Wuhan 2019 Novel Coronavirus - 2019-nCoV

Global Health Commodities Supply Chain in the Era of COVID-19 Pandemic: Challenges, Impacts, and Prospects: A Systematic Review

Background

The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern.

Objective

The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities' supply chain in the era of the COVID-19 pandemic.

Methods

A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis.

Results

Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health.

Conclusion

Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries' ambitions for achieving herd immunity quickly. Monitoring the pandemic's effect on the health commodities' supply system and designing a short-term and long-term resilient health supply chain system that can cope with current and future health catastrophes is pivotal.

Exploring the relationship across autonomous motivation, affects, and anxiety among gym practitioners during the second COVID-19 lockdown

The present study explores the association of autonomous motivation and the relationship of positive and negative affect on anxiety levels among individuals engaged in gym practitioners during the second COVID-19 lockdown. A total of 196 exercisers (29.17 ± 10.77) were enrolled in the present study, of which 112 (57.1%) were women and 84 (42.9%) were men. The survey included sociodemographic data, as well as validated instruments measuring autonomous motivation, positive and negative affect, and anxiety states related to the COVID-19 pandemic. The results revealed a positive association between autonomous motivation and positive affect (β = 0.36, CI 0.12, 0.37; p < 0.001), and a negative association between autonomous motivation and negative affect (β = - 0.17, CI - 0.31, - 0.01; p = 0.03). Moreover positive, and negative affect are negatively (β = - 0.33, CI - 0.43, - 0.24; p < 0.001) and positively (β = 0.72, CI 0.57, 0.82; p < 0.001) associated to anxiety, respectively. Thus, this study appears to emphasize the association of autonomous motivation on affect as a potential buffer against anxiety levels, particularly in a context where practitioners found themselves restricted in their usual gym practices.

The Potential of Anti-coronavirus Plant Secondary Metabolites in COVID-19 Drug Discovery as an Alternative to Repurposed Drugs: A Review

In early 2020, a global pandemic was announced due to the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), known to cause COVID-19. Despite worldwide efforts, there are only limited options regarding antiviral drug treatments for COVID-19. Although vaccines are now available, issues such as declining efficacy against different SARS-CoV-2 variants and the aging of vaccine-induced immunity highlight the importance of finding more antiviral drugs as a second line of defense against the disease. Drug repurposing has been used to rapidly find COVID-19 therapeutic options. Due to the lack of clinical evidence for the therapeutic benefits and certain serious side effects of repurposed antivirals, the search for an antiviral drug against SARS-CoV-2 with fewer side effects continues. In recent years, numerous studies have included antiviral chemicals from a variety of plant species. A better knowledge of the possible antiviral natural products and their mechanism against SARS-CoV-2 will help to develop stronger and more targeted direct-acting antiviral agents. The aim of the present study was to compile the current data on potential plant metabolites that can be investigated in COVID-19 drug discovery and development. This review represents a collection of plant secondary metabolites and their mode of action against SARS-CoV and SARS-CoV-2.

Biopsychosocial analysis of antibiotic use for the prevention or management of COVID-19 infections: A scoping review

BACKGROUND

The novelty and complexity of the COVID-19 pandemic has resulted in various coping mechanisms adopted by individuals as a means of averting the perceived fatalities of the pandemic. The use of antibiotics in the management of COVID-19 is clinically recommended under specific conditions. However, there are increasing trends of non-adherence to the recommended criteria resulting in the unwarranted use of antibiotics as an adaptative approach to the ongoing pandemic.

OBJECTIVE

The objective was to identify and classify factors associated with the unwarranted use of antibiotics in the management of COVID-19 from published literature and the perspectives of key stakeholders along a Biopsychosocial model.

METHODS

Literature was searched in the following databases: PubMed/MEDLINE, Scopus, Embase and Google Scholar for studies published between 31st December 2019 and 31st January 2022. The Arskey and O'Malley framework modified by Levac in the six-stage methodological process was adopted for this review and included: a) identification of research questions, b) identification of relevant research articles, c) selection of studies, d) data charting and synthesis, e) summary, discussion and analysis, and f) stakeholder consultations.

RESULTS

Out of 10,252 records identified from all sources, 12 studies were selected for inclusion in this scoping review. The selected articles reflected both antibiotic use and COVID-19 whilst capturing the biological (medical) and psychosocial perspectives. Most of the studies reported the overuse or abuse of Azithromycin especially in hospital settings. Common themes across the review and stakeholder consultations included fear, anxiety, media influences and deficits in public knowledge.

CONCLUSION

The findings of the study highlight the complexity of antibiotic control especially in the context of a pandemic. The identified determinants of antibiotic use provide the necessary framework to simulate health emergencies and be better positioned in the future through the development of targeted and comprehensive policies on antibiotic stewardship.

