Literature Review of Omicron: A Grim Reality Amidst COVID-19

Effect of Model-Based Iterative Reconstruction on Image Quality of Chest Computed Tomography for COVID-19 Pneumonia

PURPOSE

This study aimed to compare the image quality of chest computed tomography (CT) scans for COVID-19 pneumonia using forward-projected model-based iterative reconstruction solution-LUNG (FIRST-LUNG) with filtered back projection (FBP) and hybrid iterative reconstruction (HIR).

METHOD

The CT images of 44 inpatients diagnosed with COVID-19 pneumonia between December 2022 and June 2023 were retrospectively analyzed. The CT images were reconstructed using FBP, HIR, and FIRST-LUNG-MILD/STANDARD/STRONG. The CT values and noise of the lumen of the main trachea and erector spine muscle were measured for each group. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective evaluations included overall image quality, noise, streak artifact, visualization of normal lung structures, and abnormal CT features. One-way analysis of variance was used to compare the objective and subjective indicators among the five groups. The task-based transfer function was derived for three distinct contrasts representing anatomical structures, lower-contrast lesion, and higher-contrast lesion.

RESULTS

The results of the study demonstrated significant differences in image noise, SNR, and CNR among the five groups (P < 0.001). The FBP images exhibited the highest levels of noise and the lowest SNR and CNR among the five groups (P < 0.001). When compared to the FBP and HIR groups, the noise was lower in the FIRST-LUNG-MILD/STANDARD/STRONG group, while the SNR and CNR were higher (P < 0.001). The subjective overall image quality score of FIRST-LUNG-MILD/STANDARD was significantly better than FBP and FIRST-LUNG-STRONG (P < 0.001). FIRST-LUNG-MILD was superior to FBP, HIR, FIRST-LUNG-STANDARD, and FIRST-LUNG-STRONG in visualizing proximal and peripheral bronchovascular and subpleural vessels (P < 0.05). Additionally, FIRST-LUNG-MILD achieved the best scores in evaluating abnormal lung structure (P < 0.001). The overall interobserver agreement was substantial (intraclass correlation coefficient = 0.891). The task-based transfer function 50% values of FIRST reconstructions are consistently higher compared to FBP and HIR.

CONCLUSIONS

The FIRST-LUNG-MILD/STANDARD algorithm can enhance the image quality of chest CT in patients with COVID-19 pneumonia, while preserving important details of the lesions, better than the FBP and HIR algorithms. After evaluating various COVID-19 pneumonia lesions and considering the improvement in image quality, we recommend using the FIRST-LUNG-MILD reconstruction for diagnosing COVID-19 pneumonia.

A propensity score matched analysis of COVID-19 ongoing symptoms in primary medical staff members with different levels of stress in Jiangsu Province, China

Objective

Ongoing symptoms which originated from coronavirus disease 2019 (COVID-19) infections threaten the health of a broad population of patients. With recent changes in COVID-19 control measures in China, medical staff members are currently experiencing a high level of stress. This study aimed to investigate the prevalence of ongoing symptomatic COVID-19 and explore the potential association between stress and ongoing COVID symptoms.

Methods

From January 17th to February 2, 2023, primary medical staff members in Jiangsu Province were surveyed using a self-designed questionnaire. Univariate multinomial logistic analysis was used to illustrate the relationship between stress and ongoing symptoms after matching the low- and high-stress groups in a 1:1 ratio based on propensity scores.

Results

Analysis revealed that 14.83 % (3785/25,516) of primary medical staff members infected with COVID-19 experienced ongoing symptoms, the most common of which included cough (9.51 %), dyspnea (9.51 %), sleep problems (4.40 %), anxiety (2.29 %), and reproductive system symptoms (1.89 %). In matched patients, higher stress levels were associated with a greater risk of ongoing symptoms than in patients without ongoing symptoms for 14 of the 15 reported symptoms in this study (odds ratios [ORs] > 1 and P < 0.05). Moreover, higher levels of stress were associated with a greater risk of more ongoing symptoms, and the overall ORs increased with the number of symptoms (ORs >1 and P < 0.05).

Conclusion

To mitigate the possibility of experiencing ongoing symptoms, healthcare organizations and local authority agencies should institute helpful measures to decrease stress levels such as medical staff augmentation and enabling all staff to have a reasonable work-life balance.

