Novel coronavirus disease (COVID-19): a pandemic (epidemiology, pathogenesis and potential therapeutics)

Perception of personal protective equipment availability and mental health outcomes in workers from two national hospitals during the COVID-19 pandemic

Background

During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers.

Methods

Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires.

Results

563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association.

Conclusion

The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.

Spatial co-location patterns between early COVID-19 risk and urban facilities: a case study of Wuhan, China

Introduction

COVID-19, being a new type of infectious disease, holds significant implications for scientific prevention and control to understand its spatiotemporal transmission process. This study examines the diverse spatial patterns of COVID-19 within Wuhan by analyzing early case data alongside urban infrastructure information.

Methods

Through co-location analysis, we assess both local and global spatial risks linked to the epidemic. In addition, we use the Geodetector, identifying facilities displaying unique spatial risk characteristics, revealing factors contributing to heightened risk.

Results

Our findings unveil a noticeable spatial distribution of COVID-19 in the city, notably influenced by road networks and functional zones. Higher risk levels are observed in the central city compared to its outskirts. Specific facilities such as parking, residence, ATM, bank, entertainment, and hospital consistently exhibit connections with COVID-19 case sites. Conversely, facilities like subway station, dessert restaurant, and movie theater display a stronger association with case sites as distance increases, hinting at their potential as outbreak focal points.

Discussion

Despite our success in containing the recent COVID-19 outbreak, uncertainties persist regarding its origin and initial spread. Some experts caution that with increased human activity, similar outbreaks might become more frequent. This research provides a comprehensive analytical framework centered on urban facilities, contributing quantitatively to understanding their impact on the spatial risks linked with COVID-19 outbreaks. It enriches our understanding of the interconnectedness between urban facility distribution and transportation flow, affirming and refining the distance decay law governing infectious disease risks. Furthermore, the study offers practical guidance for post-epidemic urban planning, promoting the development of safer urban environments resilient to epidemics. It equips government bodies with a reliable quantitative analysis method for more accurately predicting and assessing infectious disease risks. In conclusion, this study furnishes both theoretical and empirical support for tailoring distinct strategies to prevent and control COVID-19 epidemics.

Pseudomembranous colitis as a complication in Covid-19

OBJECTIVE

Aim: To improve the results of treatment of patients with pseudomembranous colitis against the background of coronavirus infection.

PATIENTS AND METHODS

Materials and Methods: The study presents the results of a retrospective analysis of 96 patients with pseudomembranous colitis, who were treated in the infectious Covid department at the base of the Uzhhorod City Clinical Hospital since 2020 to 2022. The average age of patients was 55.2 years, there were 38 (39.5%) men and 58 (60.5%) women. Diagnosis of complications - pseudomembranous colitis (PMC) - was based on clinical data, ultrasound and CT of the abdominal organs, fibrocolonoscopy, laparoscopy.

RESULTS

Results: The frequency of PMC from the total number of patients who were in hospital treatment (8205 patients) due to COVID-19 was 1.17%, and this indicator was 0.62% in 2020, and 2.28% in 2021. Indications for operative treatment were: colon perforation - 9.4% of patients; peritonitis (diffuse, widespread) without obvious perforation of the colon wall - 85.5% of patients; mesenteric thrombosis - 4.1% of patients. In the case of perforation of the colon, resection of the colon was performed with the formation of a proximal colostomy and ileostomy. In case of mesenteric thrombosis, resection of the affected part of the small intestine was performed. In case of peritonitis without clear intraoperative detection of perforation of the colon wall, intraoperative lavage was performed.

CONCLUSION

Conclusions: 1) The frequency of detection of PMC in patients with COVID-19 in 2020 was 0.62%, and in 2021 - 2.28%. 2) The sensitivity of CT in the diagnosis of surgical complications of PMC was 72%, and the specificity was 58%. 3) Conservative treatment was effective in patients with PMC in 88.8% of cases, 21.2% had complications that required emergency surgical interventions. 4) The total mortality in patients with PMC was 11.36%, although this indicator was significantly higher in the event of surgical complications and operative treatment (22.4%).

Therapeutic Management with Repurposing Approaches: A Mystery During COVID-19 Outbreak

The ubiquitous pandemic that emerged due to COVID-19 affected the whole planet. People all over the globe became vulnerable to the unpredictable emergence of coronavirus. The sudden emergence of respiratory disease in coronavirus infected several patients. This affected human life drastically, from mild symptoms to severe illness, leading to mortality. COVID-19 is an exceptionally communicable disease caused by SARS-CoV-2. According to a genomic study, the viral spike RBD interactions with the host ACE2 protein from several coronavirus strains and the interaction between RBD and ACE2 highlighted the potential change in affinity from the virus causing the COVID-19 outbreak to a progenitor type of SARS-CoV-2. SARS-CoV-2, which could be the principal reservoir, is phylogenetically related to the SARS-like bat virus. Other research works reported that intermediary hosts for the transmission of viruses to humans could include cats, bats, snakes, pigs, ferrets, orangutans, and monkeys. Even with the arrival of vaccines and individuals getting vaccinated and treated with FDAapproved repurposed drugs like Remdesivir, the first and foremost steps aimed towards the possible control and minimization of community transmission of the virus include social distancing, self-realization, and self-health care. In this review paper, we discussed and summarized various approaches and methodologies adopted and proposed by researchers all over the globe to help with the management of this zoonotic outbreak by following repurposed approaches.

Knowledge, attitude, and adherence to coronavirus preventive measures among residents of the Kingdom of Saudi Arabia

Since the SARS-CoV-2 virus, the virus that causes COVID-19, has been spreading globally, variants have emerged and been identified in many countries around the world. This descriptive cross-sectional study aimed to explore the level of knowledge, attitude, and adherence to coronavirus variant preventive measures among residents of the Kingdom of Saudi Arabia. This is a cross-sectional online survey that was conducted between April and November 2020 and involved the residents of the Kingdom of Saudi Arabia. An electronic invitation for participation was sent to prospective participants, including the link to the research instrument, using social media websites. A total of 780 participants responded to a 4-part online survey developed by the investigators. The findings revealed that 72.9% of the participants (95% CI: 69.6%-75.9%) had a high level of knowledge about COVID-19; 78.2% said they supported all precautionary measures put in place by health authorities; only 29% wore face masks; and 93% wash their hands at least 5 times a day. Furthermore, 69% of the residents were always covering their mouth and nose when coughing or sneezing with a piece of tissue paper, while 71% were observing physical distancing. Participants showed a positive attitude towards supporting all the precautionary measures being put in place by the health authorities and the efforts made by healthcare workers in the kingdom. Residents in Saudi Arabia showed a high level of knowledge of COVID-19 variants. Higher levels of education, being employed, and higher income were factors that influenced participants' knowledge positively (P < .05). Females and younger age were predictors of a better attitude towards COVID-19 (P < .01).The majority of the residents were afraid of the spread and mutation of the coronavirus. This study highlights the value of continuing community service learning programs for raising knowledge retention and adherence to coronavirus variant prevention strategies.

COVID-19 knowledge, attitude, and preventive practices among government and private bank workers in Ethiopia

Background

Bank workers are among the many service-sector employees who are at risk of COVID-19 infection. Individual's adherence to control measures is affected by their COVID-19 knowledge, attitudes, and practices (KAP). Since KAP is an important cognitive key in public health prevention and promotion, this study aimed to identify COVID-19 KAP-related gaps among bank workers in Dessie City, Ethiopia and to guide banks and health authorities in taking corrective actions.

Methods

An institution-based cross-sectional study was conducted from January 1st to 30th, 2021 among 413 bank workers. A binary logistic regression was applied to determine association of independent variables with outcome variables using three different models. Variables at 95% confidence interval (CI) with a p < 0.25 from bivariate analysis were transported to three different multivariable logistic regression models and then variables with a p-value of 0.05 from the multivariable analysis of each model were declared as significantly associated with the outcome variables.

Results

The results of this study show that 84.7% [95% CI: 81.1-88.1] of bank workers had good knowledge, 50.4% positive attitude, and 50.6% [95% CI: 45.8-55.0] good practice towards prevention of COVID-19. The only variable significantly associated with knowledge in this study was positive attitude (AOR = 8.89; 95%CI: 3.34-23.64). Being ≥35 years old (AOR = 2.46; 95%CI: 1.25-4.84) and getting information on COVID-19 (AOR = 3.81; 95%CI: 1.84-7.91) were among factors significantly associated with attitude towards COVID-19 prevention, whereas being female and ≥ 35 years old (AOR = 2.56; 95%CI: 1.29-5.06) and (AOR = 2.73; 95% CI: 1.15-6.51), respectively were factors associated with good preventive practice towards COVID-19.

