The clinical and demographical profile of Coronavirus illness: The tale of Tablighi Jamaat and Zaireen in Quarantine / Isolation center at Sukkur and Hyderabad

The challenge of asymptomatic carriers of COVID-19: A rapid review of literature

OBJECTIVES

To describe the epidemiological and sociodemographic characteristics of asymptomatic carriers reported in the literature, and to review the strategies used for diagnosis and control.

METHODS

Systematic literature review approach. As inclusion criteria, all studies published between January 1 and June 26, 2020, conducted in humans, that reported people who remained asymptomatic of COVID-19. Descriptors were adapted to the interfaces of eight bibliographic databases were configured: PubMed, Ovid, SciELO, Ebsco, Scopus, LILACS, Epistemonikos and Embase.

RESULTS

About 45% of the articles reported adult population, thirteen reported mixed population (adult and pediatric). 3 525 asymptomatic people were reported, with an average of 37,1 years [0.5-82 years]. Although the effectiveness of the control and prevention measures was not reported, the identification, isolation and follow-up of contacts stands out as a potential effective mechanism to prevent the transmission.

CONCLUSIONS

The use of this information could be relevant to guide evidence-based public health policies and the protection of populations and the improvement of health care that contributes to stopping this pandemic.

Impact of Smoking on COVID-19 Symptoms in Non-Vaccinated Patients: A Matched Observational Study from Qatar

Purpose

Predisposition to acute illness from COVID-19 is suggested to correlate with cigarette smoking as it augments the risk of developing cardiovascular and respiratory illnesses, including infections. However, the effects of smoking on COVID-19 symptoms are not well described and controversial. In this study, we aim to explore the associations between smoking and COVID-19 symptoms.

Subjects and Methods

A cross-sectional study using the Ministry of Public Health (MoPH), Qatar database was administered to a Qatari population with confirmed COVID-19 disease who filled in pre-defined phone-call questionnaire between 27th February 2020 and 31st December 2020. We analyzed 11,701 non-vaccinated COVID-19 individuals (2952 smokers and 8749 non-smokers) with confirmed RT-PCR test results. The association of smoking and the presence of symptoms as well as patient characteristics was calculated using Pearson’s Chi-square and Fisher’s exact tests, adjusting for potential covariates.

Results

Compared with the non-smokers, symptomatic COVID-19 infection is significantly higher in smokers. In addition, we found fever as the most common symptom developed in COVID-19 patients followed by cough, headache, muscle ache, and sore throat. As compared to other symptoms, association of smoking with chills and abdominal pain was less evident (P < 0.05 and P < 0.001, respectively). However, both groups showed similar rates of developing cough.

Conclusion

In conclusion, smoking is associated with COVID-19 symptoms frequency in non-vaccinated patients; nevertheless, further investigations are necessary to understand the mechanism of this association which could generate new targets for the management of COVID-19 in smoker patients.

COVID-19 severity: Studying the clinical and demographic risk factors for adverse outcomes

BACKGROUND

The primary goal of the presented cross-sectional observational study was to determine the clinical and demographic risk factors for adverse coronavirus disease 2019 (COVID-19) outcomes in the Pakistani population.

METHODS

We examined the individuals (n = 6331) that consulted two private diagnostic centers in Lahore, Pakistan, for COVID-19 testing between May 1, 2020, and November 30, 2020. The attending nurse collected clinical and demographic information. A confirmed case of COVID-19 was defined as having a positive result through real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens.

RESULTS

RT-PCR testing was positive in 1094 cases. Out of which, 5.2% had severe, and 20.8% had mild symptoms. We observed a strong association of COVID-19 severity with the number and type of comorbidities. The severity of the disease intensified as the number of comorbidities increased. The most vulnerable groups for the poor outcome are patients with diabetes and hypertension. Increasing age was also associated with PCR positivity and the severity of the disease.

CONCLUSIONS

Most cases of COVID-19 included in this study developed mild symptoms or were asymptomatic. Risk factors for adverse outcomes included older age and the simultaneous presence of comorbidities.

Dental health care providers' concerns, perceived impact, and preparedness during the COVID-19 pandemic in Saudi Arabia

BACKGROUND

Dental health care providers (DHCPs)are at high risk of cross-infection during clinical practice therefore, the aim of the study was to evaluate the DHCPs Covid-19 related concerns, its perceived impact, and their preparedness in Saudi Arabia.