Anxiety and fear of COVID-19 in the UK general population: A cross-sectional study

There is still a generalized feeling of uncertainty in the population due to the coronavirus disease 2019 (COVID-19) pandemic, as restrictions on daily routines and social contact, accompanied by a large number of infections, negatively affect different areas of people's lives and, therefore, their mental health. The aim of the present study was to assess the presence of anxiety and fear of COVID-19 in the general UK population, using the Anxiety and Fear to COVID-19 Assessment Scale (Ansiedad y Miedo al COVID-19) (AMICO) scale. A descriptive, cross-sectional study based on a questionnaire was conducted in a sample of the UK general population in 2021. Socio-demographic and employment variables were included. The AMICO scale was included to measure fear and anxiety about COVID-19. The relationship between variables was studied with a categorical regression analysis. In general, participants regarded themselves as well-informed about the pandemic, although 62.6% had only received 1 dose of the vaccine. Regarding the AMICO scale the total score was 4.85 (out of 10; standard deviation 2.398). Women showed higher scores for the AMICO than men. The bivariate analysis revealed statistically significant differences in relation to self-confidence, amount of information received, and vaccination variables as related to the mean AMICO scores. An average level of anxiety and fear of COVID-19 is shown in the general UK population, which is lower than most of the studies that assessed the impact of the pandemic on the general population.

Sociodemographic Factors, Mental Health, and Emotional Eating Associated With Concern for COVID-19 Contagion in Nurses: A Cross-Sectional Study

OBJECTIVE

To determine the association between sociodemographic factors, stress, depression and anxiety, emotional eating, and concern about COVID-19 contagion in first and second-line Peruvian nurses.

METHODOLOGY

The study was cross-sectional and conducted with 500 Peruvian nurses of both sexes, over 18 years of age. Validated questionnaires were used to measure sociodemographic aspects, concern about COVID-19, generalized anxiety, depression, self-perceived stress, and emotional eating. Multiple linear regression analysis was performed to analyze the factors affecting concern about COVID-19 contagion.

RESULTS

The multiple linear regression analysis showed that stress, being between the ages of 18 and 29 years, being male, being from the coastal region or the jungle region, having a bachelor's degree, severe anxiety, and severe depression were associated with higher concern about COVID-19. On the other hand, having more than 5 to 10 years of experience and more than 10 years of experience, low emotional eating, and non-emotional eating were negatively associated with concern. This model explained 44.05% of the variability among the participating nurses.

CONCLUSION

These findings provide resources for future research on the comprehensive well-being of nursing staff by exploring various sociodemographic aspects and mental conditions associated with greater concern about COVID-19. Meanwhile, years of experience and emotional eating behavior were associated with lower concern about COVID-19. Future studies could incorporate this information to preserve the mental and physical health of nurses in the face of potential occupational threats.

Efficacy of chlorin dioxide wipes in disinfecting airway devices contaminated with Covid-19

Background

Reprocessing and disinfecting endoscopes is a routine practice in otolaryngology. An effective, safe, and rapid disinfection technique is essential during the COVID-19 pandemic.

Objective

To validate the efficacy of chlorine dioxide wipes in disinfecting three types of airway endoscopes contaminated with COVID-19-positive patient secretions.

Methods

Chlorine dioxide wipes were tested on rigid nasal endoscopes, laryngoscope blades, and flexible bronchoscopes. The endoscopes were disinfected using the wipes after exposure to COVID-19-positive patients. The tested scope was included in the study if the post procedure pre disinfection swab was positive for COVID-19 virus using RT-PCR. We analyzed 38 samples for 19 subjects (scopes) pre and post disinfection with chlorine dioxide wipes from July 2021 to February 2022.

Results

A total of four rigid endoscopes, four flexible bronchoscopes, and four laryngoscopes were included in the study which represent 24 pre and post disinfection swabs. The others were excluded because of negative pre disinfection swab. All the post disinfection PCR swab results were negative.

Conclusion

Chlorine dioxide is a convenient, fast, and effective disinfection technique for COVID-19-contaminated airway endoscopes.

Influence of COVID-19 pandemic on research and fieldwork: Perspectives from Ghana

The insurgence of COVID-19 has received all attention at the detriment of research on most diseases. Procedures and protocols devised to curb the pandemic continues to affect lives and work. As most countries prepare to tune back to normalcy, working conditions undoubtedly will not be the same as the World Health Organization still urges nations to scale up procedures and strategies against the pandemic. As research groups and projects across the globe and especially in Ghana begins work, these protocols must be fashioned into their study protocol before approval will be granted by ethical institutions. This has led to increase in research cost, with additional responsibilities aside their normal research activities. This perspective clearly points out the impact of the pandemic on research, especially fieldwork.

Initial Psychometric Development of the Fear and Anxiety to COVID-19 Scale in Nursing Professionals: An Occupational Health Assessment Tool

Objective

The effects caused by COVID-19 on the physical and mental health show the need to renew and create tools that specifically measure the fear and anxiety caused by the pandemic in healthcare professionals. The aim of the study was to measure fear and anxiety of COVID-19 in the nursing population group using a specific assessment scale.

Methods

A descriptive, cross-sectional study was carried out in Spain based on questionnaires. The sample was selected by non-probabilistic snowball sampling. Univariate and bivariate descriptive analyses were performed. For qualitative variables, a categorical regression analysis was performed.

Results

The sample consisted of 1012 nurses residing in Spain, 86.6% of whom were women, with a mean age of 40.84 years (SD = 11.51). The bivariate analysis revealed statistically significant differences in the mean score of the scale and the variables sex, level of education, m2 of the dwelling, and work area.

Conclusion

The validation of this scale provides a new management tool that should enable managers to assess anxiety and fear among their nurses, whether in the current COVID-19 pandemic or in other possible epidemiological situations to come.

Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

Background

A good understanding of the possible risk factors for coronavirus disease 19 (COVID‐19) severity could help clinicians in identifying patients who need prioritized treatment to prevent disease progression and adverse outcome. In the present study, we aimed to correlate clinical and laboratory characteristics of hospitalized COVID-19 patients to disease outcome in Saudi Arabia.