Conclusion and recommendation

Considering those significant factors responsible for determining COVID-19 KAP level of respondents, health education program and information dissemination are recommended, including appropriate strategies by policy makers and bank managers to develop effective interventions for COVID-19 transmission in banks.

Optimal evaluation of re-opening policies for COVID-19 through the use of metaheuristic schemes

A new contagious disease or unidentified COVID-19 variants could provoke a new collapse in the global economy. Under such conditions, companies, factories, and organizations must adopt reopening policies that allow their operations to reduce economic effects. Effective reopening policies should be designed using mathematical models that emulate infection chains through individual interactions. In contrast to other modeling approaches, agent-based schemes represent a computational paradigm used to characterize the person-to-person interactions of individuals inside a system, providing accurate simulation results. To evaluate the optimal conditions for a reopening policy, authorities and decision-makers need to conduct an extensive number of simulations manually, with a high possibility of losing information and important details. For this reason, the integration of optimization and simulation of reopening policies could automatically find the realistic scenario under which the lowest risk of infection was attained. In this paper, the metaheuristic technique of the Whale Optimization Algorithm is used to find the solution with the minimal transmission risk produced by an agent-based model that emulates a hypothetical re-opening context. Our scheme finds the optimal results of different generical activation scenarios. The experimental results indicate that our approach delivers practical knowledge and essential estimations for identifying optimal re-opening strategies with the lowest transmission risk.

COVID-19 associated coagulopathy: A bibliometric investigation

Infection with SARS-CoV-2 initiates an immune-hemostatic response. While both systems are intimately connected and necessary for an efficient immune response to contain the infection, excessive coagulation activation might exceed the valuable benefits by causing thrombotic consequences and excessive inflammation. This biological response is new to clinicians and researchers, and accordingly, tremendous studies have been conducted on coagulopathy and its relationship to COVID-19 disease during this pandemic. Therefore, it takes a research insight from a bibliometric perspective to determine research hotspots and trends of COVID-19 associated coagulopathy (C19-CA). The analysis relies on the Scopus database for bibliographic content and Visualization of Similarities viewer software to map bibliometric data of C19-CA. Our study finds the most eminent authors, journals, institutions, funding organizations, and countries that publish in the C19-CA. Additionally; this research employs bibliometric analysis of co-authorship, co-citations, bibliographic coupling, and co-occurrence of keywords. A total of 2242 studies were retrieved, and the number of annual publications of C19-CA showed remarkable growth. The top-publishing authors on C19-CA are Smadja, D.M., Diehl, J.L., and Gendron, N (France). The total number of articles published in English in these three years was 1241, with the original article accounting for 99.8% and conference papers accounting for 0.2%. Huazhong University of Science and Technology (China) is the top-productive institution, with the US being the top-publishing country. Journal of Thrombosis and Thrombolysis received the highest number of original articles. The research results were mainly published in the fields of Medicine, Biochemistry, Genetics, and Molecular Biology, Immunology and Microbiology. Yuanyuan Li, who is (China), is the top-collaborating author. China and its authors have the highest number of citations. Keywords' co-occurrence analyses of the authors and all keywords revealed the following themes in C19-CA; abnormal coagulation parameters, pulmonary coagulopathy, venous and arterial thrombotic disorders, distinct features of coagulopathy, inflammation, and thrombosis in COVID-19, and anticoagulants and thrombolytic therapies. By combining bibliometric analysis with VOSviewer software, we identified C19-CA's leaders, collaborating institutions, and research hotspots, as well as give references for future research paths.

Ethnopharmacological Potential of Phytochemicals and Phytogenic Products against Human RNA Viral Diseases as Preventive Therapeutics

RNA viruses have been the most destructive due to their transmissibility and lack of control measures. Developments of vaccines for RNA viruses are very tough or almost impossible as viruses are highly mutable. For the last few decades, most of the epidemic and pandemic viral diseases have wreaked huge devastation with innumerable fatalities. To combat this threat to mankind, plant-derived novel antiviral products may contribute as reliable alternatives. They are assumed to be nontoxic, less hazardous, and safe compounds that have been in uses in the beginning of human civilization. In this growing COVID-19 pandemic, the present review amalgamates and depicts the role of various plant products in curing viral diseases in humans.

Clinical profile and severity predictors of coronavirus disease 19 infection in a reference center from southern Brazil: a cross-sectional study

OBJECTIVES

The coronavirus disease pandemic has become a major global health crisis since 2019. Recent data show the association of diabetes, hypertension, and obesity with poor related outcomes in coronavirus disease infection. This descriptive study aimed to identify the clinical and laboratory parameters in patients with acute respiratory syndrome and confirmed severe acute respiratory syndrome coronavirus 2 infection.

METHODS

In this cross-sectional study, we analyzed data of 409 patients admitted to a referral hospital in Rio Grande do Sul, Brazil, with coronavirus disease infection confirmed by reverse transcription polymerase chain reaction. Clinical, laboratory, and imaging data were collected retrospectively from electronic medical records using a template with the variables of interest.

RESULTS

The average age was 64 years (52-73), and the body mass index was 27 kg/m² (22.1-31.2). Hypertension, diabetes, and obesity were observed in 58, 33, and 32% of the patients, respectively. Patients admitted to an intensive care unit were older [66 years (53-74) vs. 59 years (42.2-71.7)], with significantly higher impairment on chest computed tomography [75% (50-75) vs. 50% (25-60)] and received higher doses of corticosteroid therapy [39.4 mg (14.3-70.3) vs. 6 mg (6-14.7)]. Hematological parameters were lower in critically ill patients, with greater differences observed on the fifth day of hospitalization [hemoglobin 11.5 g/dL (9.5-13.1) vs. 12.8 g/dL (11.5-14.2), platelets 235,000 μL (143,000-357,000) vs. 270,000 μL (192,000-377,000), and lymphocytes 900 μL (555-1,500) vs. 1,629 μL (1,141-2,329)]. C-reactive protein levels and kidney function were also worse in intensive care unit patients. The mortality rate was significantly higher in the intensive care unit compared to the basic care unit (62.8 vs. 12.2%).

CONCLUSION

Our findings suggest that metabolic and cardiovascular comorbidities, as well as abnormal hematological parameters, are common findings among patients with severe respiratory syndrome related to coronavirus disease.

Serum calprotectin can indicate current and future severity of COVID-19

BACKGROUND

Predictive and prognostic biomarkers to guide 2019 novel coronavirus disease (COVID-19) are critically evolving. Dysregulated immune responses are the pivotal cause of severity mainly mediated by neutrophil activation. Thus, we evaluated the association of calprotectin, neutrophil secretory protein, and other mediators of inflammation with the severity and outcomes of COVID-19.

METHODS

This two-center prospective study focused on PCR-proven COVID-19 patients (n = 76) with different clinical presentations and SARS-CoV-2 negative control subjects (n = 24). Serum calprotectin (SC) was compared with IL-6 and other laboratory parameters.

RESULTS

Median levels of SC were significantly higher in COVID-19 patients in comparison to the control group (3760 vs. 2100 ng/ml, p < 0.0001). Elevated SC was significantly respective of disease severity (3760 ng/ml in mild up to 5700 ng/ml in severe cases, p < 0.0001). Moreover, the significant positive and negative correlations of SC with disease severity and oxygenation status indicated disease progression and respiratory worsening, respectively. It was found that SC was high in severe patients during hospitalization and significantly declined to normal after recovery. The logistic analysis identified the independent predictive power of SC for respiratory status or clinical severity. Indeed, SC behaved as a better discriminator for both outcomes, as it exhibited the largest area under the curve (receiver operating curve analysis), with the highest specificity and sensitivity when the predictive value of inflammatory biomarkers was compared.

CONCLUSION

Calprotectin can be used as a reliable prognostic tool to predict the poor clinical outcomes of COVID-19 patients.

Natural Products Against COVID-19 Inflammation: A Mini-Review

Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a virus whose genetic material is positive single-stranded RNA, being responsible for coronavirus disease 2019 (COVID- 19), an infection that compromises the lungs and consequently the respiratory capacity of the infected individual, according to the WHO in November 2021, 249,743,428 cases were confirmed, of which 5,047,652 individuals died due to complications resulting from the infection caused by SARSCOV- 2. As the infection progresses, the individual may experience loss of smell and taste, as well as breathing difficulties, severe respiratory failure, multiple organ failure, and death. Due to this new epidemiological agent in March 2020 it was announced by the director general of the World Health Organization (WHO) a pandemic status, and with that, many research groups are looking for new therapeutic alternatives through synthetic and natural bioactives. This research is a literature review of some in silico studies involving natural products against COVID-19 inflammation published in 2020 and 2021. Work like this presents relevant information to the scientific community, boosting future research and encouraging the use of natural products for the search for new antivirals against COVID-19.

