COVID-19, a worldwide public health emergency

Coronavirus disease 2019-related myocarditis genes contribute to ECMO prognosis

BACKGROUND

Acute myocardial injury, cytokine storms, hypoxemia and pathogen-mediated damage were the major causes responsible for mortality induced by coronavirus disease 2019 (COVID-19)-related myocarditis. These need ECMO treatment. We investigated differentially expressed genes (DEGs) in patients with COVID-19-related myocarditis and ECMO prognosis.

METHODS

GSE150392 and GSE93101 were analyzed to identify DEGs. A Venn diagram was used to obtain the same transcripts between myocarditis-related and ECMO-related DEGs. Enrichment pathway analysis was performed and hub genes were identified. Pivotal miRNAs, transcription factors, and chemicals with the screened gene interactions were identified. The GSE167028 dataset and single-cell sequencing data were used to validate the screened genes.

RESULTS

Using a Venn diagram, 229 overlapping DEGs were identified between myocarditis-related and ECMO-related DEGs, which were mainly involved in T cell activation, contractile actin filament bundle, actomyosin, cyclic nucleotide phosphodiesterase activity, and cytokine-cytokine receptor interaction. 15 hub genes and 15 neighboring DEGs were screened, which were mainly involved in the positive regulation of T cell activation, integrin complex, integrin binding, the PI3K-Akt signaling pathway, and the TNF signaling pathway. Data in GSE167028 and single-cell sequencing data were used to validate the screened genes, and this demonstrated that the screened genes CCL2, APOE, ITGB8, LAMC2, COL6A3 and TNC were mainly expressed in fibroblast cells; IL6, ITGA1, PTK2, ITGB5, IL15, LAMA4, CAV1, SNCA, BDNF, ACTA2, CD70, MYL9, DPP4, ENO2 and VEGFC were expressed in cardiomyocytes; IL6, PTK2, ITGB5, IL15, APOE, JUN, SNCA, CD83, DPP4 and ENO2 were expressed in macrophages; and IL6, ITGA1, PTK2, ITGB5, IL15, VCAM1, LAMA4, CAV1, ACTA2, MYL9, CD83, DPP4, ENO2, VEGFC and IL32 were expressed in vascular endothelial cells.

CONCLUSION

The screened hub genes, IL6, ITGA1, PTK2, ITGB3, ITGB5, CCL2, IL15, VCAM1, GZMB, APOE, ITGB8, LAMA4, LAMC2, COL6A3 and TNFRSF9, were validated using GEO dataset and single-cell sequencing data, which may be therapeutic targets patients with myocarditis to prevent MI progression and adverse cardiovascular events.

Clinical characteristics and risk factors for bacterial co-infections in COVID-19 patients: A retrospective study

OBJECTIVE

This study aimed to analyse the bacterial composition, distribution, drug sensitivity, and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) who develop bacterial co-infections.

METHODS

We conducted a retrospective study of 184 patients with COVID-19 admitted between December 2022 and January 2023. Data on gender, age, length of hospital stay, pneumonia classification, underlying diseases, invasive surgery, hormone therapy, inflammation indicators, and other relevant information were collected. Samples of sputum, bronchoscopy sputum, alveolar lavage fluid, middle urine, puncture fluid, wound secretions, and blood were collected for pathogen isolation, identification, and drug sensitivity testing.

RESULTS

The majority of patients with COVID-19 with bacterial co-infection were elderly and had underlying diseases. Invasive surgery and hormone therapy were identified as risk factors for co-infections. Laboratory analysis showed reduced lymphocyte counts and elevated levels of C-reactive protein and procalcitonin. The most common pathogens in co-infections were Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. The detection rate of drug-resistant strains, including methicillin-resistant S. aureus, carbapenem-resistant K. pneumoniae, carbapenem-resistant A. baumannii, carbapenem-resistant P. aeruginosa, and carbapenem-resistant E. coli, increased with the severity of pneumonia.

CONCLUSION

Respiratory tract infections were the most common site of bacterial co-infection in patients with COVID-19. Severe cases were more susceptible to multidrug-resistant pathogens, leading to a higher mortality rate. Timely control and prevention of co-infection are crucial for improving the prognosis of patients with COVID-19.

Empowering SARS-CoV-2 variant neutralization with a bifunctional antibody engineered with tandem heptad repeat 2 peptides

With the global pandemic and the continuous mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the need for effective and broadly neutralizing treatments has become increasingly urgent. This study introduces a novel strategy that targets two aspects simultaneously, using bifunctional antibodies to inhibit both the attachment of SARS-CoV-2 to host cell membranes and viral fusion. We developed pioneering IgG4-(HR2)4 bifunctional antibodies by creating immunoglobulin G4-based and phage display-derived human monoclonal antibodies (mAbs) that specifically bind to the SARS-CoV-2 receptor-binding domain, engineered with four heptad repeat 2 (HR2) peptides. Our in vitro experiments demonstrate the superior neutralization efficacy of these engineered antibodies against various SARS-CoV-2 variants, ranging from original SARS-CoV-2 strain to the recently emerged Omicron variants, as well as SARS-CoV, outperforming the parental mAb. Notably, intravenous monotherapy with the bifunctional antibody neutralizes a SARS-CoV-2 variant in a murine model without causing significant toxicity. In summary, this study unveils the significant potential of HR2 peptide-driven bifunctional antibodies as a potent and versatile strategy for mitigating SARS-CoV-2 infections. This approach offers a promising avenue for rapid development and management in the face of the continuously evolving SARS-CoV-2 variants, holding substantial promise for pandemic control.

Comparison of the level of physical activity after the COVID-19 pandemic in Poland, Slovakia and the Czech Republic

BACKGROUND

The COVID-19 pandemic was associated with limited physical activity (PA) of most of the world's population. This cross-sectional prospective study aimed to assess the levels of PA of university students in Poland, Czech Republic and Slovakia after COVID-19 using the International Physical Activity Questionnaire Short Form (IPAQ-SF).

METHODS

A total of 2635 students completed questionnaires regarding their PA levels using the IPAQ-SF between September and December 2022.

RESULTS

PA measured by metabolic equivalent of task (MET) scores, varied between the three countries: Slovakia median MET-minutes/week score 4459.9; Czech Republic 3838.8 Poland 3567.1. The results of the post hoc analysis revealed there were significant differences in MET-minutes/week values between the Czech Republic and Poland (p < 0.035) as well as between the Czech Republic and Slovakia (p < 0.037). The analysis of energetic expenditure during walking revealed that students from the Czech Republic and Slovakia had higher median MET-min/weeks values (Czech 2284.1; Slovak 2467.1) compared to their Polish (1536.1) peers (p < 0.001). Polish cohort presented with significantly higher body mass index (BMI) (p < 0.001) than Czech and Slovak groups (BMI Czech: 22.3; Slovak 22.8; Polish 23.8).

CONCLUSIONS

Significant differences in PA levels between the Czech Republic, Poland, and Slovakia university students were identified. Slovakia showed the highest median PA measured as a MET score, and Poland showed the lowest. Compared to available pre-COVID studies it seems the total level of PA in the observed cohorts has not returned to the pre-COVID levels and students remain less active.

Did everyone change their childbirth plans due to the COVID-19 pandemic? A web-based cross-sectional survey of Polish pregnant women

BACKGROUND AND AIM

With the worldwide outbreak of coronavirus, a significant impact has been observed on the functioning of healthcare systems and the process of childbirth. Women probably did not even have a choice to adjust their plans accordingly to the current situation. The aim of the study was to examine how the outbreak of the SARS CoV-2 pandemic state affected the decisions of pregnant women about their childbirth plan.

DESIGN

This cross-sectional study was performed using a web-based survey published on social media in Poland.

METHODS

The cross-sectional study was performed using web-based questionnaires. The study group included Polish women who changed their childbirth plans, compared to a group of women not sure about delivery plan change and those whose plans had not changed. The data were collected from 4 March 2020 to 2 May 2020, when the first rising count of new infections was observed in Poland and worldwide. Statistical analysis was performed using STATISTICA Software, Inc., 13.3 (2020).

