Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic

The relationship between fear of COVID-19 and food choice motives in the Iranian population

BACKGROUND AND AIM

The long-term impact of COVID-19 on nutrition and community health is inevitably noticeable. These effects can change the nutritional behavior and lifestyle of survivors. Due to the COVID consequential fear and anxiety, the pandemic can alter the motivations for choosing, buying, and consuming food. The relationship between nutritional behavior and COVID-19 fear is the primary purpose of this research.

MATERIALS & METHODS

This cross-sectional study was conducted via online and face-to-face surveys. Accessing participants was through health centers of Qazvin, Iran, and the selected centers were sampled by cluster sampling method. The study population included 331 adults aged 18 to 65. Data were collected in three sections using valid questionnaires. The Demographic Questionnaire, FCV-19S, and FCQ were used to gather demographic information, the level of fear caused by COVID-19, and food choice motivations, respectively. The statistical analyzes were performed using R software. Analysis of variance and linear regression methods were used to determine the effect of independent variables on dependent variables (p = 0.05).

RESULTS

The mean score of fear of COVID-19 in the study population was 15.25 ± 5.78. Price, Mood, Natural content, Familiarity, Convenience, and Ethical concerns were significantly and positively associated with fear of COVID-19 (p<0.05). The only food motive significantly different than before during COVID-19 was Health, which was increased (p = 0.02). Sensory appeal and Health were the most important motivations for food choices before and during COVID-19. The Ethical concern was considered the least important food motivation.

DISCUSSION AND CONCLUSION

Some food motivations were associated with fear of COVID-19, possibly due to their psychological nature. The increasing importance of the Health factor and Natural content motivations can relate to the advice of experts on the importance of eating healthy food to counteract COVID-19 and indicate people's preference for this training.

The Prevention of Viral Infections: The Role of Intestinal Microbiota and Nutritional Factors

Viral infections pose significant global challenges due to their rapid transmissibility. Therefore, preventing and treating these infections promptly is crucial to curbing their spread. This review focuses on the vital link between nutrition and viral infections, underscoring how dietary factors influence immune system modulation. Malnutrition, characterized by deficiencies in essential nutrients such as vitamins A, C, D, E, and zinc, can impair the immune system, thereby increasing vulnerability to viral infections and potentially leading to more severe health outcomes that complicate recovery. Additionally, emerging evidence highlights the role of commensal microbiota in immune regulation, which can affect hosts' susceptibility to infections. Specific dietary components, including bioactive compounds, vitamins, and probiotics, can beneficially modify gut microbiota, thus enhancing immune response and offering protection against viral infections. This review aims to elucidate the mechanisms by which dietary adjustments and gut microbiota impact the pathogenesis of viral infections, with a particular focus on strengthening the immune system.

Reopening the Bavarian State Opera Safely: Hygiene Strategies and Incidence of COVID-19 in Artistic Staff During Theater Season 2020/2021

Due to the drastically rising coronavirus disease (COVID-19) incidence since March 2020, social life was shut down across the globe, and most opera houses were closed. As a result, there are limited data on SARS-CoV-2 infections among artists. The Bavarian State Opera has been reopened in September 2020. This study aimed to identify the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees in the Bavarian State Opera. In addition, the various hygiene strategies for the work groups within the institution are described. During the study period from September 1, 2020 to July 31, 2021, 10,061 nasopharyngeal swabs were obtained from 1,460 artistic staff members in a rolling system. During the entire study period, 61 individuals tested positive for SARS-CoV-2. None of the patients had a severe disease course. Compared to the seven-day-incidence per 100,000 German inhabitants, the estimated corresponding incidence among employees was lower at 37 weeks and higher or equal at 9 weeks. Among the infected individuals, 58.3% were symptomatic, 23.3% were presymptomatic, and 18.3% were asymptomatic. Forty-five percent of employees reported that they had been infected in their private environment, 41.7% suspected that their colleagues were the main contact, and 13.3% were unsure about the origin of their infection. Twenty-four diseased employees were ballet dancers, eight from the orchestra, seven from the administration, seven from the choir singers, six from the costume department, 10 from technical support, and one guest solo singer. In the 2020/2021 theater season, increased SARS-CoV-2 infections and large disease outbreaks were avoided at the Bavarian State Opera. Hygiene strategies, that existed since the beginning, was specifically designed for various work areas in the opera. Regular, mandatory PCR testing and follow-up of positive cases with the issuance of quarantine were performed. Using this disease management approach, artistic work at and reopening of the Bavarian State Opera was feasible with a well-controlled risk.

Evaluation of normal range of serum 25 hydroxyvitamin d in iraqi healthy adults: demographic and socioeconomic effects

OBJECTIVE

Aim: To determine the normal range of serum levels of total 25(OH)VD in Iraqi healthy adult subjects and to relate its level with demographic profile and socioeconomic status..

PATIENTS AND METHODS

Materials and Methods: This cross sectional study was carried out at Iraq and the samples were collected during the period from August 2019 to January 2020. It included 649 adult subjects apparently healthy, from three governorates (Baghdad, Al-Anbar and Al-Basrah), Investigations included serum measurement of total 25(OH)D in all included individuals by using ELISA technique. Age, gender, marital state, blood pressure, smoking, sunshine exposure (%), hours of exposure/day, percentage of body surface area exposed, body mass index (BMI) subgroups, waist circumference (WC) subgroups, diet type, sport type and time, geographic factor (governorate) were measured and / or calculated and the levels of 25(OH)D were studied according to each of these factors.

RESULTS

Results: The mean ± SD level of 25(OH)D in total (n=649) studied Iraqi subjects was (16.29 ± 8.22 ng/ml), with women were significantly deficient than men (15.76 ± 6.89 ng/ml, 17.14 ± 6.85 ng/ml; p < 0.01 respectively). However, there was no significant differences in mean values of serum 25(OH)D levels among studied governorates, subgroups of BMI, WC, marital status, smokers and nonsmoker and subgroups of age. The mean value of serum 25(OH)D was found to be decreased in January, October and November as well as according to diet and sport types. There was significant positive correlation between total 25(OH)D and sun exposed surface area, sun exposure duration and with sun exposure area.

CONCLUSION

Conclusions: The mean (±SD) value of serum total 25(OH)D in Iraqi healthy subjects was 16.29 ng/ml (±8.22) reflecting the actual body status of this vitamin with lower concentration in women than in men. Type and time of sport and diet type were the major vitamin D dependent factors.

Changes in dietary habit and physical activity among the diabetic patients of Bangladesh during COVID-19: A cross-sectional study

In an effort to avert further Covid-19 transmission, the Bangladesh government took several initiatives which disrupted the routine food intake and exercise of diabetic patients. This study sought to examine the difference in dietary and exercise habits of diabetic patients between their pre-pandemic status and during COVID-19 which may be attributed to the observed poor health outcomes during the study period. This was a cross-sectional study that enrolled 604 diabetic patients using a convenience sampling technique who were attending outpatient clinics of the three selected hospitals in Bangladesh. A validated semi-structured questionnaire was used to collect information regarding eating habit and physical activity of the respondents pre- and during COVID-19 pandemic via direct interview. McNemar-Bowker test was used to assess the changes in dietary and physical activity behaviors. The current study reveals that 93.9% of the respondents were type-2 diabetic patients. During the pandemic, there was a decrease in the consumption of rice, bread, meat, fish, eggs, and dessert, while the consumption of cereals, milk, and potato/starchy vegetables increased. There was also a decrease in the frequency of drinking tea or coffee, while the consumption of soft drinks remained relatively stable. The level and duration of physical activity significantly decreased among the respondents during the pandemic. This study explored the changes in dietary habits and physical activity among the study population which not only disrupt the metabolic control of the diabetic patients but also pose a significant threat to their overall health. Therefore, it is critical to prioritize measures that support diabetic patients to maintain healthy dietary habit and to engage in regular physical activity during unprecedented times such as COVID-19 pandemic.

