COVID‑19 pandemic, also known as the coronavirus pandemic, has spread rapidly across the globe since the end of 2019 and brought impressive changes in our life and living through partial or full lockdown and reduced anthropogenic activities. Hence, it is imperative to investigate the impacts and consequences of COVID-19 on global eco-system and environment. The present study accordingly addresses the impacts and consequences of COVID-19 by ten environmental indicators; viz., global warming (or greenhouse gas emission), stratospheric ozone depletion, ozone formation (on human health), fine particulate matter formation, smog, ionizing radiation, human carcinogenic toxicity, human non-carcinogenic toxicity, water resource consumption, and effect on human health. The overall study has been performed in agreement with the standard principle and guidelines of life cycle assessment. Worldwide changes in consumption of fossil fuels, viz., petroleum, coal and natural gas, as a result of COVID-19 pandemic, has been the core theme of the study. Outcomes from the study show that COVID-19 has been a ‘blessing in disguise’ for the global environment with most of the above-mentioned indicators declining by approximately 20-30% in 2020 in comparison to the 2019 level.

COVID-19, caused by SARS-CoV-2, is responsible for widespread mortality and economic loss across almost 212 countries. The distribution of disease prevalence is, however, uneven and likely dependent on the range of human behavior and/or the pathogen and environmental variables. Here in this research we examined the correlation between daily and total COVID-19 case reports from Bangladesh and meteorological variables (average temperature, average humidity, and average wind speed) against one another using Spearman rank and Kendall correlation tests to highlight significant meteorological variables in relation to COVID-19. The tests revealed that both temperature and humidity had a non-significant correlation with COVID-19 transmission amid epicenter (EC) and non-epicenter (NEC) areas. However, a weak (KCC: 0.168, p < 0.05; SCC: 0.271, p < 0.05) correlation was found for temperature in ECs. Wind speed showed moderate to strong correlation in ECs with a very high statistical significance to both daily new cases [(KCC: 0.494, p < 0.01); (SCC: 0.689, p < 0.01)] and total cases [(KCC: 0.426, p < 0.01); (SCC: 0.617, p < 0.01)]. The COVID-19 transmission was found to have a weak (KCC: 0.354, p < 0.01) to moderate (SCC: 0.465, p < 0.01) correlation with daily new cases; however, a moderate (KCC: 0.497, p < 0.01) to strong (SCC: 0.712, p < 0.01) correlation with total cases was found in NECs. The results suggest that temperature and humidity have little influence on COVID-19 transmission, but wind speed may have some influence. Countries should prioritize social engineering to modify human behavior in order to combat the spread of COVID-19 and future pandemics.

Coronavirus disease (COVID-19) is the current global public health threat with no specific, effective, and approved treatment available till date. The outbreak of COVID-19 has led the world into an unimagined and uncertain situation by disrupting the economies, claiming human lives, and leaving many into secondary mental health problems. As per the latest WHO report, approximately 8.2 million people are infected, and nearly 0.44 million lives are lost to COVID. The infection has spread to over 200 countries and territories around the world. The world is in search of efficient diagnostics and therapeutics, including vaccines, biologics and drugs. With the rapid increase in rates of infection and time constraints, drug repurposing seems to be a potential and viable option to find the promising anti-COVID therapeutics. In the wake of a rapid increase in the number of clinical trials involving drugs for repurposing, we aim to provide information on the safety concerns related to the drugs currently investigated in trials. This review also highlights the possible mechanisms of actions, adverse drug reactions, and contraindications of the drugs under repurposing evaluation.

Since the discovery of the Coronavirus disease 2019 (COVID-19) outbreak, a vast majority of studies have been carried out that confirmed the worst outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in people with preexisting health conditions, including diabetes, obesity, hypertension, cancer, and cardiovascular diseases. Likewise, diabetes itself is one of the leading causes of global public health concerns that impose a heavy global burden on public health as well as socio-economic development. Both diabetes and SARS-CoV-2 infection have their independent ability to induce the pathogenesis and severity of multi-system organ dysfunction, while the co-existence of these two culprits can accelerate the pathophysiology and magnify the severity of the diseases. However, the exact pathophysiology of multi-system organ failure in diabetic patients after SARS-CoV-2 infection is still obscure. This review summarized the organ-specific possible molecular mechanisms of SARS-CoV-2 and diabetes-induced pathophysiology of several diseases of multiple organs, including the lungs, heart, kidney, brain, eyes, gastrointestinal system, and bones, and subsequent manifestation of multi-system organ failure.

The expression of non-coding RNAs varies greatly depending on the cell type and physiological state. Changes in expression affect the regulatory properties of these molecules. We investigated RNA-seq data from sorted blood cells of healthy control donors and severe COVID-19 patients. Our aim was to display a distinguishable piRNA differential expression portrait for each type of cell and to study the behavior of piRNA in the blood cells of COVID-19 patients. Overall piRNA expression in sorted control cells (erythrocytes, monocytes, lymphocytes, eosinophils, basophils, neutrophils) differs depending on cell type. Four of the most abundant piRNA were expressed relatively equally in all cell types, they included piR-49145, piR-49144, piR-49143 and piR-33151. By reviewing piRNA expression in each group of sorted cells from severe COVID-19 patients we observed 3 upregulated and 10 downregulated piRNAs in erythrocytes. Monocytes were presented with a larger amount of statistically significant piRNA, 4 upregulated and 35 downregulated. In lymphocytes, all 19 piRNAs were upregulated.

Abstract: This is a retrospective study of patients admitted to Jackson Hospital, Montgomery, Alabama with a diagnosis of COVID-19 from January 1, 2021, to February 15, 2022. The independent variable used in the models were patient sex, age, race, BMI category, daily D-dimer categories, categories of anticoagulation doses (Enoxaparin 40 mg VS. Enoxaparin 80 mg VS Enoxaparin 1mg/kg or equivalent), bleeding episodes, and vaccination status. The three different categories of anticoagulation doses were considered for the purpose of the study. Results: The study reviewed a total of one hundred (100) hospitalized patients. Intermediate-dose anticoagulation was found to be the optimal dose as only fourteen percent (14%) patients died compared to a thirty-six percent (36%) and fifty percent (57%) death rate among those treated with low-dose and high-dose anticoagulation, respectively. The multivariate linear regression model predicting patient oxygen requirements revealed D-Dimer and bleeding status to be statistically significant predictors with a p value of <0.01. For the patients who had a D-dimer value ≥ 2 µg/mL, the oxygenation requirement was predicted to be 31 L higher than those with a D-dimer <2 µg/mL (99% CI; p<0.01). When mean D-dimer and corresponding oxygen requirements were calculated per hospitalization days category, the D-dimer levels and oxygen requirements were noted to follow the same trends indicating both values tended to increase and decrease simultaneously. Conclusion: The study concludes daily D-dimer trends can predict COVID-19 patient survival or daily oxygen requirements indicating D-dimer can be the miracle molecule for COVID-19 prognosis.

Our report presents the findings from a treatment program that involved plant-based diets (PBDs) and supplements for 1,750 elderly cardiology patients diagnosed with COVID-19 between April 2020 and June 2023. At the start of the program, there was no published data supporting the use of PBDs for COVID-19 patients. However, after 18 months, studies were released that indicated the effectiveness of PBDs in decreasing the incidence and severity of COVID-19. Our treatment protocol differed from these studies in several ways. We carefully controlled the quality, quantity, and processing method of the foods we provided, opting for raw instead of cooked vegetables. Additionally, we incorporated supplementation that complemented the nutrients lacking in a PBD and enhanced the anti-viral, anti-inflammatory, antioxidant, antithrombotic, and immunomodulatory properties of a PBD. Our patients recovered faster (12±1.4 days vs. 20.9±4.3 days), with lower severity (2% vs. 10-20%), hospitalizations (0 vs. 5-10%), and deaths (0 vs. 15-17%) compared to the general population. These favorable outcomes are particularly noteworthy given Indonesia's high COVID-19 morbidity and mortality rates, among the highest in Asia. The findings of this report provide valuable insights for practitioners in managing high-risk elderly COVID-19 patients, particularly in avoiding severity and mortality.

Vaccines are crucial for controlling the COVID-19 pandemic, and booster doses are becoming increasingly important. This study aimed to assess the efficacy of the ChAdOx1 nCoV-19 vaccine from AstraZeneca as a third dose in healthcare workers at different time intervals (one, three, and six months). Two methods to measure immune response—ELISA (EUROIMMUN Medizinische Labordiagnostika AG, Luebeck, Germany) and ELISpot (Mabtech AB, Macka Strand, Sweden)—were used. A total of 170 participants were included in the study. The results showed that while IgG levels decreased at six months compared to levels at one and three months, they were still significantly higher than the baseline. Furthermore, neutralizing levels at three and six months after the third dose were not significantly different. These findings suggest that the immune response induced by the vaccine is robust and effective for several months. These results have significant implications for public health policymakers, as they provide strong support for booster vaccinations. The ChAdOx1 nCoV-19 vaccine appears to be a reliable option for preventing the spread of COVID-19, and this study provides valuable information for healthcare workers and policymakers in managing the pandemic.

As the COVID-19 pandemic begins to abate and national public health systems are treating the SARS-Cov-2 virus as endemic, many public health measures are no longer mandated, but remain recommended with voluntary participation. One of these is the wearing of fitted face masks, initially mandated to contain, or at least slow, the spread of SARS-CoV-2 which is primarily transmitted via aerosols emitted while breathing, coughing, or sneezing. While the habit of once wearing fitted face masks recedes into memory for much of the population, so does the knowledge of the various types of masks that were once en vogue. To create a record for the future, this paper provides the first comprehensive documentation of the nature and range of fitted facemasks that circulated during the COVID-19 pandemic.

Globally, over the past several months millions of persons contracted the coronavirus disease 2019 (COVID-19) resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as AST, ALT, GGT and ALP are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

The global coronavirus (COVID-19) pandemic has created a whole new set of risks in construction industries generating unprecedented delays, disruptions, and uncertainty on construction projects, and has forced the industries in adopting more sophisticated technologies while combating the reduced workforce on job sites. Further, the post-pandemic era of construction is expected to be a lot different as the industries will embrace the technology as the augmentation and collaboration strategy. Thus, it will be extremely hard to sustain for construction industries in the absence of effective risk management. The existing risk plans need to be inspected for their capability of handling new risks arising from COVID-19 and the project managers will need to make the necessary revisions as needed. This paper discusses on past (NORM), present (NEW NORM), and future (Post COVID-19 NORM) of the construction industry and highlights key strategies for managing projects and construction risks during and post COVID-19 pandemic.

This observational study aims to depict the impact of gender and socio-economic issues on the health status of Italian Orthopaedic patients during the COVID-19 lockdown. An Ad Hoc ques-tionnaire was developed and online administered. The following data were extracted from the questionnaire: age, body mass index (BMI), education level, distance from hospital, orthopaedic disease, concomitant medical comorbidities, living status (with/without cohabitants) and physical activity level (according to Tegner Activity Scale). The impact of the COVID-19 lockdown was studied analyzing differences related to the above-mentioned parameters. A significant increase of the call number to general practitioner and to the orthopaedic surgeon was observed during the COVID-lockdown, especially in patients with higher education level. Nonetheless, a reduced compliance in drugs assumption was observed in patients with higher education level during lockdown (p=0.007). Almost all the analyzed items were significantly in-fluenced by the distance between patient’s domicile and the nearest hospital. However, no sig-nificant differences were observed comparing pre-COVID to COVID lockdown. In the present study patients’ gender and education level revealed a significant impact on the social behavior during the COVID lockdown, compared with the pre-COVID period.

Coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached a global epidemic across the world after first reported in Wuhan, China’s Hubei province in December 2019. The pandemic is also associated with acute respiratory distress syndrome (ARDS) characterized by excess inflammation, progressive arterial hypoxemia and dyspnea. Mesenchymal stem/ stromal cells (MSCs) have been investigated as treatment for ARDS due to immunomodulatory property. Exosomes derived from MSCs play an important role in paracrine signaling of MSCs, thereby contributed to immunomodulation of the immune microenvironment. Exosomes are emerged as potential alternative to MSC cell therapy with superiority of safety. In this review, we will introduce MSC-derived exosomes and briefly discuss current progress on MSCs and exosomes in ARDS, which may have clinical implications in pathogenesis and treatment of COVID-19.

On March 2020 strict measures took place in Finland to limit the COVID -19 pandemic. A majority of the Finnish COVID -19 –patients have been located in the southern Finland and consequently cared for in the HUS Helsinki University Hospital. During the ongoing pandemic, HUS personnel’s psychological symptoms are followed via an electronic survey, which also delivers information on psychosocial support services. The baseline survey in June 2020 was sent to 25494 HUS employees out of whom 4804 (19%) answered; altogether 62.4% of the respondents were nursing staff and 8.9% medical doctors. While the follow-up continues for a year and a half, this report shares the sociodemographic characteristics of the respondents and the first results of psychological symptoms from the baseline survey. Out of those who were directly involved in pandemic patients` care, 43.4% reported potentially traumatic COVID-19 pandemic-related experiences vs. 21.8% among the other (p &lt; 0.001). While over a half of the personnel was symptomless, a group of respondents reported pandemic work –related traumatic events and concurrent depressive, insomnia and anxiety symptoms. This highlights the need to ensure appropriate psychosocial support services to all traumatized personnel and PTEs were present especially among nursing staff.