Assessing SARS-CoV-2 Testing Adherence in a University Town: Recurrent Event Modeling Analysis

BACKGROUND

Healthy Davis Together was a program launched in September 2020 in the city of Davis, California, to mitigate the spread of COVID-19 and facilitate the return to normalcy. The program involved multiple interventions, including free saliva-based asymptomatic testing, targeted communication campaigns, education efforts, and distribution of personal protective equipment, community partnerships, and investments in the local economy.

OBJECTIVE

This study identified demographic characteristics of individuals that underwent testing and assessed adherence to testing over time in a community pandemic-response program launched in a college town in California, United States.

METHODS

This study outlines overall testing engagement, identifies demographic characteristics of participants, and evaluates testing participation changes over 4 periods of the COVID-19 pandemic, distinguished by the dominant variants Delta and Omicron. Additionally, a recurrent model is employed to explore testing patterns based on the participants' frequency, timing, and demographic characteristics.

RESULTS

A total of 770,165 tests were performed between November 18, 2020, and June 30, 2022, among 89,924 (41.1% of total population) residents of Yolo County, with significant participation from racially or ethnically diverse participants and across age groups. Most positive cases (6351 of total) and highest daily participation (895 per 100,000 population) were during the Omicron period. There were some gender and age-related differences in the pattern of recurrent COVID-19 testing. Men were slightly less likely (hazard ratio [HR] 0.969, 95% CI 0.943-0.996) to be retested and more likely (HR 1.104, 95% CI 1.075-1.134) to stop testing altogether than women. People aged between 20 and 34 years were less likely to be retested (HR 0.861, 95% CI 0.828-0.895) and more likely to stop testing altogether (HR 2.617, 95% CI 2.538-2.699). However, older age groups were less likely to stop testing, especially those aged between 65-74 years and 75-84 years, than those aged between 0 and 19 years. The likelihood of stopping testing was lower (HR 0.93, 95% CI 0.889-0.976) for the Asian group and higher for the Hispanic or Latino (HR 1.185, 95% CI 1.148-1.223) and Black or African American (HR 1.198, 95% CI 1.054-1.350) groups than the White group.

CONCLUSIONS

The unique features of a pandemic response program that supported community-wide access to free asymptomatic testing provide a unique opportunity to evaluate adherence to testing recommendations and testing trends over time. Identification of individual and group-level factors associated with testing behaviors can provide insights for identifying potential areas of improvement in future testing initiatives.

Changes in symptoms and characteristics of COVID-19 patients across different variants: two years study using neural network analysis

BACKGROUND

Considering the fact that COVID-19 has undergone various changes over time, its symptoms have also varied. The aim of this study is to describe and compare the changes in personal characteristics, symptoms, and underlying conditions of individuals infected with different strains of COVID-19.

METHODS

This descriptive-analytical study was conducted on 46,747 patients who underwent PCR testing during a two-year period from February 22, 2020 to February 23, 2022, in South Khorasan province, Iran. Patient characteristics and symptoms were extracted based on self-report and the information system. The data were analyzed using logistic regression and artificial neural network approaches. The R software was used for analysis and a significance level of 0.05 was considered for the tests.

RESULTS

Among the 46,747 cases analyzed, 23,239 (49.7%) were male, and the mean age was 51.48 ± 21.41 years. There was a significant difference in symptoms among different variants of the disease (p < 0.001). The factors with a significant positive association were myalgia (OR: 2.04; 95% CI, 1.76 - 2.36), cough (OR: 1.93; 95% CI, 1.68-2.22), and taste or smell disorder (OR: 2.62; 95% CI, 2.1 - 3.28). Additionally, aging was found to increase the likelihood of testing positive across the six periods.

CONCLUSION

We found that older age, myalgia, cough and taste/smell disorder are better factors compared to dyspnea or high body temperature, for identifying a COVID-19 patient. As the disease evolved, chills and diarrhea, demonstrated prognostic strength as in Omicron.

Analysis of influencing factors of job demands of healthcare workers working in mobile cabin hospitals in China

AIM

To explore the job demands of healthcare workers (HCWs) working in mobile cabin hospitals in Shanghai and identify the influencing factors.

DESIGN

The study had a cross-sectional design.

METHODS

Using the convenience sampling method, we selected 1223 HCWs (medical team members) working in these mobile cabin hospitals during April-May 2022. The findings of the general information questionnaire and the hierarchy scale of job demands of HCWs working in mobile cabin hospitals were used for the investigation.