Lifestyle and preventive behaviors among adults during the early phase of the COVID-19 movement control order (MCO) in Malaysia

BACKGROUND

Enforcement of the movement control order (MCO) in Malaysia caused by COVID-19 impacted people's health, social, behaviors, and economic consequences. Thus, this study aims to identify adults' lifestyle and preventive behaviors during the MCO's early phase.

MATERIALS AND METHODS

This study was conducted in April 2020 using a convenience sampling technique. A total of 9987 adults aged 18 years and above from all over Malaysia participated in the study. The questionnaire was distributed through online platforms, such as Facebook, Telegram, WhatsApp, and the official website. Descriptive statistics and Chi-square test were used to describe the categorical data and the independent T-test and one-way ANOVA tests were performed to compare continuous variables between two or more groups. The level of statistical significance was set at P < .05.

RESULTS

Selangor showed the highest participation (28.4%) and most of the respondents were females (68.2%), married (67.8%), and aged between 36 and 45 years old (34.1%). This study found that 10.3% were smokers, and 46.7% of the smokers intended to quit smoking. Most respondents took their three main meals daily (72.4%), but not even half completed daily food groups (45.1%). The frequent activities were internet surfing (18.8%) and house chores (18.2%). Almost 98% of the respondents agreed to implement preventive behaviors. This study also revealed that attitudes toward preventive behaviors significantly differed across genders, age groups, categories of marital status, and monthly income categories (P < .05). Furthermore, regarding readiness for behavior change after MCO end, only gender shows a significance difference (P < .05).

CONCLUSION

This study shed light on understanding public behavior during the early phase of the pandemic that may significantly impact public health in designing relevant regulations and policies to reduce the spread of COVID-19 infections and preparing strategies for future outbreaks or pandemics. As COVID-19 evolves, continuous efforts to promote positive behavioral changes in lifestyle and preventive behavior are needed to ensure the public practices a healthy lifestyle and complies with pandemic preventive measures.

Dietary intervention with functional foods modulating gut microbiota for improving the efficacy of COVID-19 vaccines

Dysbiosis of the gut microbiota with aging contributes to a reduction in important cross-feeding bacterial reactions in the gut and immunosenescence, which could contribute to a decrease in vaccine efficacy. Fever, cough, and fatigue are the main signs of coronavirus disease 2019 (COVID-19); however, some patients with COVID-19 present with gastrointestinal symptoms. COVID-19 vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the best measures to reduce SARS-CoV-2 infection rates and the severity of COVID-19. The immunogenicity of COVID-19 vaccines is influenced by the composition of the gut microbiota, and the immune response to COVID-19 vaccines decreases with age. In this review, we discuss gut microbiota dysbiosis and immunosenescence in the older adults, the role of gut microbiota in improving the efficacy of COVID-19 vaccines, and dietary interventions to improve the efficacy of COVID-19 vaccines in the older adults.

Usability of a new digital walking program for older adults: a pilot study

BACKGROUND

Walking has been emphasized as an important solution for preventing isolation among older adults, especially given the coronavirus disease 2019 (COVID-19) pandemic, and various methods are being proposed to promote walking in this population. In this study, a walking exercise program for the elderly was developed using various latest technologies, and the effectiveness and influencing factors of the program were evaluated.

METHOD

The walking program for older adults was designed using mHealth devices, social media application, and gamified elements to prevent isolation. Twelve participants were recruited via an online community of retired individuals. This one-year study involved a one-group repeated measures experimental design; an online questionnaire was conducted four times along with a focus group interview.

RESULT

The results showed that the e-health literacy of the 12 participants increased, while Wearable Device App Literacy/Usability, digital health self-efficacy, and walking program evaluation showed a decline. In the focus group interview, participants expressed their appreciation for this program, ways to overcome its limitations, and expectations for the next program.

CONCLUSION

This study confirmed the positive effect of the online walking program for retired older adults, indicating that an online-offline convergence program suitable for the "COVID-19 era" will be necessary in the future.

Herbs-derived phytochemicals - a boon for combating COVID-19

The recent pandemic, the novel coronavirus (COVID-19), has put the whole world on alert with the threat of the virus that targets the human respiratory system. The disease has affected more than 633.6 million people globally and caused 6.5 million deaths since November 18, 2022. About 12.94 billion people are vaccinated as of November 18, 2022. Due to varied climatic conditions, SARS-CoV-2 has shown rapid mutation in recent years. Because of the lack of appropriate therapeutic drugs, inadequate diagnostic mechanisms, life-supporting medical facilities, and lack of awareness, the spread of SARS-CoV-2 has become severe. Thus, the most efficient strategy to control this disease is to follow preventive measures. However, treating SARS-CoV-2 cases in Wuhan using traditional Chinese herbs has set an example to show how traditional health can contribute to treating this novel virus. Medicinal herbs are known for their antimicrobial, antibacterial, antiviral, immunomodulatory, immunoadjuvant, and anti-inflammatory properties. These medicinal herbs are used during cooking and consumed regularly worldwide. In this view, medicinal herbs gained evident attention. These herbs can serve as a potential and economical remedy for combating the lethal effects of COVID-19. The present review highlights the phytochemicals and their mechanisms of action in preventing SARS-CoV-2.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42535-023-00601-9.

Dietary Habits and Lifestyle, Including Cardiovascular Risk among Vegetarians and Omnivores during the COVID-19 Pandemic in the Polish Population

Background: This study assessed how two food groups—omnivores (OMN) and vegetarians (VEGE)—differ in lifestyle changes, including dietary habits during the COVID-19 pandemic. Materials: A total of 861 persons participated in the survey and were divided into two groups: persons following a mixed diet (n = 489) and vegetarians, including vegans (n = 372). The mean age shows no significant differences. Methods: An online survey was conducted on the Polish population during the COVID-19 pandemic. Data was collected using social media; the survey was intended for adults and included separate sheets for different diets (OMN vs. VEGE). Results: The results in both groups were similar regarding the burden of premature diseases. Most respondents (~90%) did not indicate cardiovascular disease abnormalities. In the OMN group, overweight and obesity occurred more often, and the OMN group also showed a higher percentage of people reporting weight gain (OMN 42.7% vs. VEGE 35.9%). The results disclosed the VEGE group significantly more frequently chose products, i.e., vegetables (p = 0.029), legumes (p < 0.001), and dairy products or their plant substitutes (p = 0.002), compared to the OMN group. Conclusions: The VEGE group revealed the most regularities in dietary habits during the pandemic.

Changes in Adults' Eating Behaviors During the Initial Months of the COVID-19 Pandemic: A Narrative Review

Factors such as regulations and health concerns shifted daily habits, including eating behaviors, during the early months of the coronavirus disease 2019 (COVID-19) pandemic. This comprehensive narrative review synthesizes research on eating behavior changes during the early months of the pandemic (February to June 2020), including changes in amount, rate, and timing of food consumption, types and healthfulness of foods consumed, the occurrence of other specified eating behaviors (eg, restrained eating or binging), and reasons for eating (eg, stress or cravings), among adults. A literature search using three EBSCOhost databases and Google Scholar was conducted to identify relevant articles made available in 2020. A total of 71 articles representing 250,715 individuals from more than 30 countries were reviewed. Findings show eating behaviors changed little during the early COVID-19 pandemic for most participants. Among those whose eating behaviors changed, increases in both intake and frequency of eating meals and snacks were more common than decreases. Findings on timing of eating and healthfulness of food consumed showed mixed results. However, when changes occurred in the type of food consumed, increases were more common for snacks, homemade pastries, white bread/pasta, legumes, and fruits/vegetables; decreases were more common for meats, seafood/fish, frozen foods, fast food, dark breads/grains, and dark leafy green vegetables. During the pandemic, binging, uncontrolled eating, and overeating increased, meal skipping decreased, and restrictive eating had mixed findings. Changes in factors such as emotions and mood (eg, depression), cravings, and environmental factors (eg, food insecurity) were related to changes in eating behaviors. Findings can inform clinical practitioners in efforts to mitigate disruptions to normal, healthy eating patterns among adults both in and outside of global health catastrophes.