RESULTS

Of 969 women who completed the questionnaire and were enrolled into the study, 57.2% had not changed their childbirth plans (group I), 28.4% had changed their plans (group II), and 14.4% of respondents answered "not sure" to this question (group III). The majority of women changed their birth plans during the pandemic because of the potential absence of their partner during labour (56% of women who had changed their plans and 48% of those whose answer was "I am not sure", p < .001). Another reason was the fear of separation from the child after delivery (33% of women who had changed their plans and 30% of those whose answer was "I am not sure", p < .001).

CONCLUSION

Restrictions due to the COVID-19 outbreak have influenced the childbirth plans of pregnant women. The changes were independent of women's vision of birth before the pandemic.

IMPACT

The restriction on births with accompanying person and the risk of separation from their infant after childbirth significantly influenced the decision-making process. As a result, some women were more likely to opt for a home birth with or even without medical assistance.

PATIENT OR PUBLIC CONTRIBUTION

The study participants were women who were pregnant at the time of completing the questionnaire, were over 18 years old and spoke Polish.

Parental Burnout During the Second Year of the COVID-19 Pandemic: Exploring the Role of Parenting Stressors and Coparenting Support

The COVID-19 pandemic brought about many changes in family routines and introduced new stressors for parents. While stressors can lead to parental burnout, coparenting support may mitigate the effects of parental stress on parental burnout. The current study explored the effects of parental stress, COVID-19 stress, and coparenting support on parental burnout during the second year of the pandemic. Participants consisted of one hundred fifty-five parents in the USA (M = 39.6, SD = 7.38; female = 94.8%). Results suggested parental stress was positively associated with parental burnout while coparenting support was negatively associated with parental burnout. These findings highlight the importance of addressing parental stress and support to minimize the risk of parental burnout.

Scale of concern about COVID-19 infection in Peruvian Health Care Workers

Introduction

The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line.

Objective

To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers.

Material and methods

Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12 ± 9.61).

Results

Aiken’s V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; P = .05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (α = 0.865; CI 95%, 0.83−0.89).

Conclusions

The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Effect of religious fatalism and concern about new variants on the acceptance of COVID-19 vaccines

Introduction

To protect public health, it is important that the population be vaccinated against COVID-19; however, certain factors can affect vaccine acceptance.

Objective

The objective of this study was to determine whether religious fatalism and concern about new variants have a significant effect on the acceptance of COVID-19 vaccines.

Methodology

An explanatory study was conducted with 403 adults of legal age captured through non-probabilistic convenience sampling in vaccination centers in the 13 health networks of the Regional Health Directorate of Puno, Peru. Data were collected through a brief scale of religious fatalism, a scale of acceptance of vaccines against COVID-19 and a scale of concern about a new variant of COVID-19.

Results

The proposed model obtained an adequate fit. There was a negative effect of religious fatalism on vaccine acceptance, a positive effect of fatalism on vaccine rejection, a positive effect of concern about new variants on the acceptance of vaccines, and a positive effect of concern about new variants on vaccine rejection.

Conclusion

These findings provide evidence for the usefulness of considering both religious fatalism and concern about new variants affect the intention to receive the COVID-19 vaccine in adults in southern Peru.

[Risk of transmission of SARS-CoV-2: multi-criteria spatial evaluation in a municipality of Colombia, 2020]

OBJECTIVE

To zoning the risk of SARS-CoV-2 transmission in Villavicencio, Colombia, through a multi-criteria spatial evaluation.

MATERIALS AND METHODS

A multi-criteria evaluation model was implemented, through a hierarchical analysis process, integrated into a Geographic Information System. As criteria, descriptive attributes of the threats and vulnerabilities of viral transmission identified by means of an epidemiological model were included, on the same dimensionless numerical scale and proportional to the probability of contagion; the alternatives evaluated correspond to spatial entities represented by pixels. The criteria were weighted according to the expert judgment of the evaluators, with whom the calculation of a normalized matrix of relative priorities was performed, which allowed the estimation of a vector of weights, the degree of inconsistency of which was admissible. The magnitude of the risk was calculated with a weighted summation of the evaluation of the criteria, according to a map algebra geoprocessing.

RESULTS

The spatial heterogeneity of the risk of SARS-CoV-2 transmission was described in Villavicencio, allowing the identification of the areas with the highest probability of transmission, located in neighborhoods characterized by high socioeconomic vulnerability.

CONCLUSIONS

The cartographic representation derived from the implementation of a multicriteria model, integrated to a Geographical Information System, in the SARS-CoV-2 transmission risk analysis, constitutes a relevant methodological contribution for decision-making defining strategies of mitigation at the local level, facilitating the location and optimization of resources by the health authorities.

[Knowledge of COVID-19 and hand washing]

BACKGROUND

The best way to prevent counting the COVID-19 is hand washing. However, there is little dissemination about the importance that it has and unfortunately it has not been given the importance it deserves.

OBJECTIVE

To determine the knowledge and practices that the relatives of the 5 semester nursing students have about COVID-19 and hand washing.

METHOD

Descriptive research, with an intentional sampling of 83 people to respond to a pretest and posts with a preventive and informative training as a mediating tool for the use of presaberes, was carried out between March and May 2020.

RESULTS

The informants had basic and adequate prior knowledge of what is involved in the practice of hand washing. A reflective interpretation was made with the design of an info graphic that visualized the state of opinion from a comparison between the instruments. The results and discussion suggested that the practice of hand washing is more than just a simple act.

CONCLUSIONS

There was prior knowledge that was strengthened by training and it was interpreted that health is a heritage that must be safeguarded with responsibility and biosecurity.

Highlights in TMPRSS2 inhibition mechanism with guanidine derivatives approved drugs for COVID-19 treatment

Transmembrane protease serine 2 (TMPRSS2) has been identified as a critical key for the entry of coronaviruses into human cells by cleaving and activating the spike protein of SARS-CoV-2. To block the TMPRSS2 function, 18 approved drugs, containing the guanidine group were tested against TMPRSS2's ectodomain (7MEQ). Among these drugs, Famotidine, Argatroban, Guanadrel and Guanethidine strongly binds with TMPRSS2 S1 pocket with estimated Fullfitness energies of -1847.12, -1630.87, -1605.81 and -1600.52 kcal/mol, respectively. A significant number of non-covalent interactions such as hydrogen bonding, hydrophobic and electrostatic interactions were detected in protein-ligand complexes. In addition, the ADMET analysis revealed a perfect concurrence with the aptitude of these drugs to be developed as an anti-SARS-CoV-2 therapeutics. Further, MD simulation and binding free energy calculations were performed to evaluate the dynamic behavior and stability of protein-ligand complexes. The results obtained herein highlight the enhanced stability and good binding affinities of the Argatroban and Famotidine towards the target protein, hence might act as new scaffolds for TMPRSS2 inhibition.Communicated by Ramaswamy H. Sarma.

Lessons Learned from the COVID-19 Pandemic in Nursing Homes: A Systematic Review

Nursing homes are one of the hardest-hit environments in terms of mortality from COVID-19. Given the reactive management of the pandemic, it is necessary to reflect on, and answer, the question as to which good practices (interventions) were implemented in care homes (population) to improve management and care quality (outcomes). This systematic review aimed to identify and describe good practices adopted in care homes during the COVID-19 pandemic or other recent epidemics. We conducted searches in Embase, PubMed, ScienceDirect, ProQuest Central, and Scopus over the period 1-30 November, 2021, using the descriptors "nursing homes", "long-term care", "long-term care facilities" and "COVID-19"; and the keywords "learnings", "lessons", "positive learnings", "positive lessons", "SARS", "MERS", "COVID-19" and "pandemic". We identified 15 papers describing 14 best practices and 26 specific actions taken for COVID-19 management in long-term care facilities. Following the IDEF methodology, the practices were classified into strategic processes (staff training, communication with the national health system, person-centered care, and protocols), operational processes (cohorts, diagnostic testing, case monitoring, personal protective equipment, staff reinforcement, restriction of visits, social distancing, and alternative means for communication with families) and support processes (provision of equipment and hygiene reinforcement). Fifty percent of practices were likely to be maintained beyond the outbreak to improve the operation and quality of the long-term care facilities. This review summarizes the most common measures adopted to manage the COVID-19 pandemic in the context of increased vulnerability and highlights the deficiencies that must be addressed.

