The SARS-CoV-2 Outbreak: an Epidemiological and Clinical Perspective

Knowledge, Attitudes and Practices of the General Population in Yemen Regarding COVID-19: A Cross-Sectional Study

BACKGROUND

Following the World Health Organization declaration of COVID-19 as a pandemic, Yemen has taken preventive and precautionary measures against COVID-19 to control its spread. This study evaluated the knowledge, attitudes, and practices (KAP) of the Yemeni public regarding COVID-19.

METHODS

A cross-sectional study using an online survey was conducted during the period from September 2021 to October 2021.

RESULTS

The mean total knowledge score was 9.50 ± 2.12. The majority of the participants (93.4%) were aware that to prevent infection by the COVID-19 virus, going to crowded places and gatherings should be avoided. Approximately two thirds of the participants (69.4%) believed COVID-19 is a health threat to their community. However, in terms of actual behavior, only 23.1% of the participants reported that they did not go to any crowded places during the pandemic, and only 23.8% had worn a mask in recent days. Moreover, only about half (49.9%) reported that they were following the strategies recommended by the authorities to prevent the spread of the virus.

CONCLUSION

The findings suggest that the general public has good knowledge and positive attitudes regarding COVID-19, but that their practices are poor.

Pilot Findings on SARS-CoV-2 Vaccine-Induced Pituitary Diseases: A Mini Review from Diagnosis to Pathophysiology

Since the emergence of the COVID-19 pandemic at the end of 2019, a massive vaccination campaign has been undertaken rapidly and worldwide. Like other vaccines, the COVID-19 vaccine is not devoid of side effects. Typically, the adverse side effects of vaccination include transient headache, fever, and myalgia. Endocrine organs are also affected by adverse effects. The major SARS-CoV-2 vaccine-associated endocrinopathies reported since the beginning of the vaccination campaign are thyroid and pancreas disorders. SARS-CoV-2 vaccine-induced pituitary diseases have become more frequently described in the literature. We searched PubMed/MEDLINE for commentaries, case reports, and case series articles reporting pituitary disorders following SARS-CoV-2 vaccination. The search was reiterated until September 2022, in which eight case reports were found. In all the cases, there were no personal or familial history of pituitary disease described. All the patients described had no previous SARS-CoV-2 infection prior to the vaccination episode. Regarding the type of vaccines administered, 50% of the patients received (BNT162b2; Pfizer-BioNTech) and 50% received (ChAdOx1 nCov-19; AstraZeneca). In five cases, the pituitary disorder developed after the first dose of the corresponding vaccine. Regarding the types of pituitary disorder, five were hypophysitis (variable clinical aspects ranging from pituitary lesion to pituitary stalk thickness) and three were pituitary apoplexy. The time period between vaccination and pituitary disorder ranged from one to seven days. Depending on each case's follow-up time, a complete remission was obtained in all the apoplexy cases but in only three patients with hypophysitis (persistence of the central diabetes insipidus). Both quantity and quality of the published data about pituitary inconveniences after COVID-19 vaccination are limited. Pituitary disorders, unlike thyroid disorders, occur very quickly after COVID-19 vaccination (less than seven days for pituitary disorders versus two months for thyroid disease). This is partially explained by the ease of reaching the pituitary, which is a small gland. Therefore, this gland is rapidly overspread, which explains the speed of onset of pituitary symptoms (especially ADH deficiency which is a rapid onset deficit with evocative symptoms). Accordingly, these pilot findings offer clinicians a future direction to be vigilant for possible pituitary adverse effects of vaccination. This will allow them to accurately orient patients for medical assistance when they present with remarkable symptoms, such as asthenia, polyuro-polydipsia, or severe headache, following a COVID-19 vaccination.

Lessons from SARS‑CoV‑2 and its variants (Review)

COVID-19 has swept through mainland China by human-to-human transmission. The rapid spread of SARS-CoV-2 and its variants, including the currently prevalent Omicron strain, pose a serious threat worldwide. The present review summarizes epidemiological investigation and etiological analysis of genomic, epidemiological, and pathological characteristics of the original strain and its variants, as well as progress in diagnosis and treatment. Prevention and control measures used during the current Omicron pandemic are discussed to provide further knowledge of SARS-CoV-2.