Impact of COVID-19 on Education of Undergraduate Medical Students in Iraq

BACKGROUND: Medical students around the world, especially in Iraq, have expressed their displeasure with COVID-19. AIM: The study’s goal was to assess the impact of COVID-19 on the education of Iraqi medical students at the undergraduate level. PATIENTS AND METHODS: This cross-sectional study included undergraduate students of College of Medicine, University of Baghdad from 1st grade to 6th grade in Iraq using a validated questionnaire from the period of November 18, 2021, till December 2, 2021. Full history was taken including age, gender, and students grade, in addition to Impact of COVID-19 survey questions. The students filled the survey shared on different medical student groups on Telegram, WhatsApp, and Facebook anonymously online. All students were assured of both confidentiality and anonymity, and participation was voluntary. A convenient consecutive sampling method was used with a total sample of 406 students from different grades was collected. A descriptive statistical analysis using SPSS v28 was done. RESULTS: Median (interquartile range) age of participants was 21 (20–23) years. Most of the participants were female 250 (61.6%). Of a total 406 participants, 362 (89.2%) reported a negative effect of COVID-19 on education of undergraduate medical students. Online medical sessions do not reflect that student knowledge was the most common cause of this negative impact (336 (82.76%), next was reduced study level 305 (75.12%), then more cheating in online sessions 299 (73.65%), less efficiency of professors 281 (69.21%), reduced future healthcare 262 (64.53%), less comfortable online sessions 226 (55.67%), less relation between participants and their colleagues 188 (46.31%), and finally less study time 156 (38.42%). CONCLUSION: COVID-19 has a significant negative impact on education of undergraduate medical students in Iraq.

Coagulation parameters predict COVID-19-related thrombosis in a neural network with a positive predictive value of 98%

Thrombosis is a major clinical complication of COVID-19 infection. COVID-19 patients show changes in coagulation factors that indicate an important role for the coagulation system in the pathogenesis of COVID-19. However, the multifactorial nature of thrombosis complicates the prediction of thrombotic events based on a single hemostatic variable. We developed and validated a neural net for the prediction of COVID-19-related thrombosis. The neural net was developed based on the hemostatic and general (laboratory) variables of 149 confirmed COVID-19 patients from two cohorts: at the time of hospital admission (cohort 1 including 133 patients) and at ICU admission (cohort 2 including 16 patients). Twenty-six patients suffered from thrombosis during their hospital stay: 19 patients in cohort 1 and 7 patients in cohort 2. The neural net predicts COVID-19 related thrombosis based on C-reactive protein (relative importance 14%), sex (10%), thrombin generation (TG) time-to-tail (10%), α₂-Macroglobulin (9%), TG curve width (9%), thrombin-α₂-Macroglobulin complexes (9%), plasmin generation lag time (8%), serum IgM (8%), TG lag time (7%), TG time-to-peak (7%), thrombin-antithrombin complexes (5%), and age (5%). This neural net can predict COVID-19-thrombosis at the time of hospital admission with a positive predictive value of 98%-100%.

Respiratory technologists in the frontlines against COVID-19

BACKGROUND

The COVID-19 pandemic overwhelmed healthcare resources globally, but especially those of resource-limited countries. Strategies to supplement the number of healthcare workers attending COVID-19 patients had to be implemented. Several institutions used non-respiratory clinicians to work in COVID-19 wards. At Universitas Academic Hospital (UAH), Bloemfontein, South Africa, respiratory technologists were requested to assist with managing the oxygen supportive care of patients with severe COVID-19 and respiratory failure.

OBJECTIVES

To highlight the contribution that respiratory technologists made in the management of severe COVID-19 pneumonia patients by describing the baseline characteristics and mortality of patients with COVID-19, whose oxygen supportive care was managed primarily by respiratory technologists at UAH.

METHODS

This was a retrospective study. The investigators extracted data from the hospital files of all adult patients admitted with severe COVID-19 to UAH and where respiratory technologists were involved in their care between 1 January and 31 December 2020.

RESULTS

A total of 781 patients were admitted to UAH, of whom 106 fulfilled the inclusion criteria. The majority of the patients were female (n=68; 64.1%), and the median age (interquartile range (IQR)) was 59.5 (51 - 68) years. Hypertension (n=69; 65.1%) and diabetes mellitus (n=39; 36.8%) were the most frequent comorbidities. At the time of admission, the median oxygen saturation was 92% and the median respiratory rate oxygenation (ROX) index was 3.2. The median length of stay was 7 days and the mortality was 41.5%.

CONCLUSION

The clinical characteristics and mortality of patients whose oxygen support was managed by respiratory technologists were similar to those in previously reported studies from resource-limited settings. Respiratory technologists can form a valuable addition to the front-line team when clinicians and nurses are faced with overwhelming patient numbers in subsequent COVID-19 surges and where the mainstay of treatment is oxygen supportive care.

Willingness to Pay for a Coronavirus Vaccine and Its Associated Determinants in Lebanon

OBJECTIVES

This study aimed to investigate the willingness to pay (WTP) for a hypothetical vaccine and its associated determinants among the Lebanese general population during one of the peak episodes during the coronavirus disease 2019 (COVID-19) pandemic in Lebanon.

METHODS

An online survey was developed and delivered to the Lebanese general population. The questionnaire included the participants' sociodemographic characteristics, financial situation, attitude toward vaccination, and WTP for the hypothetical vaccine. The study was based on the contingent valuation method.

RESULTS

Among 500 individuals solicited, 352 individuals agreed to participate (participation rate = 70.4%); among them, 66% were between 18 and 45 years old, and 54% were women. Notably, 78.1% of the respondents were ready to pay for this hypothetical vaccine even if the vaccine will not be covered. The maximum WTP of the Lebanese population was approximately $60 ± $66 (range $3-$500) after excluding extreme values in the sensitivity analysis and ranged between $3 and $500. WTP was associated with the severity of COVID-19 (P<.001), the education level (P=.001), and the place to live during the lockdown (P=.045). There was an association between family income and WTP (P=.004) with a weak correlation.

CONCLUSIONS

The WTP was comparable with other studies and highly associated with the level of education, the household income, living in the city during the lockdown, and the perceived severity of COVID-19. These findings can help in understanding COVID-19 vaccination acceptance and WTP in Lebanon.

An agent-based transmission model of COVID-19 for re-opening policy design

The global pandemic caused by the coronavirus (COVID-19) disease has collapsed the worldwide economy. Elements such as non-obligatory vaccination, new strain variants and lack of discipline to follow social distancing measures suggest the possibility that COVID-19 may continue to exist, exhibiting the behavior of a seasonal disease. As the socio-economic crisis has become unsustainable, all countries are planning strategies to gradually restart their economic and social activities. Initially, several containment measures have been adopted involving social distancing, infection detection tests, and ventilation systems. Despite the implementation of such policies, there exists a lack of evaluation of their performance to reduce the contagion index. This means there are no appropriate indicators to decide which intervention or set of interventions present the most effective result. Under these conditions, the development of models that provide useful information in the design and evaluation of containment measures and re-opening policies is of prime concern. In this paper, a novel approach to model the transmission process of COVID-19 in closed environments is proposed. The proposed model can simulate the effects that result from the complex interaction among individuals when they follow a particular containment measure or re-opening policy. With the proposed model, different hypothetical re-opening policies, that are otherwise impossible to analyze in real conditions, can be tested. Computer experiments demonstrate that the proposed model provides suitable information and realistic predictions, which are appropriate for designing strategies that allow a safe return to economic activities.

C, Boland P, Doherty A, Benedetto V, Gita BE, Clegg AJ. The prevalence of mental health conditions in healthcare workers during and after a pandemic: Systematic review and meta-analysis

AIMS

This review aims to explore the prevalence and incidence rates of mental health conditions in healthcare workers during and after a pandemic outbreak and which factors influence rates.

BACKGROUND

Pandemics place considerable burden on care services, impacting on workers' health and their ability to deliver services. We systematically reviewed the prevalence and incidence of mental health conditions in care workers during pandemics.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Searches of MEDLINE, Embase, Cochrane Library and PsychINFO for cohort, cross-sectional and case-control studies were undertaken on the 31 March 2020 (from inception to 31 March 2020).

REVIEW METHODS

Only prevalence or incidence rates for mental health conditions from validated tools were included. Study selection, data extraction and quality assessment were carried out by two reviewers. Meta-analyses and subgroup analyses were produced for pandemic period (pre- and post), age, country income, country, clinical setting for major depression disorder (MDD), anxiety disorder and post-traumatic stress disorder (PTSD).

