Background. The Weekly Mortality Cycle among CoViD-19 patients has been studied.Methods. Mortality data obtained from the 'Worldometer' website were analyzed with a comparison of absolute values, percentages, and p-value. Results. For patients suffering from CoViD-19, the most favorable or the safest days of the week were Sundays and Mondays. Conclusion. The weekly cycle with decreased mortality on Sundays and Mondays is a unique phenomenon observed among victims of CoViD-19. Presumably the decreased mortality on certain days of the week related to the optimized therapeutic protocols used on the "safest days".

In this study, we surveyed over 600 participants to determine: a) major causes to mental stress during the pandemic and its future impacts, and b) diversity in public perception and acceptance (specifically for children) of Covid-19 vaccination. Statistical results and intelligent clustering outcomes indicate significant relationships between sociodemographic diversity, mental stress causes, vaccination perception, and Covid-19 infections. For instance, statistical results indicate significant dependence between mental stress due to Covid-19 and gender (p = 1.7e-05). Over 25% of males indicated work related stress comparing 35% in females however, females indicated more stressed (17%) due to relationships comparing to males (12%). Around 30% of Asian/Arabic participants don’t feel vaccination being safe as compared to 8% of white-British and 22% of white-European indicating significant dependence (p = 1.8e-08) with ethnicity. More specifically, vaccination acceptance for children is significantly dependent to ethnicity (p = 3.7e-05) where only 47% participants show willingness towards children’s vaccination. Primary dataset in this study along with experimental outcomes identifying sociodemographic information diversity with respect to public perception and acceptance of vaccination to children and potential stress factors might be useful for public and policy makers to be better prepared for future epidemics as well as working globally to combat mental health issues and running more effective vaccination campaigns.

Long COVID (LC) encompasses a constellation of long-term symptoms experienced by at least 10% of people after the initial SARS-CoV-2 infection, and so far has affected about 65 million people. The etiology of LC remains unclear; however, many pathophysiological pathways may be involved, including viral persistence; chronic, low grade inflammatory response; immune dysregulation and defective immune response; reactivation of latent viruses; autoimmunity; persistent endothelial dysfunction and coagulopathy; gut dysbiosis; hormonal dysregulation, mitochondrial dysfunction; and autonomic nervous system dysfunction. There are no specific tests for the diagnosis of LC, and clinical features including laboratory findings and biomarkers may not specifically relate to LC. Therefore, it is of paramount importance to develop and validate biomarkers that can be employed for the prediction, diagnosis and prognosis of LC and its therapeutic response. Promising candidate biomarkers that are found in some patients are markers of systemic inflammation including acute phase proteins, cytokines and chemokines; biomarkers reflecting SARS-CoV-2 persistence, reactivation of herpesviruses and immune dysregulation; biomarkers of endotheliopathy, coagulation and fibrinolysis; microbiota alterations; diverse proteins and metabolites; hormonal and metabolic biomarkers; as well as cerebrospinal fluid biomarkers. At present, there are only two reviews summarizing relevant biomarkers; however, they do not cover the entire umbrella of current biomarkers or their link to etiopathogenetic mechanisms, and the diagnostic work-up in a comprehensive manner. Herein, we aim to appraise and synopsize the available evidence on the typical laboratory manifestations and candidate biomarkers of LC, their classification based on main LC symptomatology in the frame of the epidemiological and pathogenetic aspects of the syndrome, and furthermore assess limitations and challenges as well as potential implications in candidate therapeutic interventions.

Introduction: Since its discovery in late 2019, the novel coronavirus (SARSCOVID-2) that causes COVID-19 has spread fast, prompting the World Health Organization (WHO) to designate the disease a worldwide pandemic on March 11, 2020.The epidemic has profoundly altered the preexisting global sexual and reproductive health landscape .The virus’s load has put ordinary services in jeopardy and harmed other health priorities. This encompasses both the provision and the supply of contraceptives, sexual health, new born and maternal health services. This Scoping review therefore mapped the availability evidence on the impact and effects of the COVID-19 disease outbreak on sexual and reproductive health. Methods: The methodological framework by Arksey and O’Malley guided this scoping review. A literature search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The Strobe critical review checklist was used to determine the quality of the included studies. Results:19 studies were reviewed, out of which 4 were cross sectional studies, 1 was an observational study, 1 was a descriptive analytical study and the rest were qualitative studies .Majority of the studies showed evidence on the impact of COVID-19 and family planning service, maternal and child services, and three studies reported on COVID-19 and sexual behaviour. Five of the nineteen included studies reported on the impact of COVID-19 and family planning service. Conclusion: This scoping review has granted the assessment of the impact of novel SARS-CoV-2 on Sexual and reproductive health services with regards to sexual behaviour, family planning and maternal, neonatal and child health. From the 18 articles identified and reviewed, the overall responses stipulated a significant reduction in client’s utilization of services due to challenges experiences in service implementation such as stock outs. In addition, low demand for reproductive health services by clients due to restrictions imposed on the movements of people to curb the spread of the virus. It is therefore important that Governments and relevant stakeholders in Maternal and Sexual Reproductive Health prioritize development of policies and practices that protect women from the impacts of the pandemic. Furthermore, regular audits to detect trends in MSRH are necessary to inform on going mitigation efforts.

More than 600 Healthcare workers died due to COVID-19 infection until January 2022 in Ecuador. Even though the COVID-19 vaccines are safe, local, and systemic reactions were reported among physicians. This study aims to analyze the Adverse events (AEs) of COVID-19 vaccines with an emphasis on homologous and heterologous booster doses. An electronic survey was performed in Quito- Ecuador, directed to physicians who were vaccinated with the three doses of COVID-19 vaccines. 210 participants were analyzed after administering any doses of the vaccines. At least one AE was identified in 60.0% (126/210) of the sample after the first dose, 52.40% (110/210) after the second dose, and 75.2% (158/210) after the booster dose. The most frequent AEs were localized pain, myalgia, headache, and fever. At least one drug was used in 44.3% of the population after the first dose, 37.1% after the second dose, and 63.8% in the booster dose. Heterol-ogous booster produces more AEs compared with homologous booster (80.1% vs. 53.8%), and 77.3% of participants reported that interfered with daily activities. Similar studies agree that reactogenicity occurs mainly with heterologous vaccination compared to ho-mologous vaccination. This situation affected physicians’ performance in daily activities and led them to use medication for the symptoms

Background/Objectives: The study aimed to assess the reactogenicity and immunogenicity of various SARS-CoV-2 vaccines and compare their protective effects against COVID-19 among healthcare workers (HCWs) during the Omicron outbreak in Taiwan.Methods: Conducted from March 2021 to July 2023, this prospective observational study included healthy HCWs without prior COVID-19 immunization. Participants chose between adenovirus-vectored (AstraZeneca), mRNA (Moderna, BioNTech-Pfizer), and protein-based (Medigen, Novavax) vaccines. Blood samples were taken at multiple points to measure neutralizing antibody (nAb) titers, and adverse events (AEs) were recorded via questionnaires. Results: Of 710 HCWs, 668 (94.1%) completed three doses, and 290 (40.8%) received a fourth dose during the Omicron outbreak. AEs were more common with AstraZeneca and Moderna vaccines, while Medigen caused fewer AEs. Initial nAb titers were highest with Moderna but waned over time regardless of the vaccine. Booster doses significantly increased nAb titers, with the highest levels observed in Moderna BA1 recipients. The fourth dose significantly reduced COVID-19 incidence, with Moderna BA1 being the most effective.Conclusions: Regular booster doses, especially with mRNA and adjuvant-protein vaccines, effectively enhance nAb levels and reduce infection rates, providing critical protection for frontline HCWs during variant outbreaks.

[3:46 PM] Anahita Zahertar This research explores the factors influencing bikeshare usage durations in the Detroit Metropolitan Area over two years, focusing on spatial, temporal, and COVID-19-related variables. Using a fully parametric hazard-based duration model with random parameters, we address data heterogeneity and uncover how different conditions affect bikeshare trips. Our findings reveal that a) intense environmental factors such as high traffic stress, poor weather, and high COVID-19 risk levels are associated with shorter trip durations b) in contrast, supportive initiatives like memberships, an affordable $5 Access Pass, a free one-month pass during the pandemic, and the introduction of new stations have been more likely to encourage longer rides c) furthermore, the study examines how variables like gym closures due to the pandemic, evening hours, and the addition of new stations, which were set as random variables in our model, exhibit both positive and negative relationships with ride durations. A key finding is the 20-minute mark in ride durations, which helps understand user behaviors and trip purposes. This insight aids urban planning by suggesting strategic bike station placements to enhance bikeshare system efficiency and meet diverse community needs. This study not only deepens our understanding of urban mobility dynamics but also underscores the effectiveness of adaptive strategies in promoting sustainable urban transportation.

Introduction: The disease caused by Coronavirus-2019 (COVID-19) was initially described in December 2019. Severe acute respiratory syndrome type 2 (Sars-Cov-2) is responsible for an important multisystem inflammatory spectrum. Cardiovascular conditions have been reported with an estimated frequency of 8-28%. In this context, transthoracic echocardiography associated with the analysis of the two-dimensional Global Longitudinal Strain (GLS) of the left ventricle derived from Speckle Tracking emerges as a promising modality. Objective: This study aims to evaluate the applicability of GLS and segmental deformity assessment in detecting subclinical myocardial dysfunction in patients that recovered from COVID-19 infection. Methods: The observational study involved 18 patients (mean age 52 years) with recent evidence of COVID-19 infection that underwent detailed echocardiographic evaluation with GLS, and cardiac magnetic resonance (CMR) according to segmental assessment results. The degree of correlation between the methods was analyzed and a systematic literature review was also conducted. Results: The mean left ventricular ejection fraction (LVEF) was 57.50 ± 9.98%. Only 16.6% of patients had reduced LVEF. The average GLS was – 18.70 ± 3.54% and in 44% of cases only one myocardial segment was affected, particularly the inferolateral basal. CMR revealed inflammatory cardiomyopathy. Discussion: Subclinical myocardial involvement is associated with major adverse cardiac events. Literature review supports the use of GLS for detecting early cardiac involvement. Conclusion: Speckle-tracking echocardiography has been shown to have clinical utility in a variety of settings and to offer superior prognostic value with a potential to enhance subclinical detection of myocardial changes in patients after COVID-19 infection.

This paper provides a retrospective analysis of published COVID-19 data and focuses on Costa Rica as an example of data analysis and validation in developing countries. The COVID-19 outbreak has highlighted the importance of robust health systems and adequate resources to test and manage diseases. However, due to limited resources and excessive burdens, developing countries face unique challenges in this regard. This makes it difficult to conduct widespread testing. The lack of testing kits, laboratory facilities, trained personnel, and the necessary infrastructure is a significant barrier. Additionally, logistical issues such as transportation and distribution of testing kits in remote areas further complicate the situation. On the other hand, universal healthcare in developing countries, despite the lack of extensive testing, can still provide reliable data on the spread and impact of the disease. Universal healthcare can lead to better records keeping and data collection, as all individuals, regardless of their economic status, have access to medical services. This inclusivity ensures a more comprehensive and representative data set. Therefore, while testing is an important tool in managing the pandemic, universal healthcare systems can still provide valuable insights in its absence. This description can be applied to the Costa Rica COVID-19 scenario: lack of resources for an adequate testing methodology but a universal healthcare system that ensures inclusivity. In this work, we show that the number of active cases of COVID-19 for Costa Rica does not provide reliable information that can be used to adjust the parameters of a mathematical model, so the effectiveness of the contention measures cannot be precisely stated. However, the number of hospitalizations is more reliable in the centralized and universal healthcare system, but quantifying the effectiveness of such measures requires a different set of tools. Traditionally, most pandemic data analysis is based on the estimation of the Rt number based on the number of active cases. We propose a methodology based on digital signal processing principles and elementary differential calculus. To our knowledge, these kinds of methodologies have not been of widespread use in pandemic data analysis, and, as we show, they may provide a valuable descriptive analysis of pandemic tendencies and they are an accessible, fast and reliable decision-making tool.