Efficacy and Safety of Lithium Treatment in SARS-CoV-2 Infected Patients

At the beginning of the pandemic, we observed that lithium carbonate had a positive effect on the recovery of severely ill patients with COVID-19. Lithium is able to inhibit the replication of several types of viruses, some of which are similar to the SARS-CoV-2 virus, increase the immune response and reduce inflammation by preventing or reducing the cytokine storm. Previously, we published an article with data from six patients with severe COVID-19 infection, where we proposed that lithium carbonate could be used as a potential treatment for COVID-19. Now, we set out to conduct a randomized clinical trial number EudraCT 2020–002008–37 to evaluate the efficacy and safety of lithium treatment in patients infected with severe SARS-CoV-2. We showed that lithium was able to reduce the number of days of hospital and intensive care unit admission as well as the risk of death, reduces inflammatory cytokine levels by preventing cytokine storms, and also reduced the long COVID syndromes. We propose that lithium carbonate can be used to reduce the severity of COVID-19.

Extracorporeal membrane oxygenation (ECMO) in COVID-19 patients: a pocket guide for radiologists

During the coronavirus disease 19 (COVID-19) pandemic, extracorporeal membrane oxygenation (ECMO) has been proposed as a possible therapy for COVID-19 patients with acute respiratory distress syndrome. This pictorial review is intended to provide radiologists with up-to-date information regarding different types of ECMO devices, correct placement of ECMO cannulae, and imaging features of potential complications and disease evolution in COVID-19 patients treated with ECMO, which is essential for a correct interpretation of diagnostic imaging, so as to guide proper patient management.

COVID-19 prediction through X-ray images using transfer learning-based hybrid deep learning approach

Over the past few months, the campaign against COVID-19 has developed into one of the world's most sought anti-toxin treatment scheme. It is fundamental to distinguish cases of COVID-19 precisely and quickly to help avoid this pandemic from taking a wrong turn with a proper medical reasoning and solution. While Reverse-Transcription Polymerase Chain Reaction (RT-PCR) has been useful in detection of corona virus, chest X-Ray techniques has proven to be more successful and beneficial at detection of the effects of virus. With the increase in COVID patients and the X-Rays done, it is currently possible to classify the X-Ray reports with transfer learning. This paper presents a novel approach, i.e., Hybrid Convolutional Neural Network (HDCNN), which integrates Convolutional Neural Network (CNN) and Recurrent Neural Network (RNN) architecture for the finding of COVID-19 using the chest X-Ray. The transfer learning approach, namely slope weighted activation class planning (Grad-CAMs), is used with HDCNN to display images responsible for taking decisions. In this study, HDCNN is compared with other CNNs such as Inception-v3, ShuffleNet, SqueezeNet, VGG-19 and DenseNet. As a result, HDCNN has achieved an accuracy of 98.20%, precision of 97.31%, recall of 97.1% and F1 score of 0.97. Compared to other current deep learning models, the HDCNN has achieved better results, and this can be used for diagnosis purpose after proper approvals.

Geographical and Epidemiological Characteristics of Sporadic Coronavirus Disease 2019 Outbreaks From June to December 2020 in China: An Overview of Environment-To-Human Transmission Events

China quickly brought the severe acute respiratory syndrome coronavirus 2 under control during the early stage of 2020; thus, this generated sufficient confidence among the public, which enabled them to respond to several sporadic coronavirus disease 2019 outbreaks. This article presents geographical and epidemiological characteristics of several sporadic coronavirus disease 2019 outbreaks from June to December 2020 in China. The data show that the coronavirus disease may be transmitted by imported cold-chain food and international exchange, and this viewpoint deserves our great attention.

Inflammation in COVID-19: from pathogenesis to treatment

The coronavirus disease 2019 (COVID-19) was declared a pandemic in March 2020 by the World Health Organization (WHO). To date, there were > 163 million confirmed cases of COVID-19 and the disease has claimed > 3.3 million lives globally. As with many other diseases, inflammation is a key feature of COVID-19. When inflammation is overwhelming, it may lead to unfavorable outcomes or even death. Scientists all over the world are working tirelessly in search of therapeutic strategies to suppress or modulate inflammation in COVID-19. This review gives an overview of the role of inflammation in COVID-19. It also critically examines the various treatment approaches that target the immune system and inflammation in COVID-19, as well as highlights the key findings in the numerous studies conducted thus far.