RESULTS

The total score of job demands of the included HCWs was 132.26 ± 9.53; the average score of the items was 4.73 ± 0.34. Multivariate linear regression analyses showed that the following HCWs had significantly higher job demands: female HCWs and HCWs who received psychological training or intervention during the COVID-19 pandemic, were satisfied with the doctor/nurse-patient relationship, received support from family members/friends/colleagues, believed that the risk of working in mobile cabin hospitals was high, had adapted to the working environment of mobile cabin hospitals and had college/undergraduate level of education. They would benefit from increased social support and better training in terms of psychological coping mechanisms(both theoretical knowledge and applicable skills) and COVID-19 prevention,control and treatment abilities.

From Emergence to Endemicity: A Comprehensive Review of COVID-19

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.

Doctors ranking through heterogeneous information: The new score functions considering patients' emotional intensity

With the popularity of the Internet and the growing complexity of COVID-19, more and more patients tend to consult doctors online. With the difficulty of doctor selection caused by a massive amount of information, this study proposes a hybrid multi-criteria decision-making framework, which can model patients' emotional intensity through heterogeneous information and rank doctors. Firstly, online reviews (ORs) are transformed into probabilistic linguistic term sets through sentiment analysis. Then, new score functions are proposed considering the nonlinear influence of doctors' information and the patients' negative bias toward ORs. Next, a method of weight determination combining the Term Frequency Inverse Document Frequency and the Decision-making Trial and Evaluation Laboratory method is proposed. Finally, the proposed score functions are applied to the Combined Compromise Solution (CoCoSo) method to aggregate information and rank doctors. The proposed method is verified in a case study on haodf.com. The results show that considering the emotional intensity of heterogeneous information will make the recommendations more realistic. Comparative analysis and sensitivity analysis are further performed to illustrate the availability and effectiveness of the proposed method.

An overview of the vaccine platforms to combat COVID-19 with a focus on the subunit vaccines

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus that has caused the recent coronavirus disease (COVID-19) global pandemic. The current approved COVID-19 vaccines have shown considerable efficiency against hospitalization and death. However, the continuation of the pandemic for more than two years and the likelihood of new strain emergence despite the global rollout of vaccination highlight the immediate need for the development and improvement of vaccines. mRNA, viral vector, and inactivated virus vaccine platforms were the first members of the worldwide approved vaccine list. Subunit vaccines. which are vaccines based on synthetic peptides or recombinant proteins, have been used in lower numbers and limited countries. The unavoidable advantages of this platform, including safety and precise immune targeting, make it a promising vaccine with wider global use in the near future. This review article summarizes the current knowledge on different vaccine platforms, focusing on the subunit vaccines and their clinical trial advancements against COVID-19.

COVID-19 increased in Italian children in the autumn and winter 2021-2022 period when Omicron was the dominant variant

AIM

We examined the prevalence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children during the autumn and winter season from 1 September 2021 to 30 January 2022 and compared it with the same period in 2020-2021.

METHODS

This study was carried out int the paediatric emergency department (PED) of a tertiary Italian hospital. We compared the clinical and demographical features of all children who presented during the two study periods and tested positive for SARS-CoV-2.

RESULTS

During the 2021-2022 autumn and winter season 5813 children presented to the PED, 19.0% were tested for SARS-CoV-2 and 133 (12.0%) of those tested positive. In 2020-2021, 2914 presented to the PED, 12.3% were tested, and 30 (8.3%) of those tested positive. There were no statistically significant differences in clinical severity during the two study periods, despite a higher percentage of neurological symptoms in 2020-2021. Of the SARS-CoV-2-positive cases, 29/133 (21.8%) were hospitalised during the 2021-2022 season and 10/30 (33.3%) during the previous one. Only 3/163 children required intensive care.

CONCLUSION

The greater spread of SARS-CoV-2 was probably due to the greater transmissibility of the Omicron variant, but the symptoms were mild and only 3 children required intensive care.

Twice evasions of Omicron variants explain the temporal patterns in six Asian and Oceanic countries

BACKGROUND

The ongoing coronavirus 2019 (COVID-19) pandemic has emerged and caused multiple pandemic waves in the following six countries: India, Indonesia, Nepal, Malaysia, Bangladesh and Myanmar. Some of the countries have been much less studied in this devastating pandemic. This study aims to assess the impact of the Omicron variant in these six countries and estimate the infection fatality rate (IFR) and the reproduction number [Formula: see text] in these six South Asia, Southeast Asia and Oceania countries.

