The evolution of some epidemics, as influenza, shows common patterns both in different regions and from year to year. On the contrary, epidemics like the novel COVID-19 show quite heterogeneous dynamics and are extremely susceptible to the measures taken to mitigate their spread. In this paper we propose empirical dynamic modeling to predict the evolution of influenza in Spain’s regions. It is a non-parametric method that looks into the past for coincidences with the present to make the forecasts. Here we extend the method to predict the evolution of other epidemics at any other starting territory and we test also this procedure with Spanish COVID-19 data. We finally build influenza and COVID-19 networks to check possible coincidences in the geographical distribution of both diseases. With this, we grasp the uniqueness of the geographical dynamics of COVID-19.

Background: COVID-19 has placed tremendous pressure on the global public health system and has changed daily life. Aim: To examine the relationships between the perceived threat, perceived stress, coping responses and infection control practices towards the COVID-19 pandemic among university students in China. Methods: Using a cross-sectional survey, 4,392 students were recruited from six universities in two regions of China. Methods: Data were collected via an online platform using self-reported questionnaires. Hierarchical multiple regression analyses were performed to predict the variables on COVID-19 infection control practices. Results: Pearson correlation coefficients showed a significant negative relationship between perceived stress and COVID-19 infection control practices. A significant positive relationship was observed between wishful thinking and empathetic responding, and infection control practices. Hierarchical multiple regression analyses revealed that gender, geographical location, perceived stress and emotion-focused and relationship-focused coping responses were predictors of COVID-19 infection control practices. Conclusions: The findings suggest that university students displayed moderate levels of stress, using wishful thinking and empathetic responses as coping strategies. Counselling services should therefore emphasise reassurance and empathy. Male university students tended to be less compliant with social distancing. Both counselling and public health measures should recognise the importance of gender differences. Nurses should integrate these findings into future health program planning and interventions.

The scientific, private and industrial sectors use a wide variety of technological platforms available to achieve protection against SARS-CoV-2, including vaccines. However, the virus evolves continually into new highly virulent variants, which might overcome the protection provided by vaccines and may re-expose the population to infections. Mass vaccinations should be continued in combination with more or less obligation mandatory non-pharmaceutical interventions. Therefore, the key questions to be answered are: (i) How to identify the primary and secondary infections of SARS-CoV-2? (ii) Why are neutralizing antibodies not long-lasting in both the cases of natural infections and post-vaccinations? (iii) Which are the factors responsible for this decay in neutralizing antibodies? (iv) What strategy could be adapted to develop long-term herd immunity? (v) Is the Spike the only vaccine candidate or a vaccine cocktail is better?

NF-κB is a central mediator of inflammation, response to DNA damage and oxidative stress. As a result of its central role in so many important cellular processes, NF-κB dysregulation has been implicated in the pathology of important human diseases. NF-κB activation causes inappropriate inflammatory responses in diseases including rheumatoid arthritis (RA) and multiple sclerosis (MS). Thus, modulation of NF-κB signaling is being widely investigated as an approach to treat chronic inflammatory diseases, autoimmunity and cancer. The emergence of COVID-19 in late 2019, the subsequent pandemic and the huge clinical burden of patients with life-threatening SARS-CoV-2 pneumonia led to a massive scramble to repurpose existing medicines to treat lung inflammation in a wide range of healthcare systems. These efforts continue and these efforts continue to be con-troversial. Drug repurposing strategies are a promising alternative to de-novo drug development, as they minimize drug development timelines and reduce the risk of failure due to unexpected side effects. Different experimental approaches have been applied to identify existing medicines which inhibit NF-κB that could be repurposed as anti-inflammatory drugs.

Most vulnerable individuals are particularly affected by the COVID-19 pandemic. This study takes place in a large city in France. The aim of this study is to describe the mobility of the homeless population at the begin-ning of the health crisis and to analyze its impact in terms of COVID-19 prevalence. From June to August 2020 and September to December 2020, 1272 homeless people were invited to be tested for SARS-CoV-2 antibodies and virus in and completed questionnaires. Our data show that homeless populations are sociologically dif-ferent depending on where they live. We show that people living on the street were most likely to be relocated to emergency shelters than other inhabitants. Some neighborhoods are points of attraction for homeless peo-ple in the city while others emptied during the health crisis, which had consequences for virus circulation. People with a greater number of different dwellings reported became more infected. This first study of the mo-bility and epidemiology of homeless people in time of pandemic provides unique information about mobility mapping, sociological factors of this mobility, mobility at different scales and epidemiological consequences. We suggest that homeless policies need to be radically transformed since actual model exposes people to infection in emergency.

Background: Although, negative repercussions of inadequate health service use on the health outcomes has been presumably exacerbated by COVID-19, the impact of the pandemic measures has been not evaluated properly yet. Objective: Our study aimed to quantify the COVID-19 pandemic measures’ effect on the general practitioner (GP) visit, specialist care, hospitalization and cost-related prescription nonredemption (CRPNR) among adults in Hungary, and to identify the social strata susceptible to the pandemic effect. Methods: This community-based cross-sectional study based on nationally representative data of 6,611 (Nprepandemic=5,603 and Npandemic=1,008) subjects aged 18 years and above. Data were obtained from the European Health Interview Survey 2019 (EHIS) and International Social Survey Program 2021 (ISSP) for prepandemic and pandemic, respectively. Multivariable logistic regression models were applied to determine the sociodemographic and clinical factors influencing the health care use by odds ratios (OR) along with the corresponding 95% confidence intervals (CI). To identify the social strata susceptible to pandemic effect, the interaction of the time of data collection with level of education, marital status, and ethnicity, was also tested. Results: While, the CRPNR did not changed, the frequency of GP visit, specialist care and hospitalization rate were remarkably reduced by 22.2%, 26.4%, and 6.7%, respectively, during the pandemic in Hungary. Roma proved to be not specifically affected by the pandemic in any studied respect. The pandemic restructuring of health care impacted the social subgroups evenly with respect to hospital care. However, the pandemic effect was weaker among primary educated adults (ORhigh-school vs primary-education =0.434; 95% CI 0.243-0.776, ORhigh-school vs primary-education =0.598; 95% CI 0.364-0.985), and among widows (ORwidowed vs married =2.284; 95% CI 1.043-4.998, ORwidowed vs married=1.915; 95% CI 1.157-3.168) on the frequency of GP visit and specialist visit; and the prepandemic CRPNR inequality by level of education was increased (ORhigh-school vs primary-education =0.236; 95% CI 0.075-0.743). Conclusion: Primary educated and widowed did not follow the general trend, and their prepandemic limited health care use was not reduced further during pandemic, resulting in an inequality reduction. The vulnerability of primary educated to CRPNR was the only gap widened in the pandemic period. This shows that although the management of pandemic health care use restrictions was implemented by increasing the social inequality in Hungary, the prevention of inequity in drug availability for primary educated individuals could require more support.

This study aims to investigate the changes in the structural relationship between alienation in physical education (PE) class, school happiness, and future healthy life expectancy in Korean adolescents after the COVID-19 pandemic. The data were collected from adolescents in the Republic of Korea using scales for these factors. The collected data were analyzed with frequency analysis, reliability analysis, validity analysis, independent t-test, and path analysis. The key results were as follows. First, there were partial changes in each of the parameters since the outbreak of COVID-19. Second, before the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; however, alienation in PE class did not affect future healthy life expectancy showing a complete mediating effect. Third, during the pandemic, alienation in PE class negatively affected school happiness, and school happiness positively affected future healthy life expectancy; alienation in PE class negatively affected future healthy life expectancy, showing a partial mediating effect. These findings emphasize the importance and potential of school education, especially PE, in promoting happiness and healthy life in adolescents. We expect these findings to have practical implications for future research by presenting theoretical and empirical data.

In this study, we designed a structural model to determine the relationships among push–pull factors, institutional situations, and satisfaction during the COVID-19 pandemic. The 17 selected indicators fell under five domains, namely push factors, pull factors, institutional leadership, international strategies, and satisfaction. Structural equation modeling (SEM) was used to verify the assumptions of the model. Based on 1005 degree-seeking international students' views, this study found that push and pull factors may coincidentally exist, and their functions can be modified by institutional situations. The findings suggest pull factors will, through institutional leadership, impact students' satisfaction, while push factors will not. Moreover, the detection of institutional mediation can provide useful information for specific institutes to develop their future recruiting or retaining strategies. These findings enriched our knowledge of the field during the pandemic. For future studies, this design may be useful to interpret the phenomena of global student mobility in higher education settings.

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.

This paper describes a research project carried out in an Italian public school to assess whether parents were willing to take part in food procurement decisions, as well as their ability to accurately predict what foods children would pick at school lunch and their propensity to support sustainable food choices made by the school. The methodology included a questionnaire to 500 parents and an in-depth study of 138 child/parent pairs. The study comprised: (i) presentation of an innovative recipe in the weekly menu of the school canteen; (ii) meal observations of children’s intake at school lunch during the week of the menu modification; (iii) collection of both parents’ and children’s reports on their choices of recipes from the modified weekly menu. The results are commented in light of two important changes that have recently affected Italian public school food procurement: the opening of school canteens to lunches brought from home and the measures adopted since 2020 to contain the Covid-19 pandemic. Both events go in the direction of delegating to parents the multifaceted role of the school in the food arena. The article concludes that the results of the study should discourage this approach.

Cameroon's national vaccination campaign was launched on April 12, 2021, amid a nationwide outbreak of COVID-19 with two types of vaccines. This study provides preliminary evidence of the level of coverage of the population and gives an early overview of the challenges, the achievements and the lessons learned. COVID-19 vaccine administration data were obtained from data of the Cameroon Ministry of Public Health. Descriptive statistical analyses were conducted. Thirty days after the introduction of COVID 19 vaccines, five percent of the target population was vaccinated. Women represented one third of the people vaccinated regardless of age and health conditions. Although AEFI reported were minor and scanty with both vaccines, the majority of the vaccinated did not come back for their second dose. There is a need to build confidence among eligible beneficiaries in order to expand the benefits of vaccination to control the current pandemic. The country is still far below the target which could be worrisome given that the uptake is slow and, the 391 200 doses of the AstraZeneca are going to expire in August 2021. This study offers insights into those early efforts as a contribution to significant discussions about upcoming approach to improve service delivery and uptake.

Physical distancing and wearing a face mask are key interventions to prevent COVID-19. While this remains difficult to practice for millions of firefighters in fire engines responding to emergencies, the delayed forthcoming of evidence on the physical effectiveness of such safety interventions in this setting presents a major problem. In this field experimental study, we provided initial evidence to close this gap. We examined total aerosol burden in the cabin of a fire engine whilst manipulating crew size, natural ventilation, use of FFP2 respirators and use of SCBA full-face masks during 15-minute driving periods. At the same time, we controlled for crew activity and speaking, vehicle speed, cabin air temperature, pressure and humidity. Limiting the crew size, using FFP2 respirators and not donning SCBA full-face masks was associated with a reduction of the arithmetic mean of total aerosol burden of up to 49%. Natural ventilation as tested in this study was associated with both an increase and a decrease of total aerosol burden. This study provided initial evidence on the physical effectiveness of safety interventions in fire engines to reduce potential airborne transmission of SARS-CoV-2 through aerosols. More research about the physical and clinical effectiveness of such safety interventions is needed.

Background: Health Care Workers (HCWs) are at increased risk of acquiring and transmitting COVID-19 infection. Also, they present role models for communities with regards to attitudes towards COVID-19 vaccination. Hence, hesitancy of HCWs towards vaccination can crucially affect the efforts aiming to contain the pandemic. Previously published studies paid little attention to HCWs in Arab countries, which has a population of over 440 million. Objectives: to assess the rates of COVID-19 vaccine hesitancy in Arabic-speaking HCWs residing in and outside the Arab countries, and their perceived barriers towards vaccination. Methods: a cross-sectional study based on an online survey was conducted from 14-Jan 2021 to 29-Jan 2021, targeting Arabic-speaking HCWs from all around the world. Results: the survey recruited 5,708 eligible participants (55.6% males, 44.4% females, age 30.6±10 years) from 21 Arab countries (87.5%) and 54 other countries (12.5%). Our analysis shows a significant rate of vaccine hesitancy among Arabic-speaking HCWs residing in and outside Arab countries (25.8% and 32.8%, respectively). The highest rates of hesitancy were among participants from the west region of the Arab world (Egypt, Morocco, Tunisia, and Algeria). The most cited reasons for hesitancy were concerns about side effects and distrust in vaccine expedited production and healthcare policies. Factors associated with higher hesitancy included age of 30-59, previous or current suspected or confirmed COVID-19, female gender, not knowing the vaccine type authorized in the participant’s country, and not regularly receiving the influenza vaccine. Conclusion: this is the first large-scale, multinational, post-vaccine-availability study on COVID-19 vaccine hesitancy among HCWs. It reveals high rates of hesitancy among Arab-speaking HCWs. Unless addressed properly, this hesitancy can impede the efforts for achieving widespread vaccination and collective immunity.

The burden of COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of Covid-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) respectively, sleep problems with the Athens Insomnia Scale (AIS), burnout with the Maslach Burnout Inventory (MBI) and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and over-eating was also observed. However, high Resilience was reported by 70% of the sample and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.

Pneumonia remains a major cause of morbidity and mortality worldwide, especially during COVID-19 pandemic. With the significant global health burden that pneumonia poses, it is es-sential to improve therapeutic and management strategies. The increasing emergence of antibiotic resistant bacterial strains limits options for effective antibiotic use. New antibiotics for treatment of pneumonia may address deficits in current antimicrobial drugs, with an ability to cover both typical, atypical, and resistance pathogen. Several of these newer drugs also have structural characteristics that allow for a decreased propensity in development of bacterial resistance. Po-tential use of stem cell therapies in place of corticosteroid treatments may also offer an im-provement in patient outcomes. Human mesenchymal stem cell treatments have shown efficacy and safety in treating COVID-19 induced pneumonia. Combined treatment with both stem cells and antibiotics in pneumonia in a rabbit model has also shown significantly increased efficacy in comparison to antibiotic treatment alone, presenting yet another possible route for a novel strategy in treating pneumonia, though additional future studies are necessary before clinical implementation. While pneumonia remains a major disease of concern, having newer approved antibiotics as well as novel therapies such as stem cell treatments in the pipeline offers clinicians more options in effectively treating pneumonia.