RESULTS

No studies of incidence were found. Prevalence estimates showed that the most common mental health condition was PTSD (21.7%) followed by anxiety disorder (16.1%), MDD (13.4%) and acute stress disorder (7.4%) (low risk of bias). For symptoms of these conditions there was substantial variation in the prevalence estimates for depression (95% confidence interval [CI]:31.8%; 60.5%), anxiety (95% CI:34.2%; 57.7%) and PTSD symptoms (95% CI,21.4%; 65.4%) (moderate risk of bias). Age, level of exposure and type of care professional were identified as important moderating factors.

CONCLUSION

Mental disorders affect healthcare workers during and after infectious disease pandemics, with higher proportions experiencing symptoms.

IMPACT

This review provides prevalence estimates of mental health conditions during and after a pandemic which could be used to inform service staffing impact and formulation of preventative strategies, by identifying clinical populations who may be at high risk of developing mental health symptoms and conditions.

Reduction of Cardiac Autonomic Modulation and Increased Sympathetic Activity by Heart Rate Variability in Patients With Long COVID

Although several clinical manifestations of persistent long coronavirus disease (COVID-19) have been documented, their effects on the cardiovascular and autonomic nervous system over the long term remain unclear. Thus, we examined the presence of alterations in cardiac autonomic functioning in individuals with long-term manifestations. The study was conducted from October 2020 to May 2021, and an autonomic assessment was performed to collect heart rate data for the heart rate variability (HRV) analysis. The study participants were divided into the long COVID clinical group, the intragroup, which included patients who were hospitalized, and those who were not hospitalized and were symptomatic for different periods (≤3, >3, ≤6, and >6 months), with and without dyspnoea. The control group, the intergroup, comprised of COVID-free individuals. Our results demonstrated that the long COVID clinical group showed reduced HRV compared with the COVID-19-uninfected control group. Patients aged 23–59 years developed COVID symptoms within 30 days after infection, whose diagnosis was confirmed by serologic or reverse-transcription polymerase chain reaction (swab) tests, were included in the study. A total of 155 patients with long COVID [95 women (61.29%), mean age 43.88 ± 10.88 years and 60 men (38.71%), mean age 43.93 ± 10.11 years] and 94 controls [61 women (64.89%), mean age 40.83 ± 6.31 and 33 men (35.11%), mean age 40.69 ± 6.35 years] were included. The intragroup and intergroup comparisons revealed a reduction in global HRV, increased sympathetic modulation influence, and a decrease in parasympathetic modulation in long COVID. The intragroup showed normal sympathovagal balance, while the intergroup showed reduced sympathovagal balance. Our findings indicate that long COVID leads to sympathetic excitation influence and parasympathetic reduction. The excitation can increase the heart rate and blood pressure and predispose to cardiovascular complications. Short-term HRV analysis showed good reproducibility to verify the cardiac autonomic involvement.

Factors Associated with Mental Health Outcomes in Hospital Workers during the COVID-19 Pandemic: A Mixed-Methods Study

Background: We investigated some of the factors associated with depression, perceived stress, and anxiety in clinical and nonclinical healthcare workers of two hospitals. Methods: A mixed-methods approach was used. The sample included clinical (physicians, nurses, and others) and nonclinical (security and cleaning staff) healthcare workers of two tertiary hospitals in Peru. Participants completed an online self-survey. In the qualitative analysis, data were subjected to thematic analysis. Results: We analyzed data from 613 participants, of which 8.6%, 9.0%, and 78.2% had moderate-to-severe anxiety, depression, and perceived stress, respectively. Having a previous mental health problem, being concerned about losing one’s job, having at least two COVID-19 symptoms in the preceding two weeks, and being afraid of infecting family members increased the prevalence of experiencing moderate-to-severe depression and anxiety. The qualitative analysis allowed us to identify five recurring factors that caused a negative impact on workers’ lives during the pandemic: emotional distress linked to hospital experiences of suffering and death, modification of routines, fear of COVID-19, exacerbation of mental disorders, and physical problems associated with emotional distress. Conclusions: Clinical and nonclinical healthcare workers in Peru have experienced depression, anxiety, and stress during the COVID-19 pandemic. Future research and interventions are necessary to improve psychological support for hospital workers.

COVID-19 outbreak response at a nursing hospital in South Korea in the post-vaccination era, including an estimation of the effectiveness of the first shot of the Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1-S)

Objectives

We descriptively reviewed a coronavirus disease 2019 (COVID-19) outbreak at a nursing hospital in Gyeonggi Province (South Korea) and assessed the effectiveness of the first dose of the Oxford-AstraZeneca vaccine in a real-world population.

Methods

The general process of the epidemiological investigation included a public health intervention. The relative risk (RR) of vaccinated and unvaccinated groups was calculated and compared to confirm the risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, and vaccine effectiveness was evaluated based on the calculated RR.

Results

The population at risk was confined to ward E among 8 wards of Hospital X, where the outbreak occurred. This population comprised 55 people, including 39 patients, 12 nurses, and 4 caregivers, and 19 cases were identified. The RR between the vaccinated and unvaccinated groups was 0.04, resulting in a vaccine effectiveness of 95.3%. The vaccination rate of the non-patients in ward E was the lowest in the entire hospital, whereas the overall vaccination rate of the combined patient and non-patient groups in ward E was the third lowest.

Conclusion

The first dose of the Oxford-AstraZeneca vaccine (ChAdOx1-S) was effective in preventing SARS-CoV-2 infection. To prevent COVID-19 outbreaks in medical facilities, it is important to prioritize the vaccination of healthcare providers.

Plant Polysaccharides Modulate Immune Function via the Gut Microbiome and May Have Potential in COVID-19 Therapy

Plant polysaccharides can increase the number and variety of beneficial bacteria in the gut and produce a variety of active substances, including short-chain fatty acids (SCFAs). Gut microbes and their specific metabolites have the effects of promoting anti-inflammatory activity, enhancing the intestinal barrier, and activating and regulating immune cells, which are beneficial for improving immunity. A strong immune system reduces inflammation caused by external viruses and other pathogens. Coronavirus disease 2019 (COVID-19) is still spreading globally, and patients with COVID-19 often have intestinal disease and weakened immune systems. This article mainly evaluates how polysaccharides in plants can improve the immune system barrier by improving the intestinal microecological balance, which may have potential in the prevention and treatment of COVID-19.

Global Gene Expression and Docking Profiling of COVID-19 Infection

Coronavirus is an enclosed positive-sense RNA virus with club-like spikes protruding from its surface that causes acute respiratory infections in humans. Because it is considered a member of the complex pathogen group, it has been found to infect different host species and cause a variety of diseases. So far, it has been discovered that it may affect the immune, infection, and inflammatory systems, leading to the hypothesis that the immune and inflammatory systems (signaling pathways and components) fail to control infection, opening the door to look for potential targets primarily in these systems. The study’s main purpose is to identify highly overexpressed genes and their functional implications as a result of COVID-19 infection, as well as to investigate probable infections, inflammation, and immune systems to better understand the impact of coronavirus infection. We explored the genes and pathways mostly linked with infection, inflammation, and the immune systems using the datasets available for COVID-19 infection gene expression compendium. NFKBIA, FN1, FAP, KANK4, COMP, FAM101B, COL1A2, ANKRD1, TAGLN, SPARC, ADAM19, OLFM4, CXCL10/11, OASL, FOS, APOBEC3A, IFI44L, IFI27, IFIT1, RSAD2, NDUFS1, SRSF6, HECTD1, CBX3, and DDX17 are among the genes that may be impacted by infection, according to our findings. The functional changes are mainly associated with these pathways TNF, cytokine, NF—kB, TLR, TCR, BCR, Foxo, and TGF signaling pathways are among them and there are additional pathways such as hippo signaling, apoptosis, estrogen signaling, regulating pluropotency of stem cells, ErbB, Wnt, p53, cAMP, MAPK, PI3K—AKT, oxidative phosphorylation, protein processing in endoplasmic reticulum, prolactin signaling, adipocytokine, neurotrophine signaling, and longevity regulating pathways. Moreover, we have also explored the potential herbal drug (apigenin, quercetin, and resveratrol) targets for the top-rated genes based on the overall analysis where we observe that quercetin and resveratrol as most effective.

Physician Satisfaction With Virtual Ophthalmology Clinics During the COVID-19 Pandemic: A Tertiary Eye Care Center Experience

Background

In this study, we aimed to assess ophthalmologists’ experience with teleophthalmology during the coronavirus disease 2019 (COVID-19) pandemic in the central region of Saudi Arabia. In addition, we evaluated their satisfaction level and explored their satisfaction determinants.