METHODS

We propose a Susceptible-Vaccinated-Exposed-Infectious-Hospitalized-Death-Recovered model with a time-varying transmission rate [Formula: see text] to fit the multiple waves of the COVID-19 pandemic and to estimate the IFR and [Formula: see text] in the aforementioned six countries. The level of immune evasion and the intrinsic transmissibility advantage of the Omicron variant are also considered in this model.

RESULTS

We fit our model to the reported deaths well. We estimate the IFR (in the range of 0.016 to 0.136%) and the reproduction number [Formula: see text] (in the range of 0 to 9) in the six countries. Multiple pandemic waves in each country were observed in our simulation results.

CONCLUSIONS

The invasion of the Omicron variant caused the new pandemic waves in the six countries. The higher [Formula: see text] suggests the intrinsic transmissibility advantage of the Omicron variant. Our model simulation forecast implies that the Omicron pandemic wave may be mitigated due to the increasing immunized population and vaccine coverage.

A Computational Study of Carbazole Alkaloids from Murraya koenigii as Potential SARS-CoV-2 Main Protease Inhibitors

Despite COVID-19 vaccination, immune escape of new SARS-CoV-2 variants has created an urgent priority to identify additional antiviral drugs. Targeting main protease (M^pro) expressed by SARS-CoV-2 is a therapeutic strategy for drug development due to its prominent role in viral replication cycle. Leaves of Murraya koenigii are used in various traditional medicinal applications and this plant is known as a rich source of carbazole alkaloids. Thus, this computational study was designed to investigate the inhibitory potential of carbazole alkaloids from Murraya koenigii against M^pro. Molecular docking was initially used to determine the binding affinity and molecular interactions of carbazole alkaloids and the reference inhibitor (3WL) in the active site of SARS-CoV-2 M^pro (PDB ID: 6M2N).The top scoring compounds were further assessed for protein structure flexibility, physicochemical properties and drug-likeness, pharmacokinetic and toxicity (ADME/T) properties, antiviral activity, and pharmacophore modeling. Five carbazole alkaloids (koenigicine, mukonicine, o-methylmurrayamine A, koenine, and girinimbine) displayed a unique binding mechanism that shielded the catalytic dyad of M^pro with stronger binding affinities and molecular interactions than 3WL. Furthermore, the compounds with high affinity displayed favorable physicochemical and ADME/T properties that satisfied the criteria for oral bioavailability and druggability. The pharmacophore modeling study shows shared pharmacophoric features of those compounds for their biological interaction with M^pro. During the molecular dynamics simulation, the top docking complexes demonstrated precise stability except koenigicine. Therefore, mukonicine, o-methylmurrayamine A, koenine, and girinimbine may have the potential to restrict SARS-CoV-2 replication by inactivating the M^pro catalytic activity.

Safety, immunogenicity, efficacy, and acceptability of COVID-19 vaccination in people with multiple sclerosis: a narrative review

In the last two years, a new severe acute respiratory syndrome coronavirus (SARS-CoV) infection has spread worldwide leading to the death of millions. Vaccination represents the key factor in the global strategy against this pandemic, but it also poses several problems, especially for vulnerable people such as patients with multiple sclerosis. In this review, we have briefly summarized the main findings of the safety, efficacy, and acceptability of Coronavirus Disease 2019 (COVID-19) vaccination for multiple sclerosis patients. Although the acceptability of COVID-19 vaccines has progressively increased in the last year, a small but significant part of patients with multiple sclerosis still has relevant concerns about vaccination that make them hesitant about receiving the COVID-19 vaccine. Overall, available data suggest that the COVID-19 vaccination is safe and effective in multiple sclerosis patients, even though some pharmacological treatments such as anti-CD20 therapies or sphingosine l-phosphate receptor modulators can reduce the immune response to vaccination. Accordingly, COVID-19 vaccination should be strongly recommended for people with multiple sclerosis and, in patients treated with anti-CD20 therapies and sphingosine l-phosphate receptor modulators, and clinicians should evaluate the appropriate timing for vaccine administration. Further studies are necessary to understand the role of cellular immunity in COVID-19 vaccination and the possible usefulness of booster jabs. On the other hand, it is mandatory to learn more about the reasons why people refuse vaccination. This would help to design a more effective communication campaign aimed at increasing vaccination coverage among vulnerable people.

