Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?

In Silico Exploration of CD200 as a Therapeutic Target for COVID-19

SARS-CoV-2, the pathogen causing COVID-19, continues to pose a significant threat to public health and has had major economic implications. Developing safe and effective vaccines and therapies offers a path forward for overcoming the COVID-19 pandemic. The presented study, performed by using the informational spectrum method (ISM), representing an electronic biology-based tool for analysis of protein-protein interactions, identified the highly conserved region of spike protein (SP) from SARS-CoV-2 virus, which is essential for recognition and targeting between the virus and its protein interactors on the target cells. This domain is suggested as a promising target for the drug therapy and vaccines, which could be effective against all currently circulating variants of SARS-CoV-2 viruses. The analysis of the virus/host interaction, performed by the ISM, also revealed OX-2 membrane glycoprotein (CD200) as a possible interactor of SP, which could serve as a novel therapeutic target for COVID-19 disease.

The Role of Telemedicine in the Management of Patients with Chronic Diseases in Primary Care During the COVID-19 Pandemic

Introduction:The COVID-19 pandemic has rapidly spread to many countries and has led various primary healthcare services of chronic diseases to be neglected and only partially be replaced by telemedicine services. This study aims to investigate the role of telemedicine in the management of patients with noncommunicable diseases in primary health care during the COVID-19 pandemic. Method: A narrative review of the literature was carried out through searching the PubMed and Google Scholar databases. Results: From the initial stages of the pandemic, several scientific medical societies issued guidelines which urged citizens and health personnel to adopt digital means in the provision of regular chronic care as much as possible. The significant benefits of the telemedicine sessions partially only filled the gap of the deferred chronic care. On the other hand, many barriers need to be addressed in order to achieve an equitable and high-quality implementation of telemedicine services. Conclusion:The widespread application of telemedicine and self-monitoring was brought about by the COVID-19 pandemic and currently, they have become common ways of managing non-communicable diseases in primary health care. Innovations introduced need to be maintained and integrated into conventional traditional practices, so that health systems are more resilient to future public health emergencies.

Accounting Transparency, Fear Sentiment and the COVID-19 Epidemic: For Public Health Security and the Construction of an Early Warning System

A central issue of public health security and the construction of an early warning system is to establish a set of responsibility-oriented incentives and restraint mechanisms. This is closely related to the accounting transparency of the institutional environment and the fear sentiment of the individual's predicament. This study analyses the relationship between accounting transparency, fear sentiment, and COVID-19 through a VAR model analysis. The results show a significant and negative relationship between accounting transparency and daily new COVID-19 patients. In particular, accounting transparency has a negative impact on the increase in the number of people infected with a two-period lag, while the three-period lag in the number of new epidemics has a negative impact on accounting information. Second, accounting transparency has a positive impact on the increase in the search volume on COVID-19 within a three-period lag. After the three-period lag, the number of new epidemics has a positive impact on accounting information. Third, an increase in fear sentiment can be driven by the fear of COVID-19. Fourth, in the public health early warning system, according to the abovementioned time characteristics, the system arranges the emotional counseling, early warning incentives, and institutional constraints to be dealt with in the first 4 days. In addition, in the early warning target-oriented system setting, the parallel system helps to improve the early warning efficiency.

Mathematical model optimized for prediction and health care planning for COVID-19

OBJECTIVE

The COVID-19 pandemic has threatened to collapse hospital and ICU services, and it has affected the care programs for non-COVID patients. The objective was to develop a mathematical model designed to optimize predictions related to the need for hospitalization and ICU admission by COVID-19 patients.

DESIGN

Prospective study.

SETTING

Province of Granada (Spain).

POPULATION

COVID-19 patients hospitalized, admitted to ICU, recovered and died from March 15 to September 22, 2020.

STUDY VARIABLES

The number of patients infected with SARS-CoV-2 and hospitalized or admitted to ICU for COVID-19.

RESULTS

The data reported by hospitals was used to develop a mathematical model that reflects the flow of the population among the different interest groups in relation to COVID-19. This tool allows to analyse different scenarios based on socio-health restriction measures, and to forecast the number of people infected, hospitalized and admitted to the ICU.