Background: Cancer patients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer treatments. We aimed to identify symptoms associated with COVID-19 and to assess the strength of their association in cancer and cancer-free populations. Methods: The prospective multicenter cohort study PAPESCO-19 included 878 cancer patients and 940 healthcare workers (HCWs) systematically tested for SARS-CoV-2-specific antibodies. Participants reported the results of routine screening RT-PCR and thirteen COVID-19 symptoms. Backward logistic regression identified the symptom combinations significantly associated with COVID-19. Results: COVID+ proportions were similar in patients (8%) and HCWs (9.5%, p=0.26), whereas symptomatic proportions were lower in patients (32%) than HCWs (52%, p<0.001). Anosmia, anorexia, fever, headache, and rhinorrhea together accurately discriminated (c-statistic=0.7027) COVID-19 cases in patients. Anosmia, dysgeusia/ageusia, muscle pain, intense fatigue, headache, and chest pain better discriminated (c-statistic=0.8830) COVID-19 cases in HCWs. Anosmia had the strongest association in patients (OR=7.48, 95% CI: 2.96–18.89) and HCWs (OR=5.71, 95% CI: 2.21–14.75). Conclusions: COVID-19 symptoms and their diagnostic performance differ in cancer patients and HCWs. Anosmia is associated with COVID-19 for patients, while dysgeusia/ageusia are not. Cancer patients deserve tailored preventive measures due to their particular COVID-19 symptom pattern.

Identifying the SARS-CoV-2 virus has been a unique challenge for the scientific community. In this paper, we discuss a practical solution to help guide clinicians with interpretation of the probability that a positive, or negative, COVID-19 test result indicates an infected person, based on their clinical estimate of pre-test probability of infection.The authors conducted a small survey on LinkedIn to confirm that hypothesis that that the clinical pre-test probability of COVID-19 increases relative to local prevalence of disease plus patient age, known contact, and severity of symptoms. We examined results of PPA (Positive Percent Agreement, sensitivity) and NPA (Negative Percent Agreement, specificity) from 73 individual laboratory experiments for molecular tests for SARS-CoV-2 as reported to the FIND database ¹, and for selected methods in FDA EUA submissions^2,3. Authors calculated likelihood ratios to convert pre-test to post-test probability of disease and designed an online calculator to create graphics and text to report results. Despite best efforts, false positive and false negative Covid-19 test results are unavoidable^4,5. A positive or negative test result from one laboratory has a different probability for the presence of disease than the same result from another laboratory. Likelihood ratios and confidence intervals can convert the physician or other healthcare professional’s clinical estimate of pre-test probability to post-test probability of disease. Ranges of probabilities differ depending on proven method PPA and NPA in each laboratory. We recommend that laboratories verify PPA and NPA and utilize a the “Clinician’s Probability Calculator” to verify acceptable test performance and create reports to help guide clinicians with estimation of post-test probability of COVID-19.

Telecommuting is a flexible form of work that has progressively spread over the last 40 years and which has been strongly encouraged by the measures to limit the Covid19 pandemic. There is still limited evi-dence on the effects it has on workers' health. In this survey we invited 905 workers of companies that made a limited use of telework to fill out a questionnaire to evaluate: Intrusive leadership of managers (IL), the request for work outside traditional hours (OFF-TAJD), workaholism (BWAS), effort / reward imbalance (ERI), happiness and common mental issues (CMIs), anxiety and depression, assessed by the Goldberg scale (GADS). The interaction between these variables has been studied by structural equation modeling (SEM). Intrusive leadership and working after hours were significantly associated with occu-pational stress. Workaholism is a relevant moderator of this interaction: intrusive leadership significantly increased the stress of workaholic workers. Intrusive leadership and overtime work were associated with reduced happiness, anxiety and depression. These results indicate the need to guarantee the right to disconnect, to limit the effect of the OFF-TAJD. In addition to this, companies should implement policies to prevent intrusive leadership and workaholism.

Supported wellbeing centres were set up in UK hospital trusts as an early intervention aimed at mitigating the psychological impact of COVID-19 on healthcare workers. These provided high quality rest spaces with peer-to-peer psychological support provided by National Health Service (NHS) staff volunteers called ‘wellbeing buddies’, trained in psychological first aid. The aim of the study was to explore the views of centre visitors and operational staff towards this COVID-19 workforce wellbeing provision. Qualitative semi-structured interviews were undertaken with twenty-four (20F, 4M) employees from an acute hospital trust in the UK. Interviews were digitally recorded and transcribed, data were handled and analysed using thematic analysis. Interviews generated 3 over-arching themes, and 13 sub-themes covering ‘exposure and job roles’, ‘emotional impacts of COVID-19 and ‘the wellbeing centres’. Supported wellbeing centres were viewed as critical for the wellbeing of hospital employees during the first surge of COVID-19 in the UK. Wellbeing initiatives require managerial advocacy and must be inclusive. Job-related barriers to work breaks and accessing staff wellbeing provisions should be addressed. High quality rest spaces and access to peer-to-peer support are seen to benefit individuals, teams, organisations and care quality. Training NHS staff in psychological first aid is a useful approach to supporting the wellbeing of the NHS workforce during and beyond the COVID-19 pandemic.

The emergence of the Covid-19 pandemic has created both negative and positive changes, including implementing the circular economy across the globe. This Systematic Review follows the PRISMA statement and employs the Text Mining (Voyant Tools) technique to visualize and analyze the impacts of the Covid-19 on three aspects of the circular economy: economic, social, and environmental. The research employs Latent Dirichlet Allocation (LDA) to identify five major topics: (1) Shortage of medical equipment but high medical waste during Covid-19 due to the high demand in healthcare; (2) The long term negative impacts of lockdown on economic and social activities because of Covid-19 pandemic; (3) The reports on impacts of Covid-19 pandemic on the manufacturing globally, and their coping strategies and new opportunities; (4) The impacts of international restriction on the tourism, trade, shipping, and aviation industry, causing billion-dollar losses; (5) The reduction of pollution with health environment improvements with example cases from China and EU. The research identifies current literature gaps in the circular economy and Covid- 19 topics and encourages the application of text mining tools into researching to stimulate the research process and assist in communicating with the public.

The increase in pandemics caused by RNA viruses of zoonotic origin highlights the urgent need for broad-spectrum antivirals against novel and re-emerging RNA viruses. Broad-spectrum antivirals could be deployed as first-line interventions during an outbreak while virus-specific drugs and vaccines are developed and rolled out. Viruses depend on the host’s protein synthesis machinery for replication. Several natural compounds that target the cellular DEAD-box RNA helicase eIF4A, a key component of the eukaryotic translation initiation complex eIF4F, have emerged as potential broad-spectrum antivirals. Rocaglates, a group of flavaglines of plant origin that clamp mRNAs with highly structured 5’UTRs onto the surface of eIF4A through specific stacking interactions, exhibit the largest selectivity and potential therapeutic indices among all known eIF4A inhibitors. Their unique mechanism of action limits the inhibitory effect of rocaglates to the translation of eIF4A-dependent viral mRNAs and a minor fraction of host mRNAs exhibiting stable RNA secondary structures and/or polypurine sequence stretches in their 5´UTRs, resulting in minimal potential toxic side effects. Maintaining a favorable safety profile while inducing efficient inhibition of a broad-spectrum of RNA viruses makes rocaglates into primary candidates for further development as pan-antiviral therapeutics.

The COVID-19 pandemic has brought about unprecedented changes to human lifestyles across the world. The virus and associated social restriction measures have been linked to an increase in mental health conditions. A considerable body of evidence shows that spending time in and engaging with nature can improve human health and wellbeing. Our study explores nature’s role in supporting health during the COVID-19 pandemic. We created web-based questionnaires with validated health instruments and conducted spatial analyses in a geographic information system (GIS). We collected data on people’s patterns of nature exposure, associated health and wellbeing responses, and potential socioecological drivers such as relative deprivation, access to greenspaces, and land-cover greenness. We applied a range of statistical analyses including bootstrap resampled correlations and binomial regression models, adjusting for several potential confounding factors. We found that respondents significantly changed their patterns of visiting nature as a result of the COVID-19 pandemic. People spent more time in nature and visited nature more often during the pandemic. People generally visited nature for a health and wellbeing benefit and felt that nature helped them cope during the pandemic. Greater land-cover greenness within a 250 m radius around a respondent’s postcode was important in predicting higher levels of mental wellbeing. There were significantly more food-growing allotments within 100 m and 250 m of respondents with high mental wellbeing scores. The need for a mutually-advantageous relationship between humans and the wider biotic community has never been more important. We must conserve, restore and design nature-centric environments to maintain resilient societies and planetary health.

The COVID-19 pandemic had profound negative effects on millions of couples affected by infertility and in need to resort to assisted reproductive technologies. There is no consensus over the optimal way and moment of screening triage-negative asymptomatic patients and staff. We present SARS-CoV-2 antibodies’ (IgM, IgG) seroprevalence in 516 triage-negative patients and 30 fertility care providers. The sampling for SARS-CoV-2 serological assays took place from the lockdown release throughout the second half of 2020 (17.05 - 01.12.2020). It revealed an increased seroprevalence of antibodies that closely followed the local epidemiology of COVID-19, with the highest rate of seropositivity coincident with the peak of the second wave. From 546 triage-negative individuals whose blood samples were assessed for SARS-CoV-2 antibodies, 6% yielded positive results. The overall seroconversion rate was 2.8% for IgG and 5.1% for IgM. In the group with positive IgM, we observed a negative predictive value for IgM of 98.36% (95% CI: 88.79 – 99.78%), which is clinically meaningful. Serological testing of triage-negative patients up to seven days prior to the actual fertility procedure might avoid the more expensive and not more sensitive molecular testing currently being used for patient screening in most fertility units.

Utility of vaccine campaigns to control coronavirus disease 2019 (COVID-19) is not merely dependent on vaccine efficacy and safety. Vaccine acceptance among the general public and the healthcare workers, appears to have a decisive role for successful control of the pandemic. The aim of this review was to provide an up-to-date assessment of COVID-19 vaccination acceptance rates worldwide. A systematic search of the peer-reviewed English survey literature indexed in PubMed was done on December 25, 2020. Results from 30 studies, met the inclusion criteria and formed the basis for final COVID-19 vaccine acceptance estimates. Results of an additional recent survey from Jordan and Kuwait was considered in this review as well. Survey studies on COVID-19 vaccine acceptance rates were found from 33 different countries. Among adults representing the general public, the highest COVID-19 vaccine acceptance rates were found in Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). On the other hand, the lowest COVID-19 vaccine acceptance rates were found in Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). Only eight surveys among healthcare workers (doctors, nurses) were found, with vaccine acceptance rates ranging from 27.7% in the Democratic Republic of the Congo to 78.1% in Israel. In a majority of survey studies among the general public (62%), the acceptance of COVID-19 vaccination showed a level of ≥ 70%. Low rates of COVID-19 vaccine acceptance were reported in the Middle East, Russia, Africa and several European countries. This could represent a major problem in the global efforts that aim to control the current COVID-19 pandemic. More studies are recommended to address the scope of COVID-19 vaccine hesitancy. Such studies are particularly needed in the Middle East Africa, Eastern Europe, Central Asia, Middle and Latin America.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes an outbreak of COVID-19 disease in humans with the aid of spike protein. It consists of a receptor-binding domain (RBD) that recognizes and binds to the host receptor angiotensin-converting enzyme 2 (ACE2). The aim of this study was to examine the mutational effect of spike protein on the sequence through an interaction study of the mutant spike protein and the human ACE2 protein at the structural level. A total of 17,227 spike proteins from Asia, Africa, Europe, Oceania, South America, and North America were compared to the Wuhan spike protein reference sequence (Wuhan-Hu-1). The structural and stability implications of D614G, N501Y, and S477N mutations were evaluated. The binding affinity between mutated RBD and human ACE2 protein was also studied. The D614G mutation may have originated in Germany, Europe based on the date of the first sample collection report. It is now widely circulated all over the world with most occurrences in North America. The mutations N501Y and S477N may have originated from Oceania based on the date of the first sample collection report and also have the highest occurrences in Oceania. Based on the computational analysis of mutational effects, the D614G, N501Y, and S477N mutations decreased stability and were tolerated. For disease propensity prediction, N501Y was more prone to disease compared to D614G, while S477N was not prone to disease. The mutation of D to G at position 614 and S to N at position 477 for secondary structure prediction shows no changes in secondary structure while remaining in the coil region, whereas the mutation of N to Y at position 501 changes from coil structure to extended strand. N501Y mutation has a higher affinity to human ACE2 protein compared to D614G and S477N based on a docking study. D614G spike mutation was identified to exist between the two hosts based on a comparison of SARS-CoV-2 derived between the mink and human. Further research is needed on the link between the mink mutation N501T and the mutation N501Y in humans, which has evolved as a separate variant.

There are limited proven therapies for the treatment of COVID-19. Vitamin C’s antioxidant, anti-inflammatory and immunomodulating effects, make it a potential therapeutic candidate, both for the prevention and amelioration of COVID-19 infection, and as an adjunctive therapy in the critical care of COVID-19, supporting anti-inflammatory treatment. This literature review focuses on vitamin C deficiency in respiratory infections including COVID-19; the mechanism of action in infectious disease and adrenal function supporting the anti-inflammatory actions of glucocorticosteroids: its role in preventing and treating colds and pneumonia and its role in treating sepsis and COVID-19. The evidence to date indicates that oral vitamin C (2-8g/d) may reduce incidence and duration of respiratory infections and intravenous vitamin C (2-24g/d) has been shown to reduce mortality, Intensive Care Unit and hospital stays, time on mechanical ventilation in severe respiratory infections. Further trials are urgently warranted. Given the favourable safety profile and low cost of vitamin C, and frequency of vitamin C deficiency in respiratory infections it may be worthwhile testing patients’ vitamin C status and treating accordingly with intravenous use within ICUs and orally with doses between 2 and 8g/day in hospitalised and infected persons.

Since identified as the pathogen responsible for an outbreak of severe respiratory distress in Wuhan, China, the 2019-nCoV coronavirus has caused over 30M cases and 1M deaths globally. Sporadic cases were identified in several states in the US from early January, and large-scale community transmission is believed to have started in late February, leading to a first spike in COVID-19 deaths and overall mortality in late April, and a second spike later in the summer. I show here that the dynamics of the pandemic were different in different regions of the US, showing a north-south pattern, with a first pandemic wave mainly in northern regions, followed by a second wave mainly in southern regions. Analysis of overall mortality data shows that the increase in mortality correlates well with COVID-19 incidence in most regions, and that from April through August COVID-19 deaths accounted for a substantial proportion of all deaths in all parts of the US.