At the beginning of December 2019, a new type of coronavirus emerged, SARS-CoV-2. This virus causes COVID-19, a highly contagious disease that can initially present asymptomatically and can also lead to death. Our ecological study goal was to evaluate the incidence, mortality, and lethality rates for COVID-19 between the states of Espírito Santo and Minas Gerais, with time series analysis using secondary and public databases on COVID-19 from January 2020 to July 2022. Prais-Winsten linear regression was used for trend analyses. In 2020, the rate in Espírito Santo was 2.19 times greater than Minas Gerais. This trend continued in 2021, with Espírito Santo's rate being 1.29 times greater. In 2022, Espírito Santo's rate remained 2.65 times higher than Minas Gerais. Furthermore, Espírito Santo had the highest mortality, with the exception of 2021. In turn, Minas Gerais had the highest fatality rate throughout the analyzed pandemic period. The state of Espírito Santo had a higher incidence of COVID-19, as well as higher mortality, when compared to the state of Minas Gerais. In turn, Minas Gerais had a higher fatality rate. Furthermore, both states showed similar trends for mortality, lethality, and incidence in the years 2020 and 2021.

The potential advantages of plant-based interventions in decreasing the incidence and lessening the morbidity and mortality of COVID-19 are yet to be widely acknowledged. Nevertheless, recent publications propose that these interventions could be effective. Our cardiology center conducted an interventional study in which we incorporated plant-based foods and provided supplementation to 3470 elderly COVID-19 patients with multiple comorbidities. We pay close attention to the precise selection of food items, the application of appropriate processing methods, and the provision of nourishing meals to our patients. Our outcome was highly successful as we achieved a zero mortality rate, and none of our patients experienced worsening conditions or required hospitalization. In this review article we present the mechanisms how plant-based and supplement interventions can mitigate COVID-19 disease severity and mortality. And experts have validated our hypotheses very recently. The measures and methods used to address the ongoing SARS-CoV-2 pandemic through plant-based interventions and supplements are effective and may help prevent or manage future pandemics.

Abstract: This study aims to evaluate the effectiveness of plant-based diets and supplement interventions in mitigating the severity and mortality of COVID-19 patients. Observational research suggests that a diet high in plant-based foods may decrease the likelihood and severity of SARS-CoV-2 infection. However, several studies have faced criticism regarding the accuracy of obtaining dietary questionnaires and the insufficient intake of essential vitamins and minerals in such diets. To address these issues, this study employed a prospective interventional design that strictly controlled the quality, quantity, and processing of plant-based foods provided. Furthermore, the study incorporated supplementation, which enhanced the anti-viral, anti-inflammatory, antioxidant, antithrombotic, and immunomodulatory properties of a plant-based diet against the SARS-CoV-2 virus. Of the 3,470 COVID-19 elderly patients, half already followed a plant-based diet, and the other half new patients, both with various comorbidities, were intervened with a plant-based diet and supplementation. The results showed that the participants in the non-plant-based diet group were twice as likely to have experienced moderate disease (with 95% confidence limit: 1.42-3.12) and 2.4 times more likely to have experienced severe disease (with 95% confidence limit: 1.2-5.0) with a significant p-value of less than 0.0005 and 0.016 respectively, compared to those in the PBD group. During the interventions, none of the participants experienced disease progression or hospitalization, and there were no reported deaths by the end of the study. The outcome was highly favorable and aligned with the researchers' expectations, as COVID-19 morbidity and mortality rates in Indonesia were among the highest in Asia. This research may provide significant insights into the prevention and management of COVID-19 and aid in better preparation for future pandemics.

The Covid-19 pandemic was a challenge for the whole world and it had major secondary effects on humans and environmental health. The viral infection induced, in many situations, secondary bacterial infections, especially enteric infections by destabilizing the balance of the gastrointestinal microbiota. The large-scale use of antibiotics and biocides both for curative and preventive purposes has determined an increase in bacterial resistance and at the same time the possibility of pathogenic microorganisms’ multiplication and their dissemination to natural environments. Wastewater is the main vector of faecal microorganisms that favour their dissemination into natural aquatic ecosystems. The present paper aimed to analyze the effect of Covid-19 pandemic on the microbiological quality of wastewater from sewage treatment plants in Romania and its impact on receiving rivers. In order to highlight different and important areas of Romania, 3 cities from the east, center and west were selected for a microbiological evaluation of their WWTPs influent and effluent between ante-Covid-19 and Covid-19 pandemic peak period, when the Covid-19 pandemic had a direct impact on WWTPs microbial composition. Our study showed a higher contamination with fecal bacteria linked to a higher Covid-19 incidence. The increased usage of pharmaceutical compounds, at their turn, increased the number of resistant bacteria reaching the environment via WWTP effluents.

Background: Vaccine hesitancy was one of India's problems after the COVID-19 vaccine roll-out. Earlier studies carried out to understand people's perception of the vaccine were mainly based on online or offline community-based surveys. These studies do not help to understand the actions taken by people towards vaccination. Hence, this study has been designed to understand the exact behavior of people toward the vaccine. Methods: Age-wise, the population was sub-grouped into three groups, above 18 years, 12-14 years, and 15-18 years. The data analysis has been done using cumulative coverage of vaccines in the said age groups. Results: The study shows a substantial population has missed second and booster doses of vaccine at the state, regional, and national levels in all three age groups. Even for the states that have shown the smallest number of people who missed their dose, their number is in the thousands. Conclusion: Further research is needed to know, in total population, how many people have not even taken a single dose of vaccine. Policy-level efforts are needed to cover the entire population of the country for at least a single dose and vulnerable populations, for additional booster doses after primary doses.

The pandemic caused by SARS-CoV-2 is still a major health problem. Newly emerging variants and long-COVID-19 represent a challenge for the global health system. In particular, individuals in developing countries with insufficient health care need easily accessible, affordable and effective treatments of COVID-19. Previous studies have demonstrated the efficacy of functional inhibitors of acid sphingomyelinase (FIASMA) against infections with various viruses, including early variants of SARS-CoV-2. This work investigated whether the acid sphingomyelinase inhibitors fluoxetine and sertraline, usually used as antidepressant molecules in clinical practice, can inhibit the replication of the former and recently emerged SARS-CoV-2 variants in vitro. Fluoxetine and sertraline potently inhibited the infection with pseudotyped virus like particles and SARS-CoV-2 variants D614G, alpha, delta, omicron BA.1 and omicron BA.5. These results highlight fluoxetine and sertraline as priority candidates for large-scale phase 3 clinical trials at different stages of SARS-CoV-2 infections, either alone or in combination with other medications.

The human phospholipase B-II precursor (HPLBII-P) was originally purified from white blood cells but is also found in other cellular structures such as kidney glomeruli and tubuli. The objective of this report was to investigate the relationship of HPLBII-P in urine to acute kidney injury in patients with COVID-19 Methods Urine was collected at admission from 132 COVID-19 patients admitted to the intensive care units (ICU) because of respiratory failure. HPLBII-P was measured by a sensitive ELISA. For comparison, HNL was measured in urine, by the ELISA configured with mabs 763/8F, as a sign of tubular affection in addition to routine biomarkers of kidney disease Results Overall, the concentrations of urinary HPLBII-P were almost 3-fold higher in COVID-19 patients as compared to healthy controls (p

In this study, we aimed to determine the trend of antimicrobial resistance pattern of pathogens isolated in samples collected from patients hospitalized in the intensive care unit (ICU), in selected periods before and after COVID-19. A retrospective study of bacterial pathogens was performed on 1267 patients. The resistance patterns were analyzed using Vitek 2 Compact system. Positive-bacterial culture data of 1695 samples from pre-COVID-19 period and 1562 from post-COVID-19 period were obtained. The most frequently isolated in both periods were Staphylococcus aureus and Klebsiella spp. Klebsiella spp. had a statistically significant increase in resistance rates in the post COVID-19 period, against colistin, gentamicin and aztreonam. For E. coli strains, it was registered a significant increase against colistin and a significant decrease against levofloxacin and imipenem. For Acinetobacter spp. strains it was observed a significant increase against colistin. More than 50% from the Staphylococcus aureus strains were MRSA with statistically significant increases in antimicrobial resistance rate in the post-COVID-19 period against doxycycline, linezolid, rifampicin and teicoplanin. The study revealed a significantly increasing trend of the antimicrobial resistance rate of Gram-negative pathogens (Klebsiella spp., Acinetobacter spp.) against certain antibiotics, including those used only in cases where there are no other therapeutic options.

: Background: Vaccination against COVID-19 has been the main strategy used by most countries to limit the spread of the virus. However, vaccine uptake has been low in Africa, leading to the implementation of several interventions in order to improve vaccine coverage. This study was conducted due to the lack of information about COVID-19 vaccine coverage and the factors associated with vaccine hesitancy. Methods: This cross-sectional study was carried out in Kinshasa city using multi-stage random sampling. A total of 2160 households were included in the study. The data were analyzed using Stata 15 software. The means and standard deviations were calculated for normally distributed continuous variables, while proportions with their 95% confidence intervals (CIs) were calculated for categorical variables. Pearson’s chi-square test or Fisher’s exact test was used to test the associations between dependent variables and each independent variable. Logistic regression was used to identify the factors associated with hesitancy receiving the COVID-19 vaccination. Results: The majority of respondents were aged between 25 and 34 and 35 and 49 (28.9%). During this study, 15% (95% CI [13.25–17.9]) of respondents had received at least one dose of the COVID-19 vaccine. Among the reasons given for refusing to be vaccinated, most respondents cited concerns about the vaccine being unsafe or causing adverse reactions (45%). Among the reasons given for accepting the vaccine, 26% thought that the vaccine prevented superinfection. The factors associated with hesitancy toward the COVID-19 vaccine were female gender, an age of less than 35 years, and living in non-slum households. Conclusions: Despite the interventions implemented across the country, the reluctance to be vaccinated remains a problem; this could lead to poor health outcomes, especially among the elderly and those with pre-existing conditions. It is important to step up awareness-raising campaigns in the community in order to increase the uptake of vaccination.

Background and Objectives: Although researchers suggested that non-pharmaceutical intervention (NPI) and vaccination together can provide the best protection from the COVID-19 [1], people’s willingness to adopt personal NPIs seems to decrease through the COVID-19 waves. This study seeks for an explanation for this observation based on the framework of risk perception. Materials and Methods: Two cross-sectional surveys (N = 407 in Survey 1 and N = 505 in Survey 2) were administered before and in the first outbreak of COVID-19 in Taiwan. The survey items were designed to measure people’s recognized severity of COVID-19, worry of COVID-19, intention to adopt personal NPIs, and attitude toward COVID-19 vaccines. We established a structural model according to the framework of risk perception, which was applied to fit the data of the two surveys. Results: The multigroup SEM (Structural Equation Modeling) results showed that worry (i.e., emotional component of risk perception) fully mediates the influence of recognized severity of COVID-19 (cognitive component of risk perception) on the intention to adopt NPIs in each survey. Before the outbreak (i.e., Survey 1), people’s attitude toward COVID-19 vaccines has nothing to do with their worry of COVID-19. However, when people have experienced the real outbreak of COVID-d19 (i.e., Survey 2), their attitude toward COVID-19 vaccines negatively predicts their worry of COVID-19, forming an indirectly negative effect on their intention to adopt personal NPIs, suggesting the occurrence of the Peltzman effect. That is, receiving vaccination makes people feel safer, that the other way around relaxes their alert for COVID-19, thus, declining the intention to adopt personal NPIs.

The COVID-19 pandemic has impacted the healthcare system across the globe, leading to more than 6.9 million deaths in the past four years. Cardiac Arrest is a terminal event with associated significantly high morbidity and mortality across age groups. Multiple clinical parameters, organ dysfunction, and chronic co-morbid conditions impact mortality in COVID-19 patients with heart failure. In this retrospective, administrative dataset-based study on 148899 patients admitted to the hospital with COVID-19 and heart failure diagnosis, we reported 6703 cardiac arrests and 5783 mortality. We have used ICD 10 codes to identify the diagnosis. The primary objective of the study is to find the predictors of Cardiac Arrest among patients admitted to hospitals with COVID-19 and heart failure. Secondary objective is to calculate the percentage of cardiac Arrest and mortality across the various age groups and the correlation of hours on the mechanical ventilator and mortality. Study results have shown that the use of a mechanical ventilator has the strongest co-correlation with cardiac Arrest with an odd ratio of 14.4, followed by septic shock with an odd ratio of 5.6, tension pneumothorax with an odd ratio of 4.9 preceding the acute renal failure with an odd ratio of 2.4 and sepsis 2.3. Complete heart block had an odd ratio of 1.9, followed by ESRD with a ratio of 1.6, acute pulmonary embolism with an odd ratio of 1.5, and Type 2 MI with an odd ratio of 1.49. Chronic co-morbid condition of DM had an odd ratio of 1.3, followed by Atrial fibrillation with an odd ratio of 1.1. These results and findings emphasized that multi-organ failure has a huge impact on cardiac Arrest among COVID-19 patients with heart failure.