A cross-sectional study on the response abilities of clinical and preventive medical students in public health emergency

Inconsistent training programs for public health emergency (PHE) have been criticized as a contributing factor in PHE's managerial weak points. In response, to analyze the relevant discrepancies among the medical students in the class of 2021 from Xiangya School of Medicine of Central South University, the present study conducted an online questionnaire survey using convenience sampling. The questionnaire comprised four sections, including the basic information, the subjective cognition in PHE, the rescue knowledge and capabilities of PHE, and the mastery of PHE regulations and psychological intervention abilities. To compare the abovementioned aspects, related data were collected from 235 medical students divided into two groups, namely, clinical medical students (Group A) and preventive medical students (Group B). We found a more positive attitude in PHE (P = 0.014) and a better grasp of the PHE classification (P = 0.027) and the reporting system in group B compared with group A. In addition, even if group B showed the same response capability in communicable diseases as group A, the former had less access to clinical practice, resulting in poorer performance in the noncommunicable diseases during a fire, flood, and traffic accidents (P = 0.002, P = 0.018, P = 0.002). The different emphasis of each training program contributed to the uneven distribution of abilities and cognition. Meanwhile, the lack of an integrated PHE curriculum led to unsystematic expertise. Hence, to optimize the PHE management system, equal attention should be paid to medical students with diverse majors along with a complete integrated PHE curriculum.

Post-intensive Care Unit COVID-19 Survivors: Functional Status and Respiratory Function Three Months After an Inpatient Rehabilitation Program

Introduction and objectives Long-term coronavirus disease 2019 (COVID-19) sequelae have become an increasing concern, with persistent dyspnoea and fatigue being the most common and long-lasting symptoms reported. The aim of this study was to evaluate the functional status and respiratory function three months after discharge from an inpatient rehabilitation program. Materials and methods This was a prospective study including post-ICU COVID-19 survivors consecutively admitted to an inpatient and multimodal rehabilitation program in a rehabilitation center. Evaluation of functional status (brief balance evaluation systems test (brief-BESTEST), timed up and go (TUG) test, 1 min sit to stand test (1STST), 6 min walking test (6MWT)); respiratory muscle strength (maximum expiratory pressure (MEP), maximum inspiratory pressure (MIP)); cough effectiveness (peak cough flow (PCF)); and fatigue (fatigue assessment scale (FAS)) were assessed at admission (T0), discharge (T1), and three months after discharge (T2). Results A total of 36 patients were included. Between T1 and T2, there was a significant improvement in MEP (84.47±20.89 vs 97.23±24.63 cmH₂O, p<0.001), PCF (367.83±117.24 vs 441.33±132.90 L/min, p=0.003), functional capacity (1STST (19.90±6.37 vs 23.13±6.07, p=0.004), and 6MWT (459.25±153.70 vs 500.00±163.74 meters, p=0.003)). No differences were seen in MIP, brief-BESTEST, or TUG. Patients presented a higher median final FAS score at T2 compared to T1: 21.50±5 vs 18.60±2.65, p=0.002. Conclusions Post-ICU COVID-19 survivors admitted to an inpatient rehabilitation program maintained a good functional recovery at the three-month follow-up. Despite overall improvement, we found higher scores of FAS, suggesting worse fatigue levels.

Toxicity and virucidal activity of a neon-driven micro plasma jet on eukaryotic cells and a coronavirus

Plasma medicine is a developing field that utilizes the effects of cold physical plasma on biological substrates for therapeutic purposes. Approved plasma technology is frequently used in clinics to treat chronic wounds and skin infections. One mode of action responsible for beneficial effects in patients is the potent antimicrobial activity of cold plasma systems, which is linked to their unique generation of a plethora of reactive oxygen and nitrogen species (ROS). During the SARS-CoV-2 pandemic, it became increasingly clear that societies need novel ways of passive and active protection from viral airway infections. Plasma technology may be suitable for superficial virus inactivation. Employing an optimized neon-driven micro plasma jet, treatment time-dependent ROS production and cytotoxic effects to different degrees were found in four different human cell lines with respect to their metabolic activity and viability. Using the murine hepatitis virus (MHV), a taxonomic relative of human coronaviruses, plasma exposure drastically reduced the number of infected murine fibroblasts by up to 3000-fold. Direct plasma contact (conductive) with the target maximized ROS production, cytotoxicity, and antiviral activity compared to non-conductive treatment with the remote gas phase only. Strikingly, antioxidant pretreatment reduced but not abrogated conductive plasma exposure effects, pointing to potential non-ROS-related mechanisms of antiviral activity. In summary, an optimized micro plasma jet showed antiviral activity and cytotoxicity in human cells, which was in part ROS-dependent. Further studies using more complex tissue models are needed to identify a safe dose-effect window of antiviral activity at modest toxicity.

Basic COVID-19 knowledge according to education level and country of residence: Analysis of twelve countries in Latin America

Introduction

Knowing a disease is crucial for being able to fight it, especially in a region in which COVID-19 caused so many deaths, such as Latin America.

Objective

To determine the association between basic knowledge of COVID-19 and education level according to country of residence in Latin America.

Methodology

This is an analytical cross-sectional study. Basic level of knowledge was measured through nine close-ended questions (scale validated in Peru). The score obtained was analyzed through performing a crosstab vs. gender, age, education level, and country of residence.

Results

Of a total of 9,222 respondents, almost all of them knew the common symptoms (99%), modes of transmission (93%), and knew how to recognize which was not a specific symptom (93%). Through the multivariate model, we found that there was no association with gender (p = 0.716) or age (p = 0.059), in comparison with those who had primary or a lower education level. All the other higher education levels had statistically significant scores (all p-values p < 0.001). When comparing knowledge according to countries, and using Peru as reference for comparison, Chile, Paraguay, Mexico, Bolivia, Panama, Ecuador, Costa Rica, and Colombia had a better level of knowledge (all p-values < 0.001); however, only El Salvador had a lower level (p < 0.001).

Discussion

There was lack of knowledge of some topics, difference according to academic degree and country. As Peru was one of countries that obtained the lowest level of knowledge, it could have influenced the fact that it was the most affected country in the world.

Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic: Results of a web-based multinational cross-sectional study

OBJECTIVE

To assess risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic using Mind-COVID, a prospective cross-sectional study that compares outcomes in middle-income economies and high-income economies.

METHODS

A total of 7102 pregnant women from 12 high-income economies and nine middle-income economies were included. The web-based survey used two standardized instruments, General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9).

RESULT

Pregnant women in high-income economies reported higher PHQ-9 (0.18 standard deviation [SD], P < 0.001) and GAD-7 (0.08 SD, P = 0.005) scores than those living in middle-income economies. Multivariate regression analysis showed that increasing PHQ-9 and GAD-7 scales were associated with mental health problems during pregnancy and the need for psychiatric treatment before pregnancy. PHQ-9 was associated with a feeling of burden related to restrictions in social distancing, and access to leisure activities. GAD-7 scores were associated with a pregnancy-related complication, fear of adverse outcomes in children related to COVID-19, and feeling of burden related to finances.

CONCLUSIONS

According to this study, the imposed public health measures and hospital restrictions have left pregnant women more vulnerable during these difficult times. Adequate partner and family support during pregnancy and childbirth can be one of the most important protective factors against anxiety and depression, regardless of national economic status.