The COVID-19 pandemic situation has created even more difficulties in the quick identification and screening of the COVID-19 patients for the medical specialists. Therefore, a significant study is necessary for detecting COVID-19 cases using an automated diagnosis method, which can aid in controlling the spreading of the virus. In this paper, the study suggests a Deep Convolutional Neural Network-based multi-classification approach (COV-MCNet) using eight different pre-trained architectures such as VGG16, VGG19, ResNet50V2, DenseNet201, InceptionV3, MobileNet, InceptionResNetV2, Xception which are trained and tested on the X-ray images of COVID-19, Normal, Viral Pneumonia, and Bacterial Pneumonia. The results from 3-class (Normal vs. COVID-19 vs. Viral Pneumonia) showed that only the ResNet50V2 model provides the highest classification performance (accuracy: 95.83%, precision: 96.12%, recall: 96.11%, F1-score: 96.11%, specificity: 97.84%) compared to rest of the models. The results from 4-class (Normal vs. COVID-19 vs. Viral Pneumonia vs. Bacterial Pneumonia) demonstrated that the pre-trained model DenseNet201 provides the highest classification performance (accuracy: 92.54%, precision: 93.05%, recall: 92.81%, F1-score: 92.83%, specificity: 97.47%). Notably, the ResNet50V2 (3-class) and DenseNet201 (4-class) models in the proposed COV-MCNet framework showed higher accuracy compared to the rest six models. This indicates that the designed system can produce promising results to detect the COVID-19 cases on the availability of more data. The proposed multi-classification network (COV-MCNet) significantly speeds up the existing radiology-based method, which will be helpful to the medical community and clinical specialists for early diagnosis of the COVID-19 cases during this pandemic.

Purpose: During the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running an high risk of being infected by the SARS-CoV-2 virus. This study investigates the epidemiological, clinical and lifestyles characteristics that might play roles in the susceptibility of HCWs to COVID-19 in a hit Italian hospital. Methods:Demographic, lifestyle, work-related and comorbidities data of 1447 HCWs which underwent a nasopharyngeal swab for SARS-CoV-2 were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression. Results: The cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33 (9.72-13.21). Working in a COVID-19 ward, being a former smoker (vs being a person who never smoked) and BMI were positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable. Conclusions: Assuming an equal accessibility and proper use of PPE of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing

COVID-19 emerged in Wuhan and is later declared as a pandemic by World Health Organization. Different-aged people have varying gender-wise immunity control properties that necessitates understanding COVID-19 impact on age and gender which does not exist, currently. In this paper, COVID-19 surveillance variables are extensively studied along with hospitalization, tests-performed, and recovery data. Dataset is curated from three sources; however, age and gender data belong to Belgium, particularly. Visualizations, frequencies, Pearson’s and polyserial correlation, student’s t-test, and Cramer’s V are used for enhanced analysis. Results show higher mortality rate in males and need of more ventilators to combat severe symptoms.

Evidence was brought forward in England and the USA that Black, Asian, Latino and Minority Ethnic people exhibit higher mortality risk from COVID-19 than White people. While socioeconomic factors were suggested to contribute to this trend, they arguably do not explain the range of the differences observed, allowing for possible genetic implications. Almost concurrently, the analysis of a cohort in Chinese COVID-19 patients proposed an association between the severity of the disease and the presence of the minor allele of rs12252 of the Interferon-induced transmembrane protein 3 (IFITM3) gene. This SNP, together with rs34481144, are the two most studied polymorphisms of IFITM3 and have been associated in the past with increased severity in Influenza, Dengue, Ebola, and HIV viruses. IFITM3 is an immune effector protein that is pivotal for the restriction of viral replication, but also for the regulation of cytokine production. Following up to these two developments in the ongoing SARS-CoV-2 pandemic, the present study investigates a possible association between the differences in mortality of ethnic groups in England and the combined haplotypes of rs12252 and rs34481144. The respective allele frequencies were collected for 26 populations from 1000 Genomes Project and subgroups were pooled wherever possible to create correspondences with ethnic groups in England. A significant correlation (r=0.9687, p= 0.0003) was observed between the reported Standardized Mortality Ratios and the frequency of the combined haplotype of both reference alleles, suggesting that the combination of reference alleles of the specific SNPs may be implicated in more severe outcomes of COVID-19. This study calls for further focus on the role of IFITM3 variants in the mechanism of cellular invasion of SARS-CoV-2, their impact in COVID-19 severity and their possible implications in vaccination efficacy.

The role of the immune response to SARS-CoV-2 infection is not yet well known, in particular about the persistence of circulating antibodies. The aim of the study is to compare the results of two automated systems for the determination of IgG antibodies against SARS CoV-2 and to assess the time course of the IgG response after the onset of symptoms for a period longer than that evaluated to date. IgG were measured in 98 specimens of 55 subjects with COVID-19 (time from the onset of symptoms from 3 to 109 days) using the automated tests "Abbott SARS-COV-2 IgG" and the "MAGLUMI 2019-nCoV IgG". The two methods had a concordance of 91.8%, but the quantitative correlation showed very dispersed results. All the specimens resulted positive after 17 days from the onset of the synptoms. However, the median concentrations of IgG, after a rapid increase up to about 20 days, quickly decrease to about 15% of the maximum for Maglumi. The same samples measured by Architect showed a quite constant trend up to 80 day, and then an only moderate decline. The titer of IgG against SARS-CoV-2 in patients exposed to COVID-19 may significantly and rapidly decrease, with a different time-course depending on the method used for the determination.

In the context of the economic and political uncertainty associated with the 2019-nCoV pandemic, it is necessary to determine the socio-psychological factors involved in the transformation of the behavior of insurance consumers under the influence of a biogenic threat. This study measures financial anxiety and its impact on the insurance behavior of Russian citizens. The correlation, comparative, and regression analyses of the financial anxiety of Russian citizens cover three stages of observation: before the start of the 2019 nCoV pandemic (“FA up to 19 nCoV; N = 766), during the period of quarantine measures announced in Russia in March 2020 (“FA 19-nCoV-1”; N = 856), and after the relaxation of quarantine measures at the end of April 2020 (“FA 19-nCoV-2”; N = 963).Psychological analysis data were obtained from the online survey “Financial anxiety (in the context of insurance)”. The questionnaire is psychometrically reliable and easy to use. It includes five measurement scales: MR1—Physical manifestations of financial incentive anxiety, MR2—With money shortages and financial uncertainty, MR3—The value of insurance coverage, MP4—Financial Confidence, and MR5—Perception of insurance and investment risks. It was found that Russian citizens consider it important to have insurance coverage for a “rainy day”, and they showed confidence in the insurance market during the biogenic crisis. However, unfortunately, during the 19-nCoV-1 and 19-nCoV-2 periods, Russian citizens did not feel financially secure, unlike in the period before 19-nCoV. Women showed high scores for physical manifestations of financial anxiety and low financial confidence in the future, in contrast to men, regardless of the observation period.

The novel COVID-19 disease is a contagious acute respiratory infectious disease whose causative agent has been demonstrated to be a new virus of the coronavirus family, SARS- CoV-2. Multiple studies have already reported that risk factors for severe disease include older age and the presence of at least one of several underlying health conditions. However, a recent physiopathological report and the French COVID-19 scientific council have postulated a protective effect of tobacco smoking. Thanks to a meta-analysis, we have been able to demonstrate the statistical significance in this regard of twelve series from China, France and in the US, reporting three different smoking status (current smoker,former smoker, with a smoking history) as well as disease severity (with respectively odds-ratio of 1.78 [1.08-3.10], 4.60 [3.13-7.17], 2.74 [0.63-5.89]). Subsequently and using a Bayesian approach we have established that past, and present smoking is associated with more severe COVID-19 outcomes. Finally, we refute claims linking general population smoking status (N=O(10^8) or O(10^9)) to much smaller disease course series (N=O(10^4)). The latter point in particular is presented to stimulate academic discussion, and must be further investigated by well-designed studies.

In the context of economic and political uncertainty associated with the 2019-nCoV pandemic, it is necessary to determine the socio-psychological factors in the transformation of the behavior of insurance consumers under the influence of the biogenic threat. This study is devoted to measuring financial anxiety and its impact on the insurance behavior of Russian citizens. Correlation, comparative and regression analyzes of financial anxiety of Russian citizens cover three stages of observation: before the start of the 2019 nCoV pandemic (“FA up to 19 nCoV; N = 766), during the period of quarantine measures announced in Russia in March 2020 (“ FA 19- nCoV-1 "; N = 856) and after the relaxation of quarantine measures at the end of April 2020 (" FA 19-nCoV-2 "; N = 963). Psychological analysis data were obtained from the online survey "Financial anxiety (in the context of insurance)". The questionnaire is psychometrically reliable and easy to use, including 5 measurement scales: MR1. Physical manifestations of financial incentive anxiety, MR2. With money shortages and financial uncertainty, MR3. The value of insurance coverage, MP4. Financial Confidence, MR5. Perception of insurance and investment risks. Russian citizens considered it important to have insurance coverage on a “rainy day” and showed confidence in the insurance market during the biogenic crisis. But, unfortunately, Russian citizens during the 19-nCoV-1 and 19-nCoV-2 periods did not feel financially secure in the future, unlike the period before 19-nCoV. ”Women showed high scores for physical manifestations of financial anxiety and low financial confidence in the future, in contrast to men, regardless of the observation period.

Abstract The COVID-19 pandemic is thought to began in Wuhan, China in December 2019. Mobility analysis identified East-Asia and Oceania countries to be highly-exposed to COVID-19 spread, consistent with the earliest spread occurring in these regions. However, here we show that while a strong positive correlation between case-numbers and exposure level could be seen early-on as expected, at later times the infection-level is found to be negatively correlated with exposure-level. Moreover, the infection level is positively correlated with the population size, which is puzzling since it has not reached the level necessary for population-size to affect infection-level through herd immunity. These issues are resolved if a low-virulence Corona-strain (LVS) began spreading earlier in China outside of Wuhan, and later globally, providing immunity from the later appearing high-virulence strain (HVS). Following its spread into Wuhan, cumulative mutations gave rise to the emergence of an HVS, known as SARS-CoV-2, starting the COVID-19 pandemic. We model the co-infection by an LVS and an HVS, and show that it can explain the evolution of the COVID-19 pandemic and the non-trivial dependence on the exposure level to China and the population-size in each country. We find that the LVS began its spread a few months before the onset of the HVS, and that its spread doubling-time is $\sim 1.59\pm 0.17$ times slower than the HVS. Although more slowly spreading, its earlier onset allowed the LVS to spread globally before the emergence of the HVS. In particular, in countries exposed earlier to the LVS and/or having smaller population-size, the LVS could achieve herd-immunity earlier, and quench the later-spread HVS at earlier stages. We find our two-parameter (the spread-rate and the initial onset time of the LVS) can accurately explain the current infection levels (R^2$\mathrm{=0.74}$; correlation p-value (p) of 5x10^-13$$). Furthermore, countries exposed early should have already achieved herd-immunity. We predict that in those countries cumulative infection levels could rise by no more than 2-3 times the current level through local-outbreaks, even in the absence of any containment measures. We suggest several tests and predictions to further verify the double-strain co-infection model and discuss the implications of identifying the LVS.

A 47-year-old physician suddenly noticed a persistent difficulty maintaining attention. He was awake, alert, and oriented. After two hours he developed fever, ageusia, and anosmia. He denied any previous history of psychiatric illness and was hydrated at the time of the subjective attention impairment. On admission, the patient remained oriented. He reported the persistence of attention problems, anosmia, and mild fatigue. The oxygen saturation 99% while he was breathing ambient air. Laboratory tests were unremarkable. A high-resolution computed tomography of the chest was normal. Nasopharyngeal and throat swabs specimens on reverse transcription-polymerase chain reaction analysis tested positive for SARS-CoV2. On illness day 3, the examination was unchanged, but he continued to complain of difficulties to stay focused. Then, he performed an objective attention test. The test demonstrated a moderate attentional impairment. On day 6, the patient reported a subjective worse in his concentration and performed a second test. Although his physical examination remained normal, the attention performance was worse as compared to day 3. Eight hours after worsening of attention impairment, the patient’s oxygen saturation dropped to 94%. From illness days 9 to 14, the patient evolved with clinical improvement. On day 10, a third objective attention test indicated a mild deficit. On day 16, he did not report any other symptom and the attention test was completely normal. Then, the patient returned to work. Neurological symptoms had been previously described in COVID- 19 patients. However, no previous research had investigated early cognitive deficits preceding the traditional symptoms.

Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), coronavirus disease 2019 (COVID-19)-induced infection is strongly associated with various coagulopathies that may result in either bleeding and thrombocytopenia or hypercoagulation and thrombosis. Thrombotic and bleeding or thrombotic pathologies are significant accompaniments to acute respiratory syndrome and lung complications in COVID-19. Thrombotic events and bleeding, often occurs in subjects with weak multiple risk factors and co-morbidities. Of particular interest are the various circulating inflammatory coagulation biomarkers involved directly in clotting, with specific focus on fibrin(ogen), D-dimer, P-selectin and von Willebrand Factor (vWF). Central to activity of these biomarkers are their receptors and signaling pathways on endothelial cells, platelets and erythrocytes. In this review, we discuss vascular implications of COVID-19, and relate this to circulating biomarker, endothelial, erythrocyte and platelet dysfunction. During the progression of the disease, these markers may either be within healthy levels, upregulated or eventually depleted. Most significant is that patients need to be treated early in the disease progression, when high levels of vWF, P-selectin and fibrinogen are present with still low levels of D-dimer. Progression to vWF and fibrinogen depletion with high D-dimer levels and even higher P-selectin levels, followed by the cytokine storm, will be indicative of a poor prognosis. We conclude by looking at point-of-care devises and methodologies in COVID-19 management and suggest that a personalized medicine approach should be considered in the treatment of patients.

The objective of this study is to determine the impact of COVID-19 on the performance of Pakistani Stock Market. This study uses the data of COVID-19 related positive cases, fatalities, recovers and the closing prices of PSX 100 index of the first half of 2020. The findings of the study suggest that only COVID-19 recoveries are influencing the performance of the index and the daily positive cases and fatalities are insignificantly related to the performance. Further studies can be performed by incorporating other variables such as economic growth, interest rate and inflation rate along with the COVID-19 related variables at a cross-country level.

Among the many approaches to COVID-19 prevention, the possible role of diet has so far been somewhat marginal. Nutrition is very rich in substances with a potential beneficial effect on health and some of these could have an antiviral action or in any case be important in modulating the immune system and in defending cells from the oxidative stress associated with infection. This short review draws the attention on some components of Citrus fruits and especially of the orange (Citrus sinensis), well known for its vitamin content, but less for the function of its flavonoids. Among the latter, hesperidin has recently attracted the attention of researchers, because it binds to the key proteins of the SARS-CoV-2 virus. Several computational methods, independently applied by different researchers, showed that hesperidin has a low binding energy both with the coronavirus "spike" protein, and with the main protease that transforms the early proteins of the virus (pp1a and ppa1b) into the complex responsible for viral replication. The affinity of hesperidin for these proteins is comparable if not superior to that of common chemical antivirals. The preventive efficacy of vitamin C, at dosage attainable by diet, against viral infections is controversial, but recent reviews suggest that this substance may be useful in case of increased stress on the immune system. Finally, the reasons that suggest undertaking appropriate research on the Citrus fruits addition in the diet, as a complementary prevention and treatment of COVID-19, are discussed.