Methodology

We conducted an online survey for ophthalmologists who participated in the virtual ophthalmology clinic during COVID-19 between November 2020 and September 2021. The survey was used to evaluate ophthalmologists’ experience with teleophthalmology during the pandemic. Ophthalmologists were asked to measure their satisfaction with equipment and technical issues, communication, and clinical assessment, and to provide an overall program evaluation. Data were analyzed via frequency measures (e.g., numbers, percentages, mean, and standard deviation).

Results

Out of the 113 ophthalmologists who were invited to participate in our study, 71 completed the survey. In total, 23 (32.4%) participants were general ophthalmologists, 15 (21.1%) were subspecialists in the cornea, 16 (22.5%) were subspecialists in glaucoma, one (1.4%) was a subspecialist in neuro-ophthalmology, seven (9.9%) were subspecialists in pediatric ophthalmology, eight (11.3%) were subspecialists in the retina, and one (1.4%) participant was a subspecialist in oculoplastic. Overall, 56.3% of the respondents were satisfied with teleophthalmology. Ophthalmologists who subspecialized in the retina demonstrated higher levels of satisfaction than other subspecialties. The most common challenge reported by ophthalmologists in the virtual consultation was the lack of adequate equipment to evaluate the patients (53.5%), followed by technical issues (43.7%) and the patients’ lack of experience in using virtual consultation services (38%). Overall satisfaction score was the highest among ophthalmologists who reported providing at least five video consultations before the survey.

Conclusions

The findings from our study suggest that the subspeciality of ophthalmologists and the number of video consultations conducted by ophthalmologists are important determinants in their level of satisfaction with teleophthalmology. The majority of the respondents were satisfied with the virtual clinic during the COVID-19 pandemic. The current pandemic could pave the way for the future use of telemedicine in ophthalmology if virtual eye examinations become standardized.

Biotechnological Perspectives to Combat the COVID-19 Pandemic: Precise Diagnostics and Inevitable Vaccine Paradigms

The outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause for the ongoing global public health emergency. It is more commonly known as coronavirus disease 2019 (COVID-19); the pandemic threat continues to spread aroundthe world with the fluctuating emergence of its new variants. The severity of COVID-19 ranges from asymptomatic to serious acute respiratory distress syndrome (ARDS), which has led to a high human mortality rate and disruption of socioeconomic well-being. For the restoration of pre-pandemic normalcy, the international scientific community has been conducting research on a war footing to limit extremely pathogenic COVID-19 through diagnosis, treatment, and immunization. Since the first report of COVID-19 viral infection, an array of laboratory-based and point-of-care (POC) approaches have emerged for diagnosing and understanding its status of outbreak. The RT-PCR-based viral nucleic acid test (NAT) is one of the rapidly developed and most used COVID-19 detection approaches. Notably, the current forbidding status of COVID-19 requires the development of safe, targeted vaccines/vaccine injections (shots) that can reduce its associated morbidity and mortality. Massive and accelerated vaccination campaigns would be the most effective and ultimate hope to end the COVID-19 pandemic. Since the SARS-CoV-2 virus outbreak, emerging biotechnologies and their multidisciplinary approaches have accelerated the understanding of molecular details as well as the development of a wide range of diagnostics and potential vaccine candidates, which are indispensable to combating the highly contagious COVID-19. Several vaccine candidates have completed phase III clinical studies and are reported to be effective in immunizing against COVID-19 after their rollout via emergency use authorization (EUA). However, optimizing the type of vaccine candidates and its route of delivery that works best to control viral spread is crucial to face the threatening variants expected to emerge over time. In conclusion, the insights of this review would facilitate the development of more likely diagnostics and ideal vaccines for the global control of COVID-19.

An inhibitor of leukotriene-A4 hydrolase from bat salivary glands facilitates virus infection

SignificanceAn immunosuppressant protein (MTX), which facilitates virus infection by inhibiting leukotriene A₄ hydrolase (LTA₄H) to produce the lipid chemoattractant leukotriene B₄ (LTB₄), was identified and characterized from the submandibular salivary glands of the bat Myotis pilosus. To the best of our knowledge, this is a report of an endogenous LTA₄H inhibitor in animals. MTX was highly concentrated in the bat salivary glands, suggesting a mechanism for the generation of immunological privilege and immune tolerance and providing evidence of viral shedding through oral secretions. Moreover, given that the immunosuppressant MTX selectively inhibited the proinflammatory activity of LTA₄H, without affecting its antiinflammatory activity, MTX might be a potential candidate for the development of antiinflammatory drugs by targeting the LTA₄-LTA₄H-LTB₄ inflammatory axis.

The personal protective equipment fabricated via 3D printing technology during COVID-19

COVID-19 has been spread in more than 220 countries and caused global health concerns. The supply chain disruptions have abruptly affected due to the second wave of COVID-19 in various countries and caused unavailability and shortage of medical devices and personal protective equipment for frontline healthcare workers. Three-dimensional (3D) printing has proven to be a boon and revolutionized technology to supply medical devices and tackle the situation caused by the COVID-19 pandemic. The diverse designs were produced and are currently used in hospitals by patients and frontline healthcare doctors. This review summarises the application of 3D printing during COVID-19. It collects the comprehensive information of recently designed and fabricated protective equipment like nasopharyngeal swabs, valves, face shields, facemasks and many more medical devices. The drawbacks and future challenges of 3D printed medical devices and protective equipment is discussed.

A multi-targeted approach to identify potential flavonoids against three targets in the SARS-CoV-2 life cycle

The advent and persistence of the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2)-induced Coronavirus Disease (COVID-19) pandemic since December 2019 has created the largest public health emergency in over a century. Despite the administration of multiple vaccines across the globe, there continues to be a lack of approved efficacious non-prophylactic interventions for the disease. Flavonoids are a class of phytochemicals with historically established antiviral, anti-inflammatory and antioxidative properties that are effective against cancers, type 2 diabetes mellitus, and even other human coronaviruses. To identify the most promising bioactive flavonoids against the SARS-CoV-2, this article screened a virtual library of 46 bioactive flavonoids against three promising targets in the SARS-CoV-2 life cycle: human TMPRSS2 protein, 3CLpro, and PLpro. By examining the effects of glycosylation and other structural-activity relationships, the presence of sugar moiety in flavonoids significantly reduces its binding energy. It increases the solubility of flavonoids leading to reduced toxicity and higher bioavailability. Through protein-ligand contact profiling, it was concluded that naringin formed more hydrogen bonds with TMPRSS2 and 3CLpro. In contrast, hesperidin formed a more significant number of hydrogen bonds with PLpro. These observations were complimented by the 100 ns molecular dynamics simulation and binding free energy analysis, which showed a considerable stability of docked bioflavonoids in the active site of SARS-CoV-2 target proteins. Finally, the binding affinity and stability of the selected docked complexes were compared with the reference ligands (camostat for TMPRSS2, GC376 for 3CLpro, and GRL0617 for PLpro) that strongly inhibit their respective SARS-COV-2 targets. Overall analysis revealed that the selected flavonoids could be potential therapeutic agents against SARS-CoV-2. Naringin showed better affinity and stability for TMPRSS2 and 3CLpro, whereas hesperidin showed a better binding relationship and stability for PLpro.

Ameliorating effects of probiotics on alterations in iron homeostasis and inflammation in COVID-19

Introduction

The coronavirus disease (COVID-19) is caused by the severe acute syndrome coronavirus-2 (SARS-COV-2) and still threatens human life. This pandemic is still causing increased mortality throughout the world. Many recent studies have been conducted to discover the pathophysiology of this virus.

Material and methods

However, in this narrative review, we attempted to summarize some of the alterations in physiological pathways that were evident in this viral invasion. Excessive inflammation that progresses to cytokine storm, changes in humoral and cell-mediated immunity, and observed alterations in iron metabolism are included in the pathogenesis of the virus. Iron homeostasis disturbances may persist for more than two months after the onset of COVID-19, which may lead to reduced iron bioavailability, hypoferremia, hyperferritinemia, impaired hemoglobin, and red blood cell synthesis. Furthermore, hypoferriemia may impair immune system function. Until now, the traditional treatments discovered are still being tried.

Results

However, using probiotics as an adjuvant was shown to have beneficial effects on both iron homeostasis and immunity in COVID-19. Herein, we discussed the possible mechanisms achieved by probiotics to ameliorate iron and immunity changes based on the available literature.

Conclusion

We concluded that supplementing probiotics with conventional therapy may improve COVID-19 symptoms and outcomes. Taking into consideration the use of good quality probiotics and appropriate dosage, undesirable effects can be avoided.

Toll-Like Receptors (TLRs) as Therapeutic Targets for Treating SARS-CoV-2: An Immunobiological Perspective

INTRODUCTION

Coronavirus disease-19 (COVID-19) caused by SARS-CoV-2 is presently the biggest threat to mankind throughout the globe. Increasing reports on deaths, cases of new infection, and socioeconomic losses are continuously coming from all parts of the world. Developing an efficacious drug and/or vaccine is currently the major goal to the scientific communities. In this context, toll-like receptors (TLRs) could be the useful targets in adopting effective therapeutic approaches.