The COVID-19 Pandemic: SARS-CoV-2 Structure, Infection, Transmission, Symptomology, and Variants of Concern

Since it was first detected in December 2019, the COVID-19 pandemic has spread across the world and affected virtually every country and territory. The pathogen driving this pandemic is SARS-CoV-2, a positive-sense single-stranded RNA virus which is primarily transmissible though the air and can cause mild to severe respiratory infections in humans. Within the first year of the pandemic, the situation worsened with the emergence of several SARS-CoV-2 variants. Some of these were observed to be more virulent with varying capacities to escape the existing vaccines and were, therefore, denoted as variants of concern. This chapter provides a general overview of the course of the COVID-19 pandemic up to April 2022 with a focus on the structure, infection, transmission, and symptomology of the SARS-CoV-2 virus. The main objectives were to investigate the effects of the variants of concern on the trajectory of the virus and to highlight a potential pathway for coping with the current and future pandemics.

Clinical characteristics of 1139 mild cases of the SARS-CoV-2 Omicron variant infected patients in Shanghai

In March 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surged during the Coronavirus Disease 2019 (COVID-19) pandemic in Shanghai, but over 90% of patients were mild. This study included 1139 COVID-19 patients mildly infected with the Omicron variant of SARS-CoV-2 in Shanghai from May 1 to 10, 2022, aiming to clarify the demographic characteristics and clinical symptoms of patients with mild Omicron infection. The clinical phenotypes of Omicron infection were identified by model-based cluster analysis to explore the features of different clusters. The median age of the patients was 41.0 years [IQR: 31.0-52.0 years] and 73.0% were male. The top three clinical manifestations are cough (57.5%), expectoration (48.3%), and nasal congestion and runny nose (43.4%). The prevalence of nasal congestion and runny nose varied significantly across the doses of vaccinations, with 23.1% in the unvaccinated population and 30%, 45.9%, and 44.3% in the 1-dose, 2-dose and 3-dose vaccinated populations, respectively. In addition, there were significant differences for fever (23.1%, 26.0%, 28.6%, 18.4%), head and body heaviness (15.4%, 14.0%, 26.7%, 22.4%), and loss of appetite (25.6%, 30.0%, 33.6%, 27.7%). The unvaccinated population had a lower incidence of symptoms than the vaccinated population. Cluster analysis revealed that all four clusters had multisystemic symptoms and were dominated by both general and respiratory symptoms. The more severe the degree of the symptoms was, the higher the prevalence of multisystemic symptoms will be. The Omicron variant produced a lower incidence of symptoms in mildly infected patients than previous SARS-CoV-2 variants, but the clinical symptoms caused by the Omicron variant are more complex, so that it needs to be differentiated from influenza.

Progress Update on the Epidemiology of COVID-19 Variants and the Assessment Status of Developed Vaccines

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread rapidly and diffused to more than 180 countries at varying severities. This pandemic has accounted for increased mortality and morbidity in developed as well as developing nations. The WHO has announced that there is a persistent need for the evaluation of the COVID-19 vaccine effectiveness (VE) against major outcomes, which include severe diseases, symptomatic COVID-19, and mortalities related to COVID-19. Therefore, mass vaccination programs using vaccines of high effectiveness are among the strategies that have been used by governments worldwide to impede the COVID-19 pandemic transmission. In this regard, massive efforts were made by governments, scientists, biomedical researchers, and healthcare professionals leading to the successful development of various vaccines to bring this pandemic under control. This editorial aims to shed light on the epidemiological status of COVID-19 variants, namely, Delta, Omicron, and Deltacron variants as well as discuss the effectiveness of the currently available COVID-19 vaccines.

The impact of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes

The rapidly evolving COVID-19 pandemic has resulted in an upsurge of scientific productivity to help address the global health crisis. One area of active research is the impact of COVID-19 on pregnancy. Here, we provide an epidemiological overview about what is known about the effects of maternal SARS-CoV-2 infection and COVID-19 vaccination on maternal-fetal outcomes, and identify gaps in knowledge. Pregnant people are at increased risk for severe COVID-19, and maternal SARS-CoV-2 infection increases the risk of negative maternal-fetal outcomes. Despite this elevated risk, there have been high rates of vaccine hesitancy, heightened by the initial lack of safety and efficacy data for COVID-19 vaccination in pregnancy. In response, retrospective cohort studies were performed to examine the impact of COVID-19 vaccination during pregnancy. Here, we report the vaccine's efficacy during pregnancy and its impact on maternal-fetal outcomes, as well as an overview of initial studies on booster shots in pregnancy. We found that pregnant people are at risk for more severe COVID-19 outcomes, maternal SARS-CoV-2 infection is associated with worse birth outcomes, COVID-19 vaccine hesitancy remains prevalent in the pregnant population, and COVID-19 vaccination and boosters promote better maternal-fetal outcomes. The results should help reduce vaccine hesitancy by alleviating concerns about the safety and efficacy of administering the COVID-19 vaccine during pregnancy. Overall, this review provides an introduction to COVID-19 during pregnancy. It is expected to help consolidate current knowledge, accelerate research of COVID-19 during pregnancy and inform clinical, policy, and research decisions regarding COVID-19 vaccination in pregnant people.