Materials and Methods

The present study included 199 COVID-19 patients admitted to King Fahd Specialist Hospital, Buraydah, Qassim, Saudi Arabia, from April to December 2020. Patients were followed-up until discharge either for recovery or death. Demographic data, clinical data and laboratory results were retrieved from electronic patient records.

Results

Critical COVID-19 cases showed higher mean of age and higher prevalence of co-morbid conditions. Fifty-five patients died during the observation period. Risk factors for in hospital death for COVID 19 patients were leukocytosis (OR 1.89, 95% CI 1.008–3.548, p = 0.081), lymphocytopenia (OR 2.152, 95% CI 1.079–4.295, p = 0.020), neutrophilia (OR 1.839, 95% CI 0.951–3.55, p = 0.047), thrombocytopenia (OR 2.152, 95% CI 0.852–5.430, p = 0.085), liver injury (OR 2.689, 95% CI 1.373–4.944, p = 0.003), acute kidney injury (OR 1.248, 95% CI 0.631–2.467 p = 0.319), pancreatic injury (OR 1.973, 95% CI 0.939–4.144, p = 0.056) and high D dimer (OR 2.635, 95% CI 0.747–9.287, p = 0.091).

Conclusion

Clinical and laboratory data of COVID-19 patients may help understanding the pathogenesis of the disease and subsequently improve of the outcome of patients by determination of the associated risk factors and recognition of high risk group who are more liable for complications and in hospital death. The present study put an eye on some parameters (laboratory and clinical) that should be alarming signs that the patient is at high risk bad prognosis.

Impact of COVID-19 on Health Seeking Behavior of Patients with Chronic Disease at Public Hospitals in Jimma Zone, South West Ethiopia

Background

COVID-19 is a global pandemic with unprecedented medical, economic and social consequences affecting nations across the world. This epidemic arises while chronic diseases are continued to be a public health concern. Though evidence is generated on its impact on the health care system, little is known about the Impact of COVID −19 on the care-seeking behavior of chronic patients.

Objective

To assess the Impact of COVID-19 on healthcare-seeking behavior of patients with chronic diseases attending follow-up at public hospitals in Jimma zone, South West Ethiopia.

Methods

Facility-based cross-sectional study design was employed. The sample was calculated using the single population proportion formula. Hospitals were selected by using simple random sampling. Then, the final calculated sample size for the study was proportionally allocated to each selected hospital. Data were collected from 400 participants through face-to-face interviews and card reviews. Data were entered into Epi-Data version 3.1 and then exported to SPSS version 23 for analysis. Binary and multivariable logistic regression analyses with 95% CI for odds ratio (OR) were used to identify significant factors.

Results

Of the total respondents 156 (39.0%) of them had poor health-seeking behavior. Contact history with COVID −19 patient (AOR = 2.8; 95% CI = 1.1–7.0), perceived moderate depression (AOR = 2.3; 95% CI = 1.2–4.2), perceived extreme depression (AOR = 4.3; 95% CI = 1.8–10.5), shortage of medication (AOR = 2.4; 95% CI = 1.0–6.2) increases the odds of poor health-seeking behavior. In addition, the odds of poor health-seeking in patients with no formal education were higher compared to patients with higher educational status (AOR = 2.7; 95% CI = 1.0–9.0).

Conclusion

COVID −19 outbreaks affected the health-seeking behavior of patients with chronic diseases. The impact was found to be more significant among patients who had a contact history with COVID −19 patients. Moreover, perceived depression, shortage of medication, and low educational status were significant predictors of poor health-seeking behavior. Therefore, working on the barriers to the health-seeking behavior of chronic patients may reduce the effect of COVID-19.

Mathematical Analysis of a COVID-19 Epidemic Model by Using Data Driven Epidemiological Parameters of Diseases Spread in India

This paper attempts to describe the outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) via an epidemic model. This virus has dissimilar effects in different countries. The number of new active coronavirus cases is increasing gradually across the globe. India is now in the second stage of COVID-19 spreading, it will be an epidemic very quickly if proper protection is not undertaken based on the database of the transmission of the disease. This paper is using the current data of COVID-19 for the mathematical modeling and its dynamical analysis. We bring in a new representation to appraise and manage the outbreak of infectious disease COVID-19 through SEQIR pandemic model, which is based on the supposition that the infected but undetected by testing individuals are send to quarantine during the incubation period. During the incubation period if any individual be infected by COVID-19, then that confirmed infected individuals are isolated and the necessary treatments are arranged so that they cannot taint the other residents in the community. Dynamics of the SEQIR model is presented by basic reproduction number R ₀ and the comprehensive stability analysis. Numerical results are depicted through apt graphical appearances using the data of five states and India.

Can Serum Endocan Levels be Used as an Early Prognostic Marker for Endothelial Dysfunction in COVID-19?

In this study, we aimed to investigate whether degree of pneumonia and COVID-19 prognosis are associated with serum endocan levels at the early stage, when vascular damage has started. Patients between the ages of 18-85 years who were hospitalized and followed up with a diagnosis of COVID-19 were included in the study. A total of 80 patients were divided into 2 groups as mild/moderate pneumonia and severe pneumonia. Serum endocan levels were measured on the 8th day from the onset of symptoms in all patients. Of the 80 patients included in the study, 56.3% were female and 43.8% were male. There was no significant relationship between serum endocan levels and degree of pneumonia (P = .220) and prognosis of the disease (P = .761). The correlation analysis indicated a weak positive correlation between serum endocan levels and lactate level in venous blood gas (r = .270; P = .037). During the 28-day follow-up, the mortality rate was 3.75%. It was determined that the serum endocan levels was not associated with the degree of pneumonia and was not an early prognostic marker for COVID-19.