Introduction: COVID-19's emergence caused devastating consequences worldwide, with high morbidity and mortality rates. Critically ill patients face challenges like acute respiratory failure requiring intensive measures, including mechanical ventilation. Mortality rates in ARDS are influenced by various factors. This paper focuses on describing characteristics, management, and survival factors of mechanically ventilated ICU patients in Saudi Arabia. Methods: a retrospective, noninterventional approach, we reviewed charts and data of all COVID-19-infected patients who were admitted to the ICU, particularly those requiring ventilation support at Aseer Central Hospital (ACH) in the southern region of Saudi Arabia. Results: The study enrolled 594 COVID patients, mean age 60.5 ± 17.3 years, with 67% males. Approximately half had O negative blood group. Common chronic health issues: diabetes mellitus (35.5%). Positive culture findings in almost 340 (57.2%), with Klebsiella pneumoniae being the most isolated microorganism (45.5%). Significant correlations found with mortality: age, blood culture, Rh positive group (P<0.05). Conclusion: this study provides critical insights into the clinical and epidemiological aspects of COVID-19 patients admitted to the ICU in a Saudi Arabian hospital. The research underscores the impact of age, comorbidities, laboratory markers, and treatment interventions on patient out-comes, emphasizing the significance of tailored management strategies in this context.

For over two years, the global COVID-19 pandemic has persisted, and its continuation is anticipated. The emergence and rapid spread of numerous new virus variations across continents have been observed. These variants, differing from previously known strains, manifest a spectrum of behaviors and clinical presentations, ranging from asymptomatic cases to severe illnesses and fatalities. Despite substantial research efforts in recent years, significant uncertainties persist in understanding the disease, encompassing variations in clinical outcomes, comorbidities, and challenges faced by individuals infected with COVID-19. Beyond the acute phase of infection, the prevalence of post-COVID-19 symptoms, often denoted as "long COVID," is notable, particularly in individuals recovering from the disease. Nevertheless, a research gap persists concerning the pathophysiological mechanisms underlying newly emerging viral variant infections, post-COVID-19 conditions, and the corresponding therapeutic strategies. This review is presented to analyze recent advancements in comprehending the pathophysiology and therapy of COVID-19.

A population dynamics epidemic model is developed that incorporates age of infection and age of vaccination. The model analyzes pre-symptomatic and symptomatic periods of an infected individual in terms of infection age. The model analyzes the efficacy of vaccination in terms of vaccination age. The model is applied to the 2003 SARS epidemic in Taiwan and the current COVID-19 epidemic in New York State.

Angiotensin-converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2) are recognized as entry proteins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and recently their Single Nucleotide Polymorphisms (SNP) have been studied in different populations to elucidate the impact on disease. The aim of this study was to evaluate the genetic SNP of ACE2 (rs35803318) and TMPRSS2 (rs2070788) genes in COVID-19 patients from Northeast Brazil compared with global populations, as well as the expression quantitative trait locus (eQTL). For ACE2 (rs35803318), we found 92.6% CC, 3.4% CT, and 4.0% TT genotype carriers in SARS-CoV-2-positive patients. Surprisingly, only the genotype frequencies of ACE2 SNP were not in Hardy-Weinberg equilibrium. For TMPRSS2 rs2070788, we found 22.3% GG, 50.7% AG, and 27% AA genotype carriers in SARS-CoV-2-positive patients. The expression quantitative trait loci (eQTLs) revealed that rs35803318 was associated with an altered PIR gene expression, and rs2070788 was found eQTLs association only with lung tissue. No significant association was identified between the genotype distribution of SNPs and the 'patient's outcome. In conclusion, our results suggest that ACE2 and TMPRSS2 may not be protective factors for global populations, including the Brazilian population, since the presence of SNPs does not affect the 'patient's outcome as described by other studies.

The COVID-19 pandemic, has underscored the critical importance of sustainability across various sectors, particularly within the global economy and corporate responses to pandemic-induced challenges. Companies worldwide have grappled with unprecedented financial and operational hardships, pushing some to the brink of closure. A crucial dimension of sustainability in this context pertains to corporate financing policies. Analyzing how the pandemic has impacted these policies reveals significant insights. Government support has been instrumental in mitigating pandemic-induced disruptions, but often proved insufficient for severely affected companies. Companies, seeking financial resilience, turned to state-guaranteed lines of credit as a lifeline. Additionally, moratoriums on existing credits provided temporary relief, but long-term consequences, particularly regarding corporate indebtedness. As companies adapted financing strategies, corporate indebtedness increased. Coupled with rising interest rates in late 2022, corporate financing costs surged, emphasizing the need for sustainable financial approaches addressing both short-term crises and long-term stability. In conclusion, corporate sustainability during the ongoing COVID-19 pandemic necessitates a comprehensive approach. Governments must provide adequate support, companies should pursue sustainable financing solutions, and a careful consideration of the long-term consequences of financial policy changes is essential. Prioritizing sustainability in the corporate sector prepares businesses for future crises while safeguarding global economic stability.

Objectives: In the context of COVID-19, patients with severe or critical illness may be more susceptible to developing secondary bacterial infections. This study aims to investigate the relationship between the use of prophylactic antibiotic therapy and the occurrence of bacterial or fungal isolates following the administration of tocilizumab in hospitalized COVID-19 patients who had previously received steroids during the first and second waves of the pandemic in Spain. Methods: This retrospective observational study included 70 patients hospitalized with COVID-19 who received tocilizumab and steroids between January and December 2020. Data on demographics, comorbidities, laboratory tests, microbiologic results, treatment, and outcomes were collected from electronic health records. Patients were divided into two groups based on the use of antibiotic prophylaxis, and the incidence of bacterial and fungal colonizations/infections was analyzed. Results: Among the included patients, 45 patients received antibiotic prophylaxis. No significant clinical differences were observed between patients based on prophylaxis use regarding the number of clinically diagnosed infections, ICU admissions, or mortality rates. However, patients who received antibiotic prophylaxis showed a higher incidence of colonization by multidrug-resistant germs compared to the subgroup that did not receive prophylaxis. The most commonly isolated microorganisms were Candida albicans, Enterococcus faecalis, Staphylococcus aureus, and Staphylococcus epidermidis. Conclusions: In this cohort of hospitalized COVID-19 patients treated with tocilizumab and steroids, the use of antibiotic prophylaxis did not reduce the incidence of secondary bacterial infections. However, it was associated with an increased incidence of colonization by multidrug-resistant organisms.

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country with high mortality and strict lockdown. This study explored the emotions and challenges of pregnant and post-partum women during the pandemic, using AI-based mixed-methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 post-partum. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and tried to cultivate gratitude and hope. The study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic, and also highlights women’s resilience and coping strategies.

The COVID-19 pandemic made it harder to communicate accurate information about vaccines because of the spread of misinformation. The European Medicines Agency (EMA) tried to reas-sure the public by communicating about the development and approval of COVID-19 vaccines. They surveyed patients/consumers, healthcare professional organizations, and individual stake-holders to see if their core information materials were informative and well understood. They also asked about the public's preferred communication channels. The surveys showed that indi-vidual patients/consumers generally prefer to get information about COVID-19 vaccines from the internet or mass media. Organizations and individual healthcare professionals prefer to get in-formation from national and international health authorities' sources. This supports EMA's ap-proach of using media, stakeholder engagement, and web-based formats to communicate about COVID-19 vaccines. Both at the EU and local levels, participants had a good understanding of the key messages from regulators and found the materials useful and relevant. However, some im-provements were recommended to the visuals, texts, and dissemination formats. These recom-mendations were generally consistent in both contexts. User-testing of proactive communication materials aimed at prebunking misinformation during a public health crisis helps to ensure that users understand the development and safety safeguards of novel vaccine technologies. This in-formation can then be used as a basis for evidence-based communication activities by regulators and public health bodies in an emergency context.

A large population has been infected by COVID-19 (Coronavirus disease-19) and it has been necessary a rapid and simple diagnostic method to detect the SARS-CoV-2and control its spread. We developed a colorimetric reverse transcription-loop-mediated isothermal amplification (RT-LAMP) kit that allow the detection of SARS-CoV-2 from nasopharyngeal swab samples without the need of RNA extraction. The kit utilizes three sets of LAMP primers targeting two regions of ORF1ab and one region in the E gene. The results are reported using colorimetric change of hydroxynaphthol blue, enabling visual interpretation without the need for expensive instrument. The kit demonstrated sensitivity to detect between 50 and 100 copies of the viral genome per reaction. The kit was authorized by the National Administration of Drugs, Food and Technology (ANMAT) of Argentina after validation using samples previously analyzed by gold standard RT-qPCR. The results showed sensitivity of 90,6 % and specificity of 100%, consistent with conventional RT-qPCR. In silico analysis confirmed the recognition of SARS-CoV-2 Variants of Concern (VOCs) B.1.1.7, B.1.351, P.1, B.1.617.2, B.1.427, B.1.429and lineages of variant Omicron (B.1.1.529) with 100% homology. This rapid, simple, and sensitive RT-LAMP method paves a way for a large screening strategy to be carried out at locations lacking sophisticated-instrumental and trained-staff, as particularly happen at regional hospitals and medical centers from rural areas.

The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to significant global health implications. Although the respiratory manifestations of COVID-19 are widely recognized, emerging evidence suggests that the disease may also significantly affect the gut microbiota, the intricate community of bacteria that lives within the gastrointestinal system. This extensive article intends to investigate the impact of COVID-19 on the gut microbiota, examining the underlying mechanisms, clinical implications, and potential therapeutic interventions. Understanding the complex interactions between COVID-19 and the gut microbiota will help us to gain valuable insights into the broader consequences of this viral infection on human health.

We provide a summary of various epidemiological parameters related to COVID-19 such as incubation period, serial interval and other parameters. Understanding these parameters is important for developing prevention strategies. SARS-CoV-2 can be transmitted by droplets and close contact, but there is evidence of airborne transmission. Aerosol-generating procedures have been identified as one of the specific risk factors for healthcare workers. Super-spreading events refer to situations where a small number of individuals cause the majority of infections. The basic reproductive number (R0) and the spread parameter (k) are used to characterise the transmissibility of the disease. Estimated values for R0 range from 2 to 3 and the estimated value for k is 0.1.The duration of infectiousness depends on viral load and shedding. Viral load varies according to factors such as clinical spectrum, type of variant and vaccination status. The relationship between viral load and infectivity is not fully understood.With regard to the frequency of symptoms and signs of COVID-19, fever, cough, fatigue and dyspnoea are common. The prevalence of olfactory and gustatory dysfunction (OGD) varies between studies and countries. Age and comorbidities are factors associated with olfactory dysfunction.Estimates of the proportion of asymptomatic patients range from 6% to 96%. Asymptomatic transmission is considered likely and is important for control measures.We reviewed the quantitative semiology of COVID-19 is reported on sensitivity, specificity and likelihood ratios of signs.Finally, we also review risk factors for COVID-19 (including health care workers), co-infections, and epidemiology of variants..

Hepatitis B virus reactivation (HBVr) is a well described result of immunosuppressive therapy initiation in a variety of diseases with dose and duration of treatment being the main factors determining the probability for reactivation. Such cases have been described also in Covid-19 patients treated with immunosuppressive therapies. Nevertheless, there have also been reported cases of Covid-19 infection that led to HBVr with no concurrent immunosuppressive therapy or any other described cause. In accordance with that observation, we present a patient followed for a period spanning 20 years with HBeAg negative chronic HBV infection and non-detectable HBV DNA who after a mild Covid-19 infection treated only with low dose and short duration inhaled corticosteroids (ICS), developed elevated AST and ALT as well as elevated HBV DNA levels. During the diagnostic workout other etiologies of abnormal liver biochemistries were excluded and thus the diagnosis of HBV reactivation was established and treated with entecavir. Since other causes of reactivation were excluded, and ICS dose and duration was found baring only a very low risk (&lt;1%) for HBVr, Covid-19 infection could be considered the most probable cause of reactivation.