Knowledge, attitudes, and practices regarding immunity boosting dietary behavior of mass population amid COVID-19

During the increasing spread of COVID-19 occurrences in Chattogram Metropolitan Area (CMA) of Bangladesh, a series of measures were taken to control the transmission. These measures greatly influenced the knowledge, attitudes, and practices (KAP) of the population on their dietary behavior. However, there are no current studies demonstrating the KAP of the CMA citizens regarding their dietary habit that can boost the immunity. In this study, we appraised KAP in regard to immunity boosting dietary behavior from April 26, 2021 to November 17, 2021 during implementation of lockdown measures by the government of Bangladesh. Apart from the basic knowledge and attitudes toward immunity boosting dietary behavior, we have also aimed to assess the practices of the population by whether the nutrients, especially vitamin A, B6, B9, B12, C, D, E, and trace minerals such as zinc, selenium, and iron were included in their diet and in what frequency. This study is a cross-sectional study, and the participants were recruited using both online platforms during the lockdown and through in-person interviews after the withdrawal of lockdown. After obtaining the proper consent from the participants, their sociodemographic variables, and KAP towards immunity boosting dietary behavior were assessed. Total 400 participants were included in this study and a non-probability sampling technique named purposive sampling has been followed for participants recruitment. Among the 400 participants, the majority of them (64.3%) were male, most of them (62.7%) were students, unmarried (69.5%), aged between 18-35 years (82.5%), had a bachelor's degree (50.0%), and had a monthly family income between 10000-30000 BDT (35.5%). This study indicated that 82.8% of the populations had the correct knowledge, 71.3% had favorable attitudes, and 44% had good practices regarding immunity boosting diet during COVID-19. The majority (79.3%) of the participants had an idea about nutrition, most of them (78.5%) knew the nutrients needed to strengthen their immune system, almost all (98.5%) washed fruits and vegetables purchased from the market before eating them, 78% did not often purchase food online, and 53% often ate junk food. In a binary logistic regression, correct knowledge was significantly associated with the females, having HSC or bachelor's degree, being in the occupation of business, laborer or others, and having a monthly family income between 50000-100000 or >100000. The favorable attitudes were significantly associated with having a master's degree or above, and for government job holders. However, the good practices did not show any significant association with the sociodemographic factors in binary logistic regression. Moreover, the study found the presence of bad or unhealthy practices among the populations despite having correct knowledge and favorable attitudes. Thus, this study could identify the variables, such as gender differences, education, monthly family income, and occupation on which emphasis should be given during public health campaigns or training programs to improve the KAP regarding immunity boosting diet.

Interactions among the human and organizational factors within the public sector regarding epidemic prevention and control

The management of human and organizational factors (HOFs) within the public sector directly concerns the efficacy of epidemic prevention and control (EPC). Insufficient examination of such HOFs has led to defective countermeasures. This study attempts to comprehensively identify the HOFs within the public sector critical to EPC and investigate their interactions with the weighted network theory. A total of 55 HOFs were identified, and their interactions were assessed and visualized in the Chinese context. Then, the established weighted network was analyzed to investigate the interactions and diagnose critical factors and sectors. The analysis shows that there are strong interactions among HOFs, and that the human and organizational risks emerging from administrative departments of public health, centers for disease control and prevention, and medical institutions act as the key risk sources in the complex interconnected EPC system, exacerbating risk and causing a significant domino effect. It is recommended that the authorities devote more resources to the core sectors and endeavor to reinforce those critical HOFs by implementing closer risk communication, collaboration, and response. This study may deepen and broaden the authorities' awareness and understanding of interactions among HOFs regarding epidemic mitigation, and strengthen their capacity to perceive, evaluate, and manage these factors in a proactive and effective way, thereby facilitating the success of EPC.

SARS-CoV-2 Infection Dysregulates Host Iron (Fe)-Redox Homeostasis (Fe-R-H): Role of Fe-Redox Regulators, Ferroptosis Inhibitors, Anticoagulants, and Iron-Chelators in COVID-19 Control

Severe imbalance in iron metabolism among SARS-CoV-2 infected patients is prominent in every symptomatic (mild, moderate to severe) clinical phase of COVID-19. Phase-I - Hypoxia correlates with reduced O₂ transport by erythrocytes, overexpression of HIF-1α, altered mitochondrial bioenergetics with host metabolic reprogramming (HMR). Phase-II - Hyperferritinemia results from an increased iron overload, which triggers a fulminant proinflammatory response - the acute cytokine release syndrome (CRS). Elevated cytokine levels (i.e. IL6, TNFα and CRP) strongly correlates with altered ferritin/TF ratios in COVID-19 patients. Phase-III - Thromboembolism is consequential to erythrocyte dysfunction with heme release, increased prothrombin time and elevated D-dimers, cumulatively linked to severe coagulopathies with life-threatening outcomes such as ARDS, and multi-organ failure. Taken together, Fe-R-H dysregulation is implicated in every symptomatic phase of COVID-19. Fe-R-H regulators such as lactoferrin (LF), hemoxygenase-1 (HO-1), erythropoietin (EPO) and hepcidin modulators are innate bio-replenishments that sequester iron, neutralize iron-mediated free radicals, reduce oxidative stress, and improve host defense by optimizing iron metabolism. Due to its pivotal role in 'cytokine storm', ferroptosis is a potential intervention target. Ferroptosis inhibitors such as ferrostatin-1, liproxstatin-1, quercetin, and melatonin could prevent mitochondrial lipid peroxidation, up-regulate antioxidant/GSH levels and abrogate iron overload-induced apoptosis through activation of Nrf2 and HO-1 signaling pathways. Iron chelators such as heparin, deferoxamine, caffeic acid, curcumin, α-lipoic acid, and phytic acid could protect against ferroptosis and restore mitochondrial function, iron-redox potential, and rebalance Fe-R-H status. Therefore, Fe-R-H restoration is a host biomarker-driven potential combat strategy for an effective clinical and post-recovery management of COVID-19.

A comprehensive review on pharmacologic agents, immunotherapies and supportive therapeutics for COVID-19

The emergence of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected many countries throughout the world. As urgency is a necessity, most efforts have focused on identifying small molecule drugs that can be repurposed for use as anti-SARS-CoV-2 agents. Although several drug candidates have been identified using in silico method and in vitro studies, most of these drugs require the support of in vivo data before they can be considered for clinical trials. Several drugs are considered promising therapeutic agents for COVID-19. In addition to the direct-acting antiviral drugs, supportive therapies including traditional Chinese medicine, immunotherapies, immunomodulators, and nutritional therapy could contribute a major role in treating COVID-19 patients. Some of these drugs have already been included in the treatment guidelines, recommendations, and standard operating procedures. In this article, we comprehensively review the approved and potential therapeutic drugs, immune cells-based therapies, immunomodulatory agents/drugs, herbs and plant metabolites, nutritional and dietary for COVID-19.

Effects of dietary intake behavior, food supply, nutrition, and health during the COVID-19 outbreak

The coronavirus disease 2019 (COVID-19) pandemic, which began in 2019, has far-reaching ramifications, including economic losses and health challenges that still affect various parts of the world. During our review, we learned that the entire world is working to stop the spread of the SARS-CoV-2 outbreak. We explore ways that may lower the danger of SARS-CoV-2 contamination and useful strategies to avoid the possibility of SARS-CoV-2 spreading through food. While hygienic protocols are required in the food supply sector, cleaning, disinfection, and the avoidance of cross-contamination across food categories and other related goods at different stages of the manufacturing process remain especially important because the virus can survive for long periods of time on inert materials such as food packaging. Furthermore, personal hygiene (regular washing and disinfection), wearing gloves and using masks, garments, and footwear dedicated to maintaining hygiene provide on-site safety for food sector personnel, supply chain intermediaries, and consumers. Restrictions imposed in response to the pandemic (e.g., closure of physical workplaces, canteens, cafes, restaurants, schools, and childcare institutions), changes in household grocery shopping frequency, individuals' perceived risk of COVID-19, income losses due to the pandemic, and sociodemographic factors are among the factors. The conclusions drawn from this study consider the implications of healthy diets, food system resilience, behavior change, and nutritional imbalance for policymakers and food supply chain participants, as well as the antimicrobial effects of vitamins and nutrients. During a public health crisis, people should eat less, necessitating preventive policies and nutritional advice to deal with this.