Emoji use in China: popularity patterns and changes due to COVID-19

Emojis are small pictograms that are frequently embedded within micro-texts to more directly express emotional meanings. To understand the changes in the emoji usage of internet users during the COVID-19 outbreak, we analysed a large dataset collected from Weibo, the most popular Twitter-like social media platform in China, from December 1, 2019, to March 20, 2020. The data contained 38,183,194 microblog posts published by 2,239,472 unique users in Wuhan. We calculated the basic statistics of users’ usage of emojis, topics, and sentiments and analysed the temporal patterns of emoji occurrence. After examining the emoji co-occurrence structure, we finally explored other factors that may affect individual emoji usage. We found that the COVID-19 outbreak greatly changed the pattern of emoji usage; i.e., both the proportion of posts containing emojis and the ratio of users using emojis declined substantially, while the number of posts remained the same. The daily proportion of Happy emojis significantly declined to approximately 32%, but the proportions of Sad- and Encouraging-related emojis rose to 24% and 34%, respectively. Despite a significant decrease in the number of nodes and edges in the emoji co-occurrence network, the average degree of the network increased from 34 to 39.8, indicating that the diversity of emoji usage increased. Most interestingly, we found that male users were more inclined towards using regular textual language with fewer emojis after the pandemic, suggesting that during public crises, male groups appeared to control their emotional display. In summary, the COVID-19 pandemic remarkably impacted individual sentiments, and the normal pattern of emoji usage tends to change significantly following a public emergency.

Perceptions, concerns and reported behaviours in response to the first wave of the coronavirus disease 2019 pandemic across metropolitan, regional, rural and remote Australian communities

Objective

To investigate coronavirus disease 2019 community transmission concerns and adherence to social distancing and hygiene practices across metropolitan, regional, rural and remote areas in Australia.

Design

Cross‐sectional online survey of Australian adults conducted between April and May 2020 through convenience snowball sampling.

Setting

A range of locations across all states and territories of Australia.

Participants

Six hundred and seventy‐seven Australian adults, of which 78.8% lived outside of a metropolitan area.

Main outcome measures

Perceived threat of coronavirus disease 2019; social distancing guidelines and adherence; infection concerns; hygiene practices; frequency of leaving the house; impact of coronavirus disease 2019 on day‐to‐day life.

Results

Almost all respondents perceived the threat of the coronavirus disease 2019 pandemic was serious. There were high levels of support for the Australian Government's social distancing guidelines, although the perception that social distancing guidelines in participants’ communities were ‘too strict’ increased with remoteness area classification. Most respondents reported adherence with Australian Government social distancing guidelines. There was an association between remoteness and risk perception, with non‐metropolitan respondents more likely to feel safe when leaving the house. However, there was no association between geographical remoteness and self‐reported adherence with Australian Government social distancing guidelines.

Conclusions

This study provides an important initial insight into Australian perceptions and behaviours relating to the coronavirus disease 2019 pandemic, and how perceptions and behaviours varied by geographical remoteness. The geographical remoteness of communities should be considered by policy makers to ensure effective communication with the Australian public regarding coronavirus disease 2019 and ongoing adherence with preventative health behaviours.

The Effect of Achievement Motivation and Self-Regulated Learning on Student Learning Behavior in the Time of Online Learning in Indonesia

BACKGROUND: Self-regulated learning (SRL) and achievement motivation are important variables in students’ learning behavior. AIM: The purpose of this study was to examine the effect of achievement motivation and SRL on the learning behavior of junior high school students in Indonesia during the online learning period. METHODS: The research uses a quantitative approach with a causal associative research design. The research population is junior high school students in grades VII, VIII, and IX from various regions in Indonesia during the online learning period. Research respondents total 2,880 students, who were selected through random sampling technique. Respondent data were collected using a set of questionnaires in the form of a validated achievement motivation scale, SRL, and learning behavior, and processed and analyzed using the path-analysis method. RESULTS: The results of statistical processing show that the correlation coefficient between Achievement Motivation and SRL is 0.432 with a significant relationship and is included in the category of a fairly strong relationship. The correlation coefficient between Achievement Motivation and Learning Behavior is 0.632 with a significant relationship and is included in the category of a strong relationship. The correlation coefficient between SRL and Learning Behavior is 0.675 with a significant relationship and is included in the category of a strong relationship. Based on the Path Analysis Calculation Result Table, the path coefficient value for Achievement Motivation is 0.418 with a positive relationship direction. Simultaneous test results obtained the conclusion that there is an influence between Achievement Motivation and SRL variables on Learning Behavior of 59.8%, while the remaining 40.2% is the influence of other variables not involved in this study. The direct influence of Achievement Motivation on Learning Behavior is 17.5% and the indirect effect through SRL is 8.9%, so that if added up, the total effect is 26.4%. Then, the direct influence of SRL on Learning Behavior is 24.4% and the indirect effect through Achievement Motivation is 8.9% so that if added up, the total effect is 33.4%. CONCLUSION: There is a significant effect between achievement motivation and SRL on student learning behavior simultaneously; there is a significant influence between achievement motivations on student learning behavior partially. There is a significant influence between SRL on Student Learning Behavior partially.