Objectives: Social distancing measures are currently implemented to control COVID-19 pandemic in many countries, including Saudi Arabia. The aim of this study was therefore to evaluate the awareness and adherence of the Saudi population to these measures. Methods: A web-based questionnaire was designed with 16 questions (8 questions related to demographics, 3 in relation to awareness about social distancing and 5 related to overall practice of social distancing). Results: 5105 participants completed the survey [58.4% female, 66.3% young individuals (aged 18-37 years), 55.8% bachelor degree holders, and 51.0% from the western region]. The Saudi Ministry of Health (MOH) was the main source of information about COVID-19 for most participants (78.2%). High awareness (81.3%) regarding social distancing was observed, associated mainly with female participants, those from the middle region and those with high education and income. Overall implementation of social distancing was satisfactory (score 3.13/5), with 37.8% never leaving home during the home-stay period. Better adherence to social distancing was observed for female participants, higher degree holders and those aged over 38 years. Conclusions: Organised plans by the Saudi MOH have been effective in raising awareness and improving practice of social distancing among public. However, the observed lower practice of social distancing by individuals with lower education and income indicates the need for targeted interventions to achieve better outcome.

The work presented in this paper makes multiple scientific contributions related to the investigation of the global fear associated with COVID-19 by performing a comprehensive analysis of a dataset comprising survey responses of participants from 40 countries. First, the results of subjectivity analysis of responses where participants indicated their biggest concern related to COVID-19 showed that the average subjectivity in responses by the age group of 41-50 decreased from April 2020 to June 2020, the average subjectivity in responses by the age group of 71-80 drastically increased from May 2020, and the age group of 11-20 indicated the least level of subjectivity in their responses between June 2020 to August 2020. Second, subjectivity analysis also revealed the percentage of highly opinionated, neutral opinionated, and least opinionated responses per age-group where the analyzed age groups were 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, and 81-90. For instance, the percentage of highly opinionated, neutral opinionated, and least opinionated responses by the age group of 11-20 were 17.92%, 16.24%, and 65.84%, respectively. Third, data analysis of responses from different age groups showed that the highest percentage of responses indicating that they were very worried about COVID-19 came from individuals in the age group of 21-30. Fourth, data analysis of the survey responses also revealed that in the context of taking precautions to prevent contracting COVID-19, the percentage of individuals in the age group of 31-40 taking precautions was higher as compared to the percentages of individuals from the age groups of 41-50, 51-60, 61-70, 71-80, and 81-90. Finally, a deep learning model was developed to detect if the survey respondents were seeing or planning to see a psychologist or psychiatrist for any mental health issues related to COVID-19. The deep learning model used the responses to multiple questions in the context of fear, preparedness, and response related to COVID-19 from the dataset and achieved an overall performance accuracy of 91.62% after 500 epochs.

Childhood hygiene education has resulted in individuals engaging in hand washing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

This paper presents a computational approach designed to construct and query a literature-based knowledge graph for predicting novel drug therapeutics. The main objective is to offer a platform that discovers drug combinations from FDA-approved drugs and accelerates their investigations by domain scientists. Specifically, the paper introduced the following algorithms: (1) an algorithm for constructing the knowledge graph from drug, gene, and disease mentions in the biomedical literature; (2) an algorithm for vetting the knowledge graph from drug combinations that may pose a risk of drug interaction; (3) and two querying algorithms for searching the knowledge graph by a single drug or a combination of drugs. The resulting knowledge graph had 844 drugs, 306 gene/protein features, and 19 disease mentions. The original number of drug combinations generated was 2,001. We queried the knowledge graph to eliminate noise generated from chemicals that are not drugs. This step resulted in 614 drug combinations. When vetting the knowledge graph to eliminate the potentially risky drug combinations, it resulted in predicting 200 combinations. Our domain expert manually eliminated extra 54 combinations which left only 146 combination candidates. Our three-layered knowledge graph, empowered by our algorithms, offered a tool that predicted drug combination therapeutics for scientists who can further investigate from the viewpoint of drug targets and side effects.

The present paper proposes a fractal analysis of the Covid-19 dynamics in 45 European countries. We introduce a new idea of using the box-counting dimension of the epidemiologic curves as a means of classifying the Covid-19 pandemic in the countries taken into consideration. The classification can be a useful tool in deciding upon the quality and accuracy of the data available. We also investigated the reproduction rate, which proves to have significant fractal features, thus enabling another perspective on this epidemic characteristic. Moreover, we studied the correlation between two meteorological parameters: global radiation and daily mean temperature and two Covid-19 indicators: daily new cases and reproduction rate. The fractal dimension differences between the analysed time series graphs could represent a preliminary analysis criterion, increasing research efficiency. Daily global radiation was found to be stronger linked with Covid-19 new cases than air temperature (with a greater correlation coefficient -0.386, as compared with -0.318), and consequently it is recommended as the first-choice meteorological variable for prediction models.

Neuroinflammation, defined as inflammatory reactions mediated by cytokines, chemokines, reactive oxygen species, and secondary messengers in the central nervous system (CNS) including the brain and spinal cord is the basis of many neurological disorders. Recently, erythropoietin (EPO) has been considered and studied as a modulator of neuroinflammation. On this article minireview of pathophysiology of neuroinflammation and the neuroprotective effects of EPO is discussed and a case of subacute huge subdural hematoma with double mydriasis operated urgently, treated with low daily dose (vs high dose once or twice a month in the literature) of EPO and recovered fully and discharged home with good consciousness is reported. In addition, the probable unfavorable outcome of erythropoietin administration in patients with neuroinflammation in COVID-19 is considered.

The beginning of 2020 has seen the emergence of coronavirus outbreak caused by a novel virus called SARS-CoV-2. The sudden explosion and uncontrolled worldwide spread of COVID-19 show the limitations of existing healthcare systems to timely handle public health emergencies. In such contexts, innovative technologies such as blockchain and Artificial Intelligence (AI) have emerged as promising solutions for fighting coronavirus epidemic. On the one hand, blockchain can combat pandemics by enabling early detection of outbreaks, protecting user privacy, and ensuring reliable medical supply chain during the outbreak tracking. On the other hand, AI provides intelligent solutions for identifying symptoms caused by coronavirus for treatments and supporting drug manufacturing. Motivated by these, in this paper we present an extensive survey on the use of blockchain and AI for combating coronavirus (COVID-19) epidemics based on the rapidly emerging literature. First, we introduce a new conceptual architecture which integrates blockchain and AI specific for COVID-19 fighting. Particularly, we highlight the key solutions that blockchain and AI can provide to combat the COVID-19 outbreak. Then, we survey the latest research efforts on the use of blockchain and AI for COVID-19 fighting in a wide range of applications. The newly emerging projects and use cases enabled by these technologies to deal with coronavirus pandemic are also presented. Finally, we point out challenges and future directions that motivate more research efforts to deal with future coronavirus-like epidemics.

Background: A large percentage of deaths in an epidemic or pandemic can be due to overshoot of population (herd) immunity, either from the initial peak or from planned or unplanned exit from lockdown or social distancing conditions. Objectives: We study partial unlock or reopening interaction with seasonal effects in a managed epidemic to quantify overshoot effects on small and large unlock steps and discover robust strategies for reducing overshoot. Methods: We simulate partial unlock of social distancing for epidemics over a range of replication factor, immunity duration and seasonality factor for strategies targeting immunity thresholds using overshoot optimization. Results: Seasonality change must be taken into account as one of the steps in an easing sequence, and a two step unlock, including seasonal effects, minimizes overshoot and deaths. It may cause undershoot, which causes rebounds and assists survival of the pathogen. Conclusions: Partial easing levels, even low levels for economic relief while waiting on a vaccine, have population immunity thresholds based on the reduced replication rates and may experience overshoot as well. We further find a two step strategy remains highly sensitive to variations in case ratio, replication factor, seasonality and timing. We demonstrate a three or more step strategy is more robust, and conclude that the best possible approach minimizes deaths under a range of likely actual conditions which include public response.

New coronavirus (SARS-CoV-2) treatments and vaccines are under development to combat the COVID-19 disease. Several approaches are being used by scientists for investigation including 1) various small molecule approaches targeting RNA polymerase, 3C-like protease, and RNA endonuclease and 2) exploration of antibodies obtained from convalescent plasma from patients who have recovered from COVID-19. The coronavirus genome is highly prone to mutations that lead to genetic drift and escape from immune recognition; thus, it is imperative that sub-strains with different mutations are also accounted for during vaccine development. As the disease has grown to become a pandemic, new B-cell and T-cell epitopes predicted from SARS coronavirus have been reported. Using the epitope information along with variants of the virus, we have found several variants which might cause drifts. Among such variants, 23403A>G variant (p.D614G) in spike protein B-cell epitope is observed frequently in European countries such as the Netherlands, Switzerland and France.

The COVID-19 Pandemic generated, in addition to severe symptoms, hospitalizations, and deaths worldwide, stress from the fear of the disease and social uncertainties, from restriction measures and social isolation. Stress from social isolation impacts mental health, aggravating conditions, and triggering neuropsychiatric symptoms in individuals with biopsychosocial vulnerability. During and immediately after the period of social restriction imposed by the Pandemic, the scientific community carried out several research protocols. It revealed results that relevantly demonstrate the harmful effect of the stress induced by the Pandemic situation. This review reports and discusses research results demonstrating impairments in neuropsychiatric disorders such as autism spectrum disorder, dementia, eating disorders, schizophrenia, anxiety, and depression. In addition to studies showing the effect of social isolation on disorders, research results are reported and discussed that evaluated protocols with some possible therapeutic intervention strategies during times of social restriction.

Coronavirus Disease-2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). There is sufficient experimental evidence to confirm that SARS-CoV-2 infection produces states of ciliary and flagellar dysfunction. However, these studies are unable to explain the observed effects molecularly, because they lack a sufficient understanding of the interaction between human proteins and virus proteins. Using the physical-chemical study of the human interactome in interaction with the SARS-CoV-2 proteome, we found evidence of interactions to explain the experimental effects from a molecular perspective. We found that ten viral proteins interact with key components in the maintenance of the molecular structure of axoneme. Additionally, we evaluated the pulmonary and extrapulmonary pathogenesis of COVID-19 from the point of view of ciliary dysfunction, and warned about other possible complications such as episodes of transient infertility that, due to the limitations of our work, would need verification.

The new coronavirus disease 2019 (COVID-19) pandemic is an emerging situation with high rates of morbidity and mortality, in the pathophysiology of which inflammation and thrombosis are implicated. The disease is directly connected to the nutritional status of patients and a well-balanced diet is recommended by official sources. Recently, the role of platelet activating factor (PAF) was suggested in the pathogenesis of COVID-19. In the present review several micronutrients (vitamin A, vitamin C, vitamin E, vitamin D, selenium, omega-3 fatty acids, minerals), phytonutrients and Mediterranean diet compounds (olive oil, fish, honey, plant foods) with potential anti-COVID activity are presented. We further underline that the well-known anti-inflammatory and anti-thrombotic actions of the investigated nutrients and/ or holistic dietary schemes, such as the Mediterranean diet, are also mediated through PAF. In conclusion, although there is no single food to prevent coronavirus, the aim is to follow a healthy diet containing PAF inhibitors in order to target both inflammation and thrombosis and try to avoid or/and reduce the deleterious effects of the COVID-19 epidemic.

The developments of confirmed daily Sars-CoV-2 infections can be modeled a posteriori in a comparatively simple and satisfactory way by means of a special exponential function: its exponential coefficient varies exponentially with time itself. This property enables the function to directly simulate the „daily case“ curve fragments observed for the first waves of the current epidemics in a number of counties and countries. Linear combinations of two or more of the functions allow for the modeling of the complete curves observed in the vast majority of all regions for which case number developments have been tabulated.

Policy induced decline of human mobility has been recognised to be effective in controlling the COVID-19 spread especially in the initial stage of the outbreak, although the relationship among mobility, policy implementation, and virus spread remains contentious. Coupling data of confirmed COVID-19 cases with Google mobility data in Australia, we present a state-level empirical study to: 1) inspect the temporal variation of COVID-19 spread and the change of mobility adherent to social restriction policies; 2) examine the extent that different types of mobility are associated with the COVID-19 spread in eight Australian states/territories; and 3) analyse the time-lag effect of mobility restriction on the COVID-19 spread. We find that social restriction policies implemented in the early stage of the pandemic controlled the COVID-19 spread effectively; the restriction of human mobility has a time-lag effect on growth rates, and the strength of the mobility-spread correlation increases up to seven days after policy implementation but decreases afterwards. The association between mobility and COVID-19 spread varies across space and time, and subjects to the types of mobility. Thus, it is important for governments to consider the degree to which lockdown conditions can be eased by accounting for this dynamic mobility-spread relationship.

Background: The information on the difference in clinical characteristics between severe and non-severe cases is limited in some countries including Iran. The objective of this case series is to compare the clinical characteristics, radiologic features, and laboratory findings between COVID-19 severe cases who received the intensive care unit (ICU) care with non-severe cases who did not receive ICU care. Methods: In this retrospective cohort study, 186 laboratory-confirmed patients with COVID-19 diagnosed from 1 March 2020 to 30 March 2020 were investigated. Results: This study population included 186 hospitalized patients with confirmed COVID-19. The median age was 47 years, and 88 (47.31%) were female. Of these patients, 48 were admitted and transferred to ICU. Of 186 patients, 44.62% had medical comorbidities including hypertension and diabetes. The most common clinical manifestation were shortness of breath 86.56%, myalgia 74.19%, and headache. Higher neutrophil counts, CRP, and LDH as well as the lower levels of lymphocytes were the most important laboratory finding among COVID-19 patients. As of April 15, 2020, 33 were still hospitalized. A total of 116 patients (62.70 %) had been discharged, and 36 patients (19.94 %) had died. Of the 48 patients admitted to the ICU, 33.33% have died. Conclusion: In the present study, shortness of breath was the most common clinical symptom, and the mortality rate in patients admitted to the ICU was about 33%, indicating that about one-third of patients with severe illness who admitted to the ICU section died.