Neutralizing Immunity Induced Against the Omicron BA.1 and BA.2 Variants in Vaccine Breakthrough Infections

BACKGROUND

As of early 2022, the Omicron variants are the predominant circulating lineages globally. Understanding neutralizing antibody responses against Omicron BA.1 and BA.2 after vaccine breakthrough infections will provide insights into BA.2 infectivity and susceptibility to subsequent reinfection.

METHODS

Live virus neutralization assays were used to study immunity against Delta and Omicron BA.1 and BA.2 variants in samples from 86 individuals, 24 unvaccinated (27.9%) and 62 vaccinated (72.1%), who were infected with Delta (n = 42, 48.8%) or BA.1 (n = 44, 51.2%). Among the 62 vaccinated individuals, 39 were unboosted (62.9%), whereas 23 were boosted (37.1%).

RESULTS

In unvaccinated infections, neutralizing antibodies (nAbs) against the three variants were weak or undetectable, except against Delta for Delta-infected individuals. Both Delta and BA.1 breakthrough infections resulted in strong nAb responses against ancestral wild-type and Delta lineages, but moderate nAb responses against BA.1 and BA.2, with similar titers between unboosted and boosted individuals. Antibody titers against BA.2 were generally higher than those against BA.1 in breakthrough infections.

CONCLUSIONS

These results underscore the decreased immunogenicity of BA.1 compared to BA.2, insufficient neutralizing immunity against BA.2 in unvaccinated individuals, and moderate to strong neutralizing immunity induced against BA.2 in Delta and BA.1 breakthrough infections.

Changes in preventive behaviour after COVID-19 vaccination in Thailand: a cross-sectional study

Background

Protective behaviours (e.g., mask-wearing, handwashing, avoiding social gatherings) and mass vaccination are effective ways to control the coronavirus disease 2019 (COVID-19) pandemic. Previous studies found that people who get vaccinated may change their protective behaviours. The Thai government has endorsed several mix-and-match vaccine regimens to eliminate the insufficiency of each vaccine brand. This study aimed to determine levels of protective behavioural changes after COVID-19 vaccination and its relationship with various vaccine regimens in Thailand.

Methods

A descriptive cross-sectional study was conducted between September 13, 2021, and January 14, 2022. Data were collected using an online questionnaire distributed via social media platforms and posters in public places in Thailand. The questionnaire comprised six items for demographic characteristics, seven items for COVID-19 vaccine regimens, and four items for protective behaviours. The vaccinated Thai population aged ≥ 18 years were surveyed. Statistical analyses included a Chi-squared test, Wilcoxon signed rank test, and multivariate logistic regressions.

Results

Of the 469 participants, more than half were females (67.4%), single (57.4%), and lived in an urban area (67.2%). Significant differences were observed with regard to median scores in handwashing (5.0 vs. 5.0, p-value < 0.001), physical distancing (4.0 vs. 5.0, p-value = 0.019), and avoiding social activity (4.0 vs. 5.0, p-value = 0.010) in pre- and post-vaccination situations. Approximately 70–90% of the participants did not report changes in protective behaviours after vaccination. Overall, 17.4%, 13.9%, and 12.7% of participants showed improvements in avoiding social activity, physical distancing, and handwashing respectively. Multivariate analysis revealed that improvements in protective behaviours were significantly associated with the age group (between 18 and 24 years), non-healthcare worker status, and those who lived in urban areas. No significant evidence of vaccine regimens was found relative to improved protective behaviours.

Conclusion

This evidence revealed that Thai people maintain their protective behaviours after vaccination but rather improved them. Moreover, demographic data were significantly associated with improved protective behaviours, but various vaccine regimens were not. These findings might be useful for implementing policies to maintain personal protective behaviours after vaccination against COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14494-x.