COVID-19 lockdown and environmental pollution: an Indian multi-state investigation

Originating from China, COVID-19 became the first-ever coronavirus pandemic, wreaking havoc in 218 nations. The lack of a potential treatment exacerbated by the inability of the healthcare infrastructure to contain the viral trajectory led to a worldwide lockdown. The anthropogenic halt presented an unprecedented background to quantify the effect of the anthroposphere on environmental pollution. Consequently, we analyzed the variations in the air (PM₁₀, PM_2.5, NO₂, SO₂) and water pollutants (BOD, COD, DO, coliform) using real-time monitoring data in the majorly hit Indian metropolitan states during the lockdown in contrast to 2019 levels. The overall AQI (air quality index) de-escalated by -31.35%, -34.35%, -32.63%, -29.25% in Delhi, Tamil Nadu, West Bengal, and Karnataka, respectively, from the 2019 levels. The daily concentrations of NO₂, PM_2.5, and PM₁₀ plunged tremendously. The exact pre-disposing factors responsible for higher COVID-19 transmission in some geographical centers remain elusive. Investigations have corroborated putative links between air pollutants and COVID-19 mortalities. Therefore, we further mapped PM_2.5, PM₁₀, NO₂, and SO₂ to co-relate with COVID-19 infectivity and mortality across the study states. Significant (P < 0.001) positive correlation between COVID-19 transmission was established for all pollutants with maximum co-relation with AQI followed by NO₂. River Ganga water in Uttarakhand was deemed "fit for drinking" for the first time in two decades. An aggregate of -71.94, -61.32, and -77.94 decrease in BOD, COD, total coliform levels, and an 11.75 rise in the average DO levels from 2019 data. This study will better assist the future framework of health and environment restoration policies.

Emergency Department Preparedness of Prof. Dr. R. Soeharso Orthopaedic Hospital against Coronavirus Disease-19 Pandemic: Understanding the Challenges

The potential conditions for a worldwide pandemic have been caused by the new coronavirus disease (COVID-19). Since February 2020, the World Health Organization has determined the COVID-19 pandemic status. As a result, all countries in the world, including Indonesia, must adjust to the current global conditions. The Indonesian Ministry of Health has directed all hospitals in the nation to prepare and remodel all facilities to assist the effective handling of COVID-19. As the first line, the Emergency Department has fundamental principles for controlling and treating COVID-19 spread. The challenges should be understood, and the preparations for the COVID-19 pandemic redesign orthopedic and trauma cases.

Associations between individual and environmental determinants and physical activity levels of an active population during the Spanish lockdown

Restrictions during the COVID-19 pandemic are likely to decrease physical activity (PA) levels. The purpose of the study was to explore the associations between age, gender, and exercise facilities-type membership and physical activity levels during COVID-19 lockdown among users of exercise facilities from Spain. Participants were recruited among the members of 84 exercise facilities across Spain. Data was collected through an online questionnaire between 5th and 20th of April 2020 during the COVID-19 lockdown. A total of 7062 participants met inclusion criteria and responded correctly to the International Physical Activity Questionnaire. Lower levels of total PA were found in women compared with men (β = -26, 95%CI: -40 to -13), and among older adults (β = -48, 95%CI: -10 to -85) compared with younger ones. Moreover, users of private facilities showed higher levels of PA (β = 40, 95%CI: 13 to 66) than those from low-cost and public facilities (reference). Lastly, women from private facilities showed greater levels of PA (β = 63, 95%CI: 29 to 96) than low cost and public's users, an increase higher than what was found in men (β = 7, 95%CI: -38 to 52). Therefore, gender, age and the type of exercise facility's subscription had a relevant influence on PA levels during COVID-19 lockdown in an active population. These findings are useful for public health recommendations, in order to identify subpopulations of previously active people at risk of being physically inactive during and after this pandemic.

The Impact of the Coronavirus Disease (COVID-19) Pandemic on Nurses' Turnover Intention: An Integrative Review

The COVID-19 pandemic has increased the demand and workload on nurses. In addition, the number of critical cases, the uncertainty about the disease, and the incidence rate of death from the disease impose a psychological stress on nurses. Considering the alarming issues of stress, burnout, and turnover among nurses even before the pandemic, the pandemic might have amplified such issues. Thus, the impact of the COVID-19 pandemic on nurses' turnover and turnover intention warrants investigation. The aim of this review is to appraise and integrate the current pre- and post-coronavirus disease (COVID-19) literature on nurse turnover, published between 2016 and 2021. Forty-three studies on nurses' turnover intention were appraised and synthesized. The reviewed literature suggested that nurses' turnover intention increased significantly after the COVID-19 pandemic. Post-COVID-19-pandemic studies focused more on predicting nurses' turnover intention through the pandemic's negative impact on the nurses' psychological wellbeing. The findings of this review should be considered by nurse managers and leaders in the development of policies and programs to reduce the negative impact of COVID-19 on nurse retention.