CONCLUSIONS

The mathematical model is capable of providing predictions on the evolution of the COVID-19 sufficiently in advance as to anticipate the peaks of prevalence and hospital and ICU care demands, and also the appearance of periods in which the care for non-COVID patients could be intensified.

A Simulation Study on Spread of Disease and Control Measures in Closed Population Using ABM

An infectious disease can cause a detrimental effect on national security. A group such as the military called a “closed population”, which is a subset of the general population but has many distinct characteristics, must survive even in the event of a pandemic. Hence, it requires its own distinct solution during a pandemic. In this study, we investigate a simulation analysis for implementing an agent-based model that reflects the characteristics of agents and the environment in a closed population and finds effective control measures for making the closed population functional in the course of disease spreading.

The Impact of COVID-19 Pandemic on Children with Pulmonary Arterial Hypertension. Parental Anxiety and Attitudes. Follow-Up Data from the Polish Registry of Pulmonary Hypertension (BNP-PL)

The COVID-19 pandemic has impacted healthcare systems worldwide. Little is known about the impact of the pandemic on medical and psycho-social aspects of children with rare diseases such as pulmonary arterial hypertension and their parents. The study is based on children registered in The Database of Pulmonary Hypertension in the Polish Population and a parent-reported survey deployed during the first 6 months of the pandemic. The questionnaire consisted of six question panels: demographic data, fear of COVID-19, General Anxiety Disorder-7 (GAD-7), social impact of pandemic, patients’ medical status, and alarming symptoms (appearance or exacerbation). Out of 80 children registered, we collected 58 responses (72.5% response rate). Responders (parents) were mostly female (n = 55; 94.8%) at a mean age of 40.6 ± 6.9 years. Patients (children) were both females (n = 32; 55%) and males with a mean age of 10.0 ± 5.1 years. Eleven (19%) children had symptoms of potential disease exacerbation. Eight parents (72.7%) decided for watchful waiting while others contacted their GPs or cardiologists (n = 6; 54.5%). Three children had to be hospitalized (27.3%). Most planned hospitalizations (27/48; 56.2%) and out-patient visits (20/35; 57.1%) were cancelled, delayed, or substituted by telehealth services. Among the participating parents, the study shows very high levels of anxiety (n = 20; 34.5%) and concern (n = 55; 94.8%) and the need for detailed information (52; 89.6%) regarding COVID-19 and medical service preparedness during the pandemic. The COVID-19 pandemic has influenced child healthcare and caused high levels of anxiety among parents.

Mathematical model optimized for prediction and health care planning for COVID-19

OBJECTIVE

The COVID-19 pandemic has threatened to collapse hospital and ICU services, and it has affected the care programs for non-COVID patients. The objective was to develop a mathematical model designed to optimize predictions related to the need for hospitalization and ICU admission by COVID-19 patients.

DESIGN

Prospective study.

SETTING

Province of Granada (Spain).

POPULATION

COVID-19 patients hospitalized, admitted to ICU, recovered and died from March 15 to September 22, 2020.

STUDY VARIABLES

The number of patients infected with SARS-CoV-2 and hospitalized or admitted to ICU for COVID-19.

RESULTS

The data reported by hospitals was used to develop a mathematical model that reflects the flow of the population among the different interest groups in relation to COVID-19. This tool allows to analyse different scenarios based on socio-health restriction measures, and to forecast the number of people infected, hospitalized and admitted to the ICU.

CONCLUSIONS

The mathematical model is capable of providing predictions on the evolution of the COVID-19 sufficiently in advance as to anticipate the peaks of prevalence and hospital and ICU care demands, and also the appearance of periods in which the care for non-COVID patients could be intensified.

Impact of the 2019 Novel Coronavirus Disease Pandemic on the Performance of a Cardiovascular Department in a Non-epidemic Center in Beijing, China

Background: Knowledge of the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on the performance of a cardiovascular department in a medical referral hub center from a non-epidemic area of China is limited.