The current pneumonia epidemic could evolve into a pandemic on a global scale if not effectively contained. The COVID-19 virus possesses a 61-amino acid open reading frame resembling SARS-CoV virulence factor - ORF6 peptide. The isoleucine content is 15.9% in ORF6 of SARS-CoV versus 16.4% of that in SARS-CoV-2. Given the proton affinity in the carbonyl oxygen in isoleucine, augmented proton traffic can enhance proton-ion antiport and prompt cell swelling. Calorie restriction has been confirmed in animal studies to extend lifespan, and its underlying mechanism is not fully known. As the content of essential amino acids in the open reading frame of SARS-CoV-2 reaches 57.4%, a starch/vitamin diet served for short period of time does not give rise to essential amino acids and halts virion production, which could be adopted as prophylactic approach of many viral infections. Plant-based diet or fasting/boiled rice water can also minimize the intake of essential amino acids or all amino acids respectively. Furthermore, several proteins of SARS-CoV-2 possess high valine plus glycine content which is implicated in heart disease, justifying the aforementioned approaches.

Background: The purpose of this study was to examine the prevalence and effects of current smoking on adverse outcomes among hospitalized COVID-19 patients. Methods: We performed a systematic review of the literature (PubMed) for studies published until April 25. Studies were included into the analysis if they satisfied all of the following criteria: 1. To present hospitalized patients with COVID-19. 2. To classify patients into less and more severe disease, irrespective of the severity definition (defined as “adverse ourtcome”). 3. To present data on the smoking status, separately for each severity classification. We identified 18 (from a total of 1398) relevant studies. Pooled current smoking prevalence was compared with the gender-adjusted, population-based expected prevalence by calculating Prevalence Odds Ratio (POR). The association between current, compared to non-current and former, smoking and adverse outcome was examined by calculating Odds Ratio (OR). All analyses were performed using random-effects meta-analysis. Results: Among 6515 patients, 440 of whom were current smokers, the pooled prevalence of current smoking was 6.8% (95%CI: 4.8-9.1%) and the POR was 0.21 (95%CI: 0.16-0.26, P < 0.001). In Chinese studies only, the POR was 0.22 (95%CI: 0.17-0.27, P < 0.001). Current smokers were more likely to have an adverse outcome compared to non-current smokers (OR: 1.53, 95%CI: 1.06-2.20, P = 0.022). However, they were less likely to have an adverse outcome compared to former smokers (OR: 0.42, 95%CI: 0.27-0.74, P = 0.003). Conclusion: An unexpectedly low prevalence of current smoking was observed among hospitalized patients with COVID-19. Hospitalized current smokers had higher odds compared to non-current smokers but lower odds compared to former smokers for an adverse outcome. The possibility that nicotine may have a protective effect in COVID-19 which may be masked by smoking-related toxicity and by the abrupt cessation of nicotine intake when smokers are hospitalized should be explored.

We present a case of a 47-year-old male who died unexpectedly from acute pulmonary hemorrhage 555 days after completing the BNT162b2 (Pfizer) COVID-19 vaccination primary series. Before death, he exhibited symptoms of a mild respiratory infection. Despite a healthy medical history and no medication use, the patient’s condition rapidly deteriorated and he experienced severe respiratory distress, followed by cardiopulmonary arrest with evidence of profuse pulmonary bleeding. Autopsy findings revealed massive lung congestion without embolism, normal heart size, moderate coronary atherosclerosis without myocardial infarction, and no evidence of other hemorrhagic events. The patient tested negative for COVID-19 and other respiratory pathogens at autopsy. Despite these findings, the medical examiner determined the cause of death was attributed to atherosclerotic and hypertensive cardiovascular disease, without considering the recent pulmonary hemorrhage and unremarkable medical history. Investigation into the vaccine batch indicated a higher-than-average number of serious adverse events, including fatalities. The patient's BNT162b2 batch was among the top 2.8% for reported deaths. Moreover, the autopsy failed to investigate potential contributions from the vaccine, such as the presence of the Spike protein or related antibodies. The evidence suggests that the pulmonary hemorrhage, exacerbated by a viral infection, was the immediate cause of death, with the COVID-19 vaccine potentially playing a role in the development of cardiopulmonary pathology and hemorrhage. We propose autopsy protocols for COVID-19 vaccine recipients to better investigate vaccine-related pathologies among those with one or more prior injections.

Coronavirus disease 2019 (COVID-19) is a high contagious respiratory infectious disease that has afiected millions of people worldwide. Initially, basic public health measures were implemented to control specially the spread of such virus. However, vaccination has emerged as a highly efiective strategy in combating COVID-19 and reducing its transmission. Several efiective and safe vaccines have been approved to prevent the inadvertent spread of the disease. In this study, a modeling approach is used to analyze the impact of these vaccines on the dynamics of COVID-19. By applying a higher-order numerical method, the model is solved based on reported cases in Pakistan. A spectral method is employed for the numerical solution, and the model is simulated to assess the efiects of vaccination. The Next-generation method is used to calculate the threshold quantity, known as R0, which indicates the potential for disease transmission. The study also includes a detailed stability analysis, examining the invariance properties of the model solution and discussing equilibrium points and their stability in disease-free and endemic states. Furthermore, the study presents graphical representations of the influence of special parameters on the dynamics of the pandemic.

: Background: Vaccine-related death is one of the leading causes of death among African Children. Vaccine coverage is a very important measure to decrease infant mortality. Covid-19 Pandemic has affected the healthcare system and may have disrupted vaccine coverage. Methods: DTP third doses (DTP3) Vaccine Coverage was extracted from UNICEF databases from 2012 to 2021( the last available date). Joinpoint regression was performed to detect the point where the trend changed. The annual percentage change (APC) with 95% confidence intervals (95% CI) was calculated for Africa and the regions. We compared DTP3 vaccination coverage in 2019 with 2021 in each country to verify compliance with WHO targets. Result: During the whole period, the vaccine coverage in Africa has increased with an Annual Percent change of 1.2% (IC 95% 0.9-1.5): We detected one Joint point in 2019. In 2019-2021, there was a decrease in DTP3 coverage with an APC of -3.5(95% -6.0;-0,9). (P< 0.001). Vaccination rates have decreased in many regions and countries during the last two years. Conclusions. COVID-19 has disrupted vaccine coverage, decreasing it all over Africa.

Civic engagement refers to the ways in which citizens participate in the life of a community to help shape its future or improve conditions for others. While it might have been shaped by the COVID-19 pandemic recovery, this study explored how college students perceive civic engagement on selected campuses that were partially locked down. We sampled 1036 student volunteers from six universities in Taiwan by using a self-designed module of civic engagement and transferable capabilities. The Student’s t-test, ANOVA, regression, factor analysis, and structural equation modeling (SEM) were used to interpret the differences and relationships among these variables. This study provides a more detailed example of the current status of civic engagement and its relative to transferable capabilities in a higher education setting. The related programs and institutes should take responsibility for enhancing students’ civic engagement and transferable capabilities during the pandemic. How to ameliorate the situation? The findings suggest that it should consider a student’s academic major, learning experiences in the department, and time spent on related activities during the pandemic recovery. The findings might prove useful to various campuses for enhancing ongoing practices.

Social network analysis is an essential means to uncover and examine infectious contact relations between individuals. This paper aims to investigate the spread of coronavirus disease (COVID-19) from international to the national level and find a few super spreaders which played a central role in the transmission of disease in India. Our network metrics calculated from 30 January to 6 April 2020 revealed that the maximum numbers of connections were established from Dubai (degree-144) and UK (degree-64). These two countries played a crucial role in diffusing the disease in Indian states. The eigenvector centrality of Dubai is found to be the highest, and this marked it the most influential node. However, based on the modularity class, we found that the different clusters were formed across Indian states which demonstrated the forming of a multi-layered social network structure.A significant increase in the confirmed cases was reported during the first lockdown 1.0 (22 March 2020) primarily attributed to a gathering in Delhi Religious Conference (DRC) known as Tabliqui Jamaat. As of 6 April 2020, the overall structure of the network has encompassed local transmission, and it was significantly seen in the states like Gujarat, Rajasthan, and Karnataka. An important conclusion drawn from the presented social network reveals that the COVID-19 spread till 6 April was mainly due to the local transmission across Indian states. The timely quarantine of infected cases in DRC has not led it to spread at the level of community transmission.

Background: Our study investigates the prevalence and causes of injuries among undergraduate dental students during clinical sessions. Methods: The study was conducted at the Department of Dentistry, National and Kapodistrian University of Athens, focusing on injuries reported from 2021 to 2024. Data were collected through self-reported questionnaires and clinical records. The primary variables assessed included the type of injury, the instrument involved, the clinical procedure being performed, and the immediate actions taken post-injury. Serological testing was conducted on both students and patients to assess the risk of bloodborne pathogen transmission. Results: The findings revealed a high prevalence of injuries, with needles being the most common cause, followed by burs and dental probes. The most frequent injury type was piercing, primarily affecting the fingers. Periodontal treatments, restorative procedures, and endodontic treatments were the main activities leading to injuries. Despite normal medical records for most patients treated by injured students, serological testing showed significant positivity rates for HCV and HBV. It is noteworthy that most injured students demonstrated their commitment to safety by adhering to recommended post-exposure protocols, including wound cleaning, disinfecting, and serological testing. Our study highlights the critical need for enhanced biosafety awareness and training among dental students to reduce injury risks. Conclusions: These findings underline the necessity for integrated safety protocols and continuous education to improve clinical practices and ensure student safety.

There are strong indications that the built environment intertwines consistently with the advent of Covid-19 and the need for post-disaster recovery. The advent of the Covid-19 pandemic has exerted adverse effects on both human and global developments; while the efforts to combat this menace call for an integrated human social capital index. This research seeks to adequately enhance the comprehension of how the built environment can be enhanced through resilience in the backdrop of the Covid-19 pandemic. The study's goal is to investigate the impact of a resilient built environment on increasing resilience in the aftermath of the Covid-19 pandemic in Nigeria. Overall, the quantitative study test the impact of four built environments resilience indices (Built Environment capitals; Disaster management indices, Awareness of the Covid-19 Pandemic, and Built Environment adaptive strategies) on Human social capital and Covid-19 pandemic Indices. This study reveals the role of human social capital in achieving a resilient built environment in the wake of Covid 19 pandemic in Nigeria. Also, built environment capitals, disaster management indices, and awareness on the Covid-19 have indirect effects on Covid-19 pandemic indices through the human social capital. The implication of the study is useful for Post-Covid 19 recovery; which is important for future planning of the built environment in Nigeria.

Latin America and the Caribbean (LAC) is one of the worst-hit regions globally by COVID-19 pandemic. Yet, scarce literature exists that examines the research strategy of LAC in facing COVID-19. The present study aims to quantify and assess the production of COVID-19 publications in thirty-two countries in LAC during the first half of 2020. A Scopus/PubMed/LILACS search was performed to retrieve research articles related to COVID-19 published from January 1 to July 31, 2020. Subgroup analysis including only original publications was used to better ascertain the contribution of LAC countries, and standardization measures were applied to comparisons of country-specific contributions. We identified 1291 publications across the region. Overall, most articles in the region were non-original (81.6%), and the most productive countries were Brazil (43.9%), Mexico (9.14%), and Colombia (7.98%). This trend shifted to Chile after the standardization. Among original studies, the most common study design was cross-sectional (25.8%). LAC countries generate articles primarily pertaining to diagnosis and treatment (27.4%). In the subgroup analysis, however, epidemiology and surveillance was the most prevalent research focus (24.1%). LAC countries should perform more research with a higher level of evidence to inform health policy making to ease the burden of COVID-19 in the region.