Role of sarcopenia risk in predicting COVID-19 severity and length of hospital stay in older adults: a prospective cohort study

Sarcopenia is more common in the elderly and causes adverse outcomes with increased morbidity and mortality. This prospective cohort study assessed the association of sarcopenia risk with the severity of COVID-19 at the time of admission and during hospitalisation and the length of hospital stay. Two hundred patients (aged ≥ 60 years) who were hospitalised for COVID-19 were enrolled using consecutive sampling between 29 December 2020 and 20 May 2021. The sarcopenia score of the patients was assessed using the Strength, Assistance in walking, Rising from a chair, Climbing stairs, and Falls questionnaire. The severity of COVID-19 was determined using the modified National Early Warning Score (m-NEWS) system for 2019 n-CoV-infected patients at admission (T1), day three (T2) and at discharge (T3). Data were analysed using SPSS, version 22 and STATA, version 14. Of the 165 patients included, thirty four (20·6 %) were at risk of sarcopenia. The length of hospital stay was slightly longer in patients with sarcopenia risk, but the difference was not significant (P = 0·600). The adjusted OR of respiratory rate (RR) > 20 /min at T1 for the sarcopenia risk group was 6·7-times higher than that for the non-sarcopenic group (P = 0·002). According to generalised estimating equations, after adjusting for confounding factors, the m-NEWS score was 5·6 units higher in patients at risk of sarcopenia (P < 0·001). Sarcopenia risk could exacerbate COVID-19 severity and increase RR at admission, as well as the need for oxygen therapy at discharge.

Comparative efficacy and safety of pharmacological interventions for severe COVID-19 patients: An updated network meta-analysis of 48 randomized controlled trials

BACKGROUND

To date, there has been little agreement on what drug is the "best" drug for treating severe COVID-19 patients. This study aimed to assess the efficacy and safety of different medications available at present for severe COVID-19.

METHODS

We searched databases for randomized controlled trials (RCTs) published up to February 28, 2022, with no language restrictions, of medications recommended for patients (aged 16 years or older) with severe COVID-19 infection. We extracted data on trials and patient characteristics, and the following primary outcomes: all-cause mortality (ACM), and treatment-emergent adverse events (TEAEs).

RESULTS

We identified 4021 abstracts and of these included 48 RCTs comprising 9147 participants through database searches and other sources. For decrease in ACM, we found that ivermectin/doxycycline, C-IVIG (i.e., a hyperimmune anti-COVID-19 intravenous immunoglobulin), methylprednisolone, interferon-beta/standard-of-care (SOC), interferon-beta-1b, convalescent plasma, remdesivir, lopinavir/ritonavir, immunoglobulin gamma, high dosage sarilumab (HS), auxora, and imatinib were effective when compared with placebo or SOC group. We found that colchicine and interferon-beta/SOC were only associated with the TEAEs of severe COVID-19 patients.

CONCLUSION

This study suggested that ivermectin/doxycycline, C-IVIG, methylprednisolone, interferon-beta/SOC, interferon-beta-1b, convalescent plasma (CP), remdesivir, lopinavir/ritonavir, immunoglobulin gamma, HS, auxora, and imatinib were efficacious for treating severe COVID-19 patients. We found that most medications were safe in treating severe COVID-19. More large-scale RCTs are still needed to confirm the results of this study.

Nutritional profile and outcomes of noncritical hospitalized patients with COVID-19 in a large tertiary hospital in southern Brazil

INTRODUCTION:

Patients with chronic diseases, such as diabetes and cardiovascular diseases, and old age, which are associated with a high risk of malnutrition and worse outcomes, are at a higher risk for developing the severe presentation of COVID-19.

METHODS:

This is an observational and cross-sectional study with a sample defined by convenience. Data were collected in adult inpatient units through information obtained via telephone contact with the patient/companion, records collected by the nursing staff, and medical records, tabulating demographics, body composition, previous illnesses, nutritional diagnoses, diet acceptance, and hospitalization outcomes. The following symptoms were observed: inappetence, smell, dysgeusia, odynophagia, nausea, vomiting, and diarrhea.

RESULTS:

Most deaths occurred after transfer to the intensive care unit (79.6%). Patients with the worst outcome had lower food intake with a cutoff point of 60% for diet acceptance, which seems to be an adequate discriminator between those who survived and those who did not. Gastrointestinal symptoms were significantly associated with food consumption below 60% of the planned goal. The symptoms most associated with lower energy intake were inappetence, dysgeusia, and nausea/vomiting.

CONCLUSIONS:

Reduced caloric intake and the presence of nutritional risk or its appearance during hospitalization seemed to be associated with mortality in patients with COVID-19 admitted outside the intensive care unit.

COVID-19 Smell Impairment and Crosstalk with Hypoxia Physiology

Since its apomorphic appearance in 2019, severe acute respiratory syndrome Coronavirus type 2 (SARS-CoV-2) nowadays circulates as a plesiomorphic human virus in several synapomorphic variants. The respiratory tract is the most important site of infection, the viral effects in the lungs are well described, and more than half of the patients could develop shortness of breath and dyspnea and require ventilatory support. The physiological sign of this condition is the decrease in the partial pressure of oxygen in the blood, leading to acute hypoxia, which could be a factor in the disease. In severe patients, we recorded several physiological parameters: breath frequency (BF), partial pressure of oxygen in the blood (pO2), partial pressure of carbon dioxide in the blood (pCO2), hemoglobin (Hb), heart rate (HR), and blood pressure in correlation with the olfactory threshold. We found significant correlations between reduced olfactory threshold with pO2 and hemoglobin levels, changes in heart rate, and increased HR and pCO2. These results suggest that COVID-19 causes an impaired sense of smell that decreases in threshold corresponding to the disease severity.

The impact of Ramadan during COVID-19 confinement on weight, dietary, and lifestyle habits in the Kingdom of Saudi Arabia: a cross-sectional study

Severe procedures were undertaken globally because of the COVID-19 pandemic to overcome the spread of the disease and to prevent catastrophic results affecting the health care system including social distancing, lockdowns, and quarantines. Despite the widely known health benefits of Ramadan fasting, there was a general concern regarding the lifestyle of people during Ramadan 2020 that accompanied the period of COVID-19 pandemic and the home confinement applied. The main objective for the current cross-sectional investigation was to investigate the influence of Covid-19 lockdown during Ramadan fasting on weight change on 481 participants in Saudi Arabia. Identifying the contributing risk factors to weight gain were also addressed. Around 42% of the participants had gained weight and around 38% of the participants had lost weight. Physical activity level was shown to be considered as a protective factor against weight gain (OR = 1.03 with P = 0.008), while increasing the number of meals and not adapting healthy cooking methods can both be considered as contributing factors to weight gain (OR = 1.03 with P = 0.009, and OR = 1.03 with P = 0.004, respectively). Assessing these changes during Ramadan of COVID-19 quarantine provided valuable perspective on the health and wellbeing of Saudi Arabia citizens. These findings should be considered in future studies to explore the persistence of Covid-19 related weight status and habit change.