Challenges in Micro and Small Food Enterprises during the COVID-19 Pandemic in Ecuador

Micro and small enterprises (MSEs) play a significant role in developing countries such as Ecuador. The food and beverage industry is essential for Ecuador’s economy, contributing approximately 5% to its GDP. Focusing on the impact of COVID-19 on the industry, this mixed research takes a qualitative and quantitative approach involving four stages: foundation, prefield, field, and reporting. The fieldwork was carried out when Ecuador’s economy reopened in September 2020, which saw demand increase gradually, production capacity recovering, mobility return to normal levels, and curfew restrictions reduced. As far as biosecurity protocols were concerned, communities were allowed to resume pre-pandemic activities, provided they complied with social distancing, permanent mask wearing, and strict cleaning procedures. The effect on each company’s process depends on the activities they adopted to mitigate the risk of the COVID-19 pandemic risk, e.g., service companies experienced, on average, a 22% cost increase due to the purchase of cleaning supplies, while manufacturing companies were more likely to have related measures in place and so the effect on them was on a comparatively smaller scale.

An entropy-based method to control COVID-19 rumors in online social networks using opinion leaders

- In the ongoing COVID-19 pandemic, people spread various COVID-19-related rumors and hoaxes that negatively influence human civilization through online social networks (OSN). The proposed research addresses the unique and innovative approach to controlling COVID-19 rumors through the power of opinion leaders (OLs) in OSN. The entire process is partitioned into two phases; the first phase describes the novel Reputation-based Opinion Leader Identification (ROLI) algorithm, including a unique voting method to identify the top-T OLs in the OSN. The second phase describes the technique to measure the aggregated polarity score of each posted tweet/post and compute each user's reputation. The empirical reputation is utilized to calculate the user's trust, the post's entropy, and its veracity. If the experimental entropy of the post is lower than the empirical threshold value, the post is likely to be categorized as a rumor. The proposed approach operated on Twitter, Instagram, and Reddit social networks for validation. The ROLI algorithm provides 91% accuracy, 93% precision, 95% recall, and 94% F1-score over other Social Network Analysis (SNA) measures to find OLs in OSN. Moreover, the proposed approach's rumor controlling effectiveness and efficiency is also estimated based on three standard metrics; affected degree, represser degree, and diffuser degree, and obtained 26%, 22%, and 23% improvement, respectively. The concluding outcomes illustrate that the influence of OLs is exceptionally significant in controlling COVID-19 rumors.

Factors associated with the use of the N95 respirator in university students in the daily life of COVID-19

OBJECTIVE

To identify the factors associated with the use of the N95 respirator in Nursing and Medical students in the daily life of the covid-19 pandemic.

METHODS

Descriptive-analytical cross-sectional study carried out in 2020. A total of 830 students from three universities in Peru participated in the study. Associations were evaluated using Pearson's Chi-Square and multivariate Poisson modeling with log linkage.

RESULTS

Statistically significant differences were found between the preference to use the N95 respirator in relation to masks according to the activity they perform (p=0.001) and where they live (p=0.005). The multivariate analysis reported that the associated characteristics were age, activity performed, perception and fear of being infected by covid-19.

CONCLUSION

The choice of N95 respirator is influenced by individual factors and perceptions. Spaces are needed to discuss daily life, the way of living, caring and educating, considering the socioeconomic dimensions and beliefs.

Mechanisms of the Chinese Government's Efforts to Fight COVID-19: Integration of Top-down Interventions and Local Governance

The experiences and lessons of China's response to COVID-19 have been described in several studies, but the mechanisms of the Chinese government's efforts to fight COVID-19 have not been well characterized. Despite strong policy directives and orders from the central government, the response and handling of the epidemic also reflected distinctive characteristics of local governments in terms of their governance systems and capacities. In this article, the authors analyze public health policies and mechanisms of the Chinese government's response to COVID-19 based on the integration of top-down and local governance. A compendium of key events and measures provides the foundation for our analysis. Mechanisms related to leadership, emergency response, centralized mobilization, and accountability fully reflect the decisive measures for top-down interventions in the face of emergencies. China's policies and mechanisms to address the COVID-19 pandemic are consistent with its party-state bureaucracy and socioeconomic context. However, lower levels of government have used "repeated increments" and "one-size-fits-all" practices in the implementation of antiepidemic policies. Conservative local officials are more averse to social innovation and favor strict controls to manage the pandemic. Moreover, even under a unified system, there are substantial differences in the capacity and level of crisis management among local governments, especially in the mobilization of nonprofit organizations and volunteers. In this case study, we aim to expand the existing understanding of the tension between top-down interventions and local governance innovations.

Pneumonia in Nervous System Injuries: An Analytic Review of Literature and Recommendations

Pneumonia is one of the most common complications in intensive care units and is the most common nosocomial infection in this setting. Patients with neurocritical conditions who are admitted to ICUs are no exception, and in fact, are more prone to infections such as pneumonia because of factors such as swallow dysfunction, need for mechanical ventilation, longer length of stay in hospitals, etc. Common central nervous system pathologies such as ischemic stroke, traumatic brain injury, subarachnoid hemorrhage, intracerebral hemorrhage, neuromuscular disorders, status epilepticus, and demyelinating diseases can cause long in-hospital admissions and increase the risk of pneumonia each with a mechanism of its own. Brain injury-induced immunosuppression syndrome is usually considered the common mechanism through which patients with critical central nervous system conditions become susceptible to different kinds of infection including pneumonia. Evaluating the patients and assessment of the risk factors can lead our attention toward better infection control in this population and therefore decrease the risk of infections in central nervous system injuries.

Analyzing the vaccination debate in social media data Pre- and Post-COVID-19 pandemic

The COVID-19 virus has caused and continues to cause unprecedented impacts on the life trajectories of millions of people globally. Recently, to combat the transmission of the virus, vaccination campaigns around the world have become prevalent. However, while many see such campaigns as positive (e.g., protecting lives), others see them as negative (e.g., the side effects that are not fully understood scientifically), resulting in diverse sentiments towards vaccination campaigns. In addition, the diverse sentiments have seldom been systematically quantified let alone their dynamic changes over space and time. To shed light on this issue, we propose an approach to analyze vaccine sentiments in space and time by using supervised machine learning combined with word embedding techniques. Taking the United States as a test case, we utilize a Twitter dataset (approximately 11.7 million tweets) from January 2015 to July 2021 and measure and map vaccine sentiments (Pro-vaccine, Anti-vaccine, and Neutral) across the nation. In doing so, we can capture the heterogeneous public opinions within social media discussions regarding vaccination among states. Results show how positive sentiment in social media has a strong correlation with the actual vaccinated population. Furthermore, we introduce a simple ratio between Anti and Pro-vaccine as a proxy to quantify vaccine hesitancy and show how our results align with other traditional survey approaches. The proposed approach illustrates the potential to monitor the dynamics of vaccine opinion distribution online, which we hope, can be helpful to explain vaccination rates for the ongoing COVID-19 pandemic.

Synthesis, antimicrobial evaluation and docking studies of fluorinated imine linked 1,2,3-triazoles

A diverse series of imine linked 1,2,3-triazole hybrids has been synthesized via Cu(I)-promoted click reaction, with an aim to develop some new antimicrobial molecules. The structural characterization of the synthesized triazole hybrids was accomplished using various spectral techniques like ¹H NMR, ¹³C NMR, FTIR and HRMS. Among the synthesized hybrids, 7d exhibited highest antimicrobial efficacy against R. oryzae and S. aureus with MIC of 0.0123 µmol/mL and 0.0061 µmol/mL, respectively. Docking studies of the terminal alkynes (4a, 4b) and triazole hybrids (6a, 6d, 7c, 7g) showing high potency towards E. coli DNA gyrase and C. albicans sterol 14-α demethylase were also undertaken to understand the binding behaviour.

Vacunación contra SARS-CoV-2 y su relación con enfermedad y muerte por COVID-19 en Argentina

Objetivo.

Conocer la efectividad de la vacunación contra SARS-CoV-2 para prevenir el desarrollo de enfermedad y muerte por COVID-19 en Córdoba, Argentina, en el periodo enero-junio de 2021.

Métodos.

Se llevó a cabo un estudio de cohorte retrospectivo en 1 139 458 residentes en la provincia de Córdoba. Se construyeron modelos de regresión logística múltiple que relacionaron la vacunación con la infección por SARS-CoV-2 o la muerte por COVID-19, considerando comorbilidades y factores de riesgo de enfermedades crónicas y ajustando por sexo y edad.

Resultados.