In this paper, we draw on recent experiences from the Young Lives study to discuss some of the ethical and practical challenges facing longitudinal cohort studies in low- and middle-income countries in the time of coronavirus. We argue that COVID-19 has instigated an ‘ethics of disruption’ for social researchers across the world, and for longitudinal cohort studies like Young Lives, this requires navigating three core considerations: first, managing research relationships and reciprocity within an observational study design; second, maintaining methodological continuity and consistency across time; and third, balancing an immediate short-term response to COVID-19 against the longer-term perspective. We refer to the study’s plan to implement a new COVID-19 phone survey to illustrate how the team are navigating this altered ethical terrain.

The worldwide outbreak of a novel coronavirus, SARS-CoV-2 has caused a pandemic of respiratory disease. Due to this emergency, researchers around the globe have been investigating the evolution of the genome of SARS-CoV-2 in order to design vaccines. Here I examined the evolution of GC content of SARS-CoV-2 by comparing the genomes of the members of the group Betacoronavirus. The results of this investigation revealed a highly significant positive correlation between the GC contents of betacoronaviruses and their divergence from SARS-CoV-2. The betacoronaviruses that are distantly related to SARS-CoV-2 have much higher GC contents than the latter. Conversely, the closely related ones have low GC contents, which are only slightly higher than that of SARS-CoV-2. This suggests a systematic reduction in the GC content in the SARS-CoV-2 lineage over time. The declining trend in this lineage predicts a much-reduced GC content in the coronaviruses that will descend/evolve from SARS-CoV-2 in the future. Due to the three consecutive outbreaks (MERS-CoV, SARS-CoV and SARS-CoV-2) caused by the members of the SARS-CoV-2, the scientific community is emphasizing the need for universal vaccines that are effective across many strains including those, that will inevitably emerge in the near future. The reduction in GC contents implies an increase in the rate of GC→AT mutations than that the mutational changes in the reverse direction. Therefore, understanding the evolution of base composition and mutational patterns of SARS-CoV-2 could be useful in designing broad-spectrum vaccines that could identify and neutralize the present and future strains of this virus.

Background: It is unclear why certain countries have been more severely affected by COVID-19 than other countries. Methods: In this ecological study we compared COVID-19 mortality and incidence/100,000 as well as 4 putative explanatory factors by WHO world region. Linear regression was then used to assess the country-level predictors of COVID-19 mortality/100,000 and incidence/100,000 in 204 countries with available data. Results: COVID-19 incidence and mortality/capita were greater in Europe than other regions. This was despite a higher testing rate in Europe than other regions. Europe had an older population than all other regions and a higher prevalence of obesity than Africa, South East Asia and the Eastern Mediterranean. Country level multiple linear regression revealed positive associations between mortality/capita and testing rate, percent of the population 65 years or older, and Europe compared to Western Pacific and South East Asia (all P<0.005). Results for the analyses with cases/100,000 as outcome variable were similar. Conclusion: Our results suggest that older populations as well as other undefined regional and national factors, possibly related to efficacy of control efforts, are responsible for differences in national severity COVID-19 epidemics.

In December 2019, pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection emerged in Wuhan City, Hubei Province, China. Early in 2020, the World Health Organization (WHO) announced a new name for the 2019-nCoV-caused epidemic disease: coronavirus disease 2019 (COVID-19) and declared COVID-19 to be the sixth international public health emergency. Cellular co-infection is a critical determinant of both viral fitness and infection outcome and plays a crucial role in shaping the host immune response to infections. In this study, sixty-eight public next-generation sequencing libraries from SARS-CoV-2 infected patients were retrieved from the NCBI Sequence Read Archive database using SRA-Toolkit. Using an alignment-free method based on K-mer mapping and extension, SARS-CoV-2 was identified in all except three patients. Influenza A H7N9 (3/68), Human immunodeficiency virus 1 (1/68), rhabdovirus isolate (3/68), Human metapneumovirus (1/68), coronaviruses NL63 (1/68), Parvovirus (1/68), Simian virus 40 (1/68), and hepatitis virus (1/68) genome sequences were detected in SARS-CoV-2 infected patients.

Early detection, isolation, and management of COVID-19 patients are crucial to contain the current pandemic. The CDC in USA recently included "sudden loss of taste (dysgeusia/ageusia) and smell (anosmia/hyposmia)” as symptoms of COVID-19. If these symptoms are reliable forerunner symptoms of COVID-19, then it may facilitate early detection and containment of the disease. Hence, we systematically evaluated the contemporary evidence on dysgeusia and anosmia as trigger symptoms in COVID-19. Ovid MEDLINE, EBSCO host, and Web of Science databases were searched between December 25, 2019-May 30, 2020.Of the 13 identified records, eight (totaling 11,054 COVID-19 patients), were included, as per the selection criteria. The studies emanated mostly from the European community, as well as China, the USA, and Iran. In total, anosmia and dysgeusia symptoms were present in 74.9 % and 81.3% ambulatory as well as hospitalized, mild-to-severe cases of COVID-19 patients, respectively. The European, US, and Iran data indicate that olfactory, and gustatory symptoms appear prior to general COVID-19 symptoms in a majority of the patients. To our knowledge, this is the first systematic review analyzing the prevalence of chemosensory dysfunction in COVID-19. Further, studies are essential to evaluate their utility as harbingers of COVID-19 onset, and to establish clinical practice guidelines.

A compartmental epidemiological model with seven groups is introduced herein, to account for the dissemination of diseases similar to the Coronavirus disease 2019 (COVID-19). In its simplified version, the model contains ten parameters, four of which relate to characteristics of the virus, whereas another four are transition probabilities between the groups; the last two parameters enable the empirical modelling of the effective transmissibility, associated in this study with the cumulative number of fatalities due to the disease within each country. The application of the model to the fatality data (the main input herein) of five countries (to be specific, of those which had suffered most fatalities by April 30, 2020) enabled the extraction of an estimate for the basic reproduction number $R_0$ for the COVID-19 disease: $R_0=4.91(33)$.

In this brief communication, we propose the concept that capillary regression may represent a primary pathogenic process underlying COVID-19 infection, particularly in the serious and life-threatening manifestations of the disease. We suggest that the marked elevations of pro-inflammatory mediators that are observed in these seriously ill patients may directly induce capillary regression and endothelial cell (EC) loss. Recent autopsy studies are demonstrating EC loss leading to widespread microthrombi and associated tissue damage. Recent work has indicated that interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNFα), and thrombin, individually and in combination, can potently cause capillary tube regression in experimental models in vitro and in vivo. Other pro-inflammatory mediators including interferon gamma (IFNγ), interleukin-4 (IL-4), and interleukin-13 (IL-13) were also shown to be pro-regressive and could be relevant mediators in COVID-19 patients. Interestingly, combinations of pharmacologic agents were identified that reduced capillary regression and protected capillary tube networks against these pro-inflammatory mediators. Such an approach might be an important therapeutic option going forward to treat key disease states where capillary regression plays a major underlying pathogenic role. Finally, if capillary regression is occurring in response to these pro-inflammatory mediators during COVID-19 infection, we suggest that combinations of blocking agents directed to these key pro-regressive mediators might be necessary to appropriately treat patients.

Currently, entire world is crumbled due to COVID-19 caused by novel SARS-CoV-2. Globally, over 5 million people are infected by SARS-CoV-2 with 6% fatality rate. The surface spike (S) protein plays a key role in the pathogenesis of SARS-CoV-2 by mediating viral entry through human angiotensin converting enzyme 2 (hACE2) receptors on the host cell and there is a big global race to find viral neutralizing antibodies and vaccine against S protein of SARS-CoV-2. Since SARS-CoV-2 evolved into 10 different clades in a very short span, a study on sipke protein mutation is essential to have effective vaccine coverage globally. Based on the mutation analysis of S protein from 166 Indian SARS-CoV-2 genome, a total of 40 different SNPs comprising of 14 synonymous and 26 non-synonymous mutations were observed, and notably, Indian S protein diverged into two major clusters, D614 and G614, with 11 different types. Majority of Indian strains fall in A2a and O clusters. Alarmingly, we have observed six SNPs at RBD and notably two of them at RBM (S438F and S494P). S494P SNP, similar to Bat–SARS like-CoV, may indicate a low ACE2 binding affinity. Interestingly 38% of Indian strains harbor a characteristic D614G SNP which was found predominantly in A2a cluster, mostly comprising USA and European strains with high disease severity. The association of disease severity with D614G SNP is well-correlated in states with high death rate except Maharashtra. Notably, more than 50% of D614G mutation were observed in Northern part of India and 14% in Southern part but not in Kerala and Tamil Nadu strains. Highly conserved motif, D614 (608-VAVLYQDVNCT-618) in upstream and also few downstream, of S1/S2 furin cleavage site may indicate specific key role in efficient interaction with host proteases in pathogenesis. Further studies are warranted to clarify the impact of SD614G SNP association to disease severity . Interestingly, C2367T (Y789Y) synonymous SNP is observed in 37% of Indian strains and notably similar SNPs with degeneracy bases were observed which is a key indication for the possibility of misdiagnosis by Real-Time PCR and revised strategies are needed for the precise diagnosis. Circulation of high number of signature SNPs [D614G and C2367T (Y789Y)] in certain states may be an early indication of emergence of community transmission in India. Further large genome sequence data from India will aid in deep understanding on the diversity of circulating SASR-Cov-2 and its impact on disease severity, origin of imported cases to India, community spread, effect on diagnosis and vaccine coverage.

We have analysed the death and recovery rate of Covid-19 disease progression. From the analysis, we have argued that the pandemic is over in certain countries (labelled as group-A) and for other countries (labelled as group-B) the disease appears to remain as endemic. Taking into account the serological survey (sero-survey) test results obtained by certain groups and comparing it with herd immunity threshold value one can infer that the low number of infection for group-B is either due to acquired immunity by some previous infection by other coronavirus or due to innate immunity towards this infection. This effect is stronger for group-B to slow the progress of the disease to such an extent resulting in flattening of the disease progression curve compared to group-A.

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.

Effects of the convection flow, atmospheric diffusivity and humidity on evolution and travel distances of exhaled aerosol clouds by an infected person are considered. The aim of this work is to evaluate the importance of aerosol transmission routes and the effectiveness of the 2-metre separation distance policy. A potential impact of use of face masks on the infection transmission rate, and an opportunity to reduce infection in hospitals, care homes and other public spaces by appropriate monitoring and filtering of air are also considered. The results obtained demonstrate that aerosol particles generated by coughing and sneezing can travel over 30 m. Modelling of the evolution of aerosol clouds generated by coughing and sneezing enables us to evaluate the deposition dose of aerosol particles in healthy individuals. For example, a person in a public place (e.g. supermarket or car park) can accumulate in the respiratory system up to 200 virus copies in 2 min time by breathing in virus laden aerosols. Wearing face mask considerably reduces the deposited load down to 2 virus copies per 2 min. The modelling also suggests that it should be possible to measure virus causing COVID-19 (SARS-CoV-2) within aerosol particles in hospitals and public places, e.g. care homes and supermarkets.

Recent reports suggest that the clinical course of coronavirus disease 2019 (COVID-19) in previously healthy children is usually milder as compared to adults. However, children with comorbid conditions such as diabetes are at increased risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as well as morbidity and mortality due to COVID-19. Experience in adults with diabetes shows that they are prone to faster metabolic decompensation, develop diabetes-related complications, and have a poor prognosis when hospitalized with COVID-19. Data on children are limited. The aim of this mini-review is to discuss the possible risks to children and adolescents with diabetes during the current pandemic and the special considerations in management in those affected with COVID-19. The challenges for children who develop new-onset type 1 diabetes during the COVID-19 lockdown, especially in accessing healthcare, are also discussed.

WHO was informed on 31 December 2019 of cases of unknown cause pneumonia in Wuhan City, China. On 7 January 2020 Chinese authorities reported a novel coronavirus as the cause and was temporarily labeled "2019-nCoV." Coronaviruses (CoV) are a wide family of viruses which cause diseases ranging from common cold to more serious illnesses. A novel coronavirus (nCoV) is a new strain not previously found in humans. Countries around the globe have stepped up their surveillance to quickly detect any new 2019-nCoV cases. Blockchain is developing into a safe and efficient network for secure data sharing in applications such as the financial industry, operations management, food industry, energy market, the Internet of Things and healthcare. In this paper, we are using blockchain technology as a mean to share authentic data, tracking of relevant information and help speed up the treatment process. At the same time it will preserve person’s identity. Timely deployment and suitable implementation of the proposed model have the opportunity to curb COVID-19 transmissions and associated mortality, especially in environments with inadequate access to testing facilities. This work will also facilitate in the treatment of other infectious diseases. Smart contract have been designed and implemented using the ethereum blockchain platform which has been presented in this paper. This work would facilitate multiple stakeholders who are involved within the medical system to curb the transmission of this disease.

COVID-19 has affected 210 countries around the world, killed more than 240,000 and infected more than 3.4 million. Bangladesh, a South Asian low-middle-income economy, has experienced a demographic and epidemiological transition with rapid urbanization and a gradual increase in life expectancy. It is the seventh most populous country in the world and population of the country is expected to be nearly double by 2050. The increasing burden of noncommunicable diseases in Bangladesh can be attributable to rapid urbanization and nearly 50% of all slum dwellers of the country live in Dhaka division. In 2017, National Rapid Response Team of IEDCR investigated 26 incidents of disease outbreak. The joint survey of the Power and Participation Research Centre and BRAC Institute of Governance and Development reveals that per capita daily income of urban slum and rural poor drops by 80% due to present countrywide shutdown enforced by the government to halt the spread of Covid-19. 40%-50% of these population took loans to meet the daily expenses.

Introduction: Due to the spread of SARS CoV-2 virus responsible for COVID-19 disease, there is an urgent need to analyse COVID-19 epidemic perception in Poland. This study aims to investigate social perception of coronavirus in the Internet media during the epidemic. It is a signal report highlighting the main issues in public perception and medical commutation in real time. Methods: We study the perception of COVID-19 epidemic in Polish society using quantitative analysis of its digital footprints on the Internet on platforms: Google, Twitter, YouTube, Wikipedia and electronic media represented by Event Registry, from January 2020 to 29.04.2020 (before and after official introduction to Poland on 04.03.20). We present trend analysis with a support of natural language processing techniques. Results: We identified seven temporal major clusters of interest on the topic COVID-19: 1) Chinese, 2) Italian, 3) Waiting, 4) Mitigations, 5) Social distancing and Lockdown, 6) Anti-crisis shield, 7) Restrictions releasing. There was an exponential increase of interest when the Polish government “declared war against disease” around 11/12.03.20 with a massive mitigation program. Later on, there was a decay in interest with additional phases related to social distancing and an anti-crisis legislation act with local peaks. We have found that declarations of mitigation strategies by the Polish prime minister or the minister of health gathered the highest attention of Internet users. So enacted or in force events do not affect interest to such extent. Traditional news agencies were ahead of social media (mainly Twitter) in dissemination of information. We have observed very weak or even negative correlations between a colloquial searching term 'antiviral mask' in Google, encyclopaedic definition in Wikipedia “SARS-CoV-2” as well official incidence series, implying different mechanisms governing the search for knowledge, panic related behaviour and actual risk of acquiring infection. Conclusions: Traditional and social media do not only reflect reality, but also create it. Risk perception in Poland is unrelated to actual physical risk of acquiring COVID-19. As traditional media are ahead of social media in time, we advise to choose traditional news media for a quick dissemination of information, however for a greater impact, social media should be used. Otherwise public information campaigns might have less impact on society than expected.