METHODS

This chapter has been written by incorporating the findings on TLR-based therapies against SARS-CoV-2 demonstrated in the recently published research papers/reviews.

RESULTS

TLRs are the essential components of host immunity and play critical roles in deciding the fate of SARS-CoV-2 by influencing the immunoregulatory circuits governing human immune response to this pathogen. Hitherto, a number of multi-subunit peptide-based vaccines and pharmacological agents developed against SARS-CoV-2 have been found to manipulate TLR function. Therefore, circumventing overt immunopathology of COVID-19 applying TLR-antagonists can effectively reduce the morality caused from "cytokine storm"-induced multiorgan failure. Similarly, pre-administration of TLR- agonists may be used as a prophylaxis to sensitize the immune system of the individuals having risk of infection. A lot of collaborative efforts are required for bench-to-bench transformation of these knowledges.

CONCLUSION

This chapter enlightens the potentials and promises of TLR-guided therapeutic strategies against COVID-19 by reviewing the major findings and achievements depicted in the literatures published till date.

Ischemic Priapism Progressing to Penile Gangrene in a Patient with COVID-19 Infection: A Case Report with Literature Review

Priapism is considered a rare disorder and even more rare when it occurs as a complication of COVID-19. To the best of our knowledge, only eight studies have reported priapism as a complication of COVID-19. Here, we report the case of a 66-year-old male with COVID-19 who presented with neglected priapism for three days. On local examination, penile erection was apparent in association with blackened areas on the glans penis extending to the midpenile shaft denoting penile gangrene. A clear line of demarcation was noticed at the midpenile shaft. Penile duplex was performed, showing no blood flow in both cavernosal arteries. Penile aspiration was performed, and the cavernosal blood sample showed evidence of ischemic priapism. Given the presence of penile gangrene extending to the midshaft of the penis and the poor general condition of the patient, the decision was made to perform partial penectomy and suprapubic tube placement. We recommend the establishment of a guideline for the diagnosis and prevention of thrombotic diseases in patients with COVID-19 infection as there is increasing evidence of COVID-19-related thrombotic manifestations.

Super-Spreaders or Victims of Circumstance? Childhood in Canadian Media Reporting of the COVID-19 Pandemic: A Critical Content Analysis

This qualitative research study, a critical content analysis, explores Canadian media reporting of childhood in Canada during the COVID-19 global pandemic. Popular media plays an important role in representing and perpetuating the dominant social discourse in highly literate societies. In Canadian media, the effects of the pandemic on children and adolescents’ health and wellbeing are overshadowed by discussions of the potential risk they pose to adults. The results of this empirical research highlight how young people in Canada have been uniquely impacted by the COVID-19 global pandemic. Two dominant narratives emerged from the data: children were presented “as a risk” to vulnerable persons and older adults and “at risk” of adverse health outcomes from contracting COVID-19 and from pandemic lockdown restrictions. This reflects how childhood was constructed in Canadian society during the pandemic, particularly how children’s experiences are described in relation to adults. Throughout the pandemic, media reports emphasized the role of young people’s compliance with public health measures to prevent the spread of COVID-19 and save the lives of older persons.

Plasmapheresis with Convalescent Plasma as a Rescue Therapy for COVID-19 Patients: A Case Series

: On December 29, 2019, an epidemic of an infectious disease caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was declared in Wuhan, China. The first case of COVID-19 in Iran (Qom Province) was reported in February 2020, and within a short period, the number of infected cases increased rapidly around the country. Evidence suggests that the levels of pro-inflammatory cytokines are high in critically ill patients, and there is a correlation between the high level of cytokines and the pathogenesis of COVID-19; consequently, COVID-19 may have complications, such as acute respiratory distress syndrome (ARDS) and even death. These inflammatory factors can lead to a cytokine storm, while counteracting this storm seems to be an effective therapeutic approach. In this case series, we reported two critically ill patients with COVID-19, undergoing plasmapheresis with convalescent plasma, corticosteroid therapy, and interferon administration.

Day-Level Forecasting of COVID-19 Transmission in India Using Variants of Supervised LSTM Models

The novel Corona virus SARS-CoV-2 has started with strange new pneumonia of unknown cause in Wuhan city, Hubei province of China. On March 11, 2020, the World Health Organization declared the COVID-19 outbreak as a pandemic. Due to this pandemic situation, the countries all over the world suffered from economic and psychological stress. To analyze the growth of this pandemic, this paper proposes a supervised LSTM model and its variants to predict the infectious cases in India using a publicly available dataset from John Hopkins University. Experimentation has been carried out using various models and window hyper-parameters to predict the infectious rate ahead of a week, 2 weeks, 3 weeks and a month. The prediction results infer that, every individual in India has to be safe at home and to follow the regulations provided by ICMR and the Indian Government to control and prevent others from this complicated epidemic.

A Review of SARS-CoV2: Compared With SARS-CoV and MERS-CoV

The outbreak of coronavirus disease 2019 (COVID-19) has been spreading rapidly in China and the Chinese government took a series of policies to control the epidemic. Studies found that severe COVID-19 is characterized by pneumonia, lymphopenia, exhausted lymphocytes and a cytokine storm. Studies have showen that SARS-CoV2 has significant genomic similarity to the severe acute respiratory syndrome (SARS-CoV), which was a pandemic in 2002. More importantly, some diligent measures were used to limit its spread according to the evidence of hospital spread. Therefore, the Public Health Emergency of International Concern (PHEIC) has been established by the World Health Organization (WHO) with strategic objectives for public health to curtail its impact on global health and economy. The purpose of this paper is to review the transmission patterns of the three pneumonia: SARS-CoV2, SARS-CoV, and MERS-CoV. We compare the new characteristics of COVID-19 with those of SARS-CoV and MERS-CoV.

The direct and indirect effects of bioactive compounds against coronavirus

Emerging viruses are known to pose a threat to humans in the world. COVID‐19, a newly emerging viral respiratory disease, can spread quickly from people to people via respiratory droplets, cough, sneeze, or exhale. Up to now, there are no specific therapies found for the treatment of COVID‐19. In this sense, the rising demand for effective antiviral drugs is stressed. The main goal of the present study is to cover the current literature about bioactive compounds (e.g., polyphenols, glucosinolates, carotenoids, minerals, vitamins, oligosaccharides, bioactive peptides, essential oils, and probiotics) with potential efficiency against COVID‐19, showing antiviral activities via the inhibition of coronavirus entry into the host cell, coronavirus enzymes, as well as the virus replication in human cells. In turn, these compounds can boost the immune system, helping fight against COVID‐19. Overall, it can be concluded that bioactives and the functional foods containing these compounds can be natural alternatives for boosting the immune system and defeating coronavirus.

[Seroprevalence, risk factors and clinical presentation after the first wave of COVID-19 in nursing homes of the UNIVI group: The SEROCOVID study]

Introduction

La pandémie, causée par l’infection à SARS-COV-2, a été diffusée rapidement, au cours de la « première vague », dans l’ensemble de la France, entre mars et mai 2020. Elle a été responsable d’une mortalité élevée parmi les personnes avec des comorbidités et les personnes âgées qui vivaient en EHPAD. En mai 2020, 75 % des décès, chez les personnes de plus de 75 ans, étaient survenus en EHPAD. Il est difficile d’estimer précisément la prévalence de l’infection COVID-19, pendant cette période, car seuls 50 % des diagnostics réalisés en EHPAD ont pu être faits par RT-PCR. Pendant cette période, le diagnostic reposait essentiellement sur la symptomatologie clinique des résidents.

Population et méthodes

Nous avons réalisé une étude prospective chez les résidents de 27 EHPAD (étude SEROCOVID) entre le 31 août et le 16 octobre 2020 par l’utilisation de séro-tests rapides ELISA réalisés par piqûre au bout du doigt. Nous avons recherché la séroprévalence par l’utilisation des séro-tests rapides, ainsi que la prévalence globale en cumulant les résultats positifs de la RT-PCR si elle avait été faite et du séro-test rapide. Les objectifs secondaires étaient l’étude des facteurs de risque d’infection en analyse multivariée, ainsi que la description des symptômes qui avaient conduit au diagnostic.