Method: The data on the total number of non-emergency medical cares (including the number of out-patient clinic attendances, the number of patients who were hospitalized in non-intensive care wards, and patients who underwent elective cardiac intervention procedures) and emergency medical cares [including the number of emergency department (ED attendances) and chest pain center (CPC attendances), as well as the number of patients who were hospitalized in coronary care unit (CCU) and the number of patients who underwent emergency cardiac intervention procedures] before and during the pandemic (time before the pandemic: 20th January 2019 to 31st March 2019 and time during the pandemic: 20th January 2020 to 31st March 2020) in the Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University were collected and compared.

Results: Both the non-emergency medical and emergency medical cares were affected by the pandemic. The total number of out-patient clinic attendance decreased by 44.8% and the total number of patients who were hospitalized in non-intensive care wards decreased by 56.4%. Pearson correlation analysis showed that the number of out-patient clinic attendance per day was not associated with the number of new confirmed COVID-19 cases and the cumulative number of confirmed COVID-19 patients in Beijing (r = −0.080, p = 0.506 and r = −0.071, p = 0.552, respectively). The total number of patients who underwent non-emergency cardiac intervention procedures decreased during the pandemic, although there were no statistically significant differences except for patent foramen ovale (PFO) occlusion (1.7 ± 2.9 vs. 8.3 ± 2.3, p = 0.035). As for the emergency medical cares, the ED attendances decreased by 22.4%, the total number of CPC attendances increased by 10.3%, and the number of patients who were hospitalized in CCU increased by 8.9%: these differences were not statistically significant. During the pandemic, the proportion of hospitalized patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) significantly increased (19.0 vs. 8.7%, p < 0.001; 28.8 vs. 18.0%, p < 0.001, respectively); also, the number of primary percutaneous coronary intervention (PCI) increased by 10.3%. There was no significant difference between patients before and during the pandemic regarding the age, gender, baseline and discharge medication therapy, as well as length of stay and in-hospital mortality.

Conclusions: Our preliminary results demonstrate that both the non-emergency and emergency medical cares were affected by the COVID-19 pandemic even in a referral medical center with low cross-infection risk. The number of the out-patient clinic attendances not associated with the number of confirmed COVID-19 cases could be due to different factors, such as the local government contamination measures. The proportion of hospitalized patients with acute myocardial infarction increased in our center during the pandemic since other hospitals stopped performing primary angioplasty. A hub-and-spoke model could be effective in limiting the collateral damage for patients affected by cardiovascular diseases when the medical system is stressed by disasters, such as COVID-19 pandemic.

The inhibitory effect of (-)-Epicatechin gallate on the proliferation and migration of vascular smooth muscle cells weakens and stabilizes atherosclerosis

Vascular smooth muscle cells (VSMCs) lesions play an important role in atherosclerosis. The latest findings indicate that green tea extract has potential benefits for patients with atherosclerosis, but the components and mechanisms of action are unknown. (-)-Epicatechin gallate (ECG) is the main active ingredient extracted from green tea and has significant biological functions. However, the mechanism of ECG in atherosclerosis remains unclear. Therefore, we investigated the intervention of ECG on VSMCs induced by oxidized low-density lipoprotein (ox-LDL). The results show that ECG reduces the inflammatory response by preventing the overproduction of inflammatory mediators in VSMCs. ECG regulates the cell cycle and down-regulates the expression of proliferating cell nuclear antigen (PCNA) and cyclinD1, and then exerts an anti-proliferative effect. Furthermore, inhibition of the expression of matrix metalloproteinase 2 (MMP-2) and intercellular adhesion molecule 1 (ICAM-1) may be the mechanism by which ECG inhibits the migration of ox-LDL-induced VSMCs. Oil red O staining results show that ECG can improve cell foaming and reduce the content of total cholesterol (TC). In addition, ECG significantly reduces reactive oxygen species activity and also reduces the expression of p-p38, p-JNK, p-ERK1/2, p-IκBα, p-NF-κBp65, and TLR4. These results indicate that ECG has potential clinical applications for preventing atherosclerosis.