Background : Our objectives were to investigate the incidence of elevated methemoglobin level among COVID-19 patients at intensive care unit. The correlation of methaemoglobinemia with mortality and some haematological parameters was also tested. Methods: The diagosis of coronavirus -19 infection was confirmed by RT-PCR. The quantitative method for determination of methemoglobin was it’s cyanide derivative by spectrophotometry. The reference range was less than 2 percent. Results: There were altogether 46 patients (11 male, 35 female) included. Their median age value was 70 y. ( 29 – 89). The methemoglobin median value was 4,3%. 15 of 46 patients died. The methemoglobin median value of departed patients was 8 % , and 2,5% was among survivors. ( P= 0,001) 19 patients were blood transfused. Their methemoglobin median was 11 % , otherwise the non transfused patients presented 2,7 % methemoglobin median. ( p= 0,001). We performed two binary logistic regression calculation, in order to judge the elevated methemoglobin level as an independent risk factor for the mortality. The predictor of methaemoglobin was 0,062 the constant -1,266 the odds ratio 1,06. The other binary logistic regression tested the fact of transfusion for the mortality. Predictor of transfusion 1,1474, constant -1,2527 odds ratio 3,15 There was no significant correlation between methemoglobin and CRP level. Discussion: The methemoglobin is not able to transport oxygen. It’s association with mortality is discussed by some papers.There are several hypothesis in the literature to explain it’s occurrence in COVID-19. The role of coronavirus proteins as oxydative agents was mentioned. The importance of enzyme defect is emphasized. The impact of reactive oxygen free radicals in inflammation is also probable. Some papers mentioned applying local anesthetics and azythromycin as a risk. The role of transfusion is obscure, because the methemoglobin can be elevated in blood conserves during storage. Conclusion: Testing the methemoglobin seems to be important, but the pathomechanism needs further research.. The traceability and standardization of different measurement methods at intensive care units is the key for defining it’s pathogenetic role.

A sense of crisis pervaded the university sector as Covid-19 spread, with worries about possible significant loss of income and students in its wake. This analysis examines several years of financial and student data through the pandemic (2020-2022) for Scottish universities. It shows that far from losing money or students, universities in Scotland gained both, and accelerated income growth during Covid. The University of Glasgow stands out not only among Scottish universities but also in the Russell Group in increasing income and student numbers faster than other institutions, becoming over the course of the pandemic, the third largest university in the UK and the largest in Scotland by student numbers. The driver of income growth for all Scottish universities is expanded intakes of international students, who primarily come from Asia and Africa. Across 2021 and 2022, Scottish Universities earned income totalling £1.7 billion from international tuition fee alone. Universities across the UK are increasingly dependent on yet continuing to actively pursue international tuition fees as a primary source of income. This paper documents the situation for Scotland, considering the implications of this growth trajectory in terms of: concentrating financial dependence on a single income source; rising casualisation of staff as a means of managing higher student numbers; impacts on learning and working conditions as students numbers rapidly expand; a shifting composition of students in higher education. It concludes with reflections on: a blurring boundary between the practices and values of profit-making companies and those of the charitable university sector; the ethical and colonial implications in international student recruitment and targeting of ‘new markets’ in the Global South; and the implications of all this for the shape, health and purpose of the university sector in Scotland.

The new coronavirus SARS Cov2 disease from 2019. (COVID-19), started as a cluster of unexplained pneumonia cases in Wuhan in December 2019, has spread globally and caused a serious public health threat. People were scared due to the COVID-19 cases that were rapidly increasing all over the world and the quick changes in how people lived. The COVID-19 pandemic has affected various aspects of life, one of which is the increased use of the internet, especially social media platforms. Past research has clearly linked a pandemic with signs of stress, depression, anxiety, and suicide thoughts, as well as with excessive internet use. The findings of research conducted around the world indicate that the higher the level of stress associated with the COVID-19 pandemic in an individual, the greater the tendency to develop an addiction to the internet. The aim of this paper was to provide a brief overview of the available scientific findings on the impact of the COVID-19 pandemic on mental health and internet addiction. Methods: A sweep through available literature was performed using the database Medline via the PubMed interface for articles written in English, using keywords and MeSH terms "Internet addiction", "mental health" and "COVID-19". Results: With insight into the scientific literature on COVID-19, mental health, and internet addiction, we have concluded that during the COVID-19 pandemic, time spent on the internet increased. Conclusion: Additionally, due to reduced social activities, above mentioned consequently led to internet addiction and thus to psychological distress, increased loneliness and depression.

SARS-CoV-2 infection triggers distinct patterns of disease development, characterized by significant alterations in host regulatory responses. Severe cases exhibit profound lung inflammation and systemic repercussions. Remarkably, critically ill patients display a "lipid storm", influencing the inflammatory process and tissue damage. Sphingolipids (SL) play pivotal roles in various cellular and tissue processes, including inflammation, metabolic disorders, and cancer. In this study, we employed high-resolution mass spectrometry to investigate SL metabolism in plasma samples obtained from control subjects (n=55), COVID-19 patients (n=204), and convalescent individuals (n=77). These data were correlated with inflammatory parameters associated with the clinical severity of COVID-19. Additionally, we utilized RNAseq analysis to examine the gene expression of enzymes involved in the SL pathway. Our analysis revealed the presence of thirty-eight SL species from seven families in the plasma of study participants. The most profound alterations in the SL species profile were observed in patients with severe disease. Notably, the predominant sphingomyelin (SM d18:1) species emerged as a potential biomarker for COVID-19 severity, showing decreased levels in the plasma of convalescent individuals. Elevated SM levels were positively correlated with age, hospitalization duration, clinical score, neutrophil count, as well as the production of IL-6 and IL-8. Intriguingly, we identified a putative protective effect against disease severity mediated by SM (d18:1/24:0), while ceramide (Cer) d18:1/24:1 and d18:1/24:0 was associated with increased risk. Moreover, we observed enhanced expression of key enzymes involved in SL pathway, in blood cells from severe COVID-19 patients, suggesting a primary flow towards Cer generation in tandem with SM synthesis. These findings underscore the potential of SM as a prognostic biomarker for COVID-19 and highlight promising pharmacological targets. By targeting sphingolipid pathways, novel therapeutic strategies may emerge to mitigate the severity of COVID-19 and improve patient outcomes.

The novel coronavirus has affected the mental state of the general public, more so among healthcare workers. During the pandemic when the infectivity had become intense, dental professionals were at stake as their work demanded more proximity with oral and nasal secretions. Many dentists had to close their clinics for fear of infection. This had a significant impact on their financial, social and emotional wellbeing. Stress is what arises when something we care about is at stake. Dentistry which is already a stressful discipline, the pandemic has multiplied the already existing pressures of isolation, the focus on perfectionism, compromise on treatment, and time pressures. Our study has attempted to assess the perceived stress among dentists and the various correlates impacting the same. Resilience is the capacity to bounce back productively during stressful situations. Resilience acts like a buffer to wither stress. Resilience is neither permanent nor global. In our study, we have attempted to assess resilience among dentists using a standard validated scale and various sociodemographic factors impacting resilience. Further, we have tried to assess the correlation between stress and resilience. We found that senior dentists with more years of experience had more resilience and their perceived stress was less. Though we found increased perceived stress among women dentists, resilience did not have any gender difference. It is essential to be pandemic prepared with the implementation of resilience-building strategies at various levels.

Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men. COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide. This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.

(1) Background: Our paper aimed to examine the ways in which the care centers for the elderly acted and adapted during the pandemic period, by taking into account the opinions of the beneficiaries, of the employees and of the managers of those centers. (2) Methods: in order to conduct the research we used a mixed-method approach. Considering the quantitative research, we applied a questionnaire to 430 institutionalized elderly from Timis county, Romania. Considering the qualitative analysis, we conducted interviews with 31 institutionalized elderly, with 7 employees and 4 managers. (3) Results: most institutionalized elderly were mainly satisfied with their life in the care centers, the main difficulties they had were: the impossibility of being close to loved ones, and the difficulty of adapting to the living conditions within the center, and the elderly were satisfied with the interactions they had with the staff of the care centers. (4) Conclusions: the research conducted provides a view on the lifestyle of the elderly from care centers during the pandemic, it highlights the struggles of the elderly and it can be used as a point of reference for the further improvement of the lifestyle of the elderly within the care centers.

The COVID-19 pandemic has had a major impact on health systems around the globe and Romania is no exception. The impact on healthcare expense for pregnant women has been considerable, especially in COVID-only tertiary centers, where specialized care is being provided .The aim of this study is to analyze the impact of SARS-CoV-2 infection on healthcare costs, in particular by managing cases in COVID-only maternity. Material and Methods: The objective of the study was to analyze if the model adopted by the health system consisting in complete separation of delivering obstetrical care for covid and non-covid patients was efficient. We conducted an observational study in which we compared a group of pregnant women infected with SARS-CoV-2 (study group) with a control group in which we included uninfected pregnant women. The patients were recruited from Bucur Maternity Hospital, declared a COVID-only center in march 2020. We compared the two groups in terms of expenses over the entire period of hospitalization, i.e. expense on hospitalization, medicines, medical supplies, and medical investigations.

Vaccines trigger a complicated immunological response that includes B and T cells, with B cells producing antibodies. SARS-CoV-2 immunity weakens over time after vaccination. Discovering key changes in antigen-reactive antibodies over time after vaccination could help improve vaccine efficiency. In this study, we collected data on blood antibody levels in a cohort of healthcare workers vaccinated for COVID-19 and obtained 73 antigens in samples from four groups according to the duration after vaccination, including 104 unvaccinated healthcare workers, 534 healthcare workers within 60 days after vaccination, 594 healthcare workers between 60 and 180 days after vaccination, and 141 healthcare workers over 180 days after vaccination. An efficient machine learning based framework containing four feature selection methods (least absolute shrinkage and selection operator, light gradient boosting machine, Monte Carlo feature selection, and maximum relevance minimum redundancy) and four classification algorithms (decision tree, k-nearest neighbor, random forest, and support vector machine) was designed to screen out essential antigens. Several efficient classifiers with weighted F1 value around 0.75 were constructed. This study revealed that S1+S2, S1.mFcTag, S1.HisTag, S1, S2, Spike.RBD.His.Bac, Spike.RBD.rFc, and S1.RBD.mFc were most highly ranked among all features, where S1 and S2 are the subunits of Spike, and the suffixes represent the tagging information of different recombinant proteins. Meanwhile, the classification rules were extracted from the optimal decision tree to explain quantitatively the roles of antigens in the classification. This study identified antibodies associated with decreased clinical immunity based on populations with different time spans after vaccination. These antibodies have important implications for maintaining long-term immunity to SARS-CoV-2.

COVID-19 has proven to be detrimental across the globe, most notably affecting the United States at an alarming rate compared to comparable countries. The pandemic has had multifactorial implications on the way communities in the United States prevent, prepare for, and address the virus; however, the impact of the pandemic on rural health is less well understood. Historically, rural communities have faced a unique set of challenges regarding accessing and receiving adequate healthcare, addressing chronic illness, and eliminating health disparities closely associated with the population’s socioeconomic status; the pandemic has exacerbated these challenges. The purpose of the current study was to conduct a systematic review of the literature to evaluate the effect of the COVID-19 pandemic on rural populations both at the individual and community level. Results indicated that rural health disparities increased both at the individual and system-wide levels as a direct result of the pandemic. Budget cuts significantly affected the infrastructure of rural hospitals resulting in them being unequipped to handle such high volumes of COVID-19 cases. The lack of infectious disease specialists, access to larger medical centers with substantial numbers of ICU beds and ventilators, and an overall lack of preparedness overwhelmed rural communities. Although comorbidities such as diabetes and heart disease were associated with poorer health outcomes for a multitude of reasons, the lack of clinic and physician availability for routine care during the pandemic further exacerbated the clinical link from COVID-19 positivity to comorbidities. Furthermore, mental health deteriorated as substance use increased to a greater extent in rural communities compared to urban, during the pandemic. This study shows that health comorbidities, mental health, substance use, health literacy, access to healthcare, among others can serve as key indicators for improving healthcare in rural communities. Future studies should seek to identify key issues that disproportionately affected rural communities in comparison to their urban counterparts considering the pandemic, as well as identify gaps in the availability of rural health resources that can improve the lives of millions of Americans now and during the next pandemic.

Patients with COVID-19 demonstrate higher rates of cardiovascular complications, including thromboses and thromboembolism. One may suppose that the action of SARS-CoV-2 transforms stable atherosclerotic plaques into unstable status. Cardiovascular complications in COVID-19 may be caused by progressive viral alteration the blood vessels, including vasa vasorum. A lethal case of ischemic brain disease caused by cerebral atherosclerosis and exacerbated with a stroke during COVID-19 infection is briefly described. The results of autopsy showed perivascular lymphocytic infiltration and signs of vasa vasorum vasculitis with thrombi of adventitial microvasculature. The data discussed in the article are interpreted in context of the concept giving the important role in atherogenesis to vasa vasorum.