El haber recibido una o dos dosis de vacuna en la población general redujo el riesgo de enfermar un 98,8% y 99,3%, respectivamente; y de morir un 83% y 96,5%, respectivamente. En quienes contrajeron COVID-19, la probabilidad de morir se redujo en 57% y 80%, respectivamente. En cuanto a la probabilidad de muerte, el riesgo aumentó a medida que aumentaba la edad y con la pertenencia al sexo masculino o la presencia de obesidad, hipertensión arterial o diabetes mellitus.

Conclusión.

La vacunación es efectiva y protege contra la posibilidad de contraer COVID-19, desarrollar enfermedad grave o morir. Presentar obesidad, hipertensión arterial o diabetes mellitus, en orden decreciente, aumentan el riesgo de morir.

Status of yoga and mental health among Brazilian practitioners during COVID-19: An internet-based cross-sectional survey

This study aimed to describe yoga practice and verify its association with depression, anxiety, and stress during the COVID-19 pandemic among Brazilian practitioners. A cross-sectional anonymous online survey was conducted in all regions of Brazil using a snowball sampling strategy among yoga practitioners. A total of 860 participants (87% female, aged: 19–82 years) completed the survey. Sociodemographic data, lifestyle factors, yoga practice during the pandemic, and the Depression Anxiety and Stress Scale (DASS-21) scores were collected between July 9 and July 15, 2021. Overall, 9.5%, 9.3%, and 5.6% of participants exhibited some traits (mild to severe) of depression, anxiety, and stress, respectively. Hatha yoga (48%) was the most commonly practiced yoga style. In the adjusted analysis, a higher yoga experience (> 5 years) was associated with better anxiety (odds ratio; bootstrap 95% confidence interval: 2.42; 1.32, 4.49) and stress status (1.80; 1.06, 3.00) than beginners (< 1 year). Practitioners who reported higher time and days of yoga practice during the study period were more likely to show normal levels of depression (odds ratio: 2.56–6.49; p ​< ​0.05), anxiety (odds ratio: 3.68–8.84; p ​< ​0.05), and stress (odds ratio: 2.15–5.21; p ​< ​0.05). Moreover, the maintenance of practice frequency during the pandemic was associated with higher odds of normal levels of depression (2.27; 1.39–3.79), anxiety (1.97; 1.25–3.10), and stress (1.97; 1.32–2.96). In conclusion, our findings indicated that a higher level of yoga practice was associated with better mental health levels during the COVID-19 pandemic.

Molecular Mechanisms of Cardiac Injury Associated With Myocardial SARS-CoV-2 Infection

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread around the world. The development of cardiac injury is a common condition in patients with COVID-19, but the pathogenesis remains unclear. The RNA-Seq dataset (GSE150392) comparing expression profiling of mock human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) and SARS-CoV-2-infected hiPSC-CMs was obtained from Gene Expression Omnibus (GEO). We identified 1,554 differentially expressed genes (DEGs) based on GSE150392. Gene set enrichment analysis (GSEA), Gene ontology (GO) analysis, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis showed that immune-inflammatory responses were activated by SARS-CoV-2, while muscle contraction, cellular respiration, and cell cycle of hiPSC-CMs were inhibited. A total of 15 hub genes were identified according to protein-protein interaction (PPI), among which 11 upregulated genes were mainly involved in cytokine activation related to the excessive inflammatory response. Moreover, we identified potential drugs based on these hub genes. In conclusion, SARS-CoV-2 infection of cardiomyocytes caused a strong defensive response, leading to excessive immune inflammation, cell hypoxia, functional contractility reduction, and apoptosis, ultimately resulting in myocardial injury.

Lessons Learned: Occupational Therapy in Nursing Homes during the First Wave of COVID-19 in Spain

This research aims to explore the perception that occupational therapists working in elderly care facilities have about the measures implemented against the COVID-19 pandemic in their resources, and the impact that these measures have had on occupational therapy in these facilities. An interpretive paradigm was selected, using a qualitative approach and a phenomenological design. Sixteen occupational therapists working in elderly care facilities in two Spanish regions were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was carried out using open, axial, and selective coding processes and the constant comparison method. Four themes were extracted from the analysis results: The initial chaos in senior centers; The blurring of occupational therapists’ roles; The emergence of technology; and organizational and therapeutic proposals for future pandemics. The pandemic had a significant impact on the care and therapeutic processes in elderly care facilities. Occupational therapists had to stop performing their functions to dedicate themselves to other support, auxiliary or communication tasks between the center and the families. Similarly, it is worth noting the emergence of low-cost technology to facilitate communication and to carry out some therapeutic interventions.

Perceived Safety of Learning Environment and Associated Anxiety Factors during COVID-19 in Ghana: Evidence from Physical Education Practical-Oriented Program

The outbreak of COVID-19 led to the swift migration to alternate instructional delivery models and pedagogical practices in educational institutions. This study examined the perceived safety of the learning environment and associated anxiety factors among physical education students amidst COVID-19. Using a cross-sectional design, a sample of 638 students drawn purposively and conveniently from a public university in Ghana completed a self-developed questionnaire. Frequency counts, percentages, and ordered logistic regression were used to analyze the data. Findings of the study showed that students perceived the practical lesson environment as unsafe, with self-reported moderate to high levels of anxiety during their practical lessons. The ordered logistic regression results revealed that varied factors such as age, COVID-19 information platforms, certainty about personal safety, and adequacy of preparation to manage COVID-19 cases were associated with anxiety. The study concluded that an unsafe practical physical education learning environment increases the anxiety levels of students. Academic departments/units should provide periodic interventions (e.g., positive self-talk, mental rehearsal, cognitive restructuring) and counseling services for students amidst the ongoing pandemic to help moderate situational-specific anxiety. In addition, key to the management of students' anxiety is the provision of a safe and supportive school environment, including the provision of adequate personal protective equipment for practical lessons by school authorities.

'Population self-reliance in health' and COVID-19: The need for a 4th tier in the health system

The COVID-19 pandemic is straining health systems globally. The current international biomedical focus for disease control and policies fails to include the resource of a population's capacity to be self-reliant in its health care practices. The ancient wisdom of Ayurveda ('the knowledge of life') and Local Health Traditions (LHTs) in India understand that health is about Svasthya, 'being rooted within'; a concept that includes the relationship and balance between the individual, their families, communities and the environment in creating and maintaining their own health. This 'population self-reliance in health' is the focus of the 4th tier in the health system which honours and respects an individual's capacity for self-care and their inherent responsibility to the health system and its values. It encourages the inclusion of this knowledge in the creation of health systems and in the policies that direct them. Research and practice into the 4th tier will provide health systems and policy information into how communities are managing the COVID-19 epidemic. These insights will help in the creation of future health systems that are better aligned to the 'self-reliance in health' of individuals and their communities.

Factores asociados al uso del respirador N95 en universitarios en lo cotidiano de la COVID-19

RESUMEN Objetivo: Identificar los factores asociados al uso del respirador N95 en estudiantes de Enfermería y Medicina Humana en lo cotidiano de la pandemia COVID-19. Métodos: Estudio descriptivo-analítico transversal realizado en el año 2020. Participaron 830 estudiantes de tres universidades de Perú. Se evaluaron asociaciones mediante Chi Cuadrado de Pearson y modelamiento multivariado de Poisson con link log. Resultados: Se encontró diferencias estadísticamente significativas entre la preferencia de usar el respirador N95 en comparación con las mascarillas según la actividad que desempeñan (p=0,001) y lugar de residencia (p=0,005). El análisis multivariado reportó que las características asociadas fueron la edad, la actividad que desempeña, percepción y miedo de que podrían infectarse con COVID-19. Conclusión: En la preferencia de elegir el respirador N95, intervienen factores individuales y las percepciones. Se necesitan espacios para discutir lo cotidiano, la manera de vivir, cuidar y educar; considerando dimensiones socioeconómicas y creencias.

Ambulation capacity, age, immunosuppression, and mechanical ventilation are risk factors of in-hospital death in severe COVID-19: a cohort study

IMPORTANCE

Despite ambulation capacity being associated with a decreased level of physical activity and survival may be influenced by the functional capacity, studies have not addressed the association between ambulation capacity and death in patients hospitalized by COVID-19.