Résultats

Mille cent quarante-cinq résidents ont été inclus, âgés en moyenne de 89 ± 7,5 ans (femmes 78,7 %). Le délai entre la maladie COVID-19 et le séro-test rapide réalisé à l’inclusion était en moyenne égal à cinq ± 1,7 mois. La prévalence estimée par les trois méthodes d’évaluation diagnostique (diagnostic médical, RT-PCR ou par séro-test rapide ELISA) était égale à 14 %. La prévalence globale, estimée en combinant les résultats des RT-PCR et des séro-test rapide ELISA, était estimée à 22,7 %. L’étude des facteurs de risque en analyse multivariée mettait en évidence que les résidents d’EHPAD les plus dépendants, vivant en unité protégée en raison de troubles du comportement ou dont on avait identifié un contact proche avec une personne atteinte de la COVID-19, avaient été significativement plus souvent contaminés. Enfin, les symptômes les plus fréquemment observés chez les résidents d’EHPAD différaient de ceux des plus jeunes avec des particularités gériatriques, telles que la fréquence des symptomatologies digestives et des syndromes gériatriques. La fièvre n’avait été observée que dans un tiers des cas chez les personnes âgées. Les troubles olfactifs et du goût étaient peu décrits chez les résidents.

Conclusion

Notre étude rapporte une estimation de la prévalence globale, ainsi que la séroprévalence moyenne de la maladie COVID-19 chez des résidents d’EHPAD, cinq mois après le diagnostic de la maladie COVID-19. La différence entre les deux estimations peut être expliquée par la fragilité et la baisse de l’immunité chez les résidents d’EHPAD. C’est pourquoi elle nécessiterait d’être réactivée par la vaccination de l’ensemble de résidents, même ceux déjà infectés par le SARS-COV-2. Ces éléments corroborent la stratégie gouvernementale de vaccination déployée chez l’ensemble des résidents d’EHPAD, indépendamment de leur contact antérieur avec le virus.

Promising Antiviral Activities of Natural Flavonoids against SARS-CoV-2 Targets: Systematic Review

The ongoing COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became a globally leading public health concern over the past two years. Despite the development and administration of multiple vaccines, the mutation of newer strains and challenges to universal immunity has shifted the focus to the lack of efficacious drugs for therapeutic intervention for the disease. As with SARS-CoV, MERS-CoV, and other non-respiratory viruses, flavonoids present themselves as a promising therapeutic intervention given their success in silico, in vitro, in vivo, and more recently, in clinical studies. This review focuses on data from in vitro studies analyzing the effects of flavonoids on various key SARS-CoV-2 targets and presents an analysis of the structure-activity relationships for the same. From 27 primary papers, over 69 flavonoids were investigated for their activities against various SARS-CoV-2 targets, ranging from the promising 3C-like protease (3CLpro) to the less explored nucleocapsid (N) protein; the most promising were quercetin and myricetin derivatives, baicalein, baicalin, EGCG, and tannic acid. We further review promising in silico studies featuring activities of flavonoids against SARS-CoV-2 and list ongoing clinical studies involving the therapeutic potential of flavonoid-rich extracts in combination with synthetic drugs or other polyphenols and suggest prospects for the future of flavonoids against SARS-CoV-2.

In-silico study on perovskites application in capturing and distorting coronavirus

The COVID-19 pandemic, known as coronavirus pandemic, a global pandemic, emerged from the beginning of 2020 and became dominant in many countries. As COVID-19 is one of the deadliest pandemics in history and has a high rate of distribution, a fast and extensive reaction was needed. Considering its composition, revealing the infection mechanism is beneficial for effective decisions against the spread and attack of COVID-19. Investigating data from numerous studies confirms that the penetration of SARS-CoV-2 occurs along with bonding spike protein (S protein) and through ACE2; Therefore, these two parts were the focus of research on the suppression and control of the infection. Performing lab research on all promising candidates requires years of experimental study, which is time-consuming and not an acceptable solution. Molecular dynamic simulation can decipher the performance of nano-structures in preventing the spread of coronavirus in a shorter time. This study surveyed the effect of three nano-perovskite structures (SrTiO3, CaTiO3, and BaTiO3), a cutting-edge group of perovskite materials with outstanding properties on coronavirus. Various computational parameters evaluate the effectiveness of these structures. Results of the simulation indicated that SrTiO3 performs better in SARS-CoV-2 suppression.

Epidemiological features of domestic and imported cases with COVID-19 between January 2020 and March 2021 in Taiwan

Coronavirus disease-2019 (COVID-19) is a global pandemic affecting numerous countries around the world. This study elaborates Taiwan's epidemiological characteristics from the 2020 to 2021 COVID-19 pandemic from human, temporal, and geographical dimensions. Big data for cases were obtained from a public database from the Taiwan Centers for Disease Control (CDC) in April 2021. The data were analyzed and used to compare differences, correlations, and trends for human, temporal, and geographical characteristics for imported and domestic COVID-19 cases. During the study period, 1030 cases were confirmed and the mortality rate of 1.0%. The epidemiological features indicated that most cases (953/1030, 92.5%) were imported. A comparison of the domestic confirmed and imported cases revealed the following findings: No significant difference of COVID-19 between males and females for sex was observed; For age, the risk of domestic transmission was significantly lower for 20 to 29 years old, higher for 50 to 59 years old, and >60 years old with odds ratios (ORs) (P value < .05) of 0.36, 3.37, and 2.50, respectively; For the month of infection, the ORs (P value < .05) of domestic confirmed cases during January and February 2020 were 22.428; and in terms of area of residence, the ORs (P value < .05) for domestic confirmed cases in northern and southern Taiwan were 4.473 and 0.033, respectively. Thus, the increase in domestic cases may have been caused by international travelers transmitting the virus in March 2020 and December 2020, respectively. Taiwan has been implementing effective screening and quarantine measures at airports. Moreover, Taiwan has implemented and maintained stringent interventions such as large-scale epidemiological investigation, rapid diagnosis, wearing masks, washing hands frequently, safe social distancing, and prompt clinical classifications for severe patients who were given appropriate medical measures. This is the first report comparing imported and domestic cases of COVID-19 from surveillance data from the Taiwan Centers for Disease Control during January 2020 and March 2021. It illustrates that individuals infected during overseas travel are the main risk factors for the spread of COVID-19 in Taiwan. The study also highlights the importance of longitudinal and geographically extended studies in understanding the implications of COVID-19 transmission for Taiwan's population.

Factors Affecting COVID-19 Transmission and Modelling of Close Contact Tracing Strategies

BACKGROUND

Close contact tracing is an essential measure that countries are applying to combat the epidemic of COVID-19. The purpose of contact tracing is to rapidly identify potentially infected individuals and prevent further spread of the disease. In this study, based on the factors affecting the COVID-19 transmission, a scoring protocol is provided for close contact tracing.

METHODS

First, the factors affecting the COVID-19 transmission in close contacts were identified by a rapid review of the literature. Data were gathered by searching the Embase, PubMed, Google Scholar, and Scopus databases. Then, by formulating and scoring the identified factors with two sessions of the expert panel, close contact transmission risk score determined, and a protocol for contacts tracing was designed.

RESULTS

Close contact transmission risk depends on the contact environment characteristics, the infectivity (virus shedding) of the sentinel case, and contact characteristics. Based on these factors, the close contact transmission risk score and contact tracing protocol were prepared.

CONCLUSION

The close contact transmission risk scores will provide the ability to contact classifications and developing specific tracing strategies for them. Given that there are not any specific treatments for COVID-19 and lack of universal vaccination, applying nonpharmaceutical measures such as contact tracing along with physical distancing is very crucial. Therefore, we recommended this model to the evaluation of exposure risk and contact tracing.

Sustainable and resilient strategies for touristic cities against COVID-19: An agent-based approach

Touristic cities will suffer from COVID-19 emergency because of its economic impact on their communities. The first emergency phases involved a wide closure of such areas to support "social distancing" measures (i.e. travels limitation; lockdown of (over)crowd-prone activities). In the "second phase", individual's risk-mitigation strategies (facial masks) could be properly linked to "social distancing" to ensure re-opening touristic cities to visitors. Simulation tools could support the effectiveness evaluation of risk-mitigation measures to look for an economic and social optimum for activities restarting. This work modifies an existing Agent-Based Model to estimate the virus spreading in touristic areas, including tourists and residents' behaviours, movement and virus effects on them according to a probabilistic approach. Consolidated proximity-based and exposure-time-based contagion spreading rules are included according to international health organizations and previous calibration through experimental data. Effects of tourists' capacity (as "social distancing"-based measure) and other strategies (i.e. facial mask implementation) are evaluated depending on virus-related conditions (i.e. initial infector percentages). An idealized scenario representing a significant case study has been analysed to demonstrate the tool capabilities and compare the effectiveness of those solutions. Results show that "social distancing" seems to be more effective at the highest infectors' rates, although represents an extreme measure with important economic effects. This measure loses its full effectiveness (on the community) as the infectors' rate decreases and individuals' protection measures become predominant (facial masks). The model could be integrated to consider other recurring issues on tourist-related fruition and schedule of urban spaces and facilities (e.g. cultural/leisure buildings).