Introduction: The rapid emergence of COVID-19 as a global crisis has led to the approval of many vaccinations, which were unfortunately associated with high complication rates due to a lack of sufficient safety studies. Objectives: The following manuscript focuses on discussing the demyelinating disorders that were noticed after COVID vaccine administration. Methods: We conducted a retrospective study using anonymous medical records from the US vaccine adverse events reporting system, complications retrieved included Acute disseminated encephalomyelitis (ADEM), Guillain Barre syndrome (GBS), and Multiple sclerosis (MS), outcome parameters were age, sex and the dose after which this complication was observed. Patients younger than 18 years-old were excluded as some of the vaccines, namely Janssen (JNJ-78436735) is not yet approved below this age. Results: Our analysis showed that demyelinating disorders were more likely to occur in patients over the age of 50 compared to other age groups, regardless of the type of vaccination, except for MS and ADEM occurrences after the Jansen vaccine. In addition, demyelinating complications were more likely to occur after the first dose of vaccination. Conclusion: Further research and observation of demyelinating diseases in different vaccinations, as well as additional in vitro studies, are recommended to further explain the pathogenesis of demyelinating disorder occurrence.

In the recent days, lipid nanoparticles have been successfully emerged as one of the most advanced technology for highly efficient in vivo delivery of exogenous mRNA, especially for delivery of COVID-19 vaccines. For the vaccines to be successful or protective, they require highly efficient mRNA delivery systems. However, developing effective, translatable vaccines with better safety against some of the SARS‐CoV‐2 variants is still a challenge. Lipid nanoparticles (LNPs) are composed of four different types of lipids including ionizable lipids, helper or neutral lipids, cholesterol and polyethylene glycol (PEG) attached lipids. In this review, we present recent advancements and insights in designing the advanced LNPs and their composition and properties, with a subsequent discussion on the development of COVID-19 vaccines. In particular, as the ionizable lipids are most important drivers for complexing the mRNA and in vivo delivery, the role of ionizable lipids in mRNA vaccines discussed in detail. Furthermore, the use of LNPs as effective delivery vehicles for vaccination, genome editing, and protein replacement therapy were discussed. Finally, expert opinion of LNPs for mRNA vaccines were discussed which might address the future challenges in the development of mRNA vaccines employing highly efficient LNPs using novel set of ionizable lipids.

Introduction: Since its emergence COVID-19 has become a global health threat. In Uganda, a number of COVID-19 Standard Operating Procedures (SOPs) have been put in place by the Ministry of Health Uganda, to mitigate the outbreak of the deadly COVID-19 pandemic among the population. Despite the putting in place COVID-19 SOPs, the deadly COVID-19 pandemic is still ravaging the population of Iganga District. This study investigated the level of compliance to guidelines for prevention of COVID-19 in public places in Iganga District so as to guide decision makers in making recommendations towards the entire public in order to prevent community acquisition and spread of COVID-19. Methodology: To deliver answers to the research objectives, the study adopted a cross-sectional survey design to guide the study process. Quantitative method of data collection using observational checklist were adopted for this study. The same data abstraction form helped to collect data from 3 public places which included: 3 markets, 5 public transport stations and 8 financial banks. Compliance was measured were the YES scored 1 and NO scored 0 and the ten indicators measured included: temperature screening, wearing of face masks, hand washing or sanitizing, physical distancing of at least 2 meters, information display on COVID-19, regular cleaning of public service places, cleaning of communal places, adequate ventilation, adequate waste management facilities and cleanliness of the work area. Overall a 4 point Likert scale used was: 0-2 poor, 3-5 fair, 6-8 good, 9-10 excellent were each indicator was equally important. Data was entered, cleaned and analyzed using Microsoft Excel 2019 spread sheet packages to generate tables and bar graphs. Results: Out of 5 public transportation stations studied, 80% were observed to be poorly compliant to covid-19 SOPs. On the other hand, out of 8 Financial Banks included in this study, 75% were observed to have excellent compliance levels to COVID-19 SOPs. Meanwhile, out of 3 Market places studied, 66.7% were observed to be poorly compliant to covid-19 SOPs. Conclusion; The results of the study revealed that; public places in Iganga district generally have low level of compliance to COVID-19 SOPs in terms of temperature screening, wearing of face masks, hand washing or sanitizing, social distancing of at least 2 meters and information display on COVID-19 Dos and Don’ts. Our findings suggest that there is a need to mobilize the population in Iganga district to comply with COVID-19 SOPs in terms of temperature screening, wearing of face masks, hand washing or sanitizing, social distancing of at least 2 meters and information display on COVID-19 Dos and Don’ts.

Background: Repeated SARS-CoV-2 infections are plausible and related published data are scarce. We aimed to identify factors associated with the risk of recurrent (three episodes) laboratory-confirmed symptomatic SARS-CoV-2 infections. Methods: A retrospective cohort study was conducted and 1,700 healthcare workers were enrolled. We used risk ratios (RR) and 95% confidence intervals (CI) to evaluate factors associated with symptomatic SARS-CoV-2 infections. Results: We identified 14 participants with recurrent illness episodes. Therefore, the incidence rate was 8.5 per 10,000 person-months. In multiple model, vaccinated adults (vs. unvaccinated, RR = 1.05 [1.03 - 1.06]) and those with a severe first illness episode (vs mild disease, RR = 1.05 [1.01 - 1.10]) were at increased risk for repeated symptomatic SARS-CoV-2 reinfections. Increasing age showed a protective effect (per each additional year of age: RR = 0.98 [0.97 - 0.99]). Conclusions: Our results suggest that recurrent SARS-CoV-2 infections are rare events in adults and they seem to be determined, partially, by vaccination status and age.

Unusual outbreak of Covid 19 has put the whole new challenges around the globe. In a short span of time, the world has been changed, lifestyles, social events, cultural, political events everything has been put on hold as number of countries has enforced partial or complete lockdown that resulted positive in context of controlling spread and contamination of COVID-19. Such activities have also put some effects on environment in both positive and negative way. In this study only positive impacts of COVID-19 on Environment have been highlighted that played role in regeneration of natural systems i.e., reduced air emissions, cleaner air, beaches &water bodies, reduced noise levels, biodiversity rehabilitation etc.

Optimizing intensive care resources using predicting modeling is paramount for fighting the COVID-19 pandemic. In this paper, we model the admission of COVID-19 patients in intensive care units (ICU) in Colombia using openly available data gathered from 18 March 2020 to 14 October 2020. After an intensive preprocessing of the data, we trained four different machine learning models using four different strategies for handling the imbalanced features. Our findings show that our best model (XGBoost) effectively predicts an Area Under the Curve (AUC-ROC) of 0.94, in line with the state-of-the-art results obtained in other predictive models obtained with medical data.

Neuropsychiatric manifestations of COVID-19 include delirium, general malaise, headache, and psychiatric symptoms. These manifestations are related to the neuroinflammatory response to viral antigens and proinflammatory mediators/immune cells. Tetracyclines, such as minocycline, have antibacterial and anti-inflammatory properties. Saiko-keishi-to, a traditional Japanese Kampo medicine, also has anti-inflammatory properties. Given the anti-inflammatory properties of minocycline and Saiko-keishi-to, we describe two cases of COVID-19 with prolonged headaches and general malaise successfully treated with these medications.

Despite the availability of effective vaccines that lower mortality and morbidity associated with COVID-19, many countries including Italy adopted strict vaccination policies and mandates to increase the uptake of the COVID-19 vaccine. Such mandates have sparked debates on the freedom to choose whether or not to get vaccinated. In this study, we examined the people’s belief in vaccine choice as a predictor of willingness to get vaccinated among a sample of unvaccinated individuals in Italy. An online cross-sectional survey was conducted in Italy in May 2021. The survey collected data on respondents’ demographics and region of residence, socioeconomic factors, belief in the freedom to choose to be vaccinated or not, risk perception of contracting and transmitting the disease, previous vaccine refusal, opinion on adequacy of government measures to address the pandemic, experience in requesting and being denied government aid during the pandemic, and intent to accept COVID-19 vaccination. The analysis employed binary logistic regression models using a hierarchical model building approach to assess the association between intent to accept vaccination and belief in the freedom to choose to vaccinate, while adjusting for other variables of interest. 984 unvaccinated individuals were included in the study. Respondents who agreed that people should be free to decide whether or not to vaccinate with no restrictions on their personal life had 85% lower odds of vaccine acceptance (OR=0.15 ;95% CI,0.09,0.23) after adjusting for demographic and socioeconomic factors and their risk perception of contracting and transmitting COVID-19. Belief in the freedom to choose whether or not to accept vaccinations was a major predictor of COVID-19 vaccine acceptance among a sample of unvaccinated individuals in Italy in May 2021. This understanding of how individuals prioritize personal freedoms and the perceived benefits and risks of vaccines, when making health care decisions can inform the development of public health outreach, educational programs and messaging.

Abstract: Background: COVID-19 is a respiratory disease that eventually became pandemic with 300 million people infected around the world. Alongside the improvement in COVID-19 management and vaccine development, identifying biomarkers for COVID-19 has recently reported to help in early prediction and managing severe cases which might improve outcome. The Aim of our study was to find out if there is any correlation between clinical severity and elevated hematological and biochemical markers in Covid-19 patients and its effect on the outcome Methods: We have collected data retrospectively of socio-demographic, medical history, biomarkers, and diseases outcome from five hospitals and health institutions in the Kingdom of Saudi Arabia. Results: Pneumonia was the most common presentation of COVID 19 in our cohort. All biomarkers (D-Dimer, CRP, troponin, LDH and ferritin) except for the mean lowest white blood cells were found to have significant correlation (p<0.05) with worse COVID-19 disease outcomes. There was a sig-nificant association between the inflammatory biomarkers and the disease severity of COVID 19 patients (p<0.001). Patients with evidence of severe respiratory disease particularly who required mechanical ventilation (MV) had higher biomarkers, when compared to those with stable respiratory condition (p<0.001). Conclusion: Identifying biomarkers predicts outcome for COVID-19 patients and may significantly help in the management.

Abstract Despite the lightning-fast advances in the management of SARS-CoV after 2 years of pandemic, COVID-19 continues to pose a challenge for fragile patients, who could benefit from early administration of monoclonal antibodies (mAbs) to reduce the risk of severe disease progression. We conducted a prospective study to evaluate effectiveness of mAbs against SARS-CoV-2 among patients at risk for severe disease progression, namely elderly and those with comorbidities, before the omicron variant surge. Patients were treated with either casirivimab/imdevimab, sotrovimab, and bamlanivimab/etesevimab. The rates and risk factos for clinical worsening, hospitalization, ICU admission and death (unfavourable outcomes) were evaluated. A stratified analysis according to the presence of SARS-CoV-2 IgG was also performed. Among 185 included patients, we showed low rates of unfavorable outcomes (9.2%), which were more frequent in patients with chronic kidney disease (aOR: 10.44, 95CI: 1.73-63.03; p<0.05) and basal D-dimer serum concentrations >600 ng/ml (aOR 21.74, 95CI: 1.18-397.70; p<0.05). Patients with negative SARS-CoV-2 serology at baseline showed higher C-reactive protein values compared with patients with positive serology (p <0.05) and showed a trend toward a higher admission rate to SICU and ICU compared with patients with positive serology. Our results thus showed, in a real-life setting, the efficacy of mAbs against SARS-CoV-2 before Omicron surge when the available mabs become not effective.

Objectives: This study assessed the associations between parent intent to have their child receive COVID-19 vaccination, and demographic factors and various child activities including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged <12 years completed anonymous internet-based surveys between May 10 and September 6, 2021 to assess factors associated with intention to vaccinate their child. Factors influencing parents’ decision to have their child attend in person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents’ intentions regarding children’s COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n=4,686 [77.2%]), those undecided (n=874 [14.4%] or without intention to vaccinate (n=508 [8.4%]) tended to be younger, non-White, less educated and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17-1.95) and in-person faith or community activities (aOR:4.71 (3.62-6.11). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents’ decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents’ decision whether to vaccinate their <12-year-old children for COVID-19. Child participation in in-person activities was associated with parents’ intentions not to vaccinate. Tailored communications may be useful to inform parents’ decisions regarding safety and effectiveness of vaccination.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known globally as COVID-19, originated in December 2019 in Wuhan, Hubei province in China and has rapidly spread across the globe ever since. The first recorded case in sub-Saharan Africa was in Nigeria, on the 25th February, 2020. The virus continues to spread, and new variants of the disease have emerged, the number of deaths and new infections in the countries of sub-Saharan Africa has been relatively low compared to predictive models. This could be due to several factors, such as slower transmission dynamics of the virus, a lower-case fatality rate, or a lack of testing or reliable data. Whilst this may also, in part, be due to the robustness of the nations' public health responses, there is scarce reporting on the specifics of this. However, emerging research has demonstrated that various environmental factors could influence virus transmission. The study adopted collected meteorological data that was critically analysed and discussed. The impact of three factors in the context of sub-Saharan African nations: temperature, ultraviolet (UV) exposure and pre-existing infection with Plasmodium (malaria) were discussed. These factors were discussed critically in light of the reduced rates of transmission and mortality observed.