Assessing the Compliance of Dental Clinicians towards Regulatory Infection Control Guidelines Using a Newly Developed Survey Tool: A Pilot Cross-Sectional Study in India

Adherence to the dental practice regulatory guidelines instituted during the COVID-19 pandemic is essential to minimize the transmission of SARS-CoV-2 strains. Given the lack of a valid and reliable survey tool to assess the adherence to dental practice guidelines, this study aims to develop, validate, and test a survey tool on a pilot sample of dental clinicians practicing in India. A survey tool was developed/validated through a sequential phasic approach: Phase I- developing survey using conceptual and literature framework; Phase II: ascertaining its validity and reliability; Phase III: pilot testing; and Phase IV: assessing construct validity by exploratory factor analysis (EFA) on the responses collected in Spring 2021. The EFA was achieved using a traditional unweighted least squares extraction method through a varimax rotation with Kaiser normalization. A six-factor solution with 18 items (with the global reliability of 86%) related to screening, regular infection prevention measures, infection control inside the dental operatory, disinfection of the dental unit, disposal, and other COVID-19-specific preventive measures were extracted. Our sample had higher compliance with regard to providing alcohol-based hand scrubs, providing protective gear to attendees, collecting travel/medical history, and screening patients for COVID-19 symptoms. In contrast, less compliance was observed regarding the use of paperless forms of practice and rubber dams in the operatory. The use of a validated survey tool ensures the collection of reliable and valid data, which can serve as baseline data to measure the uptake and effectiveness of dental practice regulatory guidelines in a clinical setting and community dental health clinics.

Keeping up with the COVID's-Could siRNA-based antivirals be a part of the answer?

Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This deadly infection has resulted in more than 5.2 million deaths worldwide. The global rollout of COVID-19 vaccines has without doubt saved countless lives by reducing the severity of symptoms for patients. However, as the virus continues to evolve, there is a risk that the vaccines and antiviral designed to target the infection will no longer be therapeutically viable. Furthermore, there remain fears over both the short and long-term side effects of repeat exposure to currently available vaccines. In this review, we discuss the pros and cons of the vaccine rollout and promote the idea of a COVID medicinal toolbox made up of different antiviral treatment modalities, and present some of the latest therapeutic strategies that are being explored in this respect to try to combat the COVID-19 virus and other COVID viruses that are predicted to follow. Lastly, we review current literature on the use of siRNA therapeutics as a way to remain adaptable and in tune with the ever-evolving mutation rate of the COVID-19 virus.

Assessing COVID-19 Booster Hesitancy and Its Correlates: An Early Evidence from India

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and multivariate statistical methods were used to analyze the data. Over 50% of participants reported their willingness to take the booster dose. Among the group not willing to take the booster dose (n = 303, 44.1%), a significantly larger proportion of respondents were unvaccinated with the primary series (12.2% vs. 5.2%, p < 0.001), had an annual income below 2.96 lacs/annum (52.8% vs. 33.1, p < 0.001), were residents of rural areas (38.0% vs. 23.2%, p < 0.001), were not living with vulnerable individuals (78.5% vs. 65.2%, p < 0.001) and did not have family/friends who had tested positive for COVID-19 (54.6% vs. 35.1%, p = 0.001). Demographic, vaccine variables and multi-theory model subscales to predict the initiation of booster dose among hesitant participants were statistically significant, R2 = 0.561, F (26, 244) = 11.978, p < 0.001; adjusted R2 = 0.514. Findings of this study highlight the need to develop evidence-based interventions to promote vaccine uptake, particularly among hard-to-reach communities living in developing countries.

Performance of Antigen Detection Tests for SARS-CoV-2: A Systematic Review and Meta-Analysis

Coronavirus disease 2019 (COVID-19) initiated global health care challenges such as the necessity for new diagnostic tests. Diagnosis by real-time PCR remains the gold-standard method, yet economical and technical issues prohibit its use in points of care (POC) or for repetitive tests in populations. A lot of effort has been exerted in developing, using, and validating antigen-based tests (ATs). Since individual studies focus on few methodological aspects of ATs, a comparison of different tests is needed. Herein, we perform a systematic review and meta-analysis of data from articles in PubMed, medRxiv and bioRxiv. The bivariate method for meta-analysis of diagnostic tests pooling sensitivities and specificities was used. Most of the AT types for SARS-CoV-2 were lateral flow immunoassays (LFIA), fluorescence immunoassays (FIA), and chemiluminescence enzyme immunoassays (CLEIA). We identified 235 articles containing data from 220,049 individuals. All ATs using nasopharyngeal samples show better performance than those with throat saliva (72% compared to 40%). Moreover, the rapid methods LFIA and FIA show about 10% lower sensitivity compared to the laboratory-based CLEIA method (72% compared to 82%). In addition, rapid ATs show higher sensitivity in symptomatic patients compared to asymptomatic patients, suggesting that viral load is a crucial parameter for ATs performed in POCs. Finally, all methods perform with very high specificity, reaching around 99%. LFIA tests, though with moderate sensitivity, appear as the most attractive method for use in POCs and for performing seroprevalence studies.