The paper presents the most comprehensive and large-scale study to date on how students perceive the impacts of the COVID-19 crisis on various aspects of their lives on a global level. With a sample of 30,383 students from 62 countries, the study reveals that amid the worldwide lockdown and transition to online learning students were most satisfied with the support provided by teaching staff and their universities’ public relations. Still, deficient computer skills and the perception of a higher workload prevented them from perceiving their own improved performance in the new teaching environment. Students were mainly concerned about issues to do with their future professional career and studies, and experienced boredom, anxiety and frustration. The pandemic has led to the adoption of particular hygienic behaviours (e.g. wearing masks, washing hands) and discouraged certain daily practices (e.g. leaving home, shaking hands). Students were also more satisfied with the role played by hospitals and universities during the epidemic compared to the government and banks. The findings also show that students with selected socio-demographic characteristics (male, part-time, first level, applied sciences, lower living standard, from Africa or Asia) were generally more strongly affected by the pandemic since they were significantly less satisfied with their academic work/life. Key factors influencing students' satisfaction with the role of their university are also identified. Policymakers and higher education institutions around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Objective Objective of the study was to evaluate the public perception and acceptance of community pharmacists in providing mental health support in Saudi Arabia during COVID-19. Methods An online questionnaire-based cross-sectional study was carried out among the general public (aged 15 years or above) of Saudi Arabia during March-April 2020 using QuestionPro platform. The validated questionnaire was bilingual (English and Arabic), simple, detailed, and relevant to obtain focused responses from participants. Importantly, an item related to an agreement on a statement “Pharmacist can counsel people on psychological issues” was included on a five-point Likert scale. The survey link was shared across multiple social media platforms. Results A total of 773 participants completed the survey. The majority were female (65.2%) and youngsters (48.1%). Nearly half of the participants disagreed, while 19% agreed that pharmacists could provide support on psychological issues. Factors such as age, employment status, and the management of the psychological issues during the pandemic were significantly associated with the acceptance of community pharmacists’ role in providing mental health services (p

Coronavirus disease 2019 (COVID-19) displays clinical heterogeneity, but little information is available for patients with mild or very early disease. We aimed to characterize biomarkers that are useful in discriminating the hospitalization risk in a COVID-19 cohort from Northern Italy during the first pandemic wave. We enrolled and followed for four weeks 76 symptomatic SARS-CoV-2 positive patients and age/sex-matched healthy controls. Patients with mild disease were discharged (n.42), and the remaining were hospitalized (n.34). Blood was collected before any anti-inflammatory/immunosuppressive therapy and assessed for soluble C5b-9/C5a, H3-neutrophil extracellular traps (NET), calprotectin, DNase plasma levels by ELISA, and a panel of pro-inflammatory cytokines by ELLA. Calprotectin and NET levels discriminate between hospitalized and non-hospitalized patients, while DNase negatively correlates with NET levels; there are positive correlations between calprotectin and both NET and neopterin levels. Neopterin levels increase in patients at the beginning of the disease and more in hospitalized than non-hospitalized ones. C5a and sC5b-9, and other acute phase proteins correlate with neopterin, calprotectin, and DNase. Both NET and neopterin levels negatively correlate with platelet count. We show that calprotectin, NET, and neopterin are important proinflammatory parameters potentially useful in discriminating between COVID-19 patients at risk for hospitalization.

International students were – and continue to be – particularly vulnerable to the negative consequences of the COVID-19 pandemic. 625 international students in Israel completed an online survey assessing risk and protective factors (socio-demographics, health status, COVID-19 related experiences/concerns, financial difficulties, academic challenges/experiences, social support, and coping) for student’s depression, perceived need for help, and seeking help from the university. Approximately 15% of participants had moderately-severe or severe depression. Over half needed at least a little help, but only 19.7% had asked for help. Depression symptoms were related coping (β=-.34) and health (β=.12). Need for help was related to being a postdoc (β=-0.26) and experiencing food insecurity (β=0.20). Universities need to develop services which address international students’ unique needs during global crises.

We studied the weekly number and the growth/decline rates of COVID-19 deaths in the period October 31, 2022 – February 9, 2023, in Italy, finding that that COVID-19 winter wave reached its peak during the three holyday weeks extending from December 16, 2022 to January 5, 2023, and it was definitely trending downward, returning to the same number of deaths of the end of October 2022, in the week February 3 – 9, 2023. During this period of fifteen weeks, that wave caused a number of deaths as large as 8,526. Its average growth rate was +7.89% deaths per week (ten weeks), while the average weekly decline rate was -12.32% (five weeks). Currently, Italy is experiencing a new COVID-19 wave, with the latest six weekly bulletins (October 26, 2023 – December 14, 2023) showing that the deaths have climbed from 148 to 322. The weekly growth rate has risen by +14.08% deaths, on average. In the hypothesis that this 2023-2024 wave have a duration similar to that of 2022-2023, with: i) a comparable extension of both the growing period and of the decline period and ii) similar growth/decline rates, a prediction can be cast regarding the number of COVID-19 deaths in the period November 2023 - January 2024. They could reach the amount of 4100-4200

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people worldwide since its emergence in 2019. The current global pandemic was driven by human-to-human transmission. Knowing the zoonotic origin of the disease and the potential capacity of the virus to adapt to other species, it is important to understand the extent of natural SARS-CoV-2 infection of animals, in particular cats and dogs in households that are in direct contact with their owners. Hong Kong and Seoul are two of the most densely-populated urban cities in Asia, where companion animals often live in close contact with humans. In this study, we screened sera from 1,040 cats and 855 dogs during the early phase of the pandemic in Hong Kong and Seoul for SARS-CoV-2 antibodies by using an ELISA that detects antibodies against the receptor binding domain (RBD) of the viral spike protein. Sera testing positive on ELISA were also tested for the presence of neutralizing antibodies using a surrogate virus neutralization (sVNT) and plaque reduction neutralization test (PRNT). Among feline sera, 4.51% and 2.54% of samples from Korea and Hong Kong, respectively, tested ELISA positive. However only 1.64% of samples from Korea and 0.18% from Hong Kong tested positive by sVNT, while only 0.41% of samples from Korea tested positive by PRNT. Among canine samples, 4.94% and 6.46% from Korea and Hong Kong, respectively, tested positive by ELISA, while only 0.29% sera from Korea were positive on sVNT and no canine sera tested positive by PRNT. These results confirm a low seroprevalence of SARS-CoV-2 exposure in companion animals in Korea and Hong Kong. The discordance between RBD-ELISA and neutralization tests may indicate possible ELISA cross-reactivity with other coronaviruses, especially in canine sera.

The perceived risk of being infected at work (PRIW) with COVID-19 represents a potential risk factor for workers during the current COVID-19 pandemic. In line with the job demands-resources (JD-R) model applied to safety at work, in this longitudinal study we propose that PRIW can be conceptualized as a job demand, whereas communication (i.e., the exchange of good-quality information across team members) can be conceived as a job resource. Accordingly, we hypothesized that PRIW at Time 1 (T1) would positively predict psychophysical strain at Time 2 (i.e., four months later). Furthermore, we hypothesized that communication at T1 would negatively predict psychophysical strain at T2. Overall, 297 workers took part in the study. The hypothesized relationships were tested using multiple regression analysis. Results supported our predictions: PRIW positively predicted psychophysical strain over time, whereas communication negatively predicted psychophysical strain over time. Also, results did not change after controlling for age, gender, and type of contract. Overall, this study suggests that PRIW and communication can be considered as a risk and a protective factor for work-related stress, respectively. Hence, to promote more sustainable working conditions, interventions should encourage organizations to optimize the balance between job demands and job resources related to COVID-19.

This study aimed to determine the COVID-19 recovery time and identify predictors among hospitalized patients in the Dhanusha District of Madhesh Province, Nepal. This hospital-based longitudinal study involved 507 COVID-19 patients admitted to three distinct medical facilities for therapeutic intervention between April to October 2021. Data were collected for patient demography, symptoms, vital signs, oxygen saturation levels, temperatures, heart rates, respiratory rates, and blood pressure measurements and other health-related conditions. Kaplan–Meier Survival Curve estimated the recovery time from, and Cox proportional hazard model was used to identify the predictors of recovery time. Of the total participants, mean age was 51.1 (SD=14.9) years, 68.0% were males, 49.5% recovered, and 16.8% died. The median for patient recovery was 26 days (95% CI: 25.1–26.7). Patients with severe or critical conditions were less likely to recover compared to those with milder conditions (Hazard Ratio (HR)=0.34, 95% CI: 0.15-0.79; p=0.012). In addition, an increase in oxygen saturation was associated with an elevated likelihood of recovery (HR=1.09, 95% CI=1.01-1.17, p=0.018). This study underscores the need for early admission in hospital and emphasizing the targeted interventions in severe cases. Additionally, the results highlight the importance of optimizing oxygen levels in COVID-19 patient care.

1) Background: Northwest Syria (NWS), is a conflict-affected and unstable area. Due to its limited health infrastructure, accessing advanced COVID-19 testing services is challenging. COVID-19 antigen rapid diagnostic tests (Ag-RDTs) have the potential to overcome this barrier. Therefore, a pilot project was implemented to introduce Ag-RDTs in this setting aiming to a) describe the feasibility, uptake, and results of Ag-RDTs; and b) identify facilitators and barriers to Ag-RDTs testing. 2) Methods: A cross-sectional study design involving secondary analysis of data collected during the project’s monitoring was developed. A local NGO implemented 25,000 Ag-RDTs cross boarder through trained community health workers. 3) Results: A total of 27,888 persons were found eligible and enrolled, of which 24,956 (89.5%) consented to test and 121 (0.5%) were found positive. Highest positivity was observed among those with severe COVID-19 symptoms (12.7%), those with respiratory illnesses (2.5%), persons enrolled at Afrin Hospitals (2.5%), and healthcare workers (1.9%). A non-random sample of 236 people underwent confirmatory rt-PCR test. Accordingly, observed sensitivity, specificity, positive and negative predictive values, were 80.0%, 96.1%, 91.4% and 90.3%, respectively. Key encountered challenges included obtaining informed consent and conducting confirmatory rt-PCR testing. 4) Conclusion: This project demonstrated great feasibility utilizing Ag-RDTs as a screening/diagnostic tool for COVID-19 infections with nearly 90% uptake. Considering the high specificity and negative predictive values and the higher positivity rates among severe COVID-19 symptomatic, embedding Ag-RDTs into COVID-19 testing strategies for ruling out and in COVID-19 infections would hold a great advantage.

The alterations in sleep among undergraduate students have been a burden to their mental health and academic studies. We used the Pittsburgh Sleep Quality Index scale in this study conducted among Georgian and International students. The respondents participated in this study through the University intranet as their responses remained anonymous. The survey comprised the demographic characteristics and sleep health deteriorating wake patterns such as subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. A total of 500 students completed this study, 72% were Georgian students, and 28% were international students. 50.8% of Georgian students were under the age of 20 years, and 74.3% of international students were between 21 and 30 years of age. Most Georgian students reported poor subjective sleep quality, short sleep duration, fewer sleep disturbances, and daytime dysfunction. However, sleep latency was higher among international students. Both categories of students reported using sleeping pills as the statistical significance was observed between global score and gender, subjective sleep quality, and age grade of Georgian students (p&lt;0.05). This study aimed to evaluate the sleep-wake health quality among international and Georgian undergraduate students at the University of Georgia.

SARS-CoV-2 virus infections in humans were first reported in December 2019, the boreal winter. The resulting COVID-19 pandemic was declared by the WHO in March 2020. By July 2020 COVID-19 is present in 213 countries and territories, with over 12 million confirmed cases and over half a million attributed deaths. Knowledge of other viral respiratory diseases suggests that the transmission of SARS-CoV-2 could be modulated by seasonally-varying environmental factors such as temperature and humidity. Many studies on the environmental sensitivity of COVID-19 are appearing online, and some have been published in peer-reviewed journals. Initially, these studies raised the hypothesis that climatic conditions would subdue the viral transmission rate in places entering the boreal summer and that southern hemisphere countries would experience enhanced disease. For the latter, the COVID-19 peak would coincide with the peak of the influenza season, increasing misdiagnosis and placing an additional burden on health systems. In this review, we assess the evidence that environmental drivers are a significant factor in the trajectory of the COVID-19 pandemic, globally and regionally. We critically assessed 42 peer-reviewed and 80 preprint publications that met qualifying criteria. Since the disease has been prevalent for only half a year in the northern, and a quarter of a year in the southern hemisphere, datasets capturing a full seasonal cycle in one locality are not yet available. Analyses based on space-for-time substitutions, i.e. using data from climatically distinct locations as a surrogate for seasonal progression, have been inconclusive. The reported studies present a strong northern bias. Socio-economic conditions peculiar to the ‘Global South’ have been omitted as confounding variables, thereby weakening evidence of environmental signals. We explore why research to date has failed to show convincing evidence for environmental modulation of COVID-19, and discuss directions for future research. We conclude that the evidence thus far suggests a weak modulation effect, currently overwhelmed by the scale and rate of the spread of COVID-19. Seasonally-modulated transmission, if it exists, will be more evident in 2021 and subsequent years.

As the coronavirus disease 2019 (COVID-19), which is caused by the novel SARS-CoV-2, continues to spread rapidly around the world, there is a need for well validated serological assays that allow the detection of viral specific antibody responses in COVID-19 patients or recovered individuals. In this study, we established and used multiple indirect Enzyme Linked Immunosorbent Assay (ELISA)-based serological assays to study the antibody response in COVID-19 patients. In order to validate the assays we determined the cut off values, sensitivity and specificity of the assays using sera collected from pre-pandemic healthy controls, COVID-19 patients at different time points after disease-onset, and seropositive sera to other human coronaviruses. The developed SARS-CoV-2 S1 subunit of the spike glycoprotein and nucleocapsid (N)-based ELISAs not only showed high specificity and sensitivity but also did not show any cross-reactivity with other CoVs. We also show that all RT-PCR confirmed COVID-19 patients tested in our study developed both virus specific IgM and IgG antibodies as early as week one after disease onset. Our data also suggest that the inclusion of both S1 and N in serological testing would capture as many potential SARS-CoV-2 positive cases as possible than using any of them alone. This is specifically important for tracing contacts and cases and conducting large-scale epidemiological studies to understand the true extent of virus spread in populations.