OBJECTIVE

To verify the functional, clinical, and sociodemographic risk factors associated with in-hospital death in individuals with severe COVID-19.

METHODS

It is a cohort retrospective study performed at a large tertiary hospital. Patients 18 years of age or more, of both sexes, hospitalized due to severe COVID-19 were included. Cases with dubious medical records and/or missing essential data were excluded. Patients were classified according to their ambulation capacity before the COVID-19 infection. Information regarding sociodemographic characteristics, in-hospital death, total hospital stays, Intensive Care Unit (ICU) stays, and the necessity of Mechanical Ventilation (MV) were collected from medical records and registered in a RedCap database. Multiple logistic regression analysis was used to identify possible factors associated with the in-hospital death rate.

RESULTS

Data from 1110 participants were included in the statistical analysis. The median age of the patients was 57 (46‒66) years, 58.42% (n = 590) were male, and 61.73% (n = 602) were brown or black. The case fatality rate during hospitalization was 36.0% (n = 363). In-hospital death was associated with ambulation capacity; dependent ambulators (OR = 2.3; CI 95% = 1.2-4.4) and non-functional ambulation (OR = 1.9; CI 95% = 1.1-3.3), age [older adults (OR = 3.0; CI 95% = 1.9‒4.), ICU stays (OR = 1.4; CI 95% = 1.2‒1.4), immunosuppression (OR = 5.5 CI 95% = 2.3‒13.5) and mechanical ventilation (OR = 27.5; CI 95% = 12.0-62.9).

CONCLUSION AND RELEVANCE

Decreased ambulation capacity, age, length of ICU stay, immunosuppression, and mechanical ventilation was associated with a high risk of in-hospital death due to COVID-19.

When health care workers became patients with COVID-19: A qualitative study

AIMS

This study aimed to describe the experiences of nurses and other health care workers who were infected with coronavirus disease 2019.

METHODS

An empirical phenomenological approach was used. Sixteen participants were recruited in Wuhan using purposive and snowball sampling. Semistructured, in-depth interviews were conducted by telephone in February 2020. Interviews were transcribed verbatim and analysed following Colaizzi's method.

RESULTS

Two themes emerged: (1) Intense emotional distress since becoming infected. Participants were fearful of spreading the virus to family and overwhelmed by a lack of information, experienced uncertainty and worried about treatment, felt lonely during isolation and reported moral distress about inadequate health care staffing. (2) Coping strategies were needed. They tried their best to address negative psychological reactions using their professional knowledge and gaining support from others and community resources.

CONCLUSIONS

Preparedness for catastrophic events and providing timely and accurate information are major considerations in government policy development, related to pandemics and adequacy of health care personnel. Mental health resources and support, both short- and long-term should be anticipated for health care providers to alleviate their fear and anxiety.

Immunological evaluation of an inactivated SARS-CoV-2 vaccine in rhesus macaques

Because of the relatively limited understanding of coronavirus disease 2019 (COVID-19) pathogenesis, immunological analysis for vaccine development is needed. Mice and macaques were immunized with an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine prepared by two inactivators. Various immunological indexes were tested, and viral challenges were performed on day 7 or 150 after booster immunization in monkeys. This inactivated SARS-CoV-2 vaccine was produced by sequential inactivation with formaldehyde followed by propiolactone. The various antibody responses and specific T cell responses to different viral antigens elicited in immunized animals were maintained for longer than 150 days. This comprehensive immune response could effectively protect vaccinated macaques by inhibiting viral replication in macaques and substantially alleviating immunopathological damage, and no clinical manifestation of immunopathogenicity was observed in immunized individuals during viral challenge. This candidate inactivated vaccine was identified as being effective against SARS-CoV-2 challenge in rhesus macaques.

Carbon fullerene and nanotube are probable binders to multiple targets of SARS-CoV-2: Insights from computational modeling and molecular dynamic simulation studies

The present study aimed to predict the binding potential of carbon nanotube and nano fullerene towards multiple targets of SARS-CoV-2. Based on the virulent functions, the spike glycoprotein, RNA-dependent RNA polymerase, main protease, papain-like protease, and RNA binding domain of the nucleocapsid proteins of SARS-CoV-2 were prioritized as the molecular targets and their three-dimensional (3D) structures were retrieved from the Protein Data Bank. The 3D structures of carbon nanotubes and nano-fullerene were computationally modeled, and the binding potential of these nanoparticles to the selected molecular targets was predicted by molecular docking and molecular dynamic (MD) simulations. The drug-likeness and pharmacokinetic features of the lead molecules were computationally predicted. The current study suggested that carbon fullerene and nanotube demonstrated significant binding towards the prioritized multi-targets of SARS-CoV-2. Interestingly, carbon nanotube showed better interaction with these targets when compared to carbon fullerene. MD simulation studies clearly showed that the interaction of nanoparticles and selected targets possessed stability and conformational changes. This study revealed that carbon nanotubes and fullerene are probably used as effectual binders to multiple targets of SARS-CoV-2, and the study offers insights into the experimental validation and highlights the relevance of utilizing carbon nanomaterials as a therapeutic remedy against COVID-19.

Human IgM and IgG Responses to an Inactivated SARS-CoV-2 Vaccine

Objective

The ongoing COVID-19 pandemic warrants accelerated efforts to test vaccine candidates. To explore the influencing factors on vaccine-induced effects, antibody responses to an inactivated SARS-CoV-2 vaccine in healthy individuals who were not previously infected by COVID-19 were assessed.

Methods

All subjects aged 18–60 years who did not have SARS-CoV-2 infection at the time of screening from June 19, 2021, to July 02, 2021, were approached for inclusion. All participants received two doses of inactivated SARS-CoV-2 vaccine. Serum IgM and IgG antibodies were detected using a commercial kit after the second dose of vaccination. A positive result was defined as 10 AU/mL or more and a negative result as less than 10 AU/mL. This retrospective study included 97 infection-naïve individuals (mean age 35.6 years; 37.1% male, 62.9% female).

Results

The seropositive rates of IgM and IgG antibody responses elicited after the second dose of inactivated SARS-CoV-2 vaccine were 3.1% and 74.2%, respectively. IgG antibody levels were significantly higher than IgM levels (P<0.0001). Sex had no effect on IgM and IgG antibody response after the second dose. The mean anti-IgG level in older persons (⩾42 years) was significantly lower than that of younger recipients. There was a significantly lower antibody level at > 42 days compared to that at 0–20 days (P<0.05) and 21–31 days (P<0.05) after the second dose.

Conclusion

IgG antibody response could be induced by inactivated SARS-CoV-2 vaccine in healthy individuals (>18 years), which can be influenced by age and detection time after the second dose of vaccination.

Mathematical epidemiologic and simulation modelling of first wave COVID-19 in Malaysia

Since the first coronavirus disease 2019 (COVID-19) outbreak appeared in Wuhan, mainland China on December 31, 2019, the geographical spread of the epidemic was swift. Malaysia is one of the countries that were hit substantially by the outbreak, particularly in the second wave. This study aims to simulate the infectious trend and trajectory of COVID-19 to understand the severity of the disease and determine the approximate number of days required for the trend to decline. The number of confirmed positive infectious cases [as reported by Ministry of Health, Malaysia (MOH)] were used from January 25, 2020 to March 31, 2020. This study simulated the infectious count for the same duration to assess the predictive capability of the Susceptible-Infectious-Recovered (SIR) model. The same model was used to project the simulation trajectory of confirmed positive infectious cases for 80 days from the beginning of the outbreak and extended the trajectory for another 30 days to obtain an overall picture of the severity of the disease in Malaysia. The transmission rate, β also been utilized to predict the cumulative number of infectious individuals. Using the SIR model, the simulated infectious cases count obtained was not far from the actual count. The simulated trend was able to mimic the actual count and capture the actual spikes approximately. The infectious trajectory simulation for 80 days and the extended trajectory for 110 days depicts that the inclining trend has peaked and ended and will decline towards late April 2020. Furthermore, the predicted cumulative number of infectious individuals tallies with the preparations undertaken by the MOH. The simulation indicates the severity of COVID-19 disease in Malaysia, suggesting a peak of infectiousness in mid-March 2020 and a probable decline in late April 2020. Overall, the study findings indicate that outbreak control measures such as the Movement Control Order (MCO), social distancing and increased hygienic awareness is needed to control the transmission of the outbreak in Malaysia.