Quercetin in the Prevention and Treatment of Coronavirus Infections: A Focus on SARS-CoV-2

The COVID-19 outbreak seems to be the most dangerous challenge of the third millennium due to its highly contagious nature. Amongst natural molecules for COVID-19 treatment, the flavonoid molecule quercetin (QR) is currently considered one of the most promising. QR is an active agent against SARS and MERS due to its antimicrobial, antiviral, anti-inflammatory, antioxidant, and some other beneficial effects. QR may hold therapeutic potential against SARS-CoV-2 due to its inhibitory effects on several stages of the viral life cycle. In fact, QR inhibits viral entry, absorption, and penetration in the SARS-CoV virus, which might be at least partly explained by the ability of QR and its derivatives to inhibit 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro). QR is a potent immunomodulatory molecule due to its direct modulatory effects on several immune cells, cytokines, and other immune molecules. QR-based nanopreparations possess enhanced bioavailability and solubility in water. In this review, we discuss the prospects for the application of QR as a preventive and treatment agent for COVID-19. Given the multifactorial beneficial action of QR, it can be considered a very valid drug as a preventative, mitigating, and therapeutic agent of COVID-19 infection, especially in synergism with zinc, vitamins C, D, and E, and other polyphenols.

Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc?

Vaccination against coronavirus disease 2019 (COVID-19) is the safest and most effective strategy for controlling the pandemic. However, some cases of acute cardiac events following vaccine administration have been reported, including myocarditis and myocardial infarction (MI). While post-vaccine myocarditis has been widely discussed, information about post-vaccine MI is scarce and heterogenous, often lacking in histopathological and pathophysiological details. We hereby present five cases (four men, mean age 64 years, range 50–76) of sudden death secondary to MI and tightly temporally related to COVID-19 vaccination. In each case, comprehensive macro- and microscopic pathological analyses were performed, including post-mortem cardiac magnetic resonance, to ascertain the cause of death. To investigate the pathophysiological determinants of MI, toxicological and tryptase analyses were performed, yielding negative results, while the absence of anti-platelet factor 4 antibodies ruled out vaccine-induced thrombotic thrombocytopenia. Finally, genetic testing disclosed that all subjects were carriers of at least one pro-thrombotic mutation. Although the presented cases do not allow us to establish any causative relation, they should foster further research to investigate the possible link between COVID-19 vaccination, pro-thrombotic genotypes, and acute cardiovascular events.

Impact of Coronavirus Disease of 2019 Vaccine on Health and Physical Activities Among Physical Education Students in China

Purpose

This research focused primarily on the impact of the SARS-CoV-2 Vaccine (VeroCell) on Chinese physical education (PE) students' health and physical activity (PA) performance.

Methods

This study used quantitative methods and phenomenological procedures to collect and analyze data. Survey techniques were the main method used for collecting data from Chinese university students, using a self-designed questionnaire with a Cronbach's alpha α value of 0.76. To ensure the quality of the study, confirmatory factor analyses (CFA) were conducted, and the internal consistency reliability of the instrument was measured (alpha coefficient = 0.82). The determined sample size was 490 and around 90% as the minimum sample size was determined with the help of a sample size calculator. The author using factor loadings with h2 and an independent-sample t-test analyzed the responses of the remaining valid participants (n = 443 with a response rate of 90.40).

Results

Most participants (around 94%) did not experience any adverse reactions that impacted their daily life activities, health, or performance during physical activity. However, about 30–40% of students felt lethargy, weakness, muscle pain, or swelling. Regarding the impact of the vaccine on daily life, there was no difference in the responses between participants who had only received one shot of the coronavirus disease 2019 (COVID-19) vaccine and those who had received two shots (p &gt; 0.05 in most cases).

Conclusion

The study concluded that the COVID-19 vaccine had no significant effect on PE students' daily activities, health, and PA performance. The results of this study could be used by policymakers to encourage people to get vaccinated and eradicate the isolation caused by COVID-19, which leads many people to develop various non-communicable diseases (NCDs).

Role of tyrosine kinase inhibitor in chronic myeloid leukemia patients with SARS-CoV-2 infection: A narrative Review

Severe acute respiratory syndrome (SARS) caused by a novel coronavirus-2 (CoV-2), also known as COVID-19, has spread rapidly worldwide since it is recognized as a public health emergency and has now been declared a pandemic on March 11, 2020, by the World Health Organization. The genome of SARS-CoV-2 comprises a single-stranded positive-sense RNA approximately 27 to 30 kb in size. The virus is transmitted through droplets from humans to humans. Infection with the SARS virus varies from asymptomatic to lethal, such as fever, cough, sore throat, and headache, but in severe cases, pneumonia and acute respiratory distress syndrome. Recently, no specific and effective treatment has been recommended for patients infected with the SARS virus. However, several options can be investigated to control SARS-CoV-2 infection, including monoclonal antibodies, interferons, therapeutic vaccines, and molecular-based targeted drugs. In the current review, we focus on tyrosine kinase inhibitor management and their protective role in SARS-CoV-2 patients with chronic myelogenous leukemia.

COVID-19 and Nutrition: Summary of Official Recommendations

Medical nutrition therapy may have a key role in the COVID-19 pandemic. Given the spread of misinformation, the present review organizes and summarizes nutrition recommendations regarding COVID-19, serving as a reference guide for health professionals. Nineteen official recommendations were included of international, US, Asian, European, Canadian, and Australian origin on (i) lactation, (ii) nutrition during quarantine, (iii) nutrition in high-risk groups, (iv) nutrition for recovery at home, and (v) nutrition in hospital. Breastfeeding is encouraged, and the role of hydration and the adoption of a healthy diet during quarantine are emphasized. Older people and/or people with comorbidities should be checked for malnutrition and follow a healthy diet. For patients recovering at home, hydration, protein, and energy intake should be ensured. For hospitalized patients, early feeding with a priority on enteral route is recommended.

Dietary supplements and nutraceuticals in the recovery of COVID-19: A systematic review and meta-analysis

The outbreak of nSARS-CoV2 in December 2019 turned into a global pandemic and is still underway. Infection with nSARS-CoV2 resulted in severe acute respiratory distress syndrome and was named COVID-19. COVID-19 requires the intervention of a series of therapeutics, including antiviral, anti-inflammatory, and immune-modulating molecules. Additionally, studies have demonstrated that nutraceuticals offer a promising impact in fast recovery and boosting immunity. Here, the study aimed to provide a comprehensive synthesis of the scientific evidence examining the effectiveness of nutraceuticals. A detailed search of scientific literature was conducted utilizing the most relevant scientific studies published during 2019–2022 on the intervention of nutraceuticals in the management of COVID-19. PubMed, Cochrane Central Register of Controlled Trials and Scielo databases were explored for the most relevant studies. Meta-analysis was carried out using the MedCalC tool as per PRISMA guidelines for odds ratio among the studies along with risk factor analysis and relative risk. A total of 1,308 original records were identified, where 1,268 studies were collected from different databases, and 40 additional records were obtained from non-pre-defined sources. Odds ratio, risk analysis, and risk difference analysis showed nutraceuticals intervention reported effective (P < 0.001) in COVID-19 patient over control. Nutraceuticals-based interventions had improved immunity, short-term duration, and fast recovery of COVID-19 patients.

The Effect of Fear of COVID-19 on Smoking Cessation

Aim: We aimed to investigate the relationship between fear of COVID-19 and smoking cessation success. Methods: The study is an observational analytic study. It was conducted prospectively and we included people who applied to the smoking cessation outpatient clinic between 01 Oct 2020 and 31 Oct 2020 and agreed to participate in the study. A questionnaire prepared by the researchers, the Fear of COVID-19 Scale, and the Fagerström Test for Nicotine Dependence were applied to the participants. When necessary treatments had been initiated, a particular date is determined for each participant as a smoking cessation date. Participants were called in the 1st month and 3rd months from the smoking cessation day to enquire whether they quit smoking. Results: A total of 222 people participated in this study. The mean score of the Fear of COVID-19 Scale was calculated as 18.77±6.45. The success rate of smoking cessation in the 3rd month was 55% (n=122). No significant relationship was found between smoking cessation success and the score of the Fear of COVID-19 Scale. Conclusion: Although we cannot associate it with the fear of COVID-19 alone, we believe that the pandemic increases the success of early smoking cessation. To maintain these success rates, it is important to provide adequate support to the patients. Keywords: COVID-19, fear, smoking cessation, tobacco smoking

Dietary patterns of adolescent students during the COVID-19 pandemic lockdown

This study aimed to analyze the dietary patterns of adolescent students during the COVID-19 pandemic lockdown. To achieve the research´s aim 127 adolescent students, 60 men (18.88±4.18 years) and 67 women (17.61±7.43 years) completed an online questionnaire that analyzed variables regarding their nutritional profile. Adolescent students presented a dietary pattern during the COVID-19 pandemic lockdown characterized by different associations of food consumption, On one hand, the consumption of healthier foods such as meat, fish, vegetables, legumes, rice, or pasta, and on the other hand non-healthier foods as food, alcohol, or pastries. Further investigations are needed to implement multidisciplinary interventions to develop healthier habits in schools and to encourage the adoption of healthy diets among adolescents.