Uncovering the predictors of vaccine immunogenicity is essential for infection control. We have reported that the most prevalent polymorphism of the aldehyde dehydrogenase 2 (ALDH2) gene, rs671, may be associated with an attenuated immune system. To test the inverse relation between rs671 and antibody production after COVID-19 vaccination, the levels of anti-SARS-CoV-2 Spike protein S1 subunit (S1) IgG were repeatedly measured for four months before and after vaccination with BNT162b2 or mRNA-1273, in 88 Japanese workers and students (including 45 females, aged 21–56 years, with an rs671 variant allele frequency of 0.3). The mixed model including fixed effects of the vaccine type, weeks post vaccination (categorical variable), sex, age, body height, smoking status, ethanol intake, exercise habit, perceived stress, steroid use, allergic diseases, and dyslipidemia, indicated an inverse association between log-transformed anti-S1 IgG levels and the number of rs671 variant alleles (partial regression coefficient = -0.15, p = 0.002). Our study indicated for the first time that the variant allele of ALDH2, rs671, is associated with the attenuated immunogenicity of COVID-19 mRNA vaccines. Our finding may provide a basis for personalized disease prevention based on a genetic polymorphism that is prevalent among East Asians.

The Covid-19 also known as the Coronavirus is a viral disease from the SARS-CoV-2 family of virus, as at December 2019 the first case of this virus infection was identified at Wuhan, China, this seemingly isolated case soon became a global pandemic, whose effect was felt globally which also had colossal effects on both health, economic and politics . As at the time of this research about 4.5 million people have died of the Coronavirus and over 215 million people already infected by it. This pandemic stood out not just for its scale but for how social media was a major contribution to its spread as well as to curbing it. The power of social media was used to spread misinformation as well as to spread awareness on the subject, with both having massive impact on the people. In this paper we will be running a sentimental analysis on twitter under the keyword “Covid-19 and Coronavirus”, twitter is a powerful social media tool that is known for its ability to keep trends in the form of tweets, we will be drawing correlations between the peaks of tweet with the peak of infection. We will also be analyzing to know what the impact of these tweets are having on the rate of the infection and vice versa. We will also be analyzing what people are tweeting most about, what are the talking points, comparing both real time and past tweets with real time infection and death rates using deep different learning methods to access what information can be derived from it.

Since the outbreak of COVID-19, one of the strategies used to search for new drugs has been to find inhibitors of the main protease (Mpro) of virus SARS-CoV-2. Initially, previously reported inhibitors of related proteases like the main proteases of SARS-CoV and MERS-CoV were tested. Then a huge effort has been done by the scientific community to design, synthesize and test new small molecules acting as inactivators of SARS-CoV-2 Mpro. From the structure view, these compounds can be classified into two main groups: one corresponds to modified peptides displaying an adequate sequence for high affinity and a reactive warhead, and the second one is a diverse group including chemical compounds which do not have a peptide framework. Although a drug including a SARS-CoV-2 main protease has already been commercialized, denoting the importance of this field, more compounds have been demonstrated to be promising potent inhibitors as potential antiviral drugs.

COVID-19, a global health crisis, occurred unexpectedly and has led to global transformation over all countries in the world today. While COVID-19 had claimed lives and led to an economic crisis, the impacts on the financial market cannot be overemphasized. Considering the previous financial crisis, which occurred due to poor regulations and unchecked misconduct by financial market stakeholders, COVID-19 is the first to mention an indirect crisis that almost has no direct relationship to the financial system. Thus, this paper explores the impacts of COVID-19 from a stochastic approach on Local markets by applying the GARCH model to measure the level of volatility of two (2) US stock indexes (NASDAQ and NYSE) and a Europe index (EURONEXT). Our results show that volatility existed before COVID-19, but the volatility rate increased after COVID-19, possibly due to the COVID-19 shock. We also explore the Markov-Switching Dynamic Regression (MSDR) model to corroborate our findings. We validated that there is a very high persistent volatility for all the considered local markets at the early stage COVID-19 period.

(1)Background: When the COVID-19 pandemic arrived, changes had to be made to several management aspects at our Pediatric Oncology Center. We investigated how the families per-ceived these changes. (2) Methods: Two questionnaires were developed at the Pediatric Oncology Unit of the Istituto Nazionale dei Tumori in Milan, to explore how the pandemic has affected the experience of patients who had been or were being treated at our hospital, and their families. These were administered to three samples of individuals. (3) Results: Between July and October 2020, 120 questionnaires were administered to parents of patients. The impact of school closures and the impossibility of attending sports and social activities outside the hospital were regarded as im-portant. 77.5% of parents judged the social distancing to have affected their children. Regarding the changes introduced in the management of the ward and outpatient clinic, most parents’ opinions were positive. Differences in the opinions expressed by Groups 2 and 3 were statistically significant on the topic of relationships on the ward and staff workload. The aspect most negatively affected by the pandemic was the support that patients’ parents were able to give each other. Regardless of whether patients were treated before the pandemic or after the first lockdown, their parents of all indicated a strong degree of satisfaction with the care received, and with the organizational ar-rangements. (4) Conclusions: The results of our study point us in the right direction to further improve our daily work and better respond to the needs of our patients and their families.

Purpose: To evaluate nursing leaders' perception towards communication and relationship management competencies while using digital platforms during the COVID-19 pandemic. Background: Communication and relationship management competencies among nursing leaders will ensure healthcare models are successfully implemented. Nursing leaders can achieve effective leadership by mastering these competencies leading to an overall improvement in the quality of nursing care. However, digital platforms have been rapidly evolving in the healthcare ecosystem and have been significant during the battle with COVID-19. It is crucial to ensure that nursing leaders can use digital platforms to communicate and practice efficient management in their op-erations, especially during a crisis when their services are vital. Design: Descriptive, comparative study. Methods: The study was conducted between February to March 2021. A 5-item Linkert-type questionnaire was adopted from the American Organization for Nursing Executives (2005) and was sent to identified nursing leaders in Hamad Medical Corporation through the official email. Results: Two hundred fifty nurse leaders were invited to participate, but only 116 responded positively, translating to a response rate of 46.4%. The male participants represented a larger proportion of 64.10%, while the female was 35.90%. Regarding the questionnaire, the Cronbach alpha was α ˃ 0.987, indicating that all items revealed a sufficient level of internal consistency. The respondents had a minimum of 0 and a maximum of 52.6n in the communication and relationship management items. Influencing behavior, relationship management, and effective communica-tion had the lowest scores, which indicate low competency. The F value in ANOVA analysis was close to 1.0, implying that the null hypothesis is true. The significance value is <0.5 implying that there is a difference in response on effective communication proficiency of nurse leaders. Conclusions: Digital platforms are communication tools that are widely adopted to engage and reach nurses on numerous topics. Nurse leaders should capitalize on their benefits and generate critical discussions. The continued need to research nursing leadership competencies is critical as healthcare continues to change and evolve. Educational institutions and healthcare organizations must understand that nursing leaders should strive for professional development and knowledge acquisition to improve their communication and management.

Although, severe acute respiratory syndrome coronavirus – 2 (SARS-CoV 2) represents one of the biggest challenges in the world today, the exact immunopathogenic mechanism that leads to severe or critical Coronavirus Disease 2019 (COVID-19) has remained incompletely understood. Several studies have indicated that high systemic plasma levels of inflammatory cytokines result in the so-called “cytokine storm”, with subsequent development of microthrombosis, disseminated intravascular coagulation, and multiorgan-failure. Therefore, we reasoned that elevated inflammatory cytokine might act as prognostic factors. Here, we analyzed 245 serum samples of patients with COVID-19, collected at hospital admission. We assessed the levels of heat shock protein 27 (HSP27), soluble suppressor of tumorigenicity- 2 (sST2), caspase cleaved cytokeratin 18 (cCK18), 20S proteasome, and tumor necrosis factor receptor 1 (TNFR-1) and explored their associations with overall-, 30-, 60-, 90-day- and in-hospital mortality. Moreover, we investigated their association with the risk of ventilation. We demonstrated that increased serum sST2 was uni- and multivariably associated with all endpoints. However, we also identified 20S proteasome as independent prognostic factor for in-hospital mortality. Furthermore, elevated HSP27, sST2, and 20S proteasome levels at hospital admission were univariably associated with higher risk of invasive ventilation. These findings could help to identify high-risk patients early in the course of COVID-19.

Emerging information on the interactions between the COVID-19 pandemic and global food systems has highlighted how the pandemic is accentuating food crises across Africa. Less clear, however, are how the impacts differ between farming systems. Drawing on 50 key informant interviews with farmers, village leaders and extension officers, in South Africa and Tanzania, we identify the effects of COVID-19 and associated measures to curb the spread of the disease on farming production systems, the coping mechanisms adopted by farmers, and explore their longer-term plans for adaptation. We focus on a diverse range of production systems, from small-scale mixed farming systems in Tanzania, to large-scale corporate farms in South Africa. Our findings highlight how COVID-19 restrictions have interrupted the supply chains of agricultural inputs and commodities, increasing the storage time for produce, decreasing income and purchasing power, and reducing labour availability. Farmers’ responses were heterogeneous, with highly diverse small-scale farming systems and those less engaged with international markets least affected by the associated COVID-19 measures. Large-scale farmers were most able to access capital to buffer short-term impacts, whereas smaller-scale farms shared labour, diversified to subsistence produce and sold assets. However, compounded shocks, such as recent extreme climate events, limited the available coping options, particularly for smaller-scale and emerging farmers. The study highlights the need to understand the characteristics of farm systems to better equip and support farmers, particularly in contexts of uncertainty. We propose that policy actions should focus on (i) providing temporary relief and social support and protection to financially vulnerable stakeholders, (ii) job assurance for farmworkers, and engaging an alternative workforce in farming, (iii) investing in farming infrastructure, such as storage facilities, digital communication tools, and extension services, and iv) supporting diversified agroecological farming systems.

Currently available COVID-19 mRNA vaccines have demonstrated high efficacy in clinical trials.1-3 However, cancer patients, including those with hematological malignancies, were largely excluded from these trials. In this prospective, observational study we measured anti-S protein IgG titers as well as avidity in lymphoma patients (n=67) vaccinated with a COVID-19 mRNA vaccine. Serological response rates in lymphoma patients who were treatment naïve (100% in CLL, 88.9% in other, non-CLL non-Hodgkin lymphoma patients), or who were last treated more than 24 months prior to vaccination (100% in CLL, 90% in other-NHL), were similar to healthy controls (100%). Patients on active therapy, however, had a diminished response rate (40% in CLL, 21.0% in other-NHL). No patient who received anti-CD20 monoclonal antibodies (mAb) within six months of vaccination responded. Thus, the utility of testing anti-S titers should be explored in patients on active therapy or with recent anti-CD20 mAb exposure, to assess their response to vaccination. We also propose studying passive protection with S-protein mAbs as an alternative prophylactic strategy for patients who respond poorly to vaccination.

Background: In the current era of globalization, the Indonesian government's problem today is the weakening of nationalism and patriotism among the millennial generation. The large number of foreign cultures that have entered Indonesia has caused a sense of nationalism and patriotism. In addition, Indonesia is also facing the problem of spreading the Covid-19 virus. During the pandemic, various policies set by the government received protests from some circles because they felt their freedom was restricted. Therefore, the awareness of millennial generation nationalism is needed, especially during the Covid-19 pandemic like today. This research aims to make millennials aware of nationalism sense, which mainly to prevent the spread of Covid-19. This research is used to answer the questions of what the problems that arise due to the waning of the spirit of nationalism during the pandemic are? and what efforts should be made to maintain the spirit of nationalism? Methods: This research is a qualitative study using the literature review method. The articles used are research published in 2019 to 2021 in Google Scholar, with keywords that match the topic of millennial generation nationalism in the Covid-19 pandemic. Results and Discussion: The results of the study found that the spirit of Indonesian nationalism during the Covid-19 pandemic was decreasing. The decline in the sense of nationalism is due to several government policies that impact the psychology of society and the Indonesian economy. As a result, society, particularly the millennial generation, must play a role in breaking the chain of the Covid-19 virus's propagation by following the government's health standards. Conclusion: The government and society need to work together to understand nationalism in the millennial generation, especially in dealing with problems caused by the Covid-19 pandemic. Based on this, various efforts need to be made to foster the spirit of nationalism and overcome the Covid-19 pandemic. So that later, it can produce a generation that upholds the value of nationalism in everyday life.