The Covid-19 has hit Italy in February 2020 after its outbreak in China at the beginning of January. But why Italy first among Western countries? What are the conditions that made Italy more vulnerable and the first target of such disease? What characteristics and what diffusion patterns could be highlighted and hypothesized, from the outbreak to the end of March 2020, after containment measures - including a national lock down – were introduced? In this paper we try to provide some answers to these questions, analyzing the issue from the medical, geographical and planning points of view. In particular, we started from a hypothesis of very similar economic, geographical, climatic and environmental conditions of the areas of Wuhan – in Hubei Province in China, the outbreak of the epidemics – and the Po Valley area – in Italy – where most cases and deaths were registered. Adopting an ecological approach, we compared the spatial distribution and pattern of Covid-19-related mortality in Italy with several geographical, environmental and socio-economic variables at Provincial level, analyzing them by means of spatial analytical techniques as LISA – Local Indicators of Spatial Association. Possible evidence relating Covid-19 cases and Nitrogen-related pollutants and land take arise, particularly in the Po Valley area.

The Coronavirus disease (COVID-19) caused by a novel coronavirus, SARS-CoV-2, has been declared as a global pandemic. Due to its infection rate and severity, it has emerged as one of the major global threats of the current generation. To support the current combat against the disease, this research aims to propose a Machine Learning based pipeline to detect the COVID-19 infection using the lung Computed Tomography scan images (CTI). This implemented pipeline consists of a number of sub-procedures ranging from segmenting the COVID-19 infection to classifying the segmented regions. The initial part of the pipeline implements the segmentation of the COVID-19 affected CTI using Social-Group-Optimization and Kapur’s Entropy thresholding, followed by k-means clustering and morphology-based segmentation. The next part of the pipeline implements feature extraction, selection and fusion to classify the infection. PCA based serial fusion technique is used in fusing the features and the fused feature vector is then employed to train, test and validate four different classifiers namely Random Forest, k-Nearest Neighbors (KNN), Support Vector Machine with Radial Basis Function, and Decision Tree. Experimental results using benchmark datasets show a high accuracy (> 91%) for the morphology-based segmentation task and for the classification task the KNN offers the highest accuracy among the compared classifiers (> 87%). However, this should be noted that this method still awaits clinical validation, and therefore should not be used to clinically diagnose the ongoing COVID-19 infection.

Background & Objectives: The global pandemic caused by novel coronavirus SARS-CoV-2 has claimed several lives worldwide. With the virus gathering rapid spread, the world has witnessed increasing number of confirmed cases and mortality rate, India is not far behind with approximately 37,000 affected individuals as on May 2, 2020. The ongoing pandemic has raised several questions which need to be answered by analysis of transmission of the infection. The data has been collected on daily basis from WHO and other sites. We have represented the data collated graphically using statistical packages, R and other online softwares. The present study provides a holistic overview of the spread of COVID-19 infection in India. Methods: Real-time data query was done based on daily observations using publicly available data from reference websites for COVID-19 and other government official reports for the period (15^th February, 2020 to April 28^th, 2020). Statistical analysis was performed to draw important inferences regarding COVID-19 trend in India. Results: A decrease in growth rate of cases due to COVID-19 in India post lockdown and improvement in recovery rate during the month of April was identified. The case fatality rate was estimated to be 3.22% of the total reported cases. State-wise analysis revealed a deteriorating situation in states of Maharashtra and Gujarat among others as cases continued to increase rapidly there. A positive linear correlation between the number of deaths and total cases and exponential relation between population density and number of cases reported per square km was established. Interpretation & Conclusions: Despite early preventive measures taken up by the Government of India, the increasing number of cases in India is a concern. This study compiles state-wise and district-wise data to report the daily confirmed cases, case fatalities and strategies adopted in the form of case studies. Understanding the transmission spread of SARS-CoV-2 in a diverse and populated country like India will be crucial in assessing the effectiveness of control policies towards the spread of COVID-19 infection.

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

We previously proposed a public intervention framework concept that would allow people to resume personal and economic activities. We showed that intervention measures are used in a quantitative scale to reduce transmission probabilities and disease severity. In this article, we systematically examine the origin, assumptions, performance and limitations of epidemiological models from different views used in past review. We found that nearly all model assumptions fail to hold or are remote from reality; R0 does not exit or has no utility in guiding treatment options; personalized intervention measures are vitally important to COVID-19 due to its transmission characteristic; and current epidemiological models are unable to accurately assess the true benefits of personalized intervention measures. We suggest that poor performance of the models are attributed to flawed assumption that health/disease properties can be treated as transferable properties. The flaw creates a fiction that disease properties such as infection probabilities and death risks can be transferred from any vulnerable persons to anyone in the population and thus severely limit societal ability to fight the pandemic. We finally show that the benefits of personalized mitigation measures could be determined directly by using variable Ri values for infected persons (or nodes) together assessment of death rate and disability rate; the attempt of avoiding the disease by defeating all potential transmission probabilities is unrealistic; but mitigating disease severity for specific persons is more feasible and reliable. A most reliable strategy for reviving economy is using personalized protective measures and improving person health before effective vaccine is available.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an etiologic agent of the respiratory disease in humans that is known as coronavirus disease 2019 (COVID19). The first outbreak of the disease was initially documented in Wuhan, Hubei Province, China in late December 2019 where people had experienced SARS pneumonia-like symptoms with unknown etiology. Since then it has been observed that COVID-19 positive patients have been showing mild to severe upper respiratory illness symptoms. The type of virus is known to make its transfer from animals to humans and for the concerned virus; researchers have claimed its origin from bat coronavirus at whole-genome level with a 96 % sequence identity. The COVID-19 virus is very contagious and communicable in nature and has been spread throughout the globe since its first outbreak in China. On March 9, 2020, WHO declared it as a Pandemic, and within a month it was already reported to have shown its presence in 213 countries and territories or areas. As of April 29, 2020, this novel virus infected 3,218,183 people and caused 228,029 mortalities worldwide with a variable mortality rate from 3-13 % across the planet and also varied by age and gender. Diagnosis of the disease is a key component in understanding and controlling the spread of the virus and several techniques have been devised including RT-PCR, ELISA, and sequencing-based approaches. To cure COVID-19 patients as of now we do not have proven to be a safe and effective treatment. Therapeutic options currently under investigation in various parts of the world. However, there are various effective therapeutic targets to repurpose the present antiviral therapy for developing potential interventions against SARS-CoV-2. Boosting the immune system can also help to prevent and spread of COVID-19 using various medication and exercises. In this review, our goal to summarize and discussed the present scientific advancements to fight against this novel pandemic.

Covid-19 pandemic has captivated scientists to investigate if this new disease can affect the central nervous system (CNS). The most challenging symptoms of Covid-19 are related to respiratory distress, and most patients admitted in intensive care units cannot breathe by their own. Therefore, a crucial question is if respiratory distress can be partially explained by the CNS affection. SARS-Cov-2 is a beta-coronavirus that shares high similarities with SARS-CoV. The infection of SARS‐CoV has been reported in the brains from both patients and experimental animals, where the brainstem was heavily infected. Those coronaviruses have been able to invade the brainstem via a synapse‐connected route to the medullary respiratory center, where the infected regions included the nucleus of the solitary tract and nucleus ambiguous. The vagal afferent nerves from receptors in the lung communicate with the medulla and pons respiratory control centers to coordinate inspiration and expiration. This suggests that neuroinvasion of SARS‐CoV‐2 might play a role in the acute respiratory failure of Covid-19. Therefore, acute respiratory distress in Covid-19 can be partially explained by brainstem dysfunction, suggesting the needs of more specific and aggressive treatments with the direct participation of neurologists and neurointensivists.

Outbreaks of coronavirus disease 2019 (COVID-19) have been recorded in different countries across the globe. The virus is highly contagious, hence early detection, isolation, and quarantine of infected patients will play an important role in containing the viral spread. Diagnosis in a mobile lab can aid to find infected patients in time. Here, we develop a field-deployable diagnostic workflow that can reliably detect COVID-19. Instruments used in this workflow could easily fit in a mobile cabin hospital and also be installed in the community. Different steps from sample inactivation to detection were optimized to find the fastest steps and portable instruments in detection of COVID-19. Each step was compared to that of the normal laboratory diagnosis set-up. From the results, our proposed workflow (80 min) was two times faster compared to that of the normal laboratory workflow (183 min) and a maximum of 32 samples could be detected at each run. Additionally, we showed that using 1% Rewocid WK-30 could inactivate the novel coronavirus directly without affecting the overall detection results. Comparison of our workflow using an in-house assay to that of a commercially acquired assay produced highly reliable results. From the 250 hospital samples tested, there was a high concordance 247/250 (98.8%) between the two assays. The in-house assay sensitivity and specificity were 116/116 (100%) and 131/134 (97.8%) compared to that of the commercial assay. Based on these results, we believe that our workflow is fast, reliable, adaptable and most importantly, field deployable.

In the past decades, several new diseases have emerged in new geographical areas, with pathogens including Ebola, Zika, Nipah, and coronaviruses (CoVs). Recently, a new type of viral infection has emerged in Wuhan City, China, and initial genomic sequencing data of this virus does not match with previously sequenced CoVs, suggesting a novel CoV strain (2019-nCoV), which has now been termed as severe acute respiratory syndrome CoV-2 (SARS-CoV-2). Although Coronavirus disease 2019 (COVID-19) is suspected to originate from an animal host (zoonotic origin) followed by human-to-human transmission, the possibility of other routes such as food-borne transmission should not be ruled out. Compared to diseases caused by previously known human CoVs, COVID-19 shows less severe pathogenesis but higher transmission competence, as is evident from the continuously increasing number of confirmed cases globally. Compared to other emerging viruses such as Ebola virus, avian H7N9, SARS-CoV, or MERS-CoV, SARS-CoV-2 has shown relatively low pathogenicity and moderate transmissibility. Codon usage studies suggest that this novel virus may have been transferred from an animal source such as bats. Early diagnosis by real-time PCR and next-generation sequencing has facilitated the identification of the pathogen at an early stage. Since, no antiviral drug or vaccine exists to treat or prevent SARS-CoV-2, potential therapeutic strategies that are currently being evaluated predominantly stem from previous experience with treating SARS-CoV, MERS-CoV, and other emerging viral diseases. In this review, we address epidemiological, diagnostic, clinical, and therapeutic aspects, including perspectives of vaccines and preventive measures that have already been globally recommended.

Based on recent computational and experimental studies, hesperidin, a bioactive flavonoid abundant in citrus peel, stands out for its high binding affinity to the main cellular receptors of SARS-CoV-2, outperforming drugs already recommended for clinical trials. Thus, it is very promising for prophylaxis and treatment of COVID-19, along with other coexistent flavonoids such as naringin, which could help restraining the pro-inflammatory overreaction of the immune system. Controlled hydrodynamic cavitation processes showed the highest speed, effectiveness and efficiency in the integral and green aqueous extraction of flavonoids, essential oils and pectin from citrus peel waste. After freeze-drying, the extracted pectin showed high quality and excellent antioxidant and antibacterial activities, attributed to flavonoids and essential oils adsorbed and concentrated on its surface. This study reviews the recent evidence about hesperidin as a promising molecule, and proposes a feasible and affordable process based on hydrodynamic cavitation for the integral aqueous extraction of citrus peel waste resulting in hesperidin-rich products, either aqueous extracts or pectin tablets. The uptake of this process on a relevant scale is urged, in order to achieve large-scale production and distribution of hesperidin-rich products. Meanwhile, experimental and clinical studies could determine the effective doses either for therapeutic and preventive purposes.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is characterized by a high mortality of elderly men with age-related comorbidities. In most of these patients, uncontrolled local and systemic hyperinflammation induces severe and often lethal outcomes. The aging process is characterized by the gradual development of a chronic subclinical systemic inflammation (inflamm-aging) and by acquired immune system impairment (immune senescence). Here, we advance the hypothesis that some key features of aging contribute to the disproportionate SARS-CoV-2 mortality suffered by elderly men. At least four well-recognized aging-related characteristics that are strongly expressed in older men go some way towards explaining why these patients account for the vast majority of fatalities: i. the presence of subclinical systemic inflammation without overt disease, ii. a blunted acquired immune system and type I interferon response due to the chronic inflammation; iii. the downregulation of ACE2 (SARS-CoV-2 receptor), which triggers inflammation, particularly in patients with age-related comorbid diseases such as type II diabetes; and iv. accelerated biological aging, as measured by epigenetic and senescence markers (e.g. telomere shortening) associated to the chronic inflammatory state. Though typical of the aged, especially of elderly men, it is conceivable that these features are also shared by some subsets of the younger population. The high mortality rate of SARS-CoV-2 infection suggests that clarification of the mechanisms of inflamm-aging and immune senescence can help combat not only age-related disorders but also SARS-CoV-2 infection.

COVID-19 severity is heterogeneously distributed over age strata, but current mitigation strategies are homogeneously applied to all population. Social-distancing and stay-home are effective conservative approaches but lack economic sustainability on long term. Conversely, herd-immunity is a nonrestrictive strategy which can cost remarkable number of human lives and can melt the healthcare system down. Here I propose an Age Adaptive Social Distancing (AASD) engineering strategy to mitigate COVID-19 outbreak. AASD is based on the scientific evidence that the fatality rate grows nonlinearly with age, hence also the containing strategy should adapt nonlinearly. Essentially, AASD suggests that ‘silent spreaders’ (age 0-39) should avoid/minimize direct and indirect contacts with individuals in ‘dangerous zone’ (age 40+). The rationale is: 0-19 should follow parents strategy, healthy 20-39 (low fatality rate) might conduct screened life under active surveillance, to sustain economy and acquire rational immunity; 40-59 should respect social distancing (waiting a therapy); 60+ should stay at home (waiting a vaccine). This might save human lives, reduce healthcare demand and improve economic sustainability. The final take-home message is that future studies should design precision and personalized strategies for specific contagious diseases that integrate different social constrains, active surveillance and contact tracing.