Factors influencing the COVID-19 mortality rate in the European Union: importance of medical professionals

Objective

The aim of this paper is to analyze whether health variables such as the total number of physicians, available beds, and public spending on health care influence the number of deaths. The influence of other variables such as the Human Development Index and public health measures is also analyzed.

Study design

Statistical study. Evaluation of variables associated with COVID-19 mortality in the EU.

Methods

A multiple regression analysis is performed for the countries of the European Union.

Results

Health expenditure, public health measures and the number of physicians influence the total number of deaths. The more physicians, the lower the number of deaths. However, the number of beds or the Human Development Index are not determinants of the number of deaths.

Conclusions

A greater number of medical professionals will improve health care and reduce the number of deaths.

Workplace Violence Against Physicians Treating COVID-19 Patients in Peru: A Cross-Sectional Study

BACKGROUND

The COVID-19 pandemic is an unprecedented challenge to health systems that has revealed shortcomings and increased unmet demands. Such situations might exacerbate workplace violence (WPV) against physicians, as has been reported in several parts of the world.

METHODS

To identify the frequency and characteristics of WPV suffered by physicians attending COVID-19 patients in Peru, a descriptive, cross-sectional study was conducted with an online survey of 200 physicians.

RESULTS

Of the survey respondents, 84.5% had suffered some type of WPV; 97.6% of these suffered nonphysical violence. Suffering more than one incident of violence was reported by 75.7% of respondents. The primary aggressor was a patient's family member or caregiver. Violence occurred most frequently in critical areas inside the health service facility, such as COVID-19 triage, tents, and hospital units, although it also occurred during teleconsultations. Multiple shortcomings of the health services were perceived as the main trigger of violence. Being a female physician (odds ratio [OR] = 2.48, 95% confidence interval [CI] = 1.06-5.83) and working in a COVID-19 ICU (OR = 5.84, 95% CI = 1.60-21.28) were the main factors associated with WPV.

CONCLUSION

Violence against physicians attending COVID-19 patients in Peru is common. The perceived factors that contribute most to violence are linked to deficiencies in health services.

Sleep in adults from the UK during the first few months of the coronavirus outbreak

The coronavirus disease 2019 (COVID-19) outbreak emerged at the end of 2019 and quickly spread around the world. Measures to counter COVID-19, including social distancing and lockdowns, created an unusual situation that had the potential to impact a variety of behaviours, including sleep, which is crucial for health and well-being. Data were obtained through an online survey. The total sample comprised 19,482 participants from the UK. Participants were asked several questions regarding sleep quality and quantity. Each participant completed the questionnaires once during a data collection period spanning January 20 to March 31, 2020. Data provided by different participants during different weeks (spanning time-periods just before COVID-19 was identified in the UK and during the early weeks following its arrival) were compared using analysis of variance tests and regressions. Regression analyses controlling for age, sex and ethnicity revealed significant associations of small magnitude between date of survey completion and sleep quality, sleep latency, number of awakenings and composite score of poor sleep quality. These analyses also indicated small increases in eveningness tendency as the study progressed. There was no change in sleep duration or time spent awake at night. The COVID-19 outbreak did not appear to impact negatively sleep in a substantial manner during the early stages in the UK. The small increases in sleep quality variables (except for time spent awake at night and sleep duration) and eveningness are nonetheless of interest. Further research is needed to understand how best to provide support to those most in need of a good night's sleep during this unprecedented time.

Marketing digital y su apoyo al servicio de la salud comunitaria en Centros Geriátricos

El marketing digital como componente de la mercadotecnia, utiliza el internet, páginas web y redes sociales como mecanismos que permiten ubicar productos y servicios con mayores y mejores resultados. En esta investigación se propone extender su aplicación al servicio de los grupos vulnerables y su relación con la academia, a través desarrollo de proyectos de vinculación con la sociedad que permiten resolver problemáticas sociales de los sectores más necesitados del país. La presente investigación tiene por objetivo determinar lineamientos para el desarrollo de operaciones de marketing digital que permitan ampliar los servicios gratuitos que ofertan las Instituciones de Educación Superior a favor de los adultos mayores residentes de los centros geriátricos de la Provincia de Tungurahua. El artículo emplea un enfoque cualitativo con una metodología descriptiva que permite entender y explicar la situación actual de los centros geriátricos; para el efecto, se aplicó una encuesta a una población de 216 adultos mayores y se entrevistó a 8 directores de centros geriátricos de la Provincia. Los resultados obtenidos determinaron escasa participación, conocimiento y aplicación de herramientas del marketing en centros geriátricos y se concluyó que las estrategias de marketing deberán ser direccionadas a profesionales en el área de geriatría y cuidado personalizado, considerando que los adultos mayores tienen un bajo porcentaje de participación en internet, redes sociales y páginas web.

Influence of the SARS-CoV-2 pandemic: a review from the climate change perspective

Ever since the global outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2/COVID-19) in the early part of 2020, there is no doubt that the SARS-CoV-2 pandemic has placed great tension globally and has affected almost all aspects of human endeavors. There are presently several research studies on the atmospheric environmental and economic effects of this dreaded virus. Supposedly, the responses ought to have also present innovations that would advance scientific research to mitigate its impacts since most of the ensuing consequences impact the atmospheric climatic conditions. Even when it appears that economic events would possibly return in no time, the circumstances will change. Specifically, from the existing literature, it appears that not much has been done to study the influence of the SARS-CoV-2 pandemic on climate change. Hence, this present review article will explore the possible connection between the SARS-CoV-2 pandemic and climate change. The utilization of various scientific domains for climate change studies during the SARS-CoV-2 pandemic and exploring the positive influences of the SARS-CoV-2 pandemic and measures to avoid the negative impacts on climate change owing to SARS-CoV-2 have also been discussed.

Pulmonary imaging in coronavirus disease 2019 (COVID-19): a series of 140 Latin American children

BACKGROUND

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which resulted in the worldwide coronavirus disease 2019 (COVID-19) pandemic of 2020, has particularly affected Latin America.

OBJECTIVE

The purpose of the study was to analyze the imaging findings of pulmonary COVID-19 in a large pediatric series.

MATERIALS AND METHODS

Children with SARS-CoV-2 infection confirmed by either quantitative reverse transcription-polymerase chain reaction from nasopharyngeal swabs or presence of circulating immunoglobulin M (IgM) antibodies and who underwent chest radiograph or CT or both were included in this retrospective multicenter study. Three pediatric radiologists independently reviewed radiographs and CTs to identify the presence, localization, distribution and extension of pulmonary lesions.

RESULTS

We included 140 children (71 female; median age 6.3 years, interquartile range 1.6-12.1 years) in the study. Peribronchial thickening (93%), ground-glass opacities (79%) and vascular engorgement (63%) were the most frequent findings on 131 radiographs. Ground-glass opacities (91%), vascular engorgement (84%) and peribronchial thickening (72%) were the most frequent findings on 32 CTs. Peribronchial thickening (100%), ground-glass opacities (83%) and pulmonary vascular engorgement (79%) were common radiograph findings in asymptomatic children (n=25). Ground-glass opacity and consolidation were significantly higher in children who needed intensive care admission or died (92% and 48%), in contrast with children with a favorable outcome (71% and 24%, respectively; P<0.05).

CONCLUSION

Asymptomatic children and those with mild symptoms of COVID-19 showed mainly peribronchial thickening, ground-glass opacities and pulmonary vascular engorgement on radiographs. Ground-glass opacity and consolidation were more common in children who required intensive care admission or died.

Anxiety and fear related to coronavirus disease 2019 assessment in the Spanish population: A cross-sectional study

BACKGROUND

The coronavirus disease 2019 pandemic has affected millions of people worldwide, compromising the responsiveness of governments and states and thus generating anxiety and fear at the population level.