From outbreak of COVID-19 to launching of vaccination drive: invigorating single-use plastics, mitigation strategies, and way forward

The unforeseen outbreak of the COVID-19 epidemic has significantly stipulated the use of plastics to minimize the exposure and spread of the novel coronavirus. With the onset of the vaccination drive, the issue draws even more attention due to additional demand for vaccine packaging, transport, disposable syringes, and other allied devices scaling up to many million tonnes of plastic. Plastic materials in personal protective equipment (PPE), disposable pharmaceutical devices, and packaging for e-commerce facilities are perceived to be a lifesaver for the frontline healthcare personnel and the general public amidst recurring waves of the pandemic. However, the same material poses a threat as an evil environmental polluter when attributed to its indiscriminate and improper littering as well as mismanagement. The review not only highlights the environmental consequences due to the excessive use of disposable plastics amidst COVID-19 but also recommends mixed approaches to its management by adopting the combined and step-by-step methodology of adequate segregation, sterilization, sanitization activities, technological intervention, and process optimization measures. The overview finally concludes with some crucial way-forward measures and recommendations like the development of bioplastics and focusing on biodegradable/bio-compostable material alternatives to holistically deal with future pandemics.

Roles of subdistrict health office personnel and village health volunteers in Thailand during the COVID-19 pandemic

In Thailand, 40 000 subdistrict health centre (SDHC) personnel and >1 million village health volunteers (VHVs) are responsible for primary healthcare of 23 million households in 75 032 villages. They were trained, made household visits, gave hygiene advice, participated in the 'Big Cleaning Day' campaign, produced cloth face masks, proactively identified high-risk visitors and monitored quarantined cases. 7.4 million Thais received basic education on hygiene, 1.3 million villagers joined the campaign and 3.6 million handmade cloth face masks were produced. In March 2020, 3.9 million households were visited, and 40 000 high-risk cases were detected. The intensity of proactive case findings increased to 12.6 million home visits and 834 000 cases were detected in April 2020. Almost 800 000 cases complied with the 14-day mandatory home quarantine, of which 3.6% developed symptoms suspected of respiratory tract infection. VHVs and SDHC personnel could efficiently contribute to the prevention and control of COVID-19 in Thailand.

Automated image classification of chest X-rays of COVID-19 using deep transfer learning

INTRODUCTION

In December 2019, the city of Wuhan, located in the Hubei province of China became the epicentre of an outbreak of a pandemic called COVID-19 by the World Health Organisation. The detection of this virus by rRTPCR (Real-Time Reverse Transcription-Polymerase Chain Reaction) tests reported high false negative rate. The manifestations of CXR (Chest X-Ray) images contained salient features of the virus. The objective of this paper is to establish the application of an early automated screening model that uses low computational power coupled with raw radiology images to assist the physicians and radiologists in the early detection and isolation of potential positive COVID-19 patients, to stop the rapid spread of the virus in vulnerable countries with limited hospital capacities and low doctor to patient ratio in order to prevent the escalating death rates.

MATERIALS AND METHODS

Our database consists of 447 and 447 CXR images of COVID-19 and Nofindings respectively, a total of 894 CXR images. They were then divided into 4 parts namely training, validation, testing and local/Aligarh dataset. The 4th (local/Aligarh) folder of the dataset was created to retest the diagnostics efficacy of our model on a developing nation such as India (Images from J.N.M.C., Aligarh, Uttar Pradesh, India). We used an Artificial Intelligence technique called CNN (Convolutional Neural Network). The architecture based on CNN used was MobileNet. MobileNet makes it faster than the ordinary convolutional model, while substantially decreasing the computational cost.

RESULTS

The experimental results of our model show an accuracy of 96.33%. The F1-score is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The false negative (FN) value, for the validation dataset is 6 (Fig. 3.6), for the testing dataset is 0 (Fig. 3.7) and that for the local/Aligarh dataset is 2 . The recall/sensitivity of the classifier is 93% and 96% for the 1st testing and 2nd testing (local/Aligarh) datasets (Tables 3.3 and 3.4). The recall/sensitivity for the detection of specifically COVID-19 (+) for the testing dataset is 88% and for the locally acquired dataset from India is 100%. The False Negative Rate (FNR) is 12% for the testing dataset and 0% for the locally acquired dataset (local/Aligarh). The execution time for the model to predict the input images and classify them is less than 0.1 s.

DISCUSSION AND CONCLUSION

The false negative rate is much lower than the standard rRT-PCR tests and even 0% on the locally acquired dataset. This suggests that the established model with end-to-end structure and deep learning technique can be employed to assist radiologists in validating their initial screenings of Chest X-Ray images of COVID-19 in developed and developing nations. Further research is needed to test the model to make it more robust, employ it on multiclass classification and also try sensitise it to identify new strains of COVID-19. This model might help cultivate tele-radiology.

Assessment of initial SARS-CoV-2 seroprevalence in the most affected districts in the municipality of São Paulo, Brazil

Background

São Paulo city has been one of the regions most affected by the COVID-19 pandemic in Brazil. Frequent asymptomatic and oligosymptomatic infections and poor access to diagnostic tests make serosurveys crucial to monitor the magnitude of the epidemic and to inform public health policies, such as vaccination plans.

Objectives

To estimate, early in the epidemic, the seroprevalence of antibodies to SARS-CoV-2 in adults living in the six most affected districts in São Paulo city, and to assess potential associated risk factors.

Methods

This was a cross-sectional population-based survey of 1,152 households randomly selected from 72 census tracts. During the period May 4–12, 2020, 463 participants completed a questionnaire on sociodemographic characteristics and history of symptoms in the past two weeks, and provided a blood sample. Prevalence of SARS-CoV-2 antibodies was the outcome of interest and was estimated based on results of two immunoassays, Maglumi SARS-CoV-2 chemiluminescence assay Immunoglobulin (Ig) M (IgM) and IgG, and Roche electrochemiluminescence assay total Ig. Serum samples reactive to either assay were considered positive.