This paper investigates whether the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) pandemic – also known as COronaVIrus Disease 19 (COVID-19) – could have been favored by specific weather conditions. It was found that the 2020 winter weather in the region of Wuhan (Hubei, Central China) – where the virus first broke out in December and spread widely from January to February 2020 – was strikingly similar to that of the Northern Italian provinces of Milan, Brescia and Bergamo, where the pandemic has been very severe from February to March. The similarity suggests that this pandemic worsens under weather temperatures between 4°C and 11°C. Based on this result, specific isotherm world maps were generated to locate, month by month, the world regions that share similar temperature ranges. From January to March, this isotherm zone extended mostly from Central China toward Iran, Turkey, West-Mediterranean Europe (Italy, Spain and France) up to the United State of America, coinciding with the geographic regions most affected by the pandemic from January to March. It is predicted that next spring, as the weather gets warm, the pandemic will likely worsen in northern regions (United Kingdom, Germany, East Europe, Russia and North America) while the situation will likely improve in the southern regions (Italy and Spain). However, in autumn, the pandemic could come back and affect the same regions again. The Tropical Zone and the entire Southern Hemisphere, but in restricted southern regions, could avoid a strong pandemic because of the sufficiently warm weather during the entire year. Google-Earth-Pro interactive-maps are provided as supplements.

In the war against the COVID-19 pandemic, the world is experiencing severe resource constraints. Although transmission routes are well understood, we suspect that they cause different disease consequences. We evaluate them in different forms to understand how they affect infection rates and disease severity. In determining how they affect disease outcome, we evaluated target tissue vulnerability, functional role, defense mechanisms, viral concentration, infection vicinity to target vital tissue, and host factors. We found that direct lung infection is the most lethal transmission route followed by bronchi infection. Transmissions by physical contacts, foods, and blood by low viral concentration (as expected in normal human activities) pose lower or much lower risks unless the infection is followed by subsequent lung exposures. After adding transmission route, treatment timings, and improper treatments into the list of known risk factors, we found that death rate and disability rate for young or healthy persons are nearly zero. We show that population based medical model improperly shifts nominal death rate from few vulnerable people to the population resulting in unnecessary population panic, and such panic is responsible for shutting down human activities and the world economy. Finally, we examined limitations in population-based mitigating measures and proposed for governmental and private adoption community guidelines, which are mainly to enable vulnerable people avoid exposures, prevent non-vulnerable people from serving as viral transmitters, get rid of high-risk exposure modes in working environment, improve safety for people in buses, ships and planes, and reduce death and disability rates for infected people.

A SARS-CoV receptor-binding domain (RBD) recombinant protein was developed and manufactured under current good manufacturing practices in 2016. The protein known as RBD219-N1 when formulated on Alhydrogel®, induced high-level neutralizing antibodies and protective immunity with minimal immunopathology in mice after a homologous virus challenge with SARS-CoV (MA15 strain). In this report, we examined published evidence in support of whether the SARS-CoV RBD219-N1 could be repurposed as a heterologous vaccine against Coronavirus Infectious Disease (COVID)-19. Our findings include evidence that convalescent serum from SARS-CoV patients can neutralize SARS-CoV-2. Additionally, a review of published studies using monoclonal antibodies (mAbs) raised against SARS-CoV RBD and that neutralize the SARS-CoV virus in vitro, finds that some of these mAbs bind to the receptor-binding motif (RBM) within the RBD, while others bind to domains outside this region within RBD. This information is relevant and supports the possibility of developing a heterologous SARS-CoV RBD vaccine against COVID-19, especially due to the finding that the overall high amino acid similarity (82%) between SARS-CoV and SARS-CoV-2 spike and RBD domains is not reflected in RBM region (59%). However, the high similarity (94%) in the region outside of RBM offers the potential of conserved neutralizing epitopes between both viruses.

Depression is one of the most severe sequelae of COVID-19, with major depressive disorder often characterized by disruption in white matter (WM) connectivity , stemming from changes in brain myelination. This study aimed to quantitatively assess brain myelination in clinically diagnosed post-COVID depression using recently proposed MRI method, macromolecular proton fraction (MPF) mapping. The study involved 63 recovered COVID-19 patients (52 mild, 11 moderate, 2 severe) at 13.5±10.0 months post-recovery, with matched controls without prior COVID-19 history (n=19). A post-COVID depression group (PCD, n=25) was identified based on psychiatric diagnosis, while a comparison group (noPCD, n=38) included participants with neurological COVID-19 complications, excluding clinical depression. Fast MPF mapping revealed extensive demyelination in PCD patients, particularly in juxtacortical WM (predominantly occipital lobe and medial surface), WM tracts (inferior fronto-occipital fasciculus (IFOF), posterior thalamic radiation, external capsule, sagittal stratum, tapetum), and grey matter (GM) structures (hippocampus, putamen, globus pallidus, and amygdala). The noPCD group also displayed notable demyelination but with less magnitude and propagation. Multiple regression analysis highlighted IFOF demyelination as the primary predictor of PCD presence and severity according to Hamilton scores. The number of post-COVID symptoms was a significant predictor of PCD presence while the number acute of symptoms was a significant predictor of PCD severity. This study, for the first time, reveals extensive demyelination in numerous WM and GM structures in PCD, outlining IFOF demyelination as a key biomarker.

Studies have shown that COVID-19 patients with prediabetes frequently present with high plasma glucose levels on hospital admission. However, whether the glycemic abnormalities are temporary or persist after recovery from the illness is unclear. We conducted a prospective cohort study of 69 COVID-19 patients with prediabetes (HbA1c 5.7-6.4%) who were admitted to a tertiary care hospital in Chennai, India, from May to October 2020 and were discharged alive. Over a mean follow-up of 146.6 (SD: 72.5) days, the mean fasting plasma glucose rose by 16.8 mg/dl (from 119.3-136.1 mg/dl), 2-hr post-prandial glucose by 61.0 mg/dl (from 176.2-237.2 mg/dl), and HbA1c by 0.6% (5.9-6.5%). Of the 49 (84.5%) patients who were discharged with glucose-lowering medications, 40 (81.6%) continued taking them at the first follow-up visit (mean of 50.1 days from admission), and 39 (79.6%) continued taking them at the second follow-up visit (mean of 114.3 days from first the follow-up visit). In addition, 12.1% of patients developed new-onset diabetes after recovery from the illness. Continuous monitoring of glycemia and detecting new-onset diabetes in COVID-19 patients with prediabetes after recovery are essential, as the metabolic effects of SARS-CoV-2 persist for several months.

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.

Background: Since the onset of widespread COVID-19 vaccination campaigns, there have been concerns about serious cardiovascular adverse events, including myocarditis, myocardial infarction, and venous thromboembolisms, all of which can lead to cardiopulmonary arrest. This study aimed to estimate excess cardiopulmonary arrest mortality in King County, WA, and investigate any association with COVID-19 vaccination rates. Methods: Data was obtained from the annual King County, WA, EMS reports, the U.S. Census Bureau, and The Tennessean COVID-19 Vaccine Tracker. An exploratory data analysis was performed. Excess deaths were calculated using the 2015-2020 cardiopulmonary arrest mortality trend line. The relationship between excess cardiopulmonary arrest mortality and vaccination rates was analyzed using polynomial regression analysis. A quadratic regression model was used to generate expected population growth trends. The excess mortality model for King County was used to calculate yearly estimates for excess cardiopulmonary arrest fatalities in the USA. Results: Approximately 98% of the King County population received at least one dose of a COVID-19 vaccine by 2023. Our analysis revealed a 25.7% increase in total cardiopulmonary arrests and a 25.4% increase in cardiopulmonary arrest mortality from 2020 to 2023 in King County, WA. Excess cardiopulmonary arrest deaths were estimated to have increased by 1,236% from 2020 to 2023, rising from 11 excess deaths (95% CI: -12, 34) in 2020 to 147 excess deaths (95% CI: 123, 170) in 2023. A quadratic increase in excess cardiopulmonary arrest mortality was observed with higher COVID-19 vaccination rates. The general population of King County sharply declined by 0.94% (21,300) in 2021, deviating from the expected population size. Applying our model from these data to the entire United States yielded 49,240 excess fatal cardiopulmonary arrests from 2021-2023. Conclusions: We identified a very strong ecological and temporal association between excess cardiopulmonary arrest mortality and the COVID-19 vaccination campaign, which resulted in high vaccination rates. The biological plausibility of death from acute cardiac and pulmonary causes after COVID-19 vaccination has been previously demonstrated and is concerning given these real-world observations. Urgent further research is needed to determine if similar trends are observed in other regions with attention to risk mitigation for incident events and improved survival with resuscitation.

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy and may have their health affected by living and working conditions. This study analyzed and synthesized the scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7,363 drivers. The biological risks identified were age, gender, race/ethnicity, genetics, comorbidities, and were considered non-modifiable for chronic diseases. The behavioral risks, considered modifiable, were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the number of working hours per day, week and month; time away from home, risk of musculoskeletal injury, and opportunities for rest, hours of sleep and access to health services. The results were presented in two categories: 1) biological, behavioral and environmental risks, and 2) general recommendations to promote physical, cognitive and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

Burnout represents a concern for all healthcare providers, particularly those specializing in emergency medical care for whom burnout outcomes have been well-documented. What remains unknown is the effect of burnout on redeployed medical specialists during the COVID-19 pandemic from an appointment-centered practice to emergency care directed by public health considerations. This research aims to identify and assess the burnout responses of fourteen medical specialties noted in searched returns of the four most cited articles published since 2020 about non-emergency physicians regarding their burnout brought on by the unanticipated need for them to provide emergency care during the recent pandemic. The hypothesis is that medical specialists accustomed to planning for emergency possibilities in their appointment-centered practice would demonstrate the least burnout regarding COVID-19-related emergencies. Considering coping as a process based on Lazarus's research, comparing and ranking the COVID-19 emergency responses across the various normally appointment-centered medical specialties in their employed coping strategies determines the outcome. With the hypothesis supported, suggested interventions for future pandemics—when these specialists are, again, redeployed to emergency care directed by public health considerations—are those coping strategies identified as most effective in reducing burnout while maintaining the viability of the medical specialty and excellent patient care.

Vaccination against the SARS-CoV2 virus has shown great promise in managing the spread and severity of Covid-19. While these vaccines were able to provide a favourable response in controlling the SARS-CoV2 infection, its use came with accompanying side effects. This systematic review aimed to determine the effectiveness of the different Covid-19 vaccine subtypes and discover the side effects associated with each vaccine elsewhere but specially in Trinidad and Tobago. For this systematic review, the keywords “Pfizer-BioNTech OR Moderna OR Oxford-AstraZeneca OR Janssen OR Sinopharm OR Novavax AND Covid-19 vaccine efficacy” and “Covid-19 vaccines AND Trinidad and Tobago” were researched under PubMed, MEDLINE and other internet sources through which other notable journals, and documents were discovered and searched similarly as outlined previously. In doing so, 65 relevant articles were included as part of this review. Of the studies examined, overall the vaccine with the greatest VE was found to be Pfizer-BioNTech (95%), followed by Moderna (94.1%), Novavax (89.7%), AstraZeneca (70.4%), Sinopharm (67%) and finally Janssen (66.9%). The use of Pfizer-BioNTech or Moderna was most efficacious in response to the different Covid-19 variants. Some side effects were common for all vaccine types however adverse effects were more commonly seen with vaccination by mRNA vaccines, Pfizer-BioNTech and Oxford-Astrazeneca. Researchers targeted individuals aged 18 and above residing in various geographical areas of TT, specifically focusing on those who had not received the COVID-19 vaccine and expressed hesitancy towards it. Convenience sampling was used to select the study participants, and formal in-depth virtual interviews were conducted on a one-to-one basis, employing a semi-structured questionnaire to guide the discussions. The interviews were meticulously recorded and transcribed, following the principles of reflexive thematic analysis, to distill key insights from the participants' responses. The study's findings, derived from the perspectives of 25 participants, illuminated a complex tapestry of reasons underlying vaccine hesitancy in Trinidad and Tobago. Notably, prominent themes emerged, including fear, doubts regarding vaccine efficacy, a perceived inadequacy of information, a sense of susceptibility to the virus, deep-seated mistrust, alternative herbal remedies, and religious reservations. Interestingly, the motivations expressed by these vaccine-hesitant individuals for potentially receiving the vaccine in the future were rooted in notions of necessity, an increased sense of susceptibility to the virus, a desire to reach a certain health benchmark, and a need for assurance regarding the vaccine's safety and effectiveness. This comprehensive exploration of vaccine hesitancy in TT provides valuable insights for public health officials and policymakers in crafting targeted strategies to address this critical issue within the local context. Conclusion: The findings of this study determined that vaccination against the SARS-CoV2 virus provided beneficial outcomes against infection, Covid-19 related hospitalizations, ICU admissions and mortality. While vaccination was deemed highly appropriate in managing the spread of the SARS-CoV2 virus and enhancing the outcomes in infected persons, the effectiveness of the different vaccine platforms indicated that certain vaccine platforms are preferential to others in different populations. In terms of vaccine efficacy, nucleic acid vaccines such as Pfizer-BioNTech and Moderna showed the greatest effectiveness while inactivated whole virus vaccines such as Sinopharm and viral vectors like Janssen had the least effectiveness. The side effects, joint/muscle soreness, pain at the injection site, shoulder pain, headaches, fever, chills, weakness, epistaxis, renal and certain cardiovascular events were common for all vaccine types. Adverse effects were more frequent and severe with the mRNA vaccines by Pfizer-BioNTech and Oxford-Astrazeneca than inactivated whole virus vaccines. The data collected in this research can be very useful to help individuals make a decision on which vaccine would be appropriate for them. More long-term studies are needed to better gauge the scope of side effects for each vaccine type.

Although numerous organizational researchers have acknowledged that COVID-19 shocks reduced the tourism industry’s financial performance, relevant literature remains scarce. Do tourism firms reduce corporate social responsibility (CSR) investments to decrease costs? The answer is unclear. This study fills the gap between stakeholder and cost stickiness theories. Based on a quasi-natural experiment of listed Chinese tourism companies from 2017 to 2021, the study finds that the COVID-19 shock caused tourism firms to increase strategic and decrease responsive CSR. In addition, tourism firms that adopted cost leadership strategies trimmed responsive CSR more than strategic CSR. Tourism firms with differentiated leadership strategies increased strategic and decreased responsive CSR. Tourism firms with higher levels of political connections increased responsive CSR, while tourism firms with higher organizational resilience increased strategic CSR. At the theoretical level, this study reveals the theoretical mechanism of the COVID-19 epidemic’s shock on tourism firms' adjustment of CSR from the perspective of cost stickiness. On a practical level, it helps inform tourism firms’ decision-making regarding CSR adjustments for sustainable development when they face widespread crisis scenarios.

Non-pharmaceutical interventions (NPIs), including social distancing, wearing personal protective equipment, and lockdown measures, have been at the forefront of outbreak control in nursing homes. We used a mixed methodology to assess which NPIs nursing homes in the canton of Geneva, Switzerland, followed for their staff and residents during the first wave of the pandemic, between March 1, 2020 and June 1, 2020. For the qualitative component, we interviewed the attending physicians and/or director of each nursing home. Based on in-vivo codes, NPIs for nursing home workers and residents in each nursing home were thematically classified as: maximally restrictive, moderately restrictive, and minimally restrictive. In the quantitative component, we calculated incident rate ratios (IRR) for infection between the three levels of COVID-19-related measures taken in these nursing homes. We found an equal distribution of maximally (n=4), moderately (n=4), and minimally (n=4) restrictive NPIs. The extent of restriction did not show to be significantly associated with the cumulative incidence of COVID-19 cases among residents (maximally restrictive IRR = 3.90, 95%CI 0.82-45.54, p = 0.184; moderately restrictive IRR = 3.55, 95%CI 0.75-41.42, p = 0.212 ; minimally restrictive IRR = reference). Variabilities in NPIs adopted by nursing homes, and the number of COVID-19 cases appear to be randomly affected.