Poverty is one of the indexes that can see how a country succeeds in development. In Indonesia, the poverty rate is high as the impact of the Covid-19 pandemic increases over time. Therefore, a solution is embraced in the form of government policies in tackling poverty in Indonesia. The purpose of this study is to analyze the poverty caused by the Covid-19 pandemic.What is the current state of poverty caused by the Covid-19 pandemic in Indonesia? and what are the previous government policies that have succeeded in reducing poverty in Indonesia? The method used in this study is the literature review method based on the results of critical analysis of journal articles that are relevant to the topic of discussion. The results showed that three government policies have succeeded in lowering the poverty level in Indonesia, namely the PKH program policy, the zakat policy as an indicator of poverty reduction, and the Bank Wakaf Mikro policy. Therefore, this study focuses on the policy as a study for government policy in lowering poverty levels due to the Covid-19 Pandemic.

The situation in the world of pandemics is rapidly changing, and the second wave of COVID-19 has put a lot of pressure on the government and private sector, which are primarily responsible for controlling the situation. COVID-19 positive cases have increased in recent months relative to last year, and the number of patients admitted to hospitals has also increased, despite the fact that few of them were denied admission due to shortage of beds. Normal people who experience any symptoms immediately isolate themselves and begin taking the COVID medications prescribed by medical personnel and their team. During these times, all domestic people tossed the wrappers and boxes of medicines into the regular trash can, and the waste was handed over to the waste collector, who treated it like any other domestic waste and disposed of it using open dumping or other methods. The goal of this perspective is to suggest the collections of these types of waste from domestics, and protect the natural resources like water, soil, and even living beings like animals from pollution (from the effect of SARS-CoV-2). The main challenge for environmental waste management agencies is determining who has COVID positive and which houses generate these types of waste; thus, proposed strategy may be beneficial to the long-term sustainability of natural resources and animals.

Objective In this study, we aim to synthesize some evidence on the impacts that COVID-19 is having on the epidemiology of Antimicrobial Resistance (AMR) in Africa since it was declared global pandemic by WHO in March 2020. Methodology A scoping review was undertaken by collecting and curating relevant resources from peer-reviewed articles and also from the gray literature. Mixed approaches of extracting data (qualitative and quantitative) were employed in synthesizing evidence, as suggested by Health Evidence Network (HEN). Findings A model constructed based on the synthesis of early evidences available on the effects of factors linked to COVID-19 in impacting the evolution of AMR in Africa predicted that, in cumulative terms, those factors favoring the evolution of AMR outpace those disfavoring it by no less than three folds. Conclusion COVID-19 is fueling the evolution of AMR almost unhindered in Africa. Due recognition of this crisis, concerted efforts for resource mobilization and global cooperation are needed to tackle it.

This is break direction on oxygen sources and conveyance methodologies for COVID-19 treatment. It has been adjusted from WHO and UNICEF's specialized details and direction for oxygen treatment gadgets, which is important for the WHO clinical gadget specialized arrangement, 1 and depends on current information on the circumstance in China and different nations where cases have been distinguished. This direction is proposed for wellbeing office chairmen, clinical leaders, acquisition officials, arranging officials, biomedical architects, foundation engineers and strategy producers. It portrays how to: measure oxygen interest, to distinguish oxygen sources that are accessible, and select suitable flood sources to best react to COVID-19 patients' requirements, particularly in low-and-center pay nations. WHO will refresh these suggestions as new data opens up. Coronavirus pandemic spurred fake interest for oxygen gas chambers for clinical use - both at emergency clinics and inquisitively, for home use by patients. A few patients and surprisingly sound people investigate the conceivable outcomes and likely benefits of utilizing oxygen from chambers for private utilization. Be that as it may, this isn't continuously protected, and sufficient safety measures are to be taken, bombing which there can be fatalities. This paper investigates the significance of keeping up satisfactory degrees of oxygen levels appropriate for human utilization. It advises the clinical use and the advantages and disadvantages of putting away oxygen chambers at home. The investigation likewise addresses lawful and administrative perspectives. The investigation's discoveries can help people settle on an educated choice on the protected use regarding oxygen gas. Further, it cautions on the expanded significance of guidelines and limiting access and use. This paper aims at designing an oxygen level monitoring technique in an oxygen cylinder. The amount of oxygen present inside the oxygen cylinder is very vital information when such cylinder is in use for supply of oxygen to a critical patient. The amount of oxygen present inside the cylinder is measured by the pressure at the outlet nozzle. The pressure is measured using a high precision MEMS Pressure Sensor. The output of the MEMS pressure sensor is voltage of the order milli. An amplifier is used to amplify this milli volt signal. A microcontroller is used in cascade to process the signal and display the pressure of oxygen cylinder.

The novel coronavirus has had the world on halt for a few months now. Changes in lifestyles have become a part and parcel of our daily lives, especially for students. With new teaching practices undertaken, new reforms are being made from students in kindergarten to college. This paper presents insights on the changing learning habits of Indian students due to the hit of novel coronavirus (COVID-19). A total of 648 students from various institutes took part in the survey by responding to the questionnaires on time spent by them both for online and offline studies and others asked in closed format options. The insights are derived by comparing the performance of students based on their institute types, hours spent on self-study as well as the assistance provided by the colleges. The overall confidence in particular subjects by the end of the semester is being determined as the end result.

Background: The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) represents a major threat to human health, which impairs the functionality of several organs. One of the hardest challenges in the fight against COVID-19 is the development of wide-scale, effective, and rapid laboratory tests to control disease severity, progression, and possible sudden worsening. Monitoring patients in real-time is indeed highly demanded in this pandemic era when physicians need reliable and quantitative tools to prioritize patients’ access to intensive care departments. In this regard, salivary biomarkers are extremely promising, as they allow for a fast and non-invasive specimens’ collection, which can be repeated multiple times. Methods: We compare salivary levels of immunoglobulin A subclasses (IgA1 and IgA2) and free-light chains (FLC k and λ) in a cohort of 29 SARS-CoV-2 patients and 21 healthy subjects. Results: We found that each biomarkers differs significantly between the two groups, with p-values ranging from 10-8 to 10-4. The performance ranking of these markers, shows that λFLC level (p=1.4e-8) is the best-suited candidate to discriminate the two groups, with an accuracy of 0.94 (0.87-1.00 95% CI), a precision of 0.91 (0.81-1.00 95% CI), a sensitivity of 1.00 (0.96-1.00 95% CI) and a specificity of 0.86 (0.70-1.00 95% CI). Conclusion: These results suggest λFLC as an ideal indicator of patient conditions. This is more strengthened in consideration that λFLC half-life (approximately 6 hours) is significantly shorter than the IgA one (21 days): thus λFLC appears displaying the potential to effectively monitor patients fluctuation in real-time.

Work-life after COVID-19 might never be the same again. After an economic crisis due to the pandemic, the Indonesian government is applying large-scale social restriction relaxation to allow companies to reopen. However, just after a few weeks of social relaxation, new clusters from offices are occurring. With many employees infected with COVID 19, concerns arise among employers; when is the best time for employees to get back to work after COVID-19 infection? This paper provides a general guideline to discontinue isolation in people with suspected or confirmed COVID-19 infection in non-healthcare establishments. According to the newest available evidence, commencing back to work should refer to a symptom-based strategy rather than a test-based strategy. In all circumstances, universal health protocol should be practiced at all times to minimize widespread transmission.

The SARS-CoV-2 pandemic has resulted in the generation of evolutionary-related variants. The S-protein of the B.1.1.7 variant (deletion N-terminal domain (NTD) His69Val70Tyr144) may contribute to altered infectivity. These mutations may have been presaged by animal mutations in minks housed in mink farms that according to the present analysis by modelling of protein ligand docking altered a high affinity binding site in the S-protein NTD. These mutants likely occurred only sporadically in humans. Tissue-adaptations and the size of the mink relative to the infected human population size back then may have comparatively increased the relative mutation rate. Simple, multi-threaded automated docking that is widely available, assigns increased binding of the blood type II A antigen to the SARS-Cov-2 S-protein NTD of B.1.1.7 with an overall increased docking interaction of blood group A harbouring glycolipids relative to group B or H (H, p=0.04). The top scoring glycan is identified as a DSGG (also classified as sialosyl-MSGG or disialosyl-Gb5) that may compete with heparin, which is similar to heparan sulfate linked to proteinaceous receptors on the tissue surface. Other glycolipids are found to interact with lower affinity, except long ligands that have suitable ligand binding poses to match the curved binding pocket.

In 2020, the world was plagued with COVID-19 which was first identified in Wuhan, China in November 2019. During the early phase of the pandemic with no known treatment and WHO-approved vaccines, most government and public health officials were pushing for non-pharmaceutical intervention in trying to curb the spread of COVID-19. One such intervention is the restriction on movement to reduce social mixing. However, the economic cost of locking down cities especially in developing countries is unbearable as most of these countries are running economies that were on life support before the COVID-19 pandemic. We analyze the daily COVID-19 cases in Ghana to evaluate whether there was a significant change in transmission of COVID-19 after the partial lockdown of the two main cities (Kumasi and Accra) was lifted. The results showed that there was no increase in the transmissibility of COVID-19 after the partial lockdown was lifted. Contrary to the expectation that transmissibility will increase after lifting the partial lockdown, there was a reduction of the time-dependent reproduction ratio from 3.17 to 1.23.

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

As medical schools cope with the consequences of the COVID-19 pandemic, a new cohort of students will be admitted in the fall. Administrators are again challenged to make unprecedented enrollment decisions without standardized exams. This challenge provides unique opportunities to support holistic admissions but also abruptly bypasses a process that has been employed since 1928. This article highlights key factors that are being considered during current medical school admission cycles, including limited opportunities to take standardized exams, heightened student anxiety, and potential exam alternatives. These factors are framed and discussed within the context of the medical college admission test (MCAT) exam.

Study objective Since December 2019, the coronavirus disease (COVID-19) pandemic has caused over a million deaths and resulted in adverse socio-economic impacts worldwide. However, predictability and prognostication of clinical features vary among different populations. Methods We search PubMed, EMBASE, Cochrane Library, Google Scholar, and WHO Global Health Library from December 2019 to April 2020 for studies reporting the risk factors, clinical features, and outcomes. The random-effect models for transformed prevalence (single-arm) or bivariate random-effect models (sensitivity and specificity) for correlated performance indicators. Results Among the 189 included studies representing 53,659 patients, the most sensitive predictor for COVID-19 infection was fever in adults (83%, 95% confidence interval [CI]:73–90%), and the most specific predictor was fatigue (96%, 95% CI: 80–99%). Fever was the most sensitive symptom in predicting the severity (89%, 95% CI:83–92%), followed by cough (71%, 95% CI:63–78%). The most specific predictor of severe COVID-19 was a chronic obstructive pulmonary disease (99%, 95% CI:98–99%). The stage of the outbreak and age significantly affect the prevalence of fever, fatigue, cough, and dyspnea. Fever, cough, fatigue, hypertension, and diabetes mellitus combined have a 3.06 positive likelihood ratio (PLR) and a 0.59 negative likelihood ratio (NLR) in the diagnosis. Additionally, fever, cough, sputum production, myalgia, fatigue, and dyspnea combined have a 10.44 PLR and a 0.16 NLR in predicting severe COVID-19. Conclusions Understanding the different distribution of predictors essential for screening potential COVID-19 infection and severe outcomes and the combination of symptoms could improve the pre-test probability.