Results

Weighted overall seroprevalence was 6% (95%CI 3.9–8.3%). No association was observed between seropositivity and sex, age group or education level. Participants who reported black and brown skin color showed a 2.7 fold higher prevalence than people with white skin (p = 0.007). Among the 30 seropositive individuals, 14 (46.6%) reported no COVID-19 compatible symptoms in the past two weeks.

Conclusion

This study represents the first assessment of SARS-CoV-2 seroprevalence in the city of São Paulo and 6% is the baseline estimate of a series of population-based seroprevalence surveys. Serological screening using sound serological assays is the key tool to monitoring temporal and geographic changes in the spread of the virus through an important epicenter of the COVID-19 pandemic in Brazil. Ultimately, it may inform prevention and control efforts.

The Association Between Body Mass Index, Emotional Eating and Perceived Stress during COVID-19 Partial Quarantine in Healthy Adults

Objective:

We investigated emotional eating behaviours and perceived stress during COVID-19 partial quarantine according to BMI levels in healthy adults.

Design:

Cross-sectional study.

Setting:

An online survey including demographic variables, eating attitude-related questions, Emotional Eater Questionnaire (EEQ) and Perceived Stress Scale-14 (PSS-14) was sent via online data collection platform. Self-reported weight, height and weight changes during the quarantine were also collected.

Participants:

A total of 506 people aged between 20–65 years who were partially quarantined due to COVID-19 participated in this study.

Results:

BMI was positively correlated with EEQ (r 0 ·205, P = 0·001). However, BMI was negatively linked with PSS-14 during COVID-19 (r -0·125, P = 0·001), indicating that participants with lower BMI had higher perceived stress during COVID-19. Participants gained weight during the lockdown situation (+1·20 ± 1·70 kg in men; +0·91 ± 1·40 kg in women). EEQ and PSS-14 scores of women found to be significantly higher than men (9·39 ± 5·37 in men v. 11·17 ± 5·85 in women for EEQ; 24·67 ± 8·32 in men v. 27·99 ± 7·34 in women for PSS-14). Obese participants consumed sweetened and carbonated drinks two-fold more in those compared with other participants.

Conclusion:

These findings suggest that partial quarantine may be closely related to emotional eating and weight gain, and participants with higher BMI showed more emotional eating behaviours. Therefore, certain precautions should be considered beforehand in order not to cause long-term eating disorder problems.

Characterization of the SARS-CoV-2 coronavirus X4-like accessory protein

Background

The novel coronavirus SARS-CoV-2 is currently a global threat to health and economies. Therapeutics and vaccines are in rapid development; however, none of these therapeutics are considered as absolute cure, and the potential to mutate makes it necessary to find therapeutics that target a highly conserved regions of the viral structure.

Results

In this study, we characterized an essential but poorly understood coronavirus accessory X4 protein, a core and stable component of the SARS-CoV family. Sequence analysis shows a conserved ~ 90% identity between the SARS-CoV-2 and previously characterized X4 protein in the database. QMEAN Z score of the model protein shows a value of around 0.5, within the acceptable range 0-1. A MolProbity score of 2.96 was obtained for the model protein and indicates a good quality model. The model has Ramachandran values of φ = - 57o and ψ = - 47o for α-helices and values of φ = - 130o and ψ = + 140o for twisted sheets.

Conclusions

The protein data obtained from this study provides robust information for further in vitro and in vivo experiment, targeted at devising therapeutics against the virus. Phylogenetic analysis further supports previous evidence that the SARS-CoV-2 is positioned with the SL-CoVZC45, BtRs-BetaCoV/YN2018B and the RS4231 Bat SARS-like corona viruses.

A metapopulation network model for the spreading of SARS-CoV-2: Case study for Ireland

We present preliminary results on an all-Ireland network modelling approach to simulate the spreading the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), commonly known as the coronavirus. In the model, nodes correspond to locations or communities that are connected by links indicating travel and commuting between different locations. While this proposed modelling framework can be applied on all levels of spatial granularity and different countries, we consider Ireland as a case study. The network comprises 3440 electoral divisions (EDs) of the Republic of Ireland and 890 superoutput areas (SOAs) for Northern Ireland, which corresponds to local administrative units below the NUTS 3 regions. The local dynamics within each node follows a phenomenological SIRX compartmental model including classes of Susceptibles, Infected, Recovered and Quarantined (X) inspired from Science 368, 742 (2020). For better comparison to empirical data, we extended that model by a class of Deaths. We consider various scenarios including the 5-phase roadmap for Ireland. In addition, as proof of concept, we investigate the effect of dynamic interventions that aim to keep the number of infected below a given threshold. This is achieved by dynamically adjusting containment measures on a national scale, which could also be implemented at a regional (county) or local (ED/SOA) level. We find that - in principle - dynamic interventions are capable to limit the impact of future waves of outbreaks, but on the downside, in the absence of a vaccine, such a strategy can last several years until herd immunity is reached.