OBJECTIVE

To assess the level of anxiety and fear of coronavirus disease 2019 in a Spanish adult population group.

METHODS

A descriptive cross-sectional study, using the anxiety and fear of COVID-19 assessment scale (AMICO, for its acronym in Spanish). The sample was composed of 1038 subjects. Univariate and bivariate statistical analyses were performed, after analysis of normality in the data distribution. Categorical regression analyses were also executed.

FINDINGS

The total sample size was 1036 subjects, 56.3% was made up of females, with a mean age of 48.11 years (SD = 15.13). The mean score obtained on the AMICO scale was 5.54 points (SD = 1.83), with a score range between 1.22 and 10. Bivariate analysis only demonstrated statistically significant differences in the mean score of the scale and the variables: sex, marital status, work area and academic level. The executed categorical regression analysis revealed an R2 value of 0.75 and a significance of p = 0.00.

CONCLUSIONS

The results obtained show that the Spanish population presents moderate anxiety levels to coronavirus disease 2019. Women, married, with primary and/or secondary education level, and working in the public transport, services and/or hospitality sectors are more likely to have high levels of fear and anxiety.

APPLICATION TO PRACTICE

These results could be used for therapeutic and preventive psychological interventions, and also to plan new research under sex perspective and observing the socio-economic environment.

Gender Differences in Psychological Impact of the Confinement During the COVID-19 Outbreak in Spain: A Longitudinal Study

The rapid spread of the coronavirus disease 2019 (COVID-19) has led the authorities to establish compulsory confinement for most of the Spanish population from March to May 2020. Severe isolation combined with the uncertainty and fear associated with the public health crisis can have a psychological impact on the general population. The aim of the current study was to compare possible gender differences in mental health and psychological measures throughout the confinement. One hundred and sixty-four Spanish participants (75% female; M_age = 39.8; SD = 13.5) completed the surveys at the beginning, middle, and end of the forced confinement. The psychological variables were associated with depressive, anxiety, stress, and intrusive/avoidance symptoms, as well as a total score for overall mental health, and a positive/negative affect measure. The results showed that although females had significantly higher scores than males in almost all measures at the beginning of the confinement, the gender differences were quickly vanishing away over time. In fact, intra-group analysis showed that while the female group significantly improved their results on most psychological measures, the male group improved on only one single measure. In summary, the results showed that although the female group started the confinement with higher levels of negative emotions (particularly symptoms of stress and avoidance) than the male group, these differences were significantly reduced in the first few weeks due to the overall improvement in the results of the female group.

SARS‑CoV‑2 spike protein‑induced host inflammatory response signature in human corneal epithelial cells

Coronavirus disease 2019 (COVID‑19), caused by the severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2), led to an outbreak of viral pneumonia in December 2019. The present study aimed to investigate the host inflammatory response signature‑caused by SARS‑CoV‑2 in human corneal epithelial cells (HCECs). The expression level of angiotensin‑converting enzyme 2 (ACE2) in the human cornea was determined via immunofluorescence. In vitro experiments were performed in HCECs stimulated with the SARS‑CoV‑2 spike protein. Moreover, the expression levels of ACE2, IL‑8, TNF‑α, IL‑6, gasdermin D (GSDMD) and IL‑1β in HCECs were detected using reverse transcription‑quantitative PCR and/or western blotting. It was identified that ACE2 was expressed in normal human corneal epithelium and HCECs cultured in vitro. Furthermore, the expression levels of IL‑8, TNF‑α and IL‑6 in HCECs were decreased following SARS‑CoV‑2 spike protein stimulation, while the expression levels of GSDMD and IL‑1β were increased. In conclusion, the present results demonstrated that the SARS‑CoV‑2 spike protein suppressed the host inflammatory response and induced pyroptosis in HCECs. Therefore, blocking the ACE2 receptor in HCECs may reduce the infection rate of COVID‑19.

[Impact on mental healthcare after collaboration between primary healthcare and mental health services]

INTRODUCTION

The primary care physician is the professional with whom the psychiatric patient has contact first and most frequently. For this reason, a good coordination between the Primary Healthcare (PHC) and Mental Health (MH) services is essential to provide the best care to patients and at the same time optimise the limited resources of this service. The aim of this work is to determine whether the collaboration between PHC and MH results in a more efficient use of the limited resources in MH.

METHODOLOGY

An observational, retrospective, mirror study was carried out with a total sample of 135 patients over 16 years old referred for the first time from PHC to Psychiatry. The results during the first 6 months of the collaboration between PHC and MH (POST Group) are compared with those of the 6 months prior to the intervention (PRE Group).

RESULTS

After collaboration meetings, the percentage of patients who are discharged by the psychiatrist after the first visit decreases (32.2% vs. 16%) and the percentage of follow-up by psychiatry and psychology increases. Furthermore, the percentage of patients who do not attend the first visit decreases (23.3% vs. 13.7%).

CONCLUSIONS

The data suggest that the collaboration between PHC and MH improves the effectiveness and functioning of MH services.

Intensified antibody response elicited by boost suggests immune memory in individuals administered two doses of SARS-CoV-2 inactivated vaccine

Neutralizing antibodies in the subjects of an inactivated SARS-CoV-2 vaccine clinical trial showed a decreasing trend over months. An investigation studying the third immunization suggested that the waning of neutralizing antibodies in individuals administered two doses of inactivated vaccine does not mean the disappearance of immunity.

Evaluation of the Risk of Anxiety and/or Depression during Confinement Due to COVID-19 in Central Spain

(1) Background: The confinement of the population in response to the COVID-19 pandemic was related to an increased risk of suffering from anxiety and/or depression in previous studies with other populations. (2) Methods: descriptive study using surveys (Goldberg Anxiety and Depression Scale) with 808 participants over 18 years of age between 14 and 20 of May 2020 during the confinement due to the SARS-CoV-2 virus in Spain. (3) Results: 63% of the participants were at risk of suffering from anxiety and 64.9% were at risk of depression. Variables reaching statistical significance were: age (t anxiety = -0.139 and t depression = -0.153), gender (t anxiety = -4.152 and t depression = -4.178), marital status (anxiety F = 2.893 and depression F = 3.011), symptoms compatible with COVID-19 (t anxiety = -4.177 and t depression = -3.791), previous need for psychological help (t anxiety = -5.385 and t depression = -7.136) and need for such help at the time of the study (t anxiety = -9.144 and depression = -10.995). In addition, we generated two regression models that estimate the risk of anxiety and depression. (4) Conclusions: more than half of the participants were at risk of suffering from anxiety and/or depression, confirming the negative effect of confinement on the population.

Differences in clinical characteristics and liver injury between suspected and confirmed COVID-19 patients in Jingzhou, Hubei Province of China

ABSTRACT

To evaluate the clinical characteristics and liver injury in coronavirus disease 2019 (COVID-19) patients, and analyze the differences between suspected and confirmed COVID-19 patients, this retrospective study was performed on 157 COVID-19 patients and 93 suspected patients who were ultimately excluded from COVID-19 (control patients). Differences in clinical characteristics and liver injury between suspected and confirmed COVID-19 patients were analyzed. Age, male sex, fever, chest tightness and dyspnea were related to the severity of COVID-19. C-reactive protein (CRP) and D-dimer may be predictors of the severity of COVID-19. Computed tomography (CT) played an important role in the screening of COVID-19 and the evaluation of disease severity. Multiple factors may cause liver injury in COVID-19 patients. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be more likely to cause liver injury than common respiratory infectious diseases. Age, temperature (T), white blood cell (WBC), lymphocytes (LY), hematocrit (HCT), CRP, and finger pulse oxygen saturation (SpO2) may correlate with liver function impairment and may predict the occurrence and severity of liver function impairment. Some therapeutic drugs (like glucocorticoid) may be involved in the liver function impairment of COVID-19 patients. Most liver function indices improved significantly after active treatment. Although COVID-19 and other common respiratory infectious diseases share some clinical characteristics, COVID-19 has its own characteristics.