Infection control among patients is critical for diseases like COVID-19. The concentration of patients in a few facilities burdens healthcare providers and the healthcare system. This study examined the operations of an extended anteroom in a dedicated COVID-19 hospital. It presents issues to consider in the deployment and operation of an extended anteroom through discussions by expert working groups. The subjects covered included efficient space, staffing, equipment management, and education. The process involved wearing personal protective equipment (PPE; in this case, Level D), and if necessary, wearing additional powered air purification respirators (PAPR), after moving from the preparation room to the dressing room, and when entering the hospital through the entrance passage. When leaving the hospital, personnel used a mandatory exit-only passage; in the dressing room, they undressed, and then went outside, in this order. The efficient spatial composition of the anteroom facilitated entry and exit and the separation of contaminated areas and non-contaminated areas using colors and lines. It is necessary to develop operational guidelines for hospitals that treat infectious diseases and conduct research to improve care. The study indicated the need to develop educational programs and use educational simulations to address regionally spread infectious diseases

This paper provides a framework for the assessment of household-level risk, incorporating both a individual social risk perspective and a location-based perspective. We use this framework as a heuristic to explore the effect of social reintegration choices individuals face, which are not be addressed by current policies. For example, we explore how integrating extended family households during COVID-19 without social distancing may affect household and community risk. The goal is to aid individual decision makers, who are seeking to maintain quality-of-life while navigating local policy, with nuance relating to location-specific behavior and disease prevalence.

Introduction: COVID-19 pandemic has affected HCPs in multiple way. It has caused psychological impact in form of anxiety, depression, and insomnia. In this study, we aim to study and compare the stress level, anxiety and depression among HCPs who are posted in special COVID-19 units with the HCPs who are not posted in COVID-19 units.Methods: This cross-sectional study was conducted in June 2020, at various hospitals of Karachi, Pakistan. All health care professionals (HCPs) were invited to participate. A total of 301 HCPs completed this study, who were divided into two groups; those who are posted in COVID-19 ward (Group A) and those who are not (Group B). Psychological Impact was English version of the Depression Anxiety Stress Scale - 21 (DASS-21).Results: In Group A, 70.5% had moderate, severe, or extremely severe depression compared to 49.2% in group B. In Group A, 75.4% had moderate, severe, or extremely severe anxiety compared to 44.7% in group B. In Group A, 80.3% had moderate, severe or extremely severe stress compared to 54.2% in group B. Anxiety, depression and stress were significantly higher in HCPs who were posted in COVID-19 ward compared to those who were not posted in COVID-19 wardConclusion: There was significantly higher anxiety, stress and depression in health care professionals posted in COVID-19 ward. Both the government and health care agencies should take responsibility for protecting the psychological well-being of health care communities all over the world and ensuring a healthy work environment.

As we embrace the new normal in the aftermath of Covid-19, the year 2020 also marks the decade of action as we start the 10-year countdown to achieving the Sustainable Development Goals (SDGs) by 2030. In this paper, we attempt to explore the extent to which the hardly won development gains over the last years could be reversed due to the unfolding COVID-19 global pandemic, how do we reboot the global response to accelerate the SDGs in times of uncertainties, and most importantly how to turn the recovery into an opportunity to build back better and more resilient economies. To do so, we examine the case of blockchain as one of the emerging innovative work-streams in development practices that could lead the way forward and pave the path for new developmental narratives as we all navigate the uncharted territories of the new digital age.

Background: Coronavirus disease (COVID-19) has caused more than 745,000 deaths worldwide. Vitamin D has been identified as a potential strategy to prevent or treat this disease. The purpose of the study was to measure vitamin D at hospital admission of COVID-19; Methods: We included critically ill patients with the polymerase chain reaction positive test for COVID-19, from March to April, 2020. Statistical significance was defined as P &lt; .05. All tests were 2-tailed; Results: A total of 35 patients (median age, 60 years; 26 [74.3%] male) were included. Vitamin D levels were categorized as deficient for 14 participants (40%). Vitamin D deficiency was associated with vitamin A (P= 0.003) and Zinc (P= 0.019) deficiency and lower levels of albumin (P= 0.026) and prealbumin (P= 0.009). Overall, none of the studied variables were associated with vitamin D status: mortality, intensive care unit (ICU) or hospital stay, necessity of vasoactive agents, intubation, prone position, C reactive protein (CRP), Dimer-D, Interleukin 6 levels (IL-6), ferritin levels, or bacterial superinfection; Conclusions: In this single-center, retrospective cohort study, deficient vitamin D status was found in 40% in COVID-19 critically ill patients. However, deficient vitamin D status was not associated with inflammation or outcome.

Proteases catalyse irreversible posttranslational modifications that often alter a biological function of the substrate. The protease dipeptidyl peptidase 4 (DPP4) is a pharmacological target in type 2 diabetes therapy primarily because it inactivates glucagon-like protein-1. DPP4 also has roles in steatosis, insulin resistance, cancers and inflammatory and fibrotic diseases. In addition, DPP4 binds to the spike protein of MERS virus, causing it to be the human cell surface receptor for that virus. DPP4 has been identified as a potential binding target of SARS-CoV-2 spike protein, so this question requires experimental investigation. Understanding protein structure and function requires reliable protocols for production and purification. We developed such strategies for baculovirus generated soluble recombinant human DPP4 (residues 29-766) produced in insect cells. Purification used differential ammonium sulfate precipitation, hydrophobic interaction chromatography, dye affinity chromatography in series with immobilised metal affinity chromatography, and ion exchange chromatography. The binding affinities of DPP4 to the SARS-CoV-2 full-length spike protein and its receptor binding domain (RBD) were measured using surface plasmon resonance. This optimised DPP4 purification procedure yielded 1 to 1.8 mg of pure fully active soluble DPP4 protein per litre of insect cell culture with specific activity >30 U/mg, indicative of high purity. No specific binding between DPP4 and CoV-2 spike protein was detected. In summary, a procedure for high purity high yield soluble human DPP4 was achieved and used to show that, unlike MERS, SARS-CoV-2 does not bind human DPP4.

Susceptible, infective, recovered, and hospitalized/isolated individuals are placed on the cells of a nxn square lattice, where each cell is occupied by a single individual or is vacant. At discrete time units (typically one day each) all susceptibles and infectives execute a random movement and when a coincidence of the two types occurs the susceptible is converted to infective status according to some probability. Infectives are labelled by the number of days since originally infected. At each time increment the age label of the infectives is increased by one unit. When the label reaches a number like 15 or 20 days the susceptibles recover with some probability or become isolated/hospitalized. Upon reaching some age the latter types either recover or die. Probabilities for the movements and conversions from one status to another are implemented by random numbergeneration. Simulations were carried out to investigate the effect of several probability and age parameters, the size of population (proportional to nxn) and density (related to fraction of occupied cells), and the size of the movements. Mid-term gradual conversion of susceptibles to isolated was explored as intervention policy.

Background: The COVID-19 has put global health institutions on alert. Organizations such as the CDC and WHO have developed preparedness and prevention checklist of 2019-nCoV infection to be used by public and healthcare professionals. Since COVID 19 pandemic is unexpected and no country aware of it prior to outbreak, there is limited information on the overall preparations of healthcare providers in Ethiopia. Therefore, the aim of this study was to assess early healthcare professionals’ preparedness and response to COVID 19 Pandemic in Oromia regional state, Ethiopia. Methods: The study was conducted on healthcare professionals working in public hospitals of Oromia regional state. The study was carried out by online questionnaire prepared using SurveyMonkey©. The collected data was analyzed and One-way ANOVA was used to determine the significant differences between health professionals working in different hospitals. The statistical significance associations of variables of interest was determined at 95% confidence intervals. Results: Healthcare professionals in the public hospitals of Oromia regional state, Ethiopia perceived that they are not yet well prepared and may not respond to the pandemic quickly and efficiently. Even though, they have positive response towards identifying signs and symptoms, provide education and utilization of PPE, they are still lacking in practical responses like managing cases, implementing emergency plans and isolation procedures from many others. Conclusion: As the Federal Ministry of Health, Ethiopia Public health institute and Oromia health bureau are vigilant and continually conducting preventive measures programs, extensive and maximum effort should be done to improve healthcare providers’ preparedness and response towards any emergency related to COVID-19 pandemic.

Results: A total of 6270 individuals were assessed (1615 severe and 4655 non-severe patients). The median age was 63 (95% CI: 49-74) and 47 (95% CI: 19-63) years in the severe and non-severe groups, respectively. Moreover, about 41% of patients had comorbidities. Severity was higher in patients with history of cerebrovascular disease: OR 4.85 (95% CI: 3.11-7.57). The odds of being in severe group increase by 4.81(95% CI: 3.43-6.74) for history of cardiovascular disease (CVD). This was 4.19 (95% CI: 2.84-6.19) for chronic lung disease and 3.18, 95% CI: 2.09-4.82 for cancer .The odds ratio of a diabetes and hypertension were 2.61 (95% CI: 2.02-3.3), and 2.37( 95% CI: 1.80-3.13) respectively.

BACKGROUND: From March to April 2020, Spain was the center of the SARS-CoV-2 pandemic, particularly Madrid with approximately 30% of the cases in Spain. The aim of this study is to report the suspected serious adverse drug reactions (SADRs) in COVID-19 patients versus non-COVID-19 patients detected by the prospective pharmacovigilance program based on automatic laboratory signals (ALSs) in the hospital (PPLSH) during that period. We also compared the results with the suspected SADRs detected during the same period for 2019. METHODS: All ALSs that reflected potential SADRs (including neutropenia, pancytopenia, thrombocytopenia, anemia, eosinophilia, leukocytes in cerebrospinal fluid, hepatitis, pancreatitis, acute kidney injury, rhabdomyolysis and hyponatremia were prospectively monitored in hospitalized patients during the study periods. We analyzed the incidence and the distribution of causative drugs for the COVID-19 patients. RESULTS: The incidence rate of SADRs detected in the COVID-19 patients was 760.63 (95% CI 707.89–816.01) per 10,000 patients, 4.75-fold higher than the SADR rate for non-COVID-19 patients (160.15 per 10,000 patients,95% CI 137.09–186.80), and 5.84-fold higher than the SADR rate detected for the same period in 2019 (130.19 per 10,000 patients, 95% CI 109.53–154.36). The most frequently related drugs were tocilizumab (59.84%), dexketoprofen (13.93%), azithromycin (8.43%), lopinavir-ritonavir (7.35%), dexamethasone (7.62%), and chloroquine/hydroxychloroquine (6.91%). CONCLUSIONS: The incidence rate of SADRs detected by the PPSLH in patients with COVID-19 was 4.75-fold higher than that of the non-COVID-19 patients. Caution is recommended when using medications for COVID-19 patients, especially drugs that are hepatotoxic, myotoxic, and those that induce thromboembolic events.

Background: The current coronavirus disease 2019 (COVID-19) is spreading globally at an accelerated rate. There is some previous evidence that weather may influence the incidence of COVID-19 infection. We assessed the role of meteorological factors including temperature (T) and relative humidity (RH) considering the concentrations of two air pollutants, inhalable coarse particles (PM10) and nitrogen dioxide (NO2) in the incidence of COVID-19 infections in Finland, located in arctic-subarctic climatic zone. Methods: We retrieved daily counts of COVID-19 in Finland from Jan 1 to May 31, 2020, nationwide and separately for all 21 hospital districts across the country. The meteorological and air quality data were from the monitoring stations nearest to the central district hospital. A quasi-Poisson generalized additional model (GAM) was fitted to estimate the associations between district-specific meteorological factors and the daily counts of COVID-19 during the study period. Sensitivity analyses were conducted to test the robustness of the results. Results: The incidence rate of COVID-19 gradually increased until a peak around April 6 and then decreased. There were no associations between daily temperature and incidence rate of COVID-19. Daily average RH was negatively associated with daily incidence rate of COVID-19 in two hospital districts located inland. No such association was found nationwide. The sensitivity analyses indicate the results are robust. Conclusions: Weather conditions, such as air temperature and relative humidity, may not be important factors affecting the COVID-19 incidence in the arctic and subarctic winter and spring. More evidence is needed on the associations between weather and COVID-19 during different seasons.

In the advent of COVID-19 pandemic, testing is highly essential to be able to isolate, treat infected persons, and finally curb transmission of this infectious respiratory disease. Group testing has been used previously for various infectious diseases and recently reported for large-scale population testing of COVID-19. However, possible sample dilution as a result of large pool sizes has been reported, limiting testing methods’ detection sensitivity. Moreover, the need to sample all individuals prior to pooling overburden the limited resources such as test kits. An alternative proposed strategy where test is performed on pooled samples from individuals representing different households is presented here. This strategy intends to improve group testing method through the reduction in the number of samples collected and pooled during large-scale population testing. Moreover, it introduces database system which enables continuous monitoring of the population’s virus exposure for better decision making.

The COVID-19 pandemic plagues the whole world, bringing numerous challenges which need to be addressed. One of them is the privacy of patient data. There are several problems related to data privacy in IoT environments, the use of applications, devices, and functionalities in hospital processes. Therefore, we have compared works from the literature and developed a