Measuring a panic buying behavior: the role of awareness, demographic factors, development, and verification

In this study, a new panic buying behavior (PBB) and awareness scales were established and verified during the Coronavirus Disease 2019 (COVID-19) pandemic. The PBB scales measured the relationship between people's awareness about COVID-19 and PBB. Moreover, this study investigated the potential association of some demographic factors with PBB. The online descriptive cross-sectional survey was collected from 429 Jordanians who were selected using the snowball sampling technique. The online survey started from April 1st to April 10th, 2020. Pearson correlation coefficient, one-way analysis of variance, independent sample t-test, and linear regression were used in this study. Findings indicated that both established scales were valid and reliable for achieving the required level of validity and reliability. In the current study, participants' awareness of COVID-19 was high; but, their PBB was low. Single and young individuals were positively associated with PBB. Awareness about COVID-19 and age were found to be the main predictors of PBB. This study concluded that the higher the awareness level about COVID-19, the lower PBB. High PBB may affect the world economy, highlighting the importance of COVID-19 awareness.

Effective Regulation of Gut Microbiota With Probiotics and Prebiotics May Prevent or Alleviate COVID-19 Through the Gut-Lung Axis

Coronavirus disease 2019 (COVID-19) can disrupt the gut microbiota balance, and patients usually have intestinal disorders. The intestine is the largest immune organ of the human body, and gut microbes can affect the immune function of the lungs through the gut-lung axis. Many lines of evidence support the role of beneficial bacteria in enhancing human immunity, preventing pathogen colonization, and thereby reducing the incidence and severity of infection. In this article, we review the possible approach of modulating microbiota to help prevent and treat respiratory tract infections, including COVID-19, and discuss the possibility of using probiotics and prebiotics for this purpose. We also discuss the mechanism by which intestinal micro-flora regulate immunity and the effects of probiotics on the intestinal micro-ecological balance. Based on this understanding, we propose the use of probiotics and prebiotics to modulate gut microbiota for the prevention or alleviation of COVID-19 through the gut-lung axis.

Multimodal Benefits of Exercise in Patients With Multiple Sclerosis and COVID-19

Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.

Exploring diet associations with Covid-19 and other diseases: a Network Analysis-based approach

The current global pandemic, Covid-19, is a severe threat to human health and existence especially when it is mutating very frequently. Being a novel disease, Covid-19 is impacting the patients with comorbidities and is predicted to have long-term consequences, even for those who have recovered from it. To clearly recognize its impact, it is important to comprehend the complex relationship between Covid-19 and other diseases. It is also being observed that people with good immune system are less susceptible to the disease. It is perceived that if a correlation between Covid-19, other diseases, and diet is realized, then caregivers would be able to enhance their further course of medical action and recommendations. Network Analysis is one such technique that can bring forth such complex interdependencies and associations. In this paper, a Network Analysis-based approach has been proposed for analyzing the interplay of diets/foods along with Covid-19 and other diseases. Relationships between Covid-19, diabetes mellitus type 2 (T2DM), non-alcoholic fatty liver disease (NAFLD), and diets have been curated, visualized, and further analyzed in this study so as to predict unknown associations. Network algorithms including Louvain graph algorithm (LA), K nearest neighbors (KNN), and Page rank algorithms (PR) have been employed for predicting a total of 60 disease-diet associations, out of which 46 have been found to be either significant in disease risk prevention/mitigation or in its progression as validated using PubMed literature. A precision of 76.7% has been achieved which is significant considering the involvement of a novel disease like Covid-19. The generated interdependencies can be further explored by medical professionals and caregivers in order to plan healthy eating patterns for Covid-19 patients. The proposed approach can also be utilized for finding beneficial diets for different combinations of comorbidities with Covid-19 as per the underlying health conditions of a patient. Graphical abstract.

Healthy eating - a modifiable contributor to optimize healthy living in the COVID-19 pandemic: a review

The outbreak of the novel severe acute respiratory syndrome coronavirus 2 infection in 2019 has posed major risks to global health and the economy. This coronavirus disease (COVID-19) pandemic has changed many of our everyday habits, including how we function and socialize, how we eat, and food preferences and selection. The average intake and status of certain vitamins and minerals can result in reduced immunity, which makes people more susceptible to illnesses and exacerbates malnutrition. The most critical factors in this scenario are individual risk evaluation and management techniques. Until general therapies are administered, the nutritional status of each infected patient should be assessed. The differing clinical severity of COVID-19 - from asymptomatic, to mild, to severe, to death - depends on the different metabolic status of the hosts who have contracted the virus, which is determined by their diet, age, gender, health, lifestyle, and environmental factors. A broad systematic exploration on studies of this disease was steered by means of electronic databases and was limited to articles published in English (or with an English abstract) in publications using words like 'health', 'diet', 'food', 'nutritional status', 'COVID-19', 'pandemic', 'modifiable contributor', 'immune system', 'micronutrients', 'vitamin', and so on. Careful individual consideration of the potential dietary, nutritional, medical, lifestyle, and environmental hazards, along with any supplementation with micronutrients wherever required to help to boost the body's natural defence system, with the intention to improve all levels of immunity and the use of effective risk management techniques are appropriate ways to handle the COVID-19 pandemic. © 2021 Society of Chemical Industry.

Low serum levels of zinc and 25-hydroxyvitmain D as potential risk factors for COVID-19 susceptibility: a pilot case-control study

BACKGROUND AND AIMS

This study aimed to evaluate serum 25-hydroxyvitmain D and zinc levels in coronavirus disease 2019 (COVID-19) patients in comparison to healthy subjects.

METHODS

This was a single-center case-control study performed from March 20, 2020, to January 20, 2021, in Tehran, Iran. All patients diagnosed with COVID-19 based on a positive nasopharyngeal swab polymerase chain reaction (PCR) test were included in the case group. Controls were selected from patients referred for routine checkups who had a negative COVID-19 PCR test. Age, sex, marital and educational status, comorbidities, and serum 25-hydroxyvitmain D and zinc levels of patients were recorded.

RESULTS

Ninety patients in the case group and 95 subjects in the control group who were sex and age-matched were studied. 25-hydroxyvitmain D levels lower than 20 ng/ml were observed in 58 (64%) cases and 72 (76%) controls (P = 0.09). The median 25-hydroxyvitmain D level in the case group was significantly lower than controls (26 (interquartile range [IQR] = 24) ng/ml vs. 38 (IQR = 22) ng/ml, respectively, P < 0.01). The median zinc level in the case group was 56 (IQR = 23) ng/ml, while it was 110 (IQR = 27) ng/ml among the controls (P < 0.01). There was no significant difference in the level of 25-hydroxyvitmain D and zinc between cases with and without comorbidities (P > 0.05). Susceptibility to SARS-CoV-2 infection could be predicted by serum 25-hydroxyvitmain D levels below 25.2 ng/ml (81% sensitivity; 48% specificity) or zinc levels below 86.3 mmol/ml (93% sensitivity; 92% specificity).

CONCLUSIONS

Low serum zinc and 25-hydroxyvitmain D levels appear to be risk factors for COVID-19 affliction; thus, the treatment of individuals with such deficiencies is recommended.