Enhanced contact investigations for nine early travel-related cases of SARS-CoV-2 in the United States

Coronavirus disease 2019 (COVID-19), the respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China and has since become pandemic. In response to the first cases identified in the United States, close contacts of confirmed COVID-19 cases were investigated to enable early identification and isolation of additional cases and to learn more about risk factors for transmission. Close contacts of nine early travel-related cases in the United States were identified and monitored daily for development of symptoms (active monitoring). Selected close contacts (including those with exposures categorized as higher risk) were targeted for collection of additional exposure information and respiratory samples. Respiratory samples were tested for SARS-CoV-2 by real-time reverse transcription polymerase chain reaction at the Centers for Disease Control and Prevention. Four hundred four close contacts were actively monitored in the jurisdictions that managed the travel-related cases. Three hundred thirty-eight of the 404 close contacts provided at least basic exposure information, of whom 159 close contacts had ≥1 set of respiratory samples collected and tested. Across all actively monitored close contacts, two additional symptomatic COVID-19 cases (i.e., secondary cases) were identified; both secondary cases were in spouses of travel-associated case patients. When considering only household members, all of whom had ≥1 respiratory sample tested for SARS-CoV-2, the secondary attack rate (i.e., the number of secondary cases as a proportion of total close contacts) was 13% (95% CI: 4-38%). The results from these contact tracing investigations suggest that household members, especially significant others, of COVID-19 cases are at highest risk of becoming infected. The importance of personal protective equipment for healthcare workers is also underlined. Isolation of persons with COVID-19, in combination with quarantine of exposed close contacts and practice of everyday preventive behaviors, is important to mitigate spread of COVID-19.

Is Sex a Determinant of COVID-19 Infection? Truth or Myth?

Purpose of Review

Angiotensin-converting enzyme 2 (ACE2), a specific high-affinity angiotensin II-hydrolytic enzyme, is the vector that facilitates cellular entry of SARS-CoV-1 and the novel SARS-CoV-2 coronavirus. SARS-CoV-2, which crossed species barriers to infect humans, is highly contagious and associated with high lethality due to multi-organ failure, mostly in older patients with other co-morbidities.

Recent Findings

Accumulating clinical evidence demonstrates that the intensity of the infection and its complications are more prominent in men. It has been postulated that potential functional modulation of ACE2 by estrogen may explain the sex difference in morbidity and mortality.

Summary

We review here the evidence regarding the role of estrogenic hormones in ACE2 expression and regulation, with the intent of bringing to the forefront potential mechanisms that may explain sex differences in SARS-CoV-2 infection and COVID-19 outcomes, assist in management of COVID-19, and uncover new therapeutic strategies.

COVID-19 Neurologic Complication with CNS Vasculitis-Like Pattern

Coronavirus disease 2019 (COVID-19) is a viral infection caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), which spreads rapidly from person to person and manifests in most symptomatic patients as a respiratory illness, similar to prior SARS viruses. Neurologic manifestations of COVID-19 are uncommon; those so far reported include encephalopathy, stroke from large-vessel occlusion, and polyneuropathy. We report a unique neurologic complication of COVID-19 in a patient who had extensive cerebral small-vessel ischemic lesions resembling cerebral vasculitis in a characteristic combined imaging pattern of ischemia, hemorrhage, and punctuate postcontrast enhancement. Also, a characteristic lower extremity skin rash was present in our patient. Our observation lends support to the increasingly suspected mechanism of "endotheliitis" associated with this novel coronavirus.

Aerosol-generating procedures in head and neck surgery - can we improve practice after COVID-19?

The COVID-19 pandemic has had a dramatic impact on international medicine practice. The propensity for head and neck surgery to generate aerosols needs special consideration over and above simply adopting personal protective equipment. This study sought to interrogate the literature and evaluate whether which additional measures might provide benefit if routinely adopted in minimising viral transmission.

Expert consensus on protocol of rehabilitation for COVID-19 patients using framework and approaches of WHO International Family Classifications

Coronavirus disease 2019 (COVID-19) has widely spread all over the world and the numbers of patients and deaths are increasing. According to the epidemiology, virology, and clinical practice, there are varying degrees of changes in patients, involving the human body structure and function and the activity and participation. Based on the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) and its biopsychosocial model of functioning, we use the WHO Family of International Classifications (WHO-FICs) framework to form an expert consensus on the COVID-19 rehabilitation program, focusing on the diagnosis and evaluation of disease and functioning, and service delivery of rehabilitation, and to establish a standard rehabilitation framework, terminology system, and evaluation and intervention systems based the WHO-FICs.

Mathematical Modeling of the Wuhan COVID-2019 Epidemic and Inverse Problems

Mathematical models for transmission dynamics of the novel COVID-2019 coronavirus, an outbreak of which began in December, 2019, in Wuhan are considered. To control the epidemiological situation, it is necessary to develop corresponding mathematical models. Mathematical models of COVID-2019 spread described by systems of nonlinear ordinary differential equations (ODEs) are overviewed. Some of the coefficients and initial data for the ODE systems are unknown or their averaged values are specified. The problem of identifying model parameters is reduced to the minimization of a quadratic objective functional. Since the ODEs are nonlinear, the solution of the inverse epidemiology problems can be nonunique, so approaches for analyzing the identifiability of inverse problems are described. These approaches make it possible to establish which of the unknown parameters (or their combinations) can be uniquely and stably recovered from available additional information. For the minimization problem, methods are presented based on a combination of global techniques (covering methods, nature-like algorithms, multilevel gradient methods) and local techniques (gradient methods and the Nelder–Mead method).