Post-acute COVID-19 vaccination syndrome (PACVS) is distinguished from the normal post-vaccination state by altered receptor antibodies (Semmler et al. Vaccines 2023, 11, 1642). Here, we explore the symptoms registry and standard serum markers acquired in the above study to delineate the disease phenotype of PACVS. Symptoms reported by the participants overlapped with established complex dysautonomia syndromes (ME/CFS, POTS, MCAS, SFN). However, many participants were qualified for several (131/191) or none (31/191) of these syndromes. Unbiased clustering (modified Jaccard index) revealed a prevalent cross-cohort symptomatology of malaise and chronic fatigue (&gt; 80% of cases). Overlapping clusters of (i) peripheral nerve dysfunction, dysesthesia, motor weakness, pain, vasomotor dysfunction, (ii) cardiovascular impairment, and (iii) cognitive impairment, headache, optic, oculo-motoric and acoustic dysfunctions were also frequently represented. Conspicuous serum markers encompassed increases in interleukins 6 and 8 and low fT3 levels (&gt; 80%), IgG-subclass imbalances and impaired iron-storage (&gt; 50%), and increases in sNFL (&gt; 30%). Serum markers were not correlated to specific symptoms or symptom clusters. A single and unique cause (i. e. SARS-CoV-2 vaccination) is improbable to trigger several distinct etiologies. Therefore, the symptoms and serological features observed in our study cohort probably represent facets of a single complex syndrome.

The online learning necessitated by COVID-19 social distancing limitations has resulted in the utilization of hybrid online formats focused on maintaining visual contact among learners and teachers. The preferred option of video conferencing for academic meetings has become that of Zoom. The needs of one voluntary, democratic, self-reflective university research group—grounded in responses to writing prompts—differed in learning focus. Demanding a safe space to encourage and record both self-reflection and creative questioning of other participants, the private Facebook group was chosen over video conferencing to maintain the concentration on group members’ written responses rather than how they saw themselves (and thought others saw them) on screen. A narrative research model initiated in 2015, the 2020/21 interaction of the group in the year’s worth of Facebook entries, and the yearend feedback received from group participants, will be compared with previous years when the weekly group met in-person. The results in relation to COVID-19 limitations indicate that an important aspect of self-directed learning related to trust that comes from team mindfulness is lost when face-to-face interaction is eliminated regarding the democratic nature of these meetings. With online meetings the new standard, maintaining trust requires improvements to online virtual meeting spaces.

Social distancing is a recommended solution by the World Health Organisation (WHO) to minimise the spread of COVID-19 in public places. The majority of governments and national health authorities have set the 2-meter physical distancing as a mandatory safety measure in shopping centres, schools and other covered areas. In this research, we develop a Deep Neural Network-based Model for automated people detection, tracking, and inter-people distances estimation in the crowd, using common CCTV security cameras. The proposed DNN model along with an inverse perspective mapping technique leads to a very accurate people detection and social distancing monitoring in challenging conditions, including people occlusion, partial visibility, and lighting variations. We also provide an online infection risk assessment scheme by statistical analysis of the Spatio-temporal data from the moving trajectories and the rate of social distancing violations. We identify high-risk zones with the highest possibility of virus spread and infection. This may help authorities to redesign the layout of a public place or to take precaution actions to mitigate high-risk zones. The efficiency of the proposed methodology is evaluated on the Oxford Town Centre dataset, with superior performance in terms of accuracy and speed compared to three state-of-the-art methods.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes the new Coronavirus disease (COVID-19). The symptoms range from mild to severe with a higher incidence of severe cases seen in patients with risk factors such as older age and comorbidities. COVID-19 is mainly spread through the inhalation of respiratory droplets from coughing or sneezing or via contact with droplet-contaminated surfaces. Paramedics should be aware that some aerosol generating procedures (AGPs) may put them at a higher risk of contracting the virus via possible airborne transmission. The use of remote triage clinical assessment is likely to increase as a result of the pandemic. There is no curative drug treatment for the virus and some medications may exacerbate its effects or make patients more susceptible to it. Paramedics should accept that feeling stressed by the pandemic is a natural response. Official guidelines and advice are evolving continually as the evidence on SARS-CoV-2 and COVID-19 grows. Paramedics should keep up to date with the latest clinical guidance from their employers.

Increasing global concern over COVID-19 has recently brought greater attention to studies due to the ease of person-to-person transmission and the current lack of effective antiviral therapy. Here, we proposed the application of the adverse outcome pathway (AOP) framework to support re-search on the pathogenesis of viral disease. We first constructed adverse outcome pathways (AOPs) applicable to COVID-19 management to understand whether the infection causes severe acute respiratory distress. Based on the AOP framework where mechanistic elucidation of the pathway from the interaction of chemicals (or viruses) to apical endpoints is represented, our COVID-19 AOP indicated that the molecular initiating event (MIE) was angiotensin-converting enzyme 2 (ACE2) interaction, and the key events (KEs) were the increased pro-inflammatory cytokines in immune cells, with increased mortality as an apical adverse outcome (AO). However, there is still limited information on the toxicity mechanisms of AOPs in COVID-19; therefore, detailed KEs and AOs on toxicity mechanisms will be required to fill these gaps in the data. This study demonstrated that the COVID-19 AOP framework is a suitable tool to design new drugs and to integrate crowded-sourced information for the battle against the COVID-19 pandemic.

Abstract Introduction:The Robert Koch Institute (RKI) managed the exchange of cross-border contact tracing data between public health authorities (PHA) in Germany and abroad during the COVID-19 pandemic. Aim: We aimed to describe the extent of RKI cross-border contact tracing and the challenges experienced. Methods:We analysed cross-border COVID-19 contact tracing events from 03 February to 05 April 2020 using information exchanged through the European “Early Warning Response System” (EWRS) as well as communication with International Health Regulation (IHR) national focal points. We described events by PHA involved, number of contact persons and exposure context. Results:The RKI processed 467 events, initiating contact to PHA 1,099 times (median 1, IQR [1;2]) and sharing data on 5,099 contact persons. Of 327 (70%) events with known exposure context, most common reported were exposures on aircraft 64 (14%), on cruise ships 24 (5%) and exposures related to non-transport contexts 210 (45%). Cruise ship and aircraft exposures yielded higher median numbers of authorities contacted (10[2;16], 4[2;11]) and contact persons (60 [9;269], 2[1;3]) than non-transport related exposures (1[1;6] and 1[1;2]), respectively. The median time spend on contact tracing activities was the highest for cruise ships: 5 days [IQR 3;9]. Conclusion:In the current COVID-19 pandemic cross-border contact tracing is considered a critical component of the outbreak response. While the majority of international contact tracing activities did not relate to exposure events in transport, they contributed substantially to the workload. The numerous communications highlight the need for fast and efficient global outbreak communication channels between PHA.

Suffocation syndrome is the leading cause of hypoxia and mortality in the most common lung diseases, asthma and COVID-19. Inhaled corticosteroids (ICSs) have been shown to be the main-stay of critical care in these diseases. Meanwhile, mortality from strangulated hypoxia is highest in low-income countries because ICSs are not currently available to many patients. Warm alkaline hydrogen peroxide solutions (WAHPSs) have reportedly been invented in recent years to urgently turn thick sputum, mucus, pus, serous fluid, blood clots and many other biological masses con-taining the enzyme catalase into a fluffy oxygenated foam. It has been shown that the mechanism of action of WAHPSs consists in alkaline saponification of lipid and protein-lipid complexes of bi-ological masses and their transformation into oxygen foam, because hydrogen peroxide is urgently decomposed into water and oxygen gas under the action of the biological masses catalase enzyme At that excess oxygen is absorbed into blood through lungs and increases blood oxygen saturation. Based on the described mechanism of action of WAHPSs and the high availability of their ingre-dients, it is suggested that mortality from choking and hypoxia in asthma and COVID-19 can be reduced by combining ICSs with inhaled WAHPSs, especially in poor countries. The essence of the inventions underlying the formation of WAHPSs is given.

The basic constitutional freedoms and rights of a person and citizen are in principle unlimited: the full scope of their exercise is the rule, and the restriction determined by law can only be an exception based on explicit constitutional authority and the legitimate aim of the restriction determined by the Constitution. That being so, the restrictions - in addition to being based on constitutional authority and pursuing constitutional objectives - should be commensurate with the needs to achieve these objectives. This means that restrictive legal rules must be suitable for achieving the legitimate aim pursued, must not be stricter than necessary and must be balanced between the constitutionally guaranteed subjective right of the individual and the interests of society. In this scholar paper, the authors point out the economic and legal consequences of the violation of individual privacy and data protection rights caused by the public disclosure of personal data of people who, at a certain time, were obliged to self-isolate due to suspicion of Covid-19 virus infection.

Objectives: This paper presents a statistical review of modelling simulations for frequency and sensitivity of COVID-19 testing paradigms. Methods: We performed a review of preprints and published articles on PubMed from January 1, 2020 – March 1, 2021 using the search terms “COVID screening testing”, “COVID testing frequency”, “COVID testing frequency screening” and “SARS-CoV-2 testing frequency”.Results: Several authors’ conclusions support the claim that test frequency and test sensitivity both play a role in reducing SARS-CoV-2 transmission. We highlight the interplay between frequency of testing, test sensitivity and the speed at which test results are available in our review. Conclusions: Evidence suggests that sensitivity and frequency of testing both play a part in decreasing transmission of disease. We conclude that, overall, test sensitivity plays less of a role in reducing disease transmission in a population compared to the frequency of testing and how quickly test results are available.

International data suggests that exposure for nature is beneficial for mental health and well-being. The restrictions related to Covid-19 pandemic have created a setting that allows us to investigate the importance of greenness exposure on mental health during a period of increased isolation and worry. Based on 2060 responses from an online survey in the Stockholm County, Sweden, we investigated: 1) weather the Covid-19 pandemic changed peoples’ life-style and nature-related habits, and 2) if peoples’ mental health differed depending on their exposure to greenness. Neighbourhood greenness levels were quantified by using the average Normalized Difference Vegetation Index (NDVI) within 50m, 100m, 300m, and 500m buffers surrounding the participant’s place of residence. We found that the number of individuals that reported that they visited natural areas “often” was significantly higher during the pandemic than before the pandemic. Higher levels of greenness surrounding one’s location of residence were in general associated with higher mental health/wellbeing and vitality scores, and less symptoms of depression, anxiety, and perceived and cognitive stress, after adjustments for demographic variables and walkability. In conclusion, the results from the present study provided support to the suggestion that contact with nature may be important for mental health in extreme circumstances.

Online food delivery service (OFDS) has been widely utilized during the new normal of COVID-19 pandemic especially in a developing country such as Indonesia. The purpose of this study was to determine factors influencing customer satisfaction & loyalty in OFDS during the new normal of COVID-19 pandemic in Indonesia by utilizing an extended Theory of Planned Behavior (TPB) approach. 253 respondents voluntarily participated and answered 65 questions. Structural equation modeling (SEM) indicated that Hedonic Motivation (HM) was found to have the highest effect on customer satisfaction, followed by Price (P), Information Quality (IQ), and Promotion (PRO). Interestingly, this study found out that usability factors such as Navigational Design (ND) and Perceived Ease of Use (PEOU) were not significant to customer satisfaction and loyalty in OFDS during the new normal of COVID-19. This study can be the theoretical foundation that could be very beneficial for OFDS investors, IT engineers, and even academicians. Finally, this study can be applied and extended to determine factors influencing customer satisfaction and loyalty in OFDS during the new normal of COVID-19 in other countries.

Celecoxib as adjuvant therapy has been shown in a small randomized trial for Covid-19 to prevent clinical deterioration and rapidly improve thoracic computerized axial tomography (CT-chest)¹. Multiple descriptive trials of high dose famotidine (both inpatient and outpatient) have demonstrated clinical response^2,3,4. We describe the rapid clinical responses after increasing the celecoxib dosage to 400mg bid with high dose famotidine 80mg qid in both a critical inpatient who on baseline required 40 liters per minute high flow nasal insufflation and an outpatient who declined admission but had critical Covid-19 biomarkers.

Background. Chest CT is widely regarded as a dependable imaging technique for detecting pneumonia in COVID-19 patients, but there is growing interest in microwave radiometry (MWR) of the lungs as a possible substitute for diagnosing lung involvement. Aim. The aim of the study is to examine the utility of the MWR approach as a screening tool for diagnosing pneumonia with complications in patients with COVID-19. Methods. Our study involved two groups of participants. The control group consisted of 50 individuals (24 male and 26 female) between the ages of 20 to 70 years who underwent clinical evaluations and had no known medical conditions. The main group included 142 participants (67 men and 75 women) between the ages of 20 to 87 years who were diagnosed with COVID-19 complicated by pneumonia and were admitted to the emergency department between June 2020 to June 2021. Skin and lung temperatures were measured at 14 points, including 2 additional reference points, using a previously established method. Lung temperature data were obtained with the MWR2020 (RTM-01-RES) (MMWR LTD, Edinburgh, UK), a CE Class I device. All participants underwent clinical evaluations, laboratory tests, chest CT scans, MWR of the lungs, and reverse transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2. Results. The MWR exhibits a high predictive capacity as demonstrated by its sensitivity of 98.6% and specificity of 84.0%. Conclusions. MWR of the lungs can be a valuable substitute for chest CT in diagnosing pneumonia in patients with COVID-19, especially in situations where chest CT is unavailable or impractical.