Structural Understanding of SARS-CoV-2 Drug Targets, Active Site Contour Map Analysis and COVID-19 Therapeutics

The most iconic word of the year 2020 is 'COVID-19', the shortened name for coronavirus disease 2019. The pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is responsible for multiple worldwide lockdowns, an economic crisis, and a substantial increase in hospitalizations for viral pneumonia along with respiratory failure and multiorgan dysfunctions. Recently, the first few vaccines were approved by World Health Organization (WHO) and can eventually save millions of lives. Even though, few emergency use drugs like Remdesivir and several other repurposed drugs, still there is no approved drug for COVID-19. The coronaviral encoded proteins involved in host-cell entry, replication, and host-cell invading mechanism are potentially therapeutic targets. This perspective review provides the molecular overview of SARS-CoV-2 life cycle for summarizing potential drug targets, structural insights, active site contour map analyses of those selected SARS-CoV-2 protein targets for drug discovery, immunology, and pathogenesis.

COVID-19 pandemic and reasons to prioritize the needs of the health care system to ensure its sustainability: A scoping review from January to October 2020 (Review)

The worldwide spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led the World Health Organization to characterize the pandemic as a public health emergency of international concern. National health care systems in countries during the initial surge of the pandemic were unable to handle the sanitarian crisis that had emerged. Thus, the prevention and control of future global health emergencies must be a priority. The present scoping review aimed to retrieve articles that summarize the current experience on issues related to historical knowledge, and epidemiology, clinical features and overall burden of SARS-CoV-2 on health care services. In summary, a comprehensive overview of the information that has been learnt during this period is presented in the current review. Furthermore, taking into account the global experience, the need for planning cohesive and functional health services before similar pandemic events occur in the future is highlighted. The next public health issue should be prevented rather than treated. In spite of the vaccination benefits, a number of sporadic cases of SARS-CoV-2infections will persist. Information collected remains relevant for appraising how similar threats can be faced in the future. Overall, collaborative health care plans need to be rethought to increase preparedness.

Community pharmacists' preparedness and responses to COVID-19 pandemic: A multinational study

BACKGROUND

Community pharmacists play a pivotal role in healthcare worldwide. Their role became more critical during the COVID-19 pandemic. This study aims to investigate the community pharmacists' preparedness and responses to the COVID-19 pandemic and how efficiently they were prepared to contain and prevent the spread of infection.

METHODS

An online questionnaire was distributed to community pharmacists in Saudi Arabia, Lebanon, and Jordan through social media platforms. A scoring system was developed to measure their level of adherence to the preventive measures of the global infection.

RESULTS

The total included responses were 800. Around 44% of the pharmacists reported spending less than 15 min/d reading about COVID-19 updates. Although more than half of them were reviewing official sites, 73% of them were also retrieving information through non-official channels. Additionally, almost 35% of them were directly contacting customers without physical barriers, 81% reported encountering infected customers, and 12% wore the same facial masks for more than a day. Moreover, 58% of the pharmacies reported the absence of door signs requesting infected customers to declare the infection, 43% of the pharmacies were not limiting the number of simultaneous customers, and 70% were not measuring customers' temperatures prior to entry. Collectively, the mean total score of applied protective measures was 10.12 ± 2.77 (out of 17).

CONCLUSION

The level of preparedness of the community pharmacies in these three Middle Eastern countries was not adequate for facing the COVID-19 pandemic. Health authorities in these countries should closely monitor their adherence to the protective guidelines.

The promising drugs included in WHO's Solidarity Project: a choice based in scientific knowledge and institutional competencies

BACKGROUND

In March 2020, the World Health Organization (WHO) launched the Solidarity Program, probably the largest global initiative to encourage and support research in four promising drugs, named Remdesivir, Hydroxychloroquine, β Interferon and the combination Lopinavir / Ritonavir, to reduce the mortality of Coronavirus disease 2019 (COVID-19).

OBJECTIVES

Considering the potential impact of Solidarity Program to restrain the current pandemic, the present study aims to investigate whether it was designed upon indicators of scientific productivity, defined as the level of the production of new scientific knowledge and of the institutional capabilities, estimated in terms of scientific publications and technological agreements.

METHODS

The scientific documents on Alphacoronavirus, Betacoronavirus, Gammacoronavirus and Coronavirus were retrieved from Scopus database while the technological agreements on coronavirus were obtained through Cortellis. As for the institutions and countries, we have considered the data on author's affiliations in both set of data. For comparison, we included the analysis of documents related with other drugs or therapies, such as vaccines and antibodies, which were listed in a Clarivate's report on coronaviruses research.

FINDINGS

Most of the analysis refers to documents on Coronavirus, the largest group. The number of documents related to WHO's drugs are almost five times higher than in the other groups. This subset of documents involves the largest and most diverse number of institutions and countries. As for agreements, we observed a smaller number of institutions involved in it, suggesting differences between countries in terms of technical and human capabilities to develop basic and/or clinical research on coronavirus and to develop new forms or products to treat or to prevent the disease.

MAIN CONCLUSIONS

Hence, the results shown in this study illustrate that decisions taken by an international scientific body, as WHO, were mainly based in scientific knowledge and institutional competencies.

Cytokine storm and histopathological findings in 60 cases of COVID-19-related death: from viral load research to immunohistochemical quantification of major players IL-1β, IL-6, IL-15 and TNF-α

This study involves the histological analysis of samples taken during autopsies in cases of COVID-19 related death to evaluate the inflammatory cytokine response and the tissue localization of the virus in various organs. In all the selected cases, SARS-CoV-2 RT-PCR on swabs collected from the upper (nasopharynx and oropharynx) and/or the lower respiratory (trachea and primary bronchi) tracts were positive. Tissue localization of SARS-CoV-2 was detected using antibodies against the nucleoprotein and the spike protein. Overall, we tested the hypothesis that the overexpression of proinflammatory cytokines plays an important role in the development of COVID-19-associated pneumonia by estimating the expression of multiple cytokines (IL-1β, IL-6, IL-10, IL-15, TNF-α, and MCP-1), inflammatory cells (CD4, CD8, CD20, and CD45), and fibrinogen. Immunohistochemical staining showed that endothelial cells expressed IL-1β in lung samples obtained from the COVID-19 group (p < 0.001). Similarly, alveolar capillary endothelial cells showed strong and diffuse immunoreactivity for IL-6 and IL-15 in the COVID-19 group (p < 0.001). TNF-α showed a higher immunoreactivity in the COVID-19 group than in the control group (p < 0.001). CD8 + T cells where more numerous in the lung samples obtained from the COVID-19 group (p < 0.001). Current evidence suggests that a cytokine storm is the major cause of acute respiratory distress syndrome (ARDS) and multiple organ failure and is consistently linked with fatal outcomes.

Adverse Cardiovascular Effects of Anti-COVID-19 Drugs

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 infection is the cause of the ongoing global pandemic. Mortality from COVID-19 infection is particularly high in patients with cardiovascular diseases. In addition, COVID-19 patients with preexisting cardiovascular comorbidities have a higher risk of death. Main cardiovascular complications of COVID-19 are myocardial infarction, myocarditis, acute myocardial injury, arrhythmias, heart failure, stroke, and venous thromboembolism. Therapeutic interventions in terms of drugs for COVID-19 have many cardiac adverse effects. Here, we review the relative therapeutic efficacy and adverse effects of anti-COVID-19 drugs.

The microbiota-related coinfections in COVID-19 patients: a real challenge

BACKGROUND

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of ongoing global pandemic of coronavirus disease 2019 (COVID-19), has infected millions of people around the world, especially the elderly and immunocompromised individuals. The infection transmission rate is considered more rapid than other deadly pandemics and severe epidemics encountered earlier, such as Ebola, Zika, Influenza, Marburg, SARS, and MERS. The public health situation therefore is really at a challenging crossroads.

MAIN BODY

The internal and external and resident microbiota community is crucial in human health and is essential for immune responses. This community tends to be altered due to pathogenic infections which would lead to severity of the disease as it progresses. Few of these resident microflora become negatively active during infectious diseases leading to coinfection, especially the opportunistic pathogens. Once such a condition sets in, it is difficult to diagnose, treat, and manage COVID-19 in a patient.

CONCLUSION

This review highlights the various reported possible coinfections that arise in COVID-19 patients vis-à-vis other serious pathological conditions. The local immunity in lungs, nasal passages, oral cavity, and salivary glands are involved with different aspects of COVID-19 transmission and pathology. Also, the role of adaptive immune system is discussed at the site of infection to control the infection along with the proinflammatory cytokine therapy.