SARS-CoV-2: Origin, Evolution, and Targeting Inhibition

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused an outbreak in Wuhan city, China and quickly spread worldwide. Currently, there are no specific drugs or antibodies that claim to cure severe acute respiratory diseases. For SARS-CoV-2, the spike (S) protein recognizes and binds to the angiotensin converting enzyme 2 (ACE2) receptor, allowing viral RNA to enter the host cell. The main protease (Mpro) is involved in the proteolytic process for mature non-structural proteins, and RNA-dependent RNA polymerase (RdRp) is responsible for the viral genome replication and transcription processes. Owing to the pivotal physiological roles in viral invasion and replication, S protein, Mpro, RdRp are regarded as the main therapeutic targets for coronavirus disease 2019 (COVID-19). In this review, we carried out an evolutionary analysis of SARS-CoV-2 in comparison with other mammal-infecting coronaviruses that have sprung up in the past few decades and described the pathogenic mechanism of SARS-CoV-2. We displayed the structural details of S protein, Mpro, and RdRp, as well as their complex structures with different chemical inhibitors or antibodies. Structural comparisons showed that some neutralizing antibodies and small molecule inhibitors could inhibit S protein, Mpro, or RdRp. Moreover, we analyzed the structural differences between SARS-CoV-2 ancestral S protein and D614G mutant, which led to a second wave of infection during the recent pandemic. In this context, we outline the methods that might potentially help cure COVID-19 and provide a summary of effective chemical molecules and neutralizing antibodies.

Genomic variation, origin tracing, and vaccine development of SARS-CoV-2: A systematic review

COVID-19 has spread globally to over 200 countries with more than 40 million confirmed cases and one million deaths as of November 1, 2020. The SARS-CoV-2 virus, leading to COVID-19, shows extremely high rates of infectivity and replication, and can result in pneumonia, acute respiratory distress, or even mortality. SARS-CoV-2 has been found to continue to rapidly evolve, with several genomic variants emerging in different regions throughout the world. In addition, despite intensive study of the spike protein, its origin, and molecular mechanisms in mediating host invasion are still only partially resolved. Finally, the repertoire of drugs for COVID-19 treatment is still limited, with several candidates still under clinical trial and no effective therapeutic yet reported. Although vaccines based on either DNA/mRNA or protein have been deployed, their efficacy against emerging variants requires ongoing study, with multivalent vaccines supplanting the first-generation vaccines due to their low efficacy against new strains. Here, we provide a systematic review of studies on the epidemiology, immunological pathogenesis, molecular mechanisms, and structural biology, as well as approaches for drug or vaccine development for SARS-CoV-2.

Knowledge, Attitude and Practice About Coronavirus Disease (COVID-19) Pandemic and Its Psychological Impact on Students and Their Studies: A Cross-Sectional Study Among Pharmacy Students in Saudi Arabia

Background

Individuals’ knowledge, attitude and practice towards preventive and precautionary measures of COVID-19 are essential to control the spread of the disease. Consequently, the aims of the study were to evaluate knowledge, attitude and practice of pharmacy students towards the pandemic and to assess its psychological impact on them to provide future guidance.

Methods

A cross-sectional, questionnaire-based study was conducted via a web-based survey in May 2020. All pharmacy students enrolled at Unaizah College of Pharmacy, Qassim University, were invited to take part in the study.

Results

A total of 232 out of 460 students took part in the study, giving a response rate of 50.43%. The mean total knowledge score was 9.87 ± 2.04 (maximum attainable score, 12). The majority of the participants (n=163; 70.3%) believed COVID-19 is a health threat to their community in the early months of the pandemic. Moreover, the majority (93%) also believed that the lockdown at the beginning of the pandemic was necessary to contain the pandemic. Encouragingly, 86.6% reported that they did not go to any crowded places during the pandemic with more female students avoiding crowded places compared to male students (91.6% versus 78.7%, respectively, P = 0.005). The majority (91%) also reported that they were following the strategies recommended by the authorities to prevent the spread of the virus. Encouragingly, 54.3% reported that the pandemic either had no effect or just a limited effect on their studies. However, 38.5% reported that they always felt or frequently felt nervous or anxious during the pandemic.

Conclusion

The study showed that pharmacy students had good knowledge as well as positive attitudes and good practices towards COVID-19 and the preventive measures. However, during the early months, the pandemic did have a negative psychological impact on a number of students. Consequently, proactive psychological and social support services to the students should be considered during the current and future pandemics. In addition, it is important to consider and proactively address key issues that could cause stress and anxiety among students when shifting to distance learning and assessments.