Fever remains an integral part of the acute clinical diseases management, esp. viral, for which effective therapeutics remain desired. However, the presence of often confusing fever reduction recommendations for COVID-19 in the public domain during the pandemic, as late as 28 April 2021, seems to suggest the reduction of any ‘uncomfortable’ fever ranging from 37.8 - 39oC, as opposed to WHO fever reduction guidelines (≥39oC), urgently need attention. The confusion could percolate down into different agencies who look up to these agencies for guidance in framing their own, denying the benefits of fever to populations, and effectively undo whatever successive WHO’s guidelines have achieved in the last two decades. The existence of conflicting guidelines in public domains which are open to interpretations has consequences to public health and the healthcare infrastructure, on implementation. For controlling acute infectious diseases, esp. viral, the fever remains the most important enabler. Historically, our chief obstacles to harnessing the benefits of fever in acute clinical diseases with limited therapeutics had been: a) widespread myths about ‘fevers’ arising from a general misunderstanding of basic facts; b) presence of confusing guidelines by different agencies which are open to alternate interpretation. The article attempts to briefly indicate the benefits of fever in disease resolution, dispel myths, underline vagueness in illustrative national guidelines and the need to align them with evidence-based WHO guidelines, as it has the potential to perpetuate myths/confusion in masses leading to adverse impact on disease management – more morbidity and mortality from diseases including COVID-19.

The disruption of conventional manufacturing, supply, and distribution channels for medical supplies during the COVID-19 pandemic has caused widespread shortages and catalyzed local efforts to use nontraditional, rapid manufacturing to meet urgent healthcare needs. Here we present a crisis-responsive design framework designed to assist with product development under pandemic conditions. The framework utilizes extensive stakeholder engagement, comprehensive and dynamic needs assessment, local manufacturing, and product testing for the accelerated development of healthcare products. We contrast this framework with traditional medical device manufacturing and discuss relevant regulatory policies. We highlight the applicability of the crisis-responsive framework to a successful local program that designed and supplied face shields for a large US academic hospital. Finally, we make recommendations aimed at improving future resilience to healthcare emergencies. These include continued development of open source designs suitable for rapid manufacturing and changes in regulatory policy that strike a balance between rigidity and uncontrolled innovation.

Background: In susceptible hosts, SARS-CoV2 induced hyperinflammation accounts for an increased mortality. The search of adjuvant immunomodulatory therapies has been ongoing ever since the pandemic outbreak. Aim: Our purpose was to evaluate the efficacy of cyclosporin A (CsA) as add-on therapy to standard of care in patients with severe COVID-19 pneumonia. Methods: We conducted a randomized clinical trial in patients admitted to 8 Spanish Tertiary Hospitals. Patients were stratified into two severity categories and randomized 1:1 to receive a high dose corticosteroid-based standard therapy with or without CsA. The primary endpoint was FiO2 recovery by day 12 without relapses. Results: 109 patients were included and 98 randomized: 51 of them were assigned to CsA+SoC group and 47 to Standard of Care (SoC). 96/98 of them were included in the Intention to Treat population. 35 (68.6%) patients from CsA+SoC group and 32 (71,1%) patients from SoC group reached the primary endpoint in the ITT analysis. No differences were found after stratification into age groups, severity level at admission or the combination of both. Overall, time to FiO2 normalization was 7.4 days vs 7.9 days in the experimental and control groups, respectively. Global mortality was 8.2%. Severe adverse events were uncommon and equally distributed between arms. Conclusion: Addition of CsA did not show differences over a high-dose corticosteroids-based treatment in the clinical course of included patients. A better identification of candidates who will benefit from receiving immunomodulatory drugs is necessary in future studies.

During the COVID-19 pandemic, the term “behavioural fatigue” became the centre of policy debates in Great Britain. These debates involved deciding when to go into lockdown and whether behavioural interventions could be effective. Behavioural interventions can only succeed where people’s capabilities, opportunities, and motivations to perform target behaviours are supported. Our retrospective data analyses examine the relationships between people’s capabilities, opportunities, motivations, and behaviours, i.e., adherence to lockdown guidelines. Our cross-sectional analyses include 17,962 unique participants in Great Britain who completed a survey over the initial 30 days of the first lockdown (April 2020). We examine trends in responses to each scale and then the relationships between the scales using Granger’s causality test with tests for stationarity and cointegration. A mixture of increasing and decreasing trends were identified for capabilities and opportunities. Decreasing trends were identified for motivation and behaviour. Granger’s causality tests found that capability forecasts opportunity and behaviour and that motivation forecasts opportunity. The discussion reiterates that to realize and maintain behaviour changes, policies surrounding people's capabilities, opportunities, and motivations must continue to support target behaviours.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Background: Vaccinating children against COVID-19 is an essential public health approach for preventing infection in children and adults. This study aimed to explore parents' attitudes toward and the rate of COVID-19 vaccine hesitancy among children in Oman. Methods: This cross-sectional study used an online, self-administered questionnaire. The 9-item questionnaire was validated earlier and administered between June 2021 and May 2022. Multiple logistic regression was used to determine the factors associated with vaccine hesitancy. The parents received a pre-validated Google questionnaire. Responses from the parents of children younger than 11 years of age were accepted. Results: 384 participants completed the questionnaire, including 207 males (54%). The response rate was 86% (384/447). Of the 384 participants, 69% of the parents hesitated to vaccinate their children aged 1-11-year-old children). In parents of children aged 1–4 years, parental vaccination status was significantly associated with vaccine hesitancy (odds ratio [OR]: 0.116, 95% confidence interval [CI]: 0.044–0.306; p < 0.001). Additionally, vaccine hesitancy was significantly more common in mothers than in fathers (OR: 0.451, 95% CI: 0.240–0.848; p = 0.013). . Mothers of children were 77% more likely to be hesitant than fathers (.78, 95% confidence intervals (CI) = 0.50–0.1.23; p = 0.283). Conclusion: Many parents hesitated to vaccinate their children against COVID-19. Consequently, future awareness campaigns and strategies should target new vaccines. The results of our study show that the Arabic version of the 5-point Likert Scale for Vaccination Hesitancy is a valid and reliable tool.

We present a new mathematical model of disease spread reflecting specialties of covid-19 epidemic by elevating the role social clustering of population. The model can be used to explain slower approaching herd immunity in Sweden, than it was predicted by a variety of other mathematical models; see graphs Fig. \ref{GROWTH2}. The hierarchic structure of social clusters is mathematically modeled with ultrametric spaces having treelike geometry. To simplify mathematics, we consider homogeneous trees with $p$-branches leaving each vertex. Such trees are endowed with algebraic structure, the $p$-adic number fields. We apply theory of the $p$-adic diffusion equation to describe coronavirus' spread in hierarchically clustered population. This equation has applications to statistical physics and microbiology for modeling {\it dynamics on energy landscapes.} To move from one social cluster (valley) to another, the virus (its carrier) should cross a social barrier between them. The magnitude of a barrier depends on the number of social hierarchy's levels composing this barrier. As the most appropriate for the recent situation in Sweden, we consider {\it linearly increasing barriers.} This structure matches with mild regulations in Sweden. The virus spreads rather easily inside a social cluster (say working collective), but jumps to other clusters are constrained by social barriers. This behavior matches with the covid-19 epidemic, with its cluster spreading structure. Our model differs crucially from the standard mathematical models of spread of disease, such as the SIR-model. We present socio-medical specialties of the covid-19 epidemic supporting our purely diffusional model.

This study rigorously investigates the impact of COVID-19 on the Tunisian stock market volatility. The investigation spans from January 2020 to December 2022, employing a GJR-GARCH model, bias-corrected wavelet analysis, and an ARDL approach. Specific variables related to health measures and government interventions are incorporated. The findings highlight that confirmed and death cases contribute significantly to the escalation in TUNINDEX volatility. Interestingly, certain indices related to government interventions exhibit no substantial impact on volatility, indicating a weak resilience of the Tunisian stock market amidst the challenges posed by COVID-19. However, the application of the bias-corrected wavelet analysis yields more nuanced outcomes in terms of correlations of volatility to the same metrics. Notably, the study recognizes the potential influence of uncertainties linked to the duration of lockdowns on financial market volatility. The positive and long-term impact on volatility of the US Equity Market uncertainty and VIX is evident through the Autoregressive Distributed Lag Model (ARDL), whereas economic policy uncertainty shows no significant impact. This indicates a potential vulnerability of the Tunisian stock market to future shocks, emphasizing the need for government efforts to instill investor confidence. This comprehensive exploration contributes to our understanding of the dynamics between the pandemic’ metrics, government interventions, and financial market stability. Our findings provide valuable insights for implementing risk management strategies amid the COVID‐19 crisis.

Introduction: Post-COVID-19 syndrome (PCS) is a multisystemic disorder marked by impaired physical performance as one lead symptom. Since it has been suggested that endurance training as part of medical rehabilitation may be effective to improve physical performance capacity in PCS, this study aimed to compare different modes of aerobic endurance training. Methods: Hundred-ten PCS patients (49.3±11.8 years, 38% women, time after infection=260.2±127.5 days) underwent detailed clinical screening including symptom-limited cardiopulmonary exercise testing at admission and after 4-6 weeks of inpatient medical rehabilitation. Questionnaires were used to assess disease perception. Patients performed controlled isocaloric cycle ergometer training (3-5 sessions/week, 18 min) as either continuous training (CT) at 50% of maximal workload or as interval training (IT, load=60%, relief=30%). Outcomes of PCS patients were compared to coronary artery disease patients (CAD, n=96) to evaluate overall training effectiveness. Results: Training participation was comparable between both groups with no indication of training-specific exercise-induced fatigue. Overall, PCS patients improved significantly by a mean of 6.8±12.1% for W at VT1, 3.1±10.0% for VO2 at VT1, 5.5±14.7% for O2-pulse at VT1, 7.5±15.0% for W at VO2peak, 2.7±11.0% for VO2peak and 4.6±12.4% for O2-pulse at VO2peak (all p<0.05) with no significant differences between groups (p>0.05). Both groups showed reduced levels of fatigue, anxiety and depression as well as improved quality of life and wellbeing (all p<0.05). Compared to guideline-based cardiac rehabilitation, PCS patients showed a similar improvement in workload and oxygen uptake compared to CAD patients. Conclusion: PCS patients benefit from aerobic endurance training, performed as moderate continuous or interval training as part of a medical rehabilitation program in terms of improved physical exercise capacity and disease perception. Results for PCS patients are comparable to guideline-based rehabilitation of CAD patients. Clinical Trial: NCT06016192

To control the COVID-19 pandemic, many countries implemented vaccination and imposed societal restrictions both at the national level and for international travel. As a check of the corona status, a COVID pass has been issued. A COVID pass could be obtained when fully vaccinated against COVID-19, having recovered from a documented COVID-19 episode, or a recent (24-48 hours) negative SARS-CoV-2 antigen test. A global analysis of SARS-CoV-2 immune status (determined by past infection and/or vaccination), vaccination rates, as well as societal restrictions in controlling the COVID-19 pandemic is presented.

Abstract This qualitative research study was aimed at exploring Covid-19 pandemic and its impact via online engagement on disadvantaged undergraduate students resulting in digital divide. The study was supported by the connectivism theory. The methodology approach was an eight year (2014-2022) duration systematic literature review using Educational Resources Information Center (ERIC), Google Scholar, Scopus, and Web of Science (WoS) databases as advanced search strategies. Findings from the SLR provided 56 included relevant publications as confirmed in the Reference Section. Here, findings justified factors responsible for digital divide and the digital divide impacts. Connectivism was suggested as an approach to control digital divide. This study recommends connectivism to control digital divide experienced among disadvantaged undergraduate students in South African universities via numerous supports for free trainings in computer skills, while the government provides low data cost and free Wi-Fi services.

By using the Sala-i-Martin version of extreme bounds analysis, which is based on the cumulative density function, cross-sectional evidence is presented on the robust determinants of the infection and case mortality rates of Covid-19. The results show that, for most part, different factors determine the infection and mortality rates in developed and developing countries. However, common factors are also apparent, including the risk environment, the number of tests per million and the percentage of population over 65. Notwithstanding the possibility that the official data represent a partial reflection of the truth, it is concluded that the results presented in this study provide useful information that may aid decision-making in the fight against the pandemic.

The COVID-19 pandemic has put lifestyles in question, changed daily routines and limited citizen freedoms that seemed inalienable before. A human activity that was greatly affected since the beginning of the health crisis is mobility. Focusing on mobility, we aim to discuss the transformational impact that the pandemic brought on this specific urban domain, especially with regards to the promotion of the smart growth agenda and the acceleration towards the smart city paradigm. We collect 60 initial policy responses related to urban mobility from 86 cities around the world and analyse them based on the challenge they aim to address, the exact principles of smart growth and sustainable mobility that they encapsulate and the level of ICT penetration. Our findings suggest that emerging strategies, although mainly temporary, are transformational, in line with the principles of smart growth. As a result the pandemic becomes an opportunity for shifting towards more sustainable urban planning and mobility practices. However, most policy responses adopted during the first months of the pandemic fail to leverage advancements made in the field of smart cities, and to adopt off-the-shelf solutions such as in monitoring, alerting and operations management.

Supported Wellbeing Centres have been set up in UK hospital trusts in effort to mitigate the psychological impact of COVID-19 on healthcare workers, although the extent to which these are utilised and the barriers and facilitators to access are not known. The aim of the study was to determine facility usage and gather insight into employee wellbeing and the views of employees towards this provision. The study included i) 17-week service use monitoring, ii) employee online survey with measures of wellbeing, job stressfulness, presenteeism, turnover intentions, job satisfaction, and work engagement as well as barriers and facilitators to accessing the Wellbeing Centres. Over 17 weeks, 14,934 facility visits were recorded across two sites (peak attendance in single week n= 2,605). Facilities were highly valued, but the service model was resource intensive with 134 wellbeing buddies supporting the centres in pairs. 819 hospital employees completed an online survey (88% female; 37.7% working in COVID-19 high risk areas; 52.4% frontline workers; 55.2% had accessed a wellbeing centre). There was moderate-to-high job stress (62.9%), low wellbeing (26.1%), presenteeism (68%) and intentions to leave (31.6%). Wellbeing was higher in those that accessed a wellbeing centre. Work engagement and job satisfaction were high. Healthcare organisations are urged to mobilise access to high-quality rest spaces and Psychological First Aid, but this should be localised and diversified. Strategies to address presenteeism and staff retention should be prioritised, and high dedication of healthcare workers should be recognised.