A Systematic Review of the Global Intervention for SARS-CoV-2 Combating: From Drugs Repurposing to Molnupiravir Approval

The rising outbreak of SARS-CoV-2 continues to unfold all over the world. The development of novel effective antiviral drugs to fight against SARS-CoV-2 is a time cost. As a result, some specific FDA-approved drugs have already been repurposed and authorized for COVID-19 treatment. The repurposed drugs used were either antiviral or non-antiviral drugs. Accordingly, the present review thoroughly focuses on the repurposing efficacy of these drugs including clinical trials experienced, the combination therapies used, the novel methods followed for treatment, and their future perspective. Therefore, drug repurposing was regarded as an effective avenue for COVID-19 treatment. Recently, molnupiravir is a prodrug antiviral medication that was approved in the United Kingdom in November 2021 for the treatment of COVID-19. On the other hand, PF-07321332 is an oral antiviral drug developed by Pfizer. For the treatment of COVID-19, the PF-07321332/ritonavir combination medication is used in Phase III studies and was marketed as Paxlovid. Herein, we represented the almost history of combating COVID-19 from repurposing to the recently available oral anti-SARS-CoV-2 candidates, as a new hope to end the current pandemic.

Association between lifestyle and emotional aspects of food consumption during the COVID-19 pandemic

BACKGROUND AND AIMS

Adequate nutrition during infectious outbreaks require a personal management strategy, especially when there are emotional factors involved. To evaluate the association between lifestyle and emotional aspects of food consumption during the pandemic COVID-19.

METHODS AND RESULTS

Cross-sectional study using online self-applied questionnaire with 15,372 active schoolteachers who worked in primary education (kindergarten, elementary and high school) from Minas Gerais, Brazil. Poisson Regression model with robust variance was used to determine the association between lifestyle and emotional aspects and food consumption. Greater adherence to the healthy consumption profile showed a statistically significant association with decreased weight (PR = 1.58; p = 0.000), decreased physical activity (PR = 1.27; p = 0.000), reduced income, (PR = 1.26; p = 0.000), reduced alcohol consumption (PR = 1.22; p = 0.000), and changes in mental health (PR = 1.19; p = 0.000). Unhealthy consumption profile was significantly correlated with weight gain (PR = 1.54; p = 0.000), consuming more alcohol, or started drinking during the pandemic (PR = 1.44; p = 0.000), increased physical activity (PR = 1.43; p = 0.000); increased cigarette consumption (PR = 1.17; p = 0.000), and being a younger adult (PR = 1.17; p = 0.000).

CONCLUSIONS

The COVID-19 pandemic influenced the food profiles of basic education teachers in the Minas Gerais state education system in a bidirectional manner, favoring the practice of consuming healthy or unhealthy foods.

Results of the Adult COVID-19 Lifestyle Matching Study

Objective: The aim of our case-control study was to find the influence of lifestyle and comorbidities on COVID-19 susceptibility, identify risk factors and protective factors, and identify ways to encourage people to adopt a healthy lifestyle.

Methods: Patients with COVID-19 were matched with non-COVID-19 participants in a ratio of 1:2. Univariate analysis was performed using the chi-square test, and multivariate analysis was performed using conditional logistic regression.

Results: Multivariate analysis using conditional logistic regression found that alcohol consumption (AC) and a bland diet increased the risk of COVID-19, while college degrees and above, smoking, drinking tea, and exercise, especially walking, significantly reduced the risk of COVID-19.

Conclusion: After removing the effects of demographic factors, the study demonstrated that AC significantly reduced the ability of the body to resist COVID-19 infection. Moreover, following a bland diet increased the susceptibility to COVID-19. Notably, people who drank tea and performed regular exercises, especially walking, were significantly less likely to be infected with COVID-19. College degree or above relative illiteracy is COVID-19 protective factors of infection.

Lived Experiences of COVID-19 Patients With Pulmonary Involvement: A Hermeneutic Phenomenology

The aim of this study was to explore the lived experience of COVID-19 patients with pulmonary involvement. The hermeneutic phenomenology was chosen, as this approach can extract the participant experiences as COVID-19 patients. A total of 10 COVID-19 patients with the pulmonary disease were selected as participants after being discharged from the hospital by purposive sampling method until reaching saturation. Data were collected using semi-structured interviews and by using Greatrex-White and van Manen's methods were analyzed. As a result of data analysis, five main themes were emerged: Symptoms of inducing fear, Annoying loneliness, death anxiety, Spirituality healing factor, and Valuable life again. Based on the results of the interviews, the participants' experiences showed that patients infected with COVID-19, after being discharged from the hospital, due to mental and physical problems experienced during hospitalization, need comprehensive attention and care to regain their health during convalescence.

School closures and reopenings during the COVID-19 pandemic: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to provide an overview of existing studies and evidence on the impact of school closures and reopenings during the pandemic.

INTRODUCTION

The COVID-19 pandemic has necessitated widespread school closures, and reopening schools safely has a pivotal role in the well-being of children and teachers, SARS-CoV-2 transmission control and optimal societal functioning. Widespread school closures in response to the COVID-19 pandemic have caused adverse effects on the education, physical health and mental well-being of children. An understanding of the impact of school closures and reopenings as well as factors influencing school safety is critical to bringing schools' operational status back to normal. Despite the implication of individual concerns and knowledge on disease prevention practices, there is a paucity of research on individual knowledge, needs and behaviours in the context of school reopenings. In the proposed study, we will conduct a scoping review to identify and provide inventory of the current research and evidence on the impact of COVID-19 on K-12 schools (primary and secondary schools) and vice versa.

METHODS AND ANALYSIS

Eligible studies/literature include members of K-12 (primary and secondary) schools (students, parents, staff, faculty, COVID-19 coordinator, school nurses) in countries affected by the COVID-19 pandemic. We will exclude university or college students. There will be no exclusion based on methods, timing or school operational status.All concepts regarding school closures and reopenings will be considered, and all types of research will be considered.This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews. Sources of evidence published from 2020 to 31 October 2021 will be included. The search will include PubMed, preprints in EuropePMC, ERIC, Scopus, Web of Science Core Collection, PsycINFO, Embase, CINAHL and VHL. We will cover grey literature in Harvard Think Tank Database, COVID-19 Evidence Hub like COVID-END and Google Scholar. The abstract and title screening, full-text screening and data extraction will be done by two independent reviewers.Disagreements will be resolved by an independent third reviewer. Data extract will be done on Qualtrics form to ensure accurate extraction. Citation chaining will be performed on key articles identified. A critical appraisal will be performed.The scoping review will take place from 1 August 2021 to 15 November 2021. We will perform a final round of updated search and citation chaining.

ETHICS AND DISSEMINATION

The review will be based on published works and grey literature, thus it is exempt from formal ethical approval. This protocol cannot be registered in the Prospective Register of Systematic Reviews because this registry is not for scoping reviews. We will register it in OSF Registration. The paper will appear in a peer-reviewed, open-access journal to ensure a broad dissemination.

Food Consumption and COVID-19 Risk Perception of University Students

The aim of this study is to examine the differences in COVID-19 risk perception of university students, depending on their food consumption (proinflammatory diet and non-proinflammatory diet). A total of 513 university students aged between 16 and 42 years (PDG: mean 20.26, standard deviation 3.07; NPDG: mean 21.78, standard deviation 4.12) were interviewed via an online questionnaire. The study subjects were divided into two groups: a proinflammatory diet group (PDG) who obtained higher values on pasta, rice, bread, pastries, juices, and fruit consumption; and non-proinflammatory diet group (NPGD) who presented low consumption on these products. Significant results were obtained (p < 0.05) on how a proinflammatory diet presented a higher COVID-19 risk perception in university students (PDG 7.92 ± 2.46; NPGD 7.12 ± 2.28). In addition, students with a proinflammatory diet presented lower values in depression (PDG 48.32 ± 5.33; NPGD 49.83 ± 5.23) and loneliness (PDG 4.91 ± 1.67; NPGD 5.14 ± 1.68) and higher values in openness to experience (PDG 7.5 ± 1.53; NPGD 7.20 ± 1.54) than students with a non-proinflammatory diet. Furthermore, students with a proinflammatory diet were most affected in work (loss of work, reduced work, or unaffected work) due to the COVID-19 crisis (PDG 2.54 ± 0.65; NPGD 3.99 ± 0.26). The proinflammatory diet group presented higher values in complying with the confinement rules than students with a non-proinflammatory diet (PDG 8.26 ± 1.83; NPGD 7.74 ± 2.10). The results of this study may be a useful tool to explain and prevent both the psychological and general health consequences of the COVID-19 pandemic in students.