In 2020, following the World Health Organization's declaration of COVID-19 as a pandemic, dental practices faced unprecedented disruptions globally. This retrospective cross-sectional study, conducted at a leading university dental hospital in the Lisbon Metropolitan Area, investigated the impact of these disruptions on dental caries. The study, spanning June 2019 to June 2021, included a full-mouth X-ray examination, along with sociodemographic, behavioral, and medical data. Our sample comprised 3,380 participants (2,007 females and 1,373 males), aged 18 to 99 years, divided into pre-lockdown and post-lockdown groups. We employed the Decayed, Missing, and Filled Teeth (DMFT) index to measure dental caries. Our findings revealed that nearly 90% of participants in both groups experienced dental caries, indicating a statistically significant difference between the pre-lockdown and post-lockdown periods. However, the impact of COVID-19 confinement varied among different demographic sectors, with age, educational background, and professional status emerging as the key determinants. This study highlights the need for a more nuanced understanding of the impact of the pandemic on oral health, emphasizing the role of sociodemographic factors in shaping dental health outcomes during such global health crises.

Human-to-animal SARS-CoV-2 transmission was observed, including a veterinarian contracting COVID-19 through close contact with an infected cat, suggesting an atypical anthropozoonotic transmission. This study investigated the prevalence of SARS-CoV-2 antibodies in cats during human outbreaks and elucidated the correlation between cat infections and human epidemics. A total of 1,107 cat sera samples were collected and screened for SARS-CoV-2 antibodies using a modified indirect ELISA human SARS-CoV-2 antibodies detection kit. The samples were confirmed using a cPass surrogate viral neutralization assay. The SARS-CoV-2 seropositivity rate was 22.67% (199/878), mirroring the trend observed in concomitant human case numbers. The waves of an epidemic and provinces did not significantly impact ELISA-positive cat. Notably, Chon Buri ex-hibited a strong positive correlation (r = 0.99, P = 0.009) between positive cat sera and reported human case numbers. Additionally, cPass surrogate viral neutralization revealed a 3.99% (35/878) seropositivity rate. While there were significant differences in positive cat numbers and proportions between epidemic waves. In Samut Sakhon, a positive correlation (r = 1, P = 0.042) was noted between the proportion of positive cat sera and reported human cases. The findings emphasize the need for ongoing surveillance to comprehend SARS-CoV-2 dynamics in both human and feline populations.

The susceptible-infected-recovered/removed-vaccinated (SIRV) epidemics model is an important generalization of the SIR epidemics model as it accounts quantitatively for the effects of vaccination campaigns on the temporal evolution of epidemics outbreaks. Additional to the time-dependent infection ($a(t)$) and recovery ($\mu (t)$) rates, regulating the transitions between the compartments $S\to I$ and $I\to R$, respectively, the time-dependent vaccination rate $v(t)$ accounts for the transition between the compartments $S\to V$ of susceptible to vaccinated fractions. An accurate analytical approximation is derived for arbitrary and different temporal dependencies of the rates which is valid for all times after the start of the epidemics for which the cumulative fraction of new infections $J(t)\ll 1$. As vaccination campaigns automatically reduce the rate of new infections by transferring susceptible to vaccinated persons, the limit $J(t)\ll 1$ is even better fulfilled than in the SIR-epidemics model. The comparison of the analytical approximation for the temporal dependence of the rate of new infections $\jt(t)=a(t)S(t)I(t)$, the corresponding cumulative fraction $J(t)$, and $V(t)$, respectively, with the exact numerical solution of the SIRV-equations for different illustrative examples proves the accuracy of our approach. The considered illustrative examples include the cases of stationary ratios with a delayed start of vaccinations, and an oscillating ratio of recovery to infection rate with a delayed vaccination at constant rate. The proposed analytical approximation is self-regulating as the final analytical expression for the cumulative fraction $\jinf $ after infinite time allows us to check the validity of the original assumption $J(t)\le \jinf \ll 1$.

Because the including of human anatomy forms the foundation for clinical medicine, it has contributed a pivotal role in medical education for many centuries. Thus with advancements in the science of modern, current day medicine, its continued place in the medical school curriculum deserves careful attention. In an attempt to provide guidance to decision-makers involved in clinical anatomy curriculum development at the medical school level, the Educational Affairs Committee of the American Association of Clinical Anatomists (AACA) developed this document, which defines the contours of a gross anatomy curriculum leading to the M.D. or D.O. degree. The main body of the document sets forth the anatomical concepts as well as the subject matter a student should master prior to graduation from medical school. Gross anatomy dissection is still a crucial topic in graduate and medical school. The nature and content of gross anatomy, which was historically regarded as a core course in the first year of medical education in MBBS, MD, DO, and some PhD and Graduate curricula as well as in other disciplines of selective graduate education and non-allopathic medical programs, have been significantly impacted by emerging challenges in the pedagogy of delivering medical education in the past ten years. A seemingly ever-increasing emphasis on additional modules in molecular biology, emerging pharmacotherapeutics and pathophysiology content have resulted in a condensation and apparent erosion of previously allotted classroom and laboratory hours in the gross anatomy curriculum. In addition, an imposition of financial constraints and a decreasing availability of sufficient cadaver donations to support gross anatomy dissection labs has also occurred in some locations. An innovative clinically focused cadaveric anatomy program is described which has improved the delivery and content retention of medical and graduate students and has become one of the most sought-after modules in the revised clinically oriented curriculum and has been deemed highly relevant to current medical education and graduate studies.

Radiological imaging is essential for acute patient management in Intensive Care Units (ICUs); however, it introduces the risk of exposure to ionizing radiation. This review synthesizes research on radiation exposure in intensive care unit (ICU) settings, highlighting its rise during the COVID-19 pandemic and repetitive imaging. Our analysis extends to radiation safety thresholds, revealing that some ICU patients exceed annual occupational limits, emphasizing the need to balance diagnostic utility against potential long-term risks, such as cancer. Prospective studies have demonstrated an increase in the median Cumulative Effective Dose (CED) in patients with trauma over time, prompting calls for improved awareness and monitoring. Moreover, innovative dose-reduction strategies and optimized protocols, especially in neuro-ICU units, promise to mitigate these risks. This review highlights the essential but risky role of radiological imaging in critical care. It advocates rigorous radiation management protocols to safeguard patient health, while ensuring the continuity of high-quality medical care.

SARS-CoV-2 infection can lead to life-threatening clinical manifestations. Patients with cardiovascular disease (CVD) are at higher risk for severe courses of COVID-19. However, strategies to predict the course of SARS-CoV-2 infection in CVD patients at the time of hospital admission are still missing. Here, we investigated whether this prediction is achievable by prospectively analysing the blood immunophenotype of 94 participants, including 20 uninfected and 37 acutely SARS-CoV-2-infected CVD patients and 37 healthy donors, using a 36-colour spectral flow cytometry panel. Unsupervised data analysis revealed little differences between healthy donors and CVD patients, whereas the distribution of the cell populations changed dramatically in SARS-CoV-2-infected CVD patients. The latter had more mature NK cells, activated monocyte subsets, central memory CD4+ T cells, and plasmablasts but fewer dendritic cells, CD16+ monocytes, innate lymphoid cells, and CD8+ T cell subsets. Moreover, we identified an immune signature characterised by mucosal-associated invariant T (MAIT) cells, intermediate effector CD8+ T cells, and natural killer T (NKT) cells that is predictive for CVD patients with a severe course of COVID-19. Thus, intensified immunophenotype analyses can help identify patients at risk of severe COVID-19 at hospital admission, improving clinical outcomes through specific treatment.

Background: Coronavirus disease (COVID-19) has caused one of the worst global pandemics in recent decades. It has disrupted education systems worldwide, leading to a forced shift from traditional face-to-face to blended or fully distanced learning, requiring a higher level of student readiness for self-directed learning (SDL) and a more internal locus of control (LOC). Objective: This study explored the relationship between locus of control and level of readiness for SDL among Saudi nursing students and whether the COVID-19 pandemic has impacted this relation-ship. Methods: a cross-sectional correlational descriptive study was conducted to survey 277 Saudi nursing students enrolled in the bachelor program at one of the reputable universities in Saudi Arabia. An E-questionnaire containing two scales, the Self-Directed Learning Readiness Scale for Nursing Education, and the Locus of Control Scale, was used to collect data in addition to the selected participants’ characteristics. Results: Nursing students had a moderate-to-low level of readiness for SDL (mean = 144.0), and the majority had an external LOC. There was a significant association between the locus of control and level of readiness for self-directed learning (r = 0.19*, p = 0.001), and the internal locus of control was more significantly associated with self-directed learning (r = 0.22*, p = 0.0001) than with external locus of control. Conclusion: The study findings indicate a propensity of respondents towards an external locus of control, whereas most of the respondents’ reported levels of readiness ranged between low and moderate across all dimensions of self-directed learning. This study was not registered.

The devastating effects of COVID-19 permeates virtually all aspects of life across geographic boundaries. As the lockdown is eased, and reinstated, across many parts of the world, attention is now shifting towards how to navigate the ‘now normal’ rather than the ‘next normal,’ of doing business with a view to achieving sustainable development. This study highlights some of the challenges and opportunities for micro, small, and medium enterprises (MSMEs) in times of crisis such as COVID-19. Conceptual by orientation, the study provides a broad overview of trends in crises times, drawing upon a range of qualitative accounts. The overarching message is the current direction of travel for MSMEs in sustaining their bottom-line, not after the crisis, but at this particular moment in time. The study highlights some implications for ‘pivoting,’ in order to cushion the impact of the pandemic on efforts to capacitate MSMEs in leveraging value co-creation with the consumers. The implications of the here and now are discussed.

Little is known about the long-term durability of the induced immune response in subjects af-fected by obesity, particularly in those with an abdominal distribution of adipose tissue. We evaluated SARS-CoV-2-specific antibody response after BNT162b2 vaccine booster dose, com-paring individuals with abdominal obesity (AO) with those without, discerning between indi-viduals previously infected or not. IgG-TrimericS were measured in 511 subjects at baseline, 21 days after vaccine dose-1 and at one, three, six and nine months after dose-2 and at one and three months after booster dose. Nucleocapsid antibodies were assessed at baseline and at the end of the study to detect SARS-CoV-2 infection. To evaluate the three-months difference in absolute variation of IgG-TrmicericS levels from booster dose we used multivariable linear regression that showed interaction between AO and SARS-CoV-2 infection status (p=0.016). AO is associated with higher absolute IgG-TrimericS variation in prior infected individuals, regardless of possi-ble confounders and IgG-TrimericS levels at booster dose (p=0.0125). No interaction was evinced using BMI in the same regression model (p=0.418). The robust response in the development of antibodies after booster dose, observed in people with OA and previous infection, may support the recommendations to undergo the booster dose also in this population group.

Air pollution is one of the biggest problems of this age, not only it contributes to climate change but also it has a negative effect on public and individual health due to rising morbidity and mortality. There are various contaminants that play a significant role in human disease. Numerous toxins are released into the environment as a result of anthropogenic activities including burning fossil fuels for transportation and electricity generation. In order to assist decision-makers in finding a long-term solution for improving environmental quality and population health status, NO2 pollution monitoring and regulation is an essential task. Based on data acquired from Sentinel-5P, the study presented a comparison of NO2 measurements in Sentinel-5P and ground-based stations over the urban area of Fujairah during 2021 and comparison analysis of the tropospheric NO2 column spatial configuration over urban area of Fujairah during comparable periods of pre, mid and post Covid-19 pandemic era as 2019, 2020 and 2021, respectively. These findings demonstrate remarkable tropospheric NO2 column number density decreases even of 85% in the busier areas of emirate of Fujairah during the pandemic era. Sentinel-5P measurements draw attention to the significant reduction in NO2 pollution over Fujairah during the COVID-19 lockdown where we had less traffic, which is supported by ground stations-based calculations.

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.

(1) Background: SARS-CoV-2 infection is mostly accompanied by mild COVID-19 symptoms in children. However, the multisystem inflammatory syndrome (MIS-C) and long-term sequelae are often severe complications. Therefore, the protection of the pediatric population against SARS-CoV-2 with effective vaccines is particularly important. Here we compare the humoral and cellular immune responses elicited in children (n=15) aged 5-11 years vaccinated with RBD-based vaccines combined in a heterologous scheme of SOBERANA® 02 and SOBERANA® Plus with those from children (n=10) aged 4-11 years who recovered from mild symptomatic COVID-19. (2) Methods: Blood samples were taken 14 days after last dose for vaccinated and 45-60 days after the infection diagnosis for COVID-19 recovered children. Anti-RBD IgG and ACE2-RBD inhibition were assessed by ELISA; IgA, cytokine and cytotoxic related proteins profile were determined by multiplex assays. Total B and T cell subpopulations and IFN-γ release were measured by multiparametric flow cytometry using a large panel of antibodies after in vitro stimulation with S1 peptides. (3) Results: Significant higher levels of specific anti-RBD IgG and IgA and ACE2-RBD inhibition capacity were found in vaccinated children in comparison to COVID-19 recovered children. Th1-like and Th2-like CD4+ T cells were also significantly higher in vaccinated subjects. IFN-γ secretion were higher in central memory CD4+ T cells of COVID-19 recovered children, but no differences between both groups were found in CD4+ and CD8+ T cells effector, terminal and naïve T cell subpopulations. High levels of IL-2, IL-6, IFN-γ and IL-10 in contrast to low levels of IL-4 suggesting a predominant Th1 cell polarization. Cytotoxic-related proteins granzyme A and B, perforin and granulin were also found in the supernatant after S1 stimulation in both vaccinated and recovered children. (4) Conclusions: Vaccination with the heterologous scheme of SOBERANA® 02/ SOBERANA® Plus induces strong antibody and cellular immune response compared to natural infections of young children.

In an ever-evolving landscape of higher education institution, the College of Arts and Sciences at St. Michael's College, Iligan City, Philippines, embarked on a strategic journey to navigate the challenges and opportunities of the post-pandemic era. This study, conducted in August 2022, delves into the multifaceted dimensions of their strategic planning processes. Through qualitative methods that use intensive in-depth reviews of literature, informal interviews, observation, and thematic analysis, this research unveils a narrative of adaptation, innovation, and internationalization. It explores how the institution resiliently adapted to the COVID-19 pandemic, leveraged technological advancements to enhance educational delivery, fostered interdisciplinary collaboration at the nexus of arts and sciences, and embraced internationalization through partnerships and cultural exchange. Anchored in a robust theoretical framework, this study resonates with broader trends in higher education, echoing the global call for agile, student-centric, and forward-thinking institutions. As this institution's journey unfolds, its experiences and lessons resonate with academic leaders, administrators, faculty, students, and stakeholders, inviting reflection and dialogue on the future of higher education.