Human Identical Sequences, hyaluronan, and hymecromone ─ the new mechanism and management of COVID-19

COVID-19 caused by SARS-CoV-2 has created formidable damage to public health and market economy. Currently, SARS-CoV-2 variants has exacerbated the transmission from person-to-person. Even after a great deal of investigation on COVID-19, SARS-CoV-2 is still rampaging globally, emphasizing the urgent need to reformulate effective prevention and treatment strategies. Here, we review the latest research progress of COVID-19 and provide distinct perspectives on the mechanism and management of COVID-19. Specially, we highlight the significance of Human Identical Sequences (HIS), hyaluronan, and hymecromone ("Three-H") for the understanding and intervention of COVID-19. Firstly, HIS activate inflammation-related genes to influence COVID-19 progress through NamiRNA-Enhancer network. Accumulation of hyaluronan induced by HIS-mediated HAS2 upregulation is a substantial basis for clinical manifestations of COVID-19, especially in lymphocytopenia and pulmonary ground-glass opacity. Secondly, detection of plasma hyaluronan can be effective for evaluating the progression and severity of COVID-19. Thirdly, spike glycoprotein of SARS-CoV-2 may bind to hyaluronan and further serve as an allergen to stimulate allergic reaction, causing sudden adverse effects after vaccination or the aggravation of COVID-19. Finally, antisense oligonucleotides of HIS or inhibitors of hyaluronan synthesis (hymecromone) or antiallergic agents could be promising therapeutic agents for COVID-19. Collectively, Three-H could hold the key to understand the pathogenic mechanism and create effective therapeutic strategies for COVID-19.

Remote Auscultation of Heart and Lungs as an Acceptable Alternative to Legacy Measures in Quarantined COVID-19 Patients-Prospective Evaluation of 250 Examinations

The COVID-19 pandemic accelerated the assimilation of telemedicine platforms into medical practice. Nevertheless, research-based evidence in this field is still accumulating. This was a prospective, cross-sectional comparative assessment of a remote physical examination device used mainly for heart and lung digital auscultation. We analyzed usage patterns, user (physician) subjective appreciation and compared it to legacy measures. Eighteen physicians (median age 36 years (IQR 32-45): two interns, seven residents and nine senior physicians; eleven internists, five geriatricians and two pediatricians) executed over 250 remote physical examinations. Their median work duration with quarantined patients was 60 days (IQR 45-60). The median number of patients examined by a single physician was 17 (IQR 10-34). Regarding overall estimation, all participants tended to prefer the remote examination in the setting of quarantined patients (median 6, IQR 3.75-8), while no statistically significant difference was demonstrated compared to the indifference value (p = 0.122). Internists preferred tele-medical examination over non-internists, with significant differences between groups regarding heart auscultation, (median 7, (IQR 3-7) vs. median 2, (IQR 1-5, respectively)), p = 0.044. In the setting of quarantined patients, from the physicians' perspective, a digital platform for remote auscultation of heart and lungs was considered as an acceptable alternative to legacy measures.

Can the SARS-CoV-2 Omicron Variant Confer Natural Immunity against COVID-19?

The coronavirus disease 2019 (COVID-19) pandemic is still ongoing, with no signs of abatement in sight. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent of this pandemic and has claimed over 5 million lives, is still mutating, resulting in numerous variants. One of the newest variants is Omicron, which shows an increase in its transmissibility, but also reportedly reduces hospitalization rates and shows milder symptoms, such as in those who have been vaccinated. As a result, many believe that Omicron provides a natural vaccination, which is the first step toward ending the COVID-19 pandemic. Based on published research and scientific evidence, we review and discuss how the end of this pandemic is predicted to occur as a result of Omicron variants being surpassed in the community. In light of the findings of our research, we believe that it is most likely true that the Omicron variant is a natural way of vaccinating the masses and slowing the spread of this deadly pandemic. While the mutation that causes the Omicron variant is encouraging, subsequent mutations do not guarantee that the disease it causes will be less severe. As the virus continues to evolve, humans must constantly adapt by increasing their immunity through vaccination.