METHODS

This cross-sectional study on DHCPs was carried out at five dental teaching hospitals/colleges in four provinces of Saudi Arabia from October to December 2020. A 35-item valid and reliable questionnaire was used to assess the concerns, perceived impact, and preparedness of DHCPs in the COVID-19 pandemic. Chi-square tests and logistic regression were used to compare parameters between the clinical and non-clinical staff.

RESULTS

A total of 320 DHCPs participated in this study with proportion of clinical staff (57.5%) surpassing the non-clinical staff (42.5%). The clinical DHCPs felt greater odds of falling ill with COVID-19 than non-clinical workers (OR, 2.61) and willing to look for another job (OR, 3.50). The higher proportion in both groups was worried that people close to them would be at higher exposure risk (96.3%) however, slightly more clinical DHCPs were concerned for their children than a non-clinical worker (OR, 3.57). The clinical DHCPs have greater odds of worrying that people would avoid them and their family members because of their job (OR, 2.75). A higher proportion in both groups (75.0%, 63.2%) felt that they would feel stress at work. More non-clinical DHCPs (94.1%) had received training for infection control than clinical (94.1% vs 63.0%: OR 0.10). Similarly, more DHCPs in the nonclinical group received adequate personal protective equipment training (88.2%; OR, 0.48). Most participants practiced self-preparation such as buying masks and disinfection (94.4%, 96.9%).

CONCLUSION

The majority of DHCPs felt concerned about their risk of exposure and falling ill from infection and infecting friends/family. These concerns could potentially affect the working of DHCPs during this pandemic. Measures to improve protection for DHCPs, minimize psychological implications, and potential social stigmatization should be identified at the planning phase before any pandemic.

Robotics and AI for Teleoperation, Tele-Assessment, and Tele-Training for Surgery in the Era of COVID-19: Existing Challenges, and Future Vision

The unprecedented shock caused by the COVID-19 pandemic has severely influenced the delivery of regular healthcare services. Most non-urgent medical activities, including elective surgeries, have been paused to mitigate the risk of infection and to dedicate medical resources to managing the pandemic. In this regard, not only surgeries are substantially influenced, but also pre- and post-operative assessment of patients and training for surgical procedures have been significantly impacted due to the pandemic. Many countries are planning a phased reopening, which includes the resumption of some surgical procedures. However, it is not clear how the reopening safe-practice guidelines will impact the quality of healthcare delivery. This perspective article evaluates the use of robotics and AI in 1) robotics-assisted surgery, 2) tele-examination of patients for pre- and post-surgery, and 3) tele-training for surgical procedures. Surgeons interact with a large number of staff and patients on a daily basis. Thus, the risk of infection transmission between them raises concerns. In addition, pre- and post-operative assessment also raises concerns about increasing the risk of disease transmission, in particular, since many patients may have other underlying conditions, which can increase their chances of mortality due to the virus. The pandemic has also limited the time and access that trainee surgeons have for training in the OR and/or in the presence of an expert. In this article, we describe existing challenges and possible solutions and suggest future research directions that may be relevant for robotics and AI in addressing the three tasks mentioned above.

SARS-CoV-2 infection and smoking: What is the association? A brief review

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The link between smoking and the expression of SARS-CoV-2 key entry genes is discussed.

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Smoking-related cardiac and respiratory diseases are risk factors for COVID-19.

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The impact of smoking on ACE-2 and TMPRSS2 receptors expression is controversial.

Susceptibility to severe illness from COVID-19 is anticipated to be associated with cigarette smoking as it aggravates the risk of cardiovascular and respiratory illness, including infections. This is particularly important with the advent of a new strain of coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) that has led to the present pandemic, coronavirus disease 2019 (COVID-19). Although, the effects of smoking on COVID-19 are less described and controversial, we presume a link between smoking and COVID-19. Smoking has been shown to enhance the expression of the angiotensin-converting enzyme-2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) key entry genes utilized by SARS-CoV-2 to infect cells and induce a ‘cytokine storm’, which further increases the severity of COVID-19 clinical course. Nevertheless, the impact of smoking on ACE-2 and TMPRSS2 receptors expression remains paradoxical. Thus, further research is necessary to unravel the association between smoking and COVID-19 and to pursue the development of potential novel therapies that are able to constrain the morbidity and mortality provoked by this infectious disease. Herein we present a brief overview of the current knowledge on the correlation between smoking and the expression of SARS-CoV-2 key entry genes, clinical manifestations, and disease progression.