Worldwide, the COVID-19 pandemic, which was brought on by the brand-new coronavirus SARS-CoV-2, has claimed a sizable number of lives. Despite the urgency, COVID-19 does not have any particular antiviral treatments at this time. As a result, scientists are concentrating on repurposing already existing antiviral medications or creating brand-new ones. The SARS-CoV-2 main protease, which is necessary for viral replication, has been identified as a possible target for a family of medicines called main protease inhibitors (MPIs). Studies of the major proteases from SARS-CoV and MERS-CoV, which have remarkably similar structures and functions to SARS-CoV-2, have provided insight for the creation of MPIs. By analyzing the MPI trials for SARS-CoV and MERS-CoV, this review sheds light on the possible therapeutic uses of MPIs for COVID-19. The review talks about how MPIs work, how effective they are against SARS-CoV and MERS-CoV, and how safe they are. The paper also emphasizes current developments in the creation of MPIs for SARS-CoV-2, including as computational studies, in vitro and in vivo research, and clinical trials. According to the review, there is a lot of hope for MPIs in the treatment of COVID-19, and numerous medications are in the works. Although more research is needed to assess their safety and effectiveness in clinical settings, these medications may offer patients with COVID-19 a much-needed therapeutic option. The review also emphasizes the importance of ongoing research into the structure and function of the SARS-CoV-2 main protease, as this information will be critical for the development of effective MPIs and other antiviral drugs in the future.

Coronavirus disease-2019 (COVID-19) was seen as a respiratory disease, however, an increasing number of reports indicated that the spike protein could also be the cause of the long-term post-infectious conditions known as Long-COVID characterized by a group of unresponsive idiopathic severe neuro, cardio-vascular disorders, including strokes, cardiopathies, neuralgias, fibromyalgia, and Parkinson's like-disease. Different lines of pieces of evidence confirmed that the spike protein that can be found on the surface of the SARS-CoV-2 virus latches onto angiotensin-converting enzyme 2 (ACE2) receptors located on target cells. The RNA genome of coronaviruses, which, has a median length of 29 kb and is the longest among all RNA viruses, is comprised of six to ten open reading frames (ORFs) that are responsible for encoding both the replicase and structural proteins for the virus. Each of the components of the viral genome is packaged into a helical nucleocapsid that is surrounded by a lipid bilayer. The viral envelope of coronaviruses is typically made up of three proteins that include the membrane protein (M), the envelope protein (E), and the spike protein (S). The spike protein not only facilitates the virus entry into healthy cells, which is the first step in infection but also promote profound damage to different organs and tissues leading to severe impairments and long-term disabilities. Here, we discussed the pervasive mechanism that spikes mRNA adopted to alter multipotent and pluripotent stem cell (SCs) genomes and the acquired disability of generating an infinite number of affected clonal cells. This stance is based on the molecular and evolutionary aspects obtained from retrotransposons-retrotransposition in mammalians and humans that documented the frequent integration of mRNA molecules into genomes and thus into DNA. Retrotransposition is the molecular process in which transcribed and spliced mRNAs are accidentally reverse-transcribed and inserted into new genomic positions to form a retrogene. Sequence-specific traits of mRNA clearly showed long interspersed element-1 (LINE-1 or L1) to confirm the retrotransposition, considered the most abundant autonomously active retrotransposons in the human genome. In mammals, L1 retrotransposons drive retrotransposition and are composed of long terminal repeats (LTRs) and non-LTR retrotransposons (mainly long interspersed nuclear elements or LINEs); specifically, the LTR-mediated retrocopies are immediately cotranscribed with their flanking LTR retrotransposons. In response to retrotransposons transposition, stem cells (SCs) employ a number of silencing mechanisms, such as DNA methylation and histone modification. This manuscript theorizes the expression patterns, functions, and regulation of mRNA Spike protein imprinted by SCs retrotransposons which generate unlimited lines of affected cell progenies and tissues as the main condition of untreatable Spike-related inflammatory conditions.

Introduction: The objectives of this study were to (1) investigate the association between human blood type and COVID-19 infection in both inpatient and longitudinal populations at our institution in South Florida and (2) identify the association between blood type and severity of COVID-19 infection via presence of cellular biomarkers of severe infection in hospitalized individuals. Methods: This study consists of (1) a single-center retrospective analysis of 669 of 2,741 COVID-19 positive screened patients seen from January 1, 2020 until March 31, 2021 at the University of Miami Emergency Department (ED) who tested positive for COVID-19 infection and had a documented ABO blood type and (2) a longitudinal SARS-CoV-2 immunity study (“CITY”) at the University of Miami Miller School of Medicine consisting of 185 survey participants. COVID-19 outcome rates and 95% confidence intervals were calculated for each ABO blood type and Rh group using Chi-squared tests for categorical and ANOVA for continuous variables in the inpatient cohort and Chi-squared tests for the longitudinal cohort, all executed in R studio. Results: Our inpatient cohort had a mean age of 53.6 (± 17.9) years with 48% males and 52% females. When compared to patients with other blood types, those with O- demonstrated less risk of developing COVID-19 pneumonia (26.7% for O- vs. 69.2% for type A-, 56.5% for A+, 71.4% for AB+, 53.7% for B+, 51.5% for O+, p-value= 0.003 via Chi-squared test) and decreased mortality due to COVID-19 infection (17.0% mortality for O vs. 26.3% for A, 29.2% for B, p-value= 0.012 via Chi-squared test). Blood type O- demonstrated less elevated levels of LDH than did other blood types (p-value= 0.001, ANOVA) and a higher frequency of clinically accepted baseline levels of troponin (0.04 ng/mL) (p-value= 0.026, ANOVA) (Figure 1). Most of the longitudinal cohort was ABO blood grouping type O (47% (87/185)), with 33.5% type A, 14.1% B, and 5.4% AB. Most individuals were Rh positive (85.9%). There was no significant association found between COVID status (infection vs. non-infection) and ABO (Chi-squared test (3, N = 185) = 1.8, p = 0.6) or Rh (Chi-squared test (1, N = 185) = 0.16, p = 0.7) blood typing. Nearly all participants had been vaccinated (95.1% (176/185)), with a majority reporting primary vaccination with Pfizer (57.8% (107/185)), followed by Moderna (33% (61/185)), and Johnson & Johnson (4.3% (8/185)). 8 participants (4.3%) were unvaccinated. Conclusions: In an inpatient setting, blood type O sustained less risk of COVID-19 mortality and O- demonstrated less risk of developing COVID-19 pneumonia. In a longitudinal setting, there was no association found between blood type and COVID-19 severity. As the novelty of COVID-19 infection declines with time, further studies on risk-stratification by blood type are encouraged.

The Covid-19 pandemic and the subsequent implementation of lockdown measures have significantly impacted global electricity consumption, necessitating accurate energy consumption forecasts for optimal energy generation and distribution during a pandemic. In this study, we propose a new forecasting model called the Multivariate Multilayered LSTM with Covid-19 case injection ($\proposedModel$) for improved energy forecast during the next occurrence of a similar pandemic. We utilize data from commercial buildings in Melbourne, Australia during the Covid-19 pandemic to predict energy consumption and evaluate the model's performance against commonly used methods such as LSTM, Bi-LSTM, Linear Regression, Support Vector Machine and the previously published work of Multilayered LSTM (M-LSTM). The proposed forecasting model was analyzed using the following metrics of mean percent absolute error (MPAE), normalized root mean square error (NRMSE), and $R^2$ score values. The model $\proposedModel$ demonstrates superior performance, achieving the lowest MPAE values of 0.061, 0.093, and 0.158 for data sets from 3 different buildings, respectively. Our results highlight the improved precision and accuracy of the model, providing valuable information for energy management and decision-making during the challenges posed by the occurrence of a pandemic like Covid-19 in the future.

New Jersey was among the first states impacted by the COVID-19 pandemic, with one of the highest overall death rates in the nation. Nevertheless, relatively few reports have been published focusing specifically on New Jersey. Here we report on molecular, clinical, and epidemiologic observations from the largest healthcare network in the state, in a cohort of vaccinated and unvaccinated individuals with laboratory-confirmed SARS-CoV-2 infection. We conducted molecular surveillance of SARS-CoV-2-positive nasopharyngeal swabs collected in nine hospitals from December 2020 through June 2022, using both whole genome sequencing (WGS) and a real-time RT-PCR screening assay targeting spike protein mutations found in variants of concern (VOC) within our region. De-identified clinical data were obtained retrospectively, including demographics, COVID-19 vaccination status, ICU admission, ventilator support, mortality, and medical history. Statistical analyses were performed to identify associations between SARS-CoV-2 variants, vaccination status, clinical outcomes, and medical risk factors. A total of 5,007 SARS-CoV-2-positive nasopharyngeal swabs were successfully screened and/or sequenced. Variant screening identified three predominant VOC, including Alpha (n =714), Delta (n =1,877), and Omicron (n =1,802). Omicron isolates were further sub-typed as BA.1 (n =899), BA.2 (n =853), and BA.4/BA.5 (n =50); the remaining 614 isolates were classified as “Other”. Approximately 31.5% (1,577/5,007) of the samples were associated with vaccine breakthrough infections, which increased in frequency following the emergence of Delta and Omicron. Severe clinical outcomes included ICU admission (336/5007 = 6.7%), ventilator support (236/5007 = 4.7%), and mortality (430/5007 = 8.6%), with increasing age being the most significant contributor to each (p &lt;0.001). Unvaccinated individuals accounted for 79.7% (268/336) of ICU admissions, 78.3% (185/236) of ventilator cases, and 74.4% (320/430) of deaths. Highly significant (p &lt;0.001) increases in mortality were observed in individuals with cardiovascular disease, hypertension, cancer, diabetes, and hyperlipidemia, but not with obesity, thyroid disease, or respiratory disease. Significant differences (p &lt;0.001) in clinical outcomes were also noted between SARS-CoV-2 variants, including Delta, Omicron BA.1, and Omicron BA.2. Vaccination was associated with significantly improved clinical outcomes in our study, despite an increase in breakthrough infections associated with waning immunity, greater antigenic variability, or both. Underlying comorbidities contributed significantly to mortality in both vaccinated and unvaccinated individuals, with increasing risk based on the total number of comorbidities. Real-time RT-PCR-based screening facilitated timely identification of predominant variants using a minimal number of spike protein mutations, with faster turnaround time and reduced cost compared to WGS. Continued evolution of SARS-CoV-2 variants will likely require ongoing surveillance for new VOCs, with real-time assessment of clinical impact.

The paper proposed a modification of the GeoSER(D) model previously developed by us by detailing the age structure of the population, personal schedule on weekdays and working days, and individual health characteristics of the agents, this made it possible to build a more realistic model of the functioning of the city and its residents. The developed model made it possible to simulate the spread of 3 types of the strain of the COVID-19 virus, and to analyze the adequacy of this model in the case of unhindered spread of the virus among city residents. The paper showed that SARS COV 2 spreads mainly from contacts in workplaces and transport, and schoolchildren and preschool children are the consequence, not the initiator of the epidemic. Fluctuations in the dynamics of various indicators of the spread of SARS COV 2 associated with the difference in the daily schedule on weekdays and weekends. It has been shown that people's daily schedules strongly influence the spread of SARS COV 2. For the more contagious "rapid" strains of SARS COV 2 (omicron), immunocompetent people become a significant source of infection. For the less contagious "slow strains" (alpha) of SARS COV 2, the most active source of infection is immunocompromised individuals (pregnant women). The more contagious – "fast" strain of the SARS COV 2 virus (omicron) spreads faster in public transport. For less contagious – "slow" strains of the virus (alpha), the greatest infection occurs due to work and educational contacts.

Metabolic-associated fatty liver disease (MAFLD) and its potential impact on the severity of COVID-19 have gained significant attention during the pandemic. This review aimed to explore the genetic determinants associated with MAFLD, previously recognized as non-alcoholic fatty liver disease (NAFLD), and their potential influence on COVID-19 outcomes. Various genetic polymorphisms, including PNPLA3 (rs738409), GCKR (rs780094), TM6SF2 (rs58542926), and LYPLAL1 (rs12137855), have been investigated in relation to MAFLD susceptibility and progression. Genome-wide association studies and meta-analyses have revealed associations between these genetic variants and MAFLD risk, as well as their effects on lipid metabolism, glucose regulation, and liver function. Furthermore, emerging evidence suggests a possible connection between these MAFLD-associated polymorphisms and the severity of COVID-19. Studies exploring the association between indicated genetic variants and COVID-19 outcomes have shown conflicting results. Some studies observed a potential protective effect of certain variants against severe COVID-19, while others reported no significant associations. This review highlights the importance of understanding the genetic determinants of MAFLD and its potential implications for COVID-19 outcomes. Further research is needed to elucidate the precise mechanisms linking these genetic variants to disease severity and to develop gene profiling tools for early prediction of COVID-19 outcomes. If confirmed as determinants of disease severity, these genetic polymorphisms could aid in identifying high-risk individuals and improving the management of COVID-19.

Introduction: SARS-CoV-2 infection was first reported in 2019 and has since spread throughout the world. This is a cross-sectional study in cooperation with 118 Department of Pre-Hospital and Territorial Emergency (118 SET) of Taranto City and the University of Bari, Aldo Moro, and the School of Medicine from Italy. We conducted a study on how the COVID-19 epidemics evolved and how it was contained by different countermeasures by taking into account data showing socio-demographic and that older persons, as well as individuals with comorbidities and poor metabolic health, and people coming from economically depressed areas with lower quality of life in general, are more likely to develop severe COVID-19 infection. Objective: Examine the association between county-level socio-demographic risk factors and COVID-19 incidence and mortality, determining the possible emo-biological markers, ferritin, and lymphocytes, that could be indicative of SARS-CoV-2 infection. Methods: Descriptive cross-sectional study on 600 patients examined and treated at general hospital Ninh Thuan from January to September 2022. Results: 33/600 patients were confirmed to be infected with SARS-CoV-2 (5.5%), males 4.8% and females 5.8%, the median age of infected patients is 36 years. Most infections were mild (75.8%). Our results revealed that the structure and the spatial arrangement of socio-demographic arrangements are important either as epidemiological determinants or as disease markers. Conclusion: Approximately 5.5% of patients infected with SARS-CoV-2 come to examination and treatment at the hospital, these findings suggested that possible infection rate in the burden of the COVID-19 pandemic, the sociodemographic risk factors, and their root causes must be addressed. In addition, lab results obtained from affected patients showed that lymphocytes and ferritin could be considered traits of mild COVID-19 infection.