCR to detect the presence of SARS-CoV-2.

Results

394 surfaces and air samples were obtained from spaces with high public influx such as offices, shopping centres and nursing homes. The virus was not detected in any of the samples analysed.

Conclusion

Although we cannot emphatically conclude that there is no risk of environmental 27 infection by SARS-CoV-2 in non-sanitary spaces, we can affirm that the risk is almost non- existent.

Proportion of asymptomatic infection and nonsevere disease caused by SARS-CoV-2 Omicron variant: A systematic review and analysis

SARS-CoV-2 Omicron variant seemed to cause milder disease compared to previous predominated variants. We aimed to conduct a meta-analysis to assess the pooled proportion of nonsevere disease and asymptomatic infection among COVID-19 patients infected with Omicron and Delta. We searched PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. We included studies of SARS-CoV-2 Omicron infection from November 1, 2021, to April 18, 2022, and studies of Delta infection from October 1, 2020, to June 30, 2022. Studies without corresponding data, with less than 50 patients, or obviously biased concerning main outcome were excluded. Meta-analysis was performed in R 4.2.0 with the "meta" package. Subgroup analyses were conducted by study group and vaccination status. The pooled proportion of asymptomatic infection and nonsevere disease with Omicron were 25.5% (95% confidence interval [CI] 17.0%-38.2%) and 97.9% (95% CI 97.1%-98.7%), significantly higher than those of Delta with 8.4% (95% CI 4.4%-16.2%) and 91.4% (95% CI 87.0%-96.0%). During Omicron wave, children and adolescents had higher proportion of asymptomatic infection, SOTR and the elderly had lower proportion of nonsevere disease, vaccination of a booster dose contributed to higher proportion of both asymptomatic infection and nonsevere disease. This study estimates the pooled proportion of asymptomatic infection and nonsevere disease caused by SARS-CoV-2 Omicron compared to other predominant variants. The result has important implications for future policy making.

Impacts of the Pandemic, Animal Source Food Retailers' and Consumers' Knowledge and Attitudes toward COVID-19, and Their Food Safety Practices in Chiang Mai, Thailand

The COVID-19 pandemic affected the food supply chain, retailers, and consumers owing to infection awareness. This study evaluated the impacts COVID-19 on ASF retailers' businesses and consumers' livelihoods, as well as their knowledge toward the disease, attitudes, and food safety practices to prevent infections. The study includes a cross-sectional component that was conducted in urban/peri-urban (U/PU) and rural areas in Chiang Mai province. In another part of the study, a structured questionnaire was developed for animal source food (ASF) retailers and consumers, with three primary parts for data analysis: general information, COVID-19 impacts, and knowledge, attitudes, and practices (KAP) assessment. Data corresponding to three periods of interest (before the COVID-19 outbreak, during partial lockdown, and present) were gathered and analyzed. In this study, 155 retailers and 150 consumers participated, of which the majority of the respondents were female (70.3% and 82.7%, respectively) with average ages of 47.4 and 44.9 years, respectively. The most noticeable effect of COVID-19 was a decline in income for retailers and consumers. The KAP scores of consumers in both areas were not significantly different, whereas the retailer attitudes toward COVID-19 prevention and food safety practices scored more highly in rural areas than in U/PU. During the partial lockdown, food safety practices significantly improved relative to the time preceding the outbreak, and these practices have remained constant to the present day. The results revealed that gender, age group, business type, and type of ASF retailers were associated with the KAP of the retailers, whereas gender, age group, education, number of family members, and occupation were associated with the KAP of the consumers. Our findings provide in-depth information about the effects of COVID-19 on ASF retailers and consumers, as well as their KAP regarding the outbreak and food safety, which may serve as support in developing policies for improved health and food safety.

Designing Mobile Epidemic Prevention Medical Stations for the COVID-19 Pandemic and International Medical Aid

The demand for mobile epidemic prevention medical stations originated from the rapid spread of the COVID-19 pandemic. In order to reduce the infection risk of medical practitioners and provide flexible medical facilities in response to the variable needs of the pandemic, this research aimed to design mobile medical stations for COVID-19 epidemic prevention, the emergence of which began in February 2020. The mobile medical stations include a negative pressure isolation ward, a positive pressure swabbing station, a fever clinic and a laboratory. In Taiwan, many medical institutions used the mobile swabbing station design of this study to practice COVID-19 screening pre-tests. Internationally, this study assisted Palau in setting up medical stations to provide anti-epidemic goods and materials. The design of this study not only provides a highly flexible and safe medical environment but the benefits of screening can also be used as resources for medical research, forming an economic circulation for operation sustainability. In addition, the design of this study can also be used during the non-epidemic period as a healthcare station for rural areas or as a long-term community medical station.