Diagnostic value of Chest CT and Initial Real-Time RT-PCR in COVID-19 Infection

Objectives:

To evaluate the diagnostic value of the rtRT-PCR test and CT in patients presenting with typical clinical symptoms of COVID-19.

Methods:

The study with the participation of four center in Turkey was performed retrospectively from 20 March-15 April 2020 in 203 patients confirmed for COVID-19. The initial rtRT-PCR test was positive in 142 (70.0%) of the patients (Group-I) and negative in 61 patients (Group-II).

Results:

The mean age of the patients in Group-I was 49.7±18.0 years and the time between the onset of symptoms and admission to the hospital was 3.6±2.0 days; whereas the same values for the patients in Group-II were 58.1±19.9 and 5.3±4.2, respectively (p=0.004; p=0.026). Initial rtRT-PCR was found positive with 83.5% sensitivity and 74.1% PPV in patients with symptom duration of less than five days. It was found that rtRT-PCR positivity correlated negatively with the presence of CT findings, age, comorbidity, shortness of breath, and symptom duration, while rtRT-PCR positivity correlated positively with headache. Presence of CT findings was positively correlated with age, comorbidity, shortness of breath, fever, and the symptom duration.

Conclusions:

It should be noted that a negative result in the rtRT-PCR test does not rule out the possibility of COVID-19 diagnosis in patients whose symptom duration is longer than five days, who are elderly with comorbidities and in particular who present with fever and shortness of breath. In these patients, typical CT findings are diagnostic for COVID-19. A normal chest CT is no reason to loosen up measures of isolation in patients with newly beginning symptoms until the results are obtained from the PCR test.

Mathematical Models for COVID-19 Pandemic: A Comparative Analysis

COVID-19 pandemic represents an unprecedented global health crisis in the last 100 years. Its economic, social and health impact continues to grow and is likely to end up as one of the worst global disasters since the 1918 pandemic and the World Wars. Mathematical models have played an important role in the ongoing crisis; they have been used to inform public policies and have been instrumental in many of the social distancing measures that were instituted worldwide. In this article, we review some of the important mathematical models used to support the ongoing planning and response efforts. These models differ in their use, their mathematical form and their scope.

Models for COVID-19 Pandemic: A Comparative Analysis

COVID-19 pandemic represents an unprecedented global health crisis in the last 100 years. Its economic, social and health impact continues to grow and is likely to end up as one of the worst global disasters since the 1918 pandemic and the World Wars. Mathematical models have played an important role in the ongoing crisis; they have been used to inform public policies and have been instrumental in many of the social distancing measures that were instituted worldwide. In this article we review some of the important mathematical models used to support the ongoing planning and response efforts. These models differ in their use, their mathematical form and their scope.

Attitudes, Anxiety, and Behavioral Practices Regarding COVID-19 among University Students in Jordan: A Cross-Sectional Study

The COVID-19 pandemic represents a major public health, economic, political, and scientific concern in most countries around the globe where COVID-19 cases and deaths have been confirmed. This study assessed the attitudes, anxiety, and behavioral practices of university students in Jordan regarding COVID-19 during the early period of the infection (March 19-21, 2020) using a validated, self-administered survey questionnaire. Positive attitudes or low-risk practices were given 1 point, whereas negative attitudes or high-risk practices were scored 0. Percentages of the total score were used for categorizing data into negative attitudes or high-risk practices (≤ 60%), moderate attitudes or moderate-risk practices (60.01-80%), and positive attitudes or low-risk practices (> 80%). Generally, the university students displayed positive attitudes and low-risk practices toward preventing COVID-19, with an average score of 81.1% and 84.3%, respectively. Approximately two-thirds (69.1%) of the students showed a positive attitude toward COVID-19 seriousness, concern of contracting the virus, and the appropriate prevention measures, and low-risk practices (67.6%) toward preventing COVID-19 including implementation of social distancing and good hygiene. Female, older, medical, or postgraduate students practiced significantly more (P ≤ 0.05) appropriate hygiene and social distancing behaviors toward COVID-19 than their counterparts of each group. More than two-thirds (69.2%) of the students were anxious that they might become infected with COVID-19. These results are important for health authorities to develop appropriate educational programs and protective health measures including good respiratory etiquette and handwashing practices, to enhance safer lifestyles and prevent COVID-19 transmission.