Elements and COVID-19: A Comprehensive Overview of Studies on Their Blood/Urinary Levels and Supplementation with an Update on Clinical Trials

Simple Summary

COVID-19 is a disease caused by the SARS-CoV-2 coronavirus spreading mainly through person-to-person contact. It has caused millions of deaths around the world and lasting health problems in individuals who have survived the disease. This review concisely summarizes certain issues related to COVID-19 with a focus on elements and gives an update on clinical trials where some minerals will be tested/have been tested alone or in combination with drugs, vitamins, or plant extracts/herbal formulations in COVID-19 patients and in those at higher COVID-19 risk.

Abstract

The current report provides a brief overview of the clinical features, hematological/biochemical abnormalities, biomarkers, and AI-related strategies in COVID-19; presents in a nutshell the pharmacological and non-pharmacological therapeutic options; and concisely summarizes the most important aspects related to sociodemographic and behavioral factors as well as comorbidities having an impact on this disease. It also gives a brief outline of the effect of selected elements on immune response and collects data on the levels of micro-/macro-elements and toxic metals in the blood/urine of SARS-CoV-2 infected patients and on supplementation with minerals in COVID-19 subjects. Moreover, this review provides an overview of clinical trials based on the use of minerals alone or in combination with other agents that can provide effective responses toward SARS-CoV-2 infection. The knowledge compiled in this report lays the groundwork for new therapeutic treatments and further research on biomarkers that should be as informative as possible about the patient’s condition and can provide more reliable information on COVID-19 course and prognosis. The collected results point to the need for clarification of the importance of mineral supplementation in COVID-19 and the relationships of the levels of some minerals with clinical improvement.

Surveillance of SARS-CoV-2 antibodies of patients in the local affected area during Wuhan lockdown

BACKGROUND

Serosurveillance is crucial in estimating the range of SARS-CoV-2 infections, predicting the possibility of another wave, and deciding on a vaccination strategy. To understand the herd immunity after the COVID-19 pandemic, the seroprevalence was measured in 3062 individuals with or without COVID-19 from the clinic.

METHODS

The levels of SARS-CoV-2 antibody IgM and IgG were measured by the immuno-colloidal gold method. A fusion fragment of nucleocapsid and spike protein was detected by a qualitative test kit with sensitivity (89%) and specificity (98%).

RESULTS

The seroprevalence rate for IgM and IgG in all outpatients was 2.81% and 7.51%, respectively. The sex-related prevalence rate of IgG was significantly higher (P < 0.05) in women than men. The highest positive rate of IgM was observed in individuals < 20 years of age (3.57%), while the highest seroprevalence for IgG was observed in persons > 60 years of age (8.61%). Positive rates of IgM and IgG in the convalescent patients were 31.82% and 77.27%, respectively, which was significantly higher than individuals with suspected syndromes or individuals without any clinical signs (P < 0.01). Seroprevalence for IgG in medical staff was markedly higher than those in residents. No significant difference of seroprevalence was found among patients with different comorbidities (P > 0.05).

CONCLUSIONS

The low positive rate of the SARS-CoV-2 IgM and nucleic acid (NA) test indicated that the SARS-CoV-2 outbreak is subsiding after 3 months, and the possibility of reintroduction of the virus from an unidentified natural reservoir is low. Seroprevalence provides information for humoral immunity and vaccine in the future.

The Role of Diet and Supplementation of Natural Products in COVID-19 Prevention

Recently, a discussion has begun on the global management strategy against COVID-19 based on the hypothesis that individuals' macro- and micronutrient status combined with antiviral drugs and herbs can be an ally against the infection. The hypothesis is that people's nutritional and oxidative scavenging capacity may provide fundamental data to predict severe and acute pulmonary distress following SARS-Cov2 infection. Consequently, the scientific community has addressed the role of balanced diets, nutritional supplements, and micronutrients, including folk herbal formulations, in reducing hospitalization and the severity of pulmonary impact in COVID-19 by preventing the most serious forms of the infection. This led to an animated debate on the potential effectiveness of some vitamins, micronutrients, and traditional Chinese medicine in preventing COVID-19, with some authors convinced that plant extracts could act oppositely, exacerbating the effect of the infection. While current research is still far to assess the suggestions and issues raised in this short communication, it is undoubtedly true that determining an individual's current metabolic status, including macro- and micronutrients, is an essential factor in defining any individuals' deficiencies, which will need to be addressed urgently through a proper diet, specific personalized nutritional supplementation, and lifestyle changes.

Insight into COVID-19's epidemiology, pathology, and treatment

The newly emerged 2019 coronavirus disease (COVID-19) has urged scientific and medical communities to focus on epidemiology, pathophysiology, and treatment of SARS-CoV-2. Indeed, little is known about the virus causing this severe acute respiratory syndrome pandemic, coronavirus (SARS-CoV-2). Data already collected on viruses belonging to the coronaviridae family are of interest to improve our knowledge rapidly on this pandemic. The current review aims at delivering insight into the fundamental advances inSARS-CoV-2 epidemiology, pathophysiology, life cycle, and treatment.

Known Unknowns in an Era of Technological and Viral Disruptions—Implications for Theory, Policy, and Practice

Technology is composed of the words “Techne” and “Logos” that refer to the artistic/creative and the logical/scientific aspects of its dualism. And so inherent this Promethean concept lie the concepts of the Schumpeterian creative destruction and also the promise and potential for humanity’s better tomorrows. We live in an era of artificial intelligence–driven as well as viral disruptions that challenge the mind as well as the body. At the same time, the impact of our pursuit of prosperity at any cost on the environment triggers displaced people floods and viral pandemics undermining the standard of living and more importantly the foundations of trust in institutions and in a better tomorrow feeding populist movements and autocratic trends in democracies as well as emboldening dictators. This work discusses the concepts of Risk Management 5.0, Industry 4.0, Industry 5.0, Society 5.0, Digital Transformation, Blockchain, and the role of AI via the Internet of Things architectures that could enable “smarter as well as more humane solutions to our challenges.”

The Mental Health Status and Associated Factors Among Medical Students Engaged in Online Learning at Home During the Pandemic: A Cross-Sectional Study From China

Background: The purpose of this study was to assess the mental health status of medical students engaged in online learning at home during the pandemic, and explore the potential risk factors of mental health. Methods: A cross-sectional study was conducted via an online survey among 5,100 medical students from Wannan Medical College in China. The Depression, Anxiety and Stress scale (DASS-21) was used to measure self-reported symptoms of depression, anxiety, and stress among medical students during online learning in the pandemic. Results: In total, 4,115 participants were included in the study. The prevalence symptoms of depression, anxiety, and stress were 31.9, 32.9, and 14.6%, respectively. Depression was associated with gender, grade, length of schooling, relationship with father, students' daily online learning time, and students' satisfaction with online learning effects. Anxiety was associated with gender, length of schooling, relationship with father, relationship between parents, students' daily online learning time, and students' satisfaction with online learning effects. Stress was associated with grade, relationship with father, relationship between parents, students' daily online learning time, and students' satisfaction with online learning effects. Conclusions: Nearly one-third of medical students survived with varying degrees of depression, anxiety, and stress symptoms during online learning of the COVID-19 pandemic. Gender, grade, length of schooling, family environment, and online learning environment play vital roles in medical students' mental health. Families and schools should provide targeted psychological counseling to high-risk students (male, second-year and third-year, four-year program). The findings of this study can provide reference for educators to cope with the psychological problems and formulate the mental health curriculum construction among medical students during online learning.