Background: Comorbidities have been frequently reported in COVID-19 patients, which often lead to more severe outcomes. The underlying molecular mechanisms behind these clinical observations have not yet been explained. Herein, we investigated the disease-specific gene expression signatures that may induce susceptibility to SARS-CoV-2 infection. Methods: We studied 30 frequently occurring acute, chronic, or infectious diseases of recent times that have shown comorbidity in one or another respiratory disease(s) caused by pathogenic human infecting coronaviruses, especially SARS-CoV-2. We retrieved array-based gene expression data for each disease and control from relevant datasets. Subsequently, all the datasets were quantile normalized, and log-2 transformed data was used for analysis. Results The expression of ACE2 receptor and host proteases, namely FURIN and TMPRSS2 that are essential for cellular entry of SARS-CoV-2, was upregulated in all six studied subtypes of leukemia (hereafter, referred as leukemia). The expression of ACE2 was also increased in psoriasis, lung cancer, Non-alcoholic fatty liver disease (NAFLD), breast cancer, and pulmonary arterial hypertension patients. The expression of FURIN was higher in psoriasis, NAFLD, lung cancer, and in type II diabetic liver, whereas it was lowered in breast cancer. Similarly, the expression of TMPRSS2 was increased during lung cancer and type II diabetes; it was decreased during psoriasis, NAFLD, lung cancer, breast cancer, and cervical cancer.Furthermore, a heightened expression of genes that are involved in immune response was observed in leukemia patients, as shown by the higher expression of IFNA2, IFNA8, IFNA10, IFNA14, IFNA16, IFNA21, IFNB1, CXCL10, and IL6. The expression of JAK1, STAT1, IL6, and CXCL10 was higher in NAFLD. Besides, JAK1 and STAT1 were upregulated in type II diabetic muscles. In addition, most of the upregulated genes in COVID-19 patients showed a similar trend in leukemia, NAFLD, and psoriasis. Furthermore, SARS-CoV-2, SARS-CoV and MERS CoV, were found to commonly alter two genes, namely, CARBONIC ANHYDRASE 11 and CLUSTERIN.Conclusions: The genes that may confer susceptibility to SARS-CoV-2 infection are mostly upregulated in leukemia patients; hence, leukemia patients are relatively more susceptible to develop COVID-19, followed by other chronic disorders, such as, NAFLD, type II diabetes, psoriasis, and hypertension. This study identifies key genes that are altered in the studied diseases types, which may aid in the infection of SARS-CoV-2 and underlie COVID-19 associated comorbidities.

Global emerge of zoonotic novel corona virus (COVID-19) became a pandemic and its effect to mankind is talk of the town now a days. This tiny, invisible enemy has affected every country in the world and almost every living directly or indirectly and nationwide complete lockdown has triggered a short-term environmental impact. Since 2003, corona virus came into existence in the form of Severe Acute Respiratory Syndrome (SARS) and more evolved Middle East Respiratory Syndrome (MERS) in 2012. This time, at the end of December 2019, outbreak of novel corona virus COVID-19 (also known as SARS-CoV₂, nCoV-2019) draw attention as global health emergency. World Health Organization (WHO) report says that the outbreak of this virus is so immense, it has already affected 35,57,235 people and caused death to 2,45,150 people worldwide and 46,433 Indians got affected with 1568 death as on 5^th May 2020 (2:00 am) and these numbers are increasing exponentially day by day. Virologist, micro-biologist and science community are hammering their head very hard to find out cure and vaccine against this powerful virus and to prevent mass demise of mankind. In order to curb the spread of COVID-19, Janta curfew on 22.03.2020 and nationwide complete lockdown was implemented in India for 21 days (phase-I, from 25.03.2020 to 14.04.2020) to stop community transmission of third stage, for 19 days (phase-II, 15.04.2020 to 03.05.2020) and 14 days (phase-III, 04.05.2020 to 17.05.2020) complete lockdown to minimize the community transmission effect. During complete lockdown and quarantine period a drastic change in Earth’s atmosphere, including reduction in emission of greenhouse gases, air pollution (~50% fall in air quality index), noise pollution, water pollution and solid waste pollution, have been recorded by government agencies as well as private agencies. In this paper we considered data of Janta curfew, phase-I and phase-II lockdown to link between geological and environmental aspect related to environmental impact due to emerge of COVID-19 and massive reduction in pollution level during complete lockdown in India. We propose future lockdown strategies to minimize the emission of greenhouse gas by ~100 Mt to ~200Mt (3.33% to 6.66%) of GHG_total per year by 2-4 days per month nationwide lockdown or ~70 Mt to ~140 Mt (2.33% to 4.66%) of GHG_total per year by 2-4 days per month complete lockdown of energy sectors only.

The first case of Corona Virus Disease 2019 (COVID-19) was reported in Wuhan, China in December 2019. Since then, COVID-19 has quickly spread out to all provinces in China and over 150 countries or territories in the world. With the first level response to public health emergencies (FLRPHE) launched over the country, the outbreak of COVID-19 in China is achieving under control in China. We develop a mathematical model based on epidemiology of COVID-19, incorporating the isolation of healthy people, confirmed cases and close contacts. We calculate the basic reproduction numbers 2.5 in China (excluding Hubei province) and 2.9 in Hubei province with the initial time on January 30 which show the severe infectivity of COVID-19, and verify that the current isolation method effectively contains the transmission of COVID-19. Under the isolation of healthy people, confirmed cases and close contacts, we find a noteworthy phenomenon that is the potential second epidemic of COVID-19, and estimate the peak time and value and the cumulative number of cases. Simulations show that the isolation of close contacts tracked measure can efficiently contain the transmission of the potential second epidemic of COVID-19. With isolation of all susceptible people or all infected people or both, there is no potential second epidemic of COVID-19. Furthermore, resumption of work and study can increase the transmission risk of the potential second epidemic of COVID-19.

Seroprevalence of anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) antibodies in the postvaccination period in Kenya remains to be elucidated. This study aimed to determine the seroprevalence of anti-SARS-CoV-2 IgM and IgG and evaluate vaccination uptake in Nairobi, Kenya. This was a cross-sectional study conducted in a university setting. Serum anti-SARS-CoV-2 IgM and IgG levels were assayed using enzyme-linked immunosorbent assays. Mann–Whitney U test was used for binary comparisons and Kruskal–Wallis Test for multigroup comparisons. Statistical significance was set at p &lt; 0.05. A total of 189 participants were enrolled (median age, 21 years; female, 50.8%). The seroprevalence of anti-SARS-CoV-2 was 12.7% for IgM and 87.8% for IgG. Anti-SARS-CoV-2 IgG titers were higher among the vaccinated vs. non-vaccinated individuals (p &lt; 0.001, U = 2817.5), females vs. males (p = 0.024, U = 3616), and those vaccinated &lt; 6 months before the study vs. those vaccinated &gt;1 year earlier (p = 0.002, H = 12.359). The vaccination hesitancy rate was 43.4% and the underlying reasons included mistrust (22.4%), health concerns (19.7%), and lack of information (18.4%). Despite the high seroprevalence of anti-SARS-CoV-2 IgG, the high vaccine hesitancy rate necessitates community engagement and education prior to vaccines roll out.

Human existence and development ever demanded suitable shelter, the dual direc-tion relationship of human-residence have always been a material dealt with to enhance residential living conditions. The emersion of COVID-19 pandemic had introduced ab-rupt and dramatic changes in human life protocols, that exerted clear pressure on differ-ent sectors within the built environment. Housing beard great impact due to needs of so-cial distancing and quarantine obligations to increase chances of human existence. In order to measure human adaptation and residence alterations following new residential requirements, Quality of life investigations to promotse better built environment for oc-cupants had been facilitated using theory of residential dissatisfaction already been adopted in current study. Residents’ responses had been extracted regarding their dissat-isfaction applying Likert scale for measurement and evaluation. The study focused on homogenous housing estates in Erbil City precisely apartments have been selected with different plans and building layouts for their widespread use in the city and have been occupied during the three stages of study to go beyond investigating direct impact of the pandemic towards permanence of alterations and adaptation even after pandemic. Rea-sons causing changed dissatisfaction levels have been investigated for better reliability towards formulating final conclusions and recommendations. Findings showed in-creased dissatisfaction during pandemic in most of spaces, apartment layout and space design significantly affected responses and demands. Levels of dissatisfaction after pan-demic were different from stability to slight decline in dissatisfaction. The effect of limited external spaces in apartments had limited the possibility to manage the pressure, a case that might be less demanding in single family housing due to availability of private gar-dens.

The COVID-19 pandemic has shown varying effects on adolescents’ mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N=1607) at the end of the first year of the pandemic in relation to these factors. Data was collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to females, a higher percentage of male adolescents reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, females demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of male adolescents during the COVID-19 pandemic in Sweden.

The emergence of the COVID-19 pandemic triggered a swift transition to online learning, remote work and an increased demand for proficiency in telehealth and digital health among health professions students as they prepare for their future careers. In responding to the question: “What are the essential constructs and the validity of a digital competence assessment scale for health professions students", this study sought to develop and validate a digital competence assessment scale (DigiCAS-HPS). The present study followed a mixed-methods approach: qualitative methods (phase 1) for generating and refining items in the scale through literature review on digital frameworks, pilot testing and expert review, and quantitative methods (phase 2) including exploratory and confirmatory factor analysis for its validation. The study revealed a two-factor structure, encompassing Digital Communication, Collaboration, and Online Security (Factor 1) and Digital Content Development and Software Mastery (Factor 2), demonstrating strong construct validity and reliability. Regarding differences in digital competence across groups, older and soon-to-graduate students exhibited higher proficiency in digital content development and software mastery. The two critical facets of DigiCAS-HPS scale could tailor training programs and ensure that health professions students are well-prepared for the evolving telehealthcare landscape. This promotes the growth and accessibility of telehealth, which is increasingly vital in the post-COVID-19 new normal era.

Objective: This study examined the impact of Japan’s state of emergency on trends in diabetes care during the coronavirus disease 2019 (COVID-19) pandemic. Design: A descriptive and retrospective study. Setting: Showa University Hospital, Japan. Participants: Patients with diabetes who received medical treatment from 2018 to 2020. Determinants of interest: Number of patients with diabetes visiting the hospital per week. To examine the impact of the Japan’s state of emergency, the number hospital visiting by patients with diabetes was summarized from 28 weeks of data, from calendar week 8 to week 35, for each year. Results: Compared with the mean of 2018 and 2019, no significant difference was found between the three periods (before, during, and after the state of emergency). However, the numbers of patients from both inside and outside Tokyo increased at 7 weeks after the state of emergency was lifted. Conclusions: A significant increase in the numbers of patients with diabetes was seen compared with the same period in 2018 and 2019, suggesting that the state of emergency may have hindered diabetes care. Therefore, patients with diabetes should be followed up continuous of diabetes care while keeping a close eye on measures.

Objective: to assess level of trust in health services during COVID-19 pandemic in Brazil. Methods: Cross-sectional study, carried out between 2020 and 2021, among Brazilians over 18. A non-probabilistic sampling was used. Descriptive and inferential statistics were applied, using the Local Bivariate Moran’s technique was used to verify the existence of spatial dependence between the incidence and mortality of COVID-19 and trust in health services. Furthermore, multinomial regression was also used to analyze the factors associated with the confidence level, with the calculation of the Odds Ratio and with a confidence interval of 95%. Results: 50.6% reported trust in hospital services while 41.4% did not trust Primary Health Care services. With the application of the Local Bivariate Moran, both for the incidence and mortality of COVID-19, the trust in tertiary care and primary care services showed a statistically significant spatial association predominant in the Midwest (High-Low) and North (Low-High) regions of Brazil. The level of trust was associated with education, religion, region of the country and income. Conclusions: The level of trust in hospital services, more than Primary Health Care services, may be related to the population's culture of prioritizing the search for hospital care at the detriment of health promotion and disease prevention

Introduction: The COVID-19 pandemic overwhelmed health systems globally, and affected delivery of other health services. We conducted a study in Uganda to describe interventions for continuity of access to other health services. Methods: We reviewed documents and interviewed 21 key informants. Thematic analysis was conducted to identify themes using the World Health Organization health system building blocks as a guiding framework. Results: Governance strategies included establishment of coordination committees and development and dissemination of guidelines. Infrastructure and commodities strategies included review of drug supply plans and allowing emergency orders. Workforce strategies included provision of infection prevention and control equipment, recruitment and provision of incentives. Service delivery modifications included designation of facilities for COVID-19 management, patient self-management, dispensing drugs for longer periods and leveraging community patient networks to distribute medicines. However, multi-month drug dispensing led to drug stock-outs while community drug distribution was associated with stigma concerns. Conclusions: Health service maintenance during emergencies requires coordination to harness existing health system investments. The service continuity committee coordinated efforts to maintain services and should remain a critical element of emergency response. Self-management and leveraging patient networks should address stigma to support service continuity in similar settings and strengthen service delivery beyond the pandemic.

This study aims to identify factors associated with anxiety levels of adults living in Singapore before the pandemic and during the COVID-19 outbreak. Data were collected using a cross-sectional web-based survey conducted from July to November 2020 accruing 264 eligible participants. Ordered logistic regression was used to assess Generalized Anxiety Disorder-7 (GAD-7), ranked as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) before the pandemic and during the pandemic. About 74% of participants were female, 50% were aged 25-34, and 50% were married. The GAD-7 level went up from pre-pandemic for both moderate (from 12.5% to 16%) and severe GAD (from 2% to 11%). Alcohol consumption (AOR 1.79, 95% CI 1.04-3.06), loneliness (AOR 1.28, 95% CI 1.05-1.54), and difficulty in switching off social media (AOR 2.21, 95% CI 1.29-3.79) predicted increased GAD-7 levels. The quality of life (AOR 0.84, 95% CI 0.79-0.90) was significantly associated with decreased GAD-7 levels. The results heighten the awareness that early initiation of mental health support is crucial for the population in addition to the various financial support measures provided by the government as they are adapting to live with the COVID-19 pandemic.

Background A decline in cardiovascular hospitalizations was observed during the initial phases of the COVID-19 pandemic. We examine the continued effect of the pandemic on cardiovascular hospitalizations and the associated mortality rates during the first year of the pandemic in Israel. Methods We conduct a retrospective cohort study using the data of Clalit Health Services, the largest healthcare organization in Israel. We divide the Corona year into six periods (three lockdowns and three post-lockdowns) and compare the incidence rates of cardiovascular hospitalizations and their 30-day mortality during each period to the previous three years. Results The number of non-STEMI hospitalizations during the first year of the pandemic was 13.7% lower than the average of the previous three years (95% CI 11%-17%); STEMI hospitalizations were 15.7% lower (95% CI 13%-19%); and CHF hospitalizations were 23.9% lower (95%, CI 21%-27%). No significant differences in 30-day mortality rates were observed for AMI patients during most of the periods, whereas the annual 30-day all-cause mortality rate of CHF was 23% higher. Conclusions Hospitalizations for AMI and CHF were significantly lower during the first year of the pandemic relative to 2017–9. Mortality rates were higher in the case of CHF patients but not in the case of AMI patients, possibly due a change in the clinical acuity of patients arriving at the hospitals. We conclude that targeted public health messaging should be implemented, together with proactive monitoring in order to identify residual disability in patients that may have received non-optimal treatment during the pandemic.

Background: The abrupt implementation of COVID-19 lockdown had impacted the management of diabetes mellitus. Limited access to health facilities and alterations in daily lifestyle put metabolic control among patients at risk. Thus, we observed the differences in metabolic control parameters in diabetic patients before and during the lockdown. Methods: We performed searches from five databases. Meta-analyses were done using random or fixed-effect approaches with glycemic control parameters (HbA1c, RBG, FBG, TIR, TAR, TBR) as primary outcomes. Mean difference (MD), Confidence Interval (CI), and p-value were calculated. Lipid profile presented as secondary outcome. Results: 21 studies with 3992 diabetic patients were included in the study. Meta-analysis presented an increase on HbA1c of T1D and T2D patients [MD=+0.06% (95%CI -0.10–0.23), I²=77%, p=0.45], TBR of T1D patients [MD=-0.05% (95%CI -0.38–0.28), I²=0%, p=0.77], FBG of T2D patients [MD=+3,47 mg/dL (95%CI 1.22–5.73), I²=0%, p=0.002], and lipid profile on qualitative analysis. However, TIR, TAR, and RBG of T1D patients were improved [MD=+3.52% (95%CI 0.29–6.74), I²=76%, p=0.03; MD=-3.36% (95%CI -6.48–-0.25), I²=75%, p=0.03; MD=-0.91 mg/dL (95%CI -4.52–6.34), I²=88%, p=0.74]. Conclusion: Lockdown enforcement did not worsen the glycemic control parameter in diabetic patients. Particular parameters inclined to improve during the lockdown.

The coronavirus (COVID-19) pandemic was particularly invasive in Italy during the period between March and late April 2020 then decreased in both in the number of infections and in the seriousness of the illness throughout the summer of 2020. In this discussion, we measure the severity of the disease by the ratio of Intensive Care Units (ICU) spaces occupied by COVID-19 patients and the number of Active Cases (AC) each month from April to October 2020. We also use the ratio of the number of Deaths (D) to the number of Active Cases. What clearly emerges, from rigorous statistical analysis, is a progressive decrease in both ratios until August, indicating progressive mitigation of the disease. This is particularly evident when comparing March-April with July-August; during the summer period the two ratios became roughly 18 times lower. We test such sharp decreases against possible bias in counting active cases and we confirm their statistical significance. We then interpret such evidence in terms of the well-known seasonality of the human immune system and the virus-inactivating effect of stronger UV rays in the summer. Both ratios, however, increased again in October as ICU/AC began to increase in September 2020. These ratios and the exponential growth of infections in October indicate that the virus - if not contained by strict measures - will lead to unsustainable challenges for the Italian health system in the winter of 2020-2021 .

Chronic noncommunicable diseases (CNCDs) have been a major public health concern worldwide, especially diabetes, cardiovascular disease, chronic obstructive pulmonary disease, hypertension, in addition to obesity, which is even more worrying when the subject involves the covid-19 pandemic, because such incidences correlate with the need for intensive care units, including the possibility of death of the patient. Therefore, for countries with the highest numbers of critical cases, it is important to assess the incidence of these diseases to guide the public that most needs guidance on public policies for social isolation.

Institutional quarantine was one of the key public health measures used to control the spread of the COVID-19. Institutional quarantine has been associated with several psychosocial and economic risks to affected individuals. However, little is known about the psychosocial and economic risks it poses to affected persons in low-resource countries, since it is a relatively new strategy for controlling disease spread in these settings. This article provides insights into the economic and psychosocial risks encountered by affected persons in a low-resource context. We conducted narrative interviews with 20 adults placed under institutional quarantine to contain the COVID-19 pandemic in Uganda. Institutional quarantine exposed affected persons to an intricate range of economic and psychosocial risks including loss of livelihoods and/or income, financial distress, fear, worry, anger, loneliness and stigma. The experience of specific risks was shaped by an intersection of individual and contextual factors. However, disregard for economic and social issues and shortcomings in the implementation of institutional quarantine contributed profoundly to the occurrence of risks. Integration of measures for identification and continuous management of the broad range of potential risks to individuals and bridging gaps in the implementation of institutional quarantine, may help to minimise associated economic and psychosocial risks.

Following the WHO's declaration of a public health emergency due to the COVID-19 outbreak, the subsequent quarantine and confinement measures that were adopted, including distance learning measures, were shown to have caused a significant deterioration in the mental health of medical students. The goal of this study was to explore the mediating role of resilience and life satisfac-tion in the relationship between perceived stress and burnout among medical students in the con-text of COVID-19. A transversal assessment was performed using an online questionnaire, to which 462 students responded. The instruments applied were the Perceived Stress Scale-10, the Resilience Scale-25 items, the Satisfaction with Life Scale (SWLS) and the Burnout Scale (Olden-burg Inventory). A regression model was estimated for each dimension of burnout. The results revealed that resilience and life satisfaction play a mediating role in the association between stress and the dimensions of burnout. This suggests that measures of promoting mental health based on resilience and improving perceptions of life should be implemented.

Rainwater harvesting could be an optional water source to fulfil the emergency water demand in different setups. The aim was to assess if the rainwater harvesting potential for households and selected institutions were sufficient to satisfy the emergency water demand for the prevention of COVID-19 in Dilla town, Southern, Ethiopia. Rain water harvesting potential for households and selected institutions were quantified using 17 years’ worth of rainfall data from Ethiopian Metrology Agency. With an average annual rainfall of 1464 mm, households with 40 and 100 m2 roof sizes have a potential to harvest between 15.71-31.15 m3 and 41.73-82.73 m3 of water using Maximum Error Estimate. Meanwhile 7.2-39.7 m3 and 19.11-105.35 m3 of water can be harvested from the same roof sizes using Coefficient of Variation for calculation. Considering mean monthly rainfall, the health centres and Dilla University can attain 45.7% and 77% of their emergency water demand, while the rest of the selected institutions in Dilla Town can attain more than 100 % of their demand using only rainwater. Rain water can be an alternative water source for the town in the fight against COVID-19.

Background: COVID-19 vaccines have been a game changer in the pandemic, their extensive use was favorable compared to the burden of COVID-19 complications. Despite the low incidence of complications, it was important to analyze them carefully to understand the underlying mechanisms and predisposing factors. For instance, myopericarditis especially from mRNA vaccines, and its relatively higher prevalence in young adults and adolescents has raised a public concern about the use of this vaccine in this group. We aimed through this review to compare the age likelihood of ADEM from COVID-19 vaccines, with that reported in myopericarditis cases; secondary outcome parameters included the gender and number of doses needed to induce COVID-19 vaccines related ADEM. Methodology: A literature search has been conducted on relevant databases to retrieve all case reports/series and systematic reviews describing ADEM with possible linkage to COVID-19. Exclusion criteria included any report not including the desired outcome parameters. Our results were then qualitatively compared with a similar systematic review reporting myopericarditis from COVID-19 vaccines. Results: In 38 cases with ADEM, mean age was 49±16 compared to 25±14 in myopericarditis, females were more likely to be affected, and while most of myopericarditis cases develop after the second dose, most of ADEM cases develop after the first dose (76%). Moreover, age>56 years was more predictive of negative outcome after ADEM in the form of death or permanent vegetative state. Conclusion: The discrepancy in age, gender and number of doses needed to induce complications between ADEM and myopericarditis, signify that the tissue affected is the major orchestrator of the age, gender, and dose characteristics, and not the type of vaccines. A leakier blood brain barrier with aging, might allow easier passage of autoantibodies and cytokines into the brain while lack of inhibitory immune checkpoints in the myocardium in young age might explain the higher prevalence of those cases in young adults and adolescents.

Ongoing COVID-19 Pandemic has resulted into massive damage to various platforms of global economy which has caused disruption to human livelihood. Natural Language Processing has been extensively used in different organizations to categorize sentiments, perform recommendation, summarizing information and topic modelling. This research aims to understand the non-medical impact of COVID-19 on global economy by leveraging the natural language processing methodology. This methodology comprises of text classification which includes topic modelling on unstructured COVID-19 media articles dataset provided by Anacode. Like other Natural Language Processing algorithms, Latent Dirichlet allocation (LDA) and Non-negative matrix factorization (NMF) has been proposed to classify the media articles dataset in order to analyze COVID-19 pandemic impacts in the different sectors of global economy. Model Accuracy was examined based on the coherence and perplexity score which came out to be 0.51 and -10.90 using LDA algorithm. Both the LDA and NMF algorithm identified similar prevalent topics that was impacted by COVID-19 pandemic in multiple sectors of economy. Through intertopic distance map visualization produced by LDA algorithm, it can be reciprocated that general industries which includes children schooling, parental care, and family gatherings had the major impact followed by business sector and the financial industry.

Aim: This study aimed to understand the role of workforce agility as a coping strategy to curtail the COVID-19 pandemic. Method: The study reviewed and integrated two lines of literature to develop a theoretical framework to help business organizations to respond, adapt, and recover from the COVID-19 pandemic crisis. Results: The results showed that there are several commonalities between the workforce agility literature and the crisis management literature, mostly manifested in the speed of responding to uncertain and unpredictable, adverse events in the business environment. A thorough review of key themes in both kinds of literature led to developing a theoretical framework that links crisis drivers, crisis enablers, crisis capabilities, and response strategy. Workforce agility can be used as a coping strategy to deal with the COVID-19 pandemic crisis. Both kinds of literature evolve to respond to any crisis; the crisis management literature focuses on Meso-level (organizational level) or collective actions to mitigate the crisis, while the workforce agility literature focuses on the Micro-level (individual level). However, the successful response to any crisis requires the synergy of both actions. Future Studies: The results of this research are of prime importance for both researchers and practitioners. Researchers can use the theoretical framework as a baseline for building empirical research design. The current study also sets the context for future researchers who are interested in workforce agility to test the validity of agile work behaviors in real adverse context. It also opens a new stream of debate by deconstructing understudied links between workforce agility, resilience, and crisis management. Mangerial implication: For practitioners to ensure a successful response to any impending crisis, they must develop their employees’ agile behaviors. Practitioners can also redesign their recruitment strategy to select the right individuals with the right agile attributes, abilities, and behaviors to easily alter their behaviors according to the progressing crisis phases. Finally, practitioners can design continual learning interventions to include required agile skills and competencies to prepare their employees for future crises.

Despite the fact that COVID-19 is no longer a global pandemic due to development and integration of different technologies for the diagnosis and treatment of the disease. Technological advancement in the field of molecular biology, electronics, computer science, artificial intelligence, Internet of Things, nanotechnology etc. has led to the development of molecular approaches and computer aided diagnosis for the detection of COVID-19. This study provides a holistic approach on COVID-19 detection based on (1) molecular diagnosis which include RT-PCR, antigen-antibody and CRISPR-based biosensors and (2) computer aided detection based on AI-driven models which include Deep Learning and Transfer learning approach. The review also provide comparison between these 2 emerging technologies and open research issues for the development of smart-IoMT-enable platform for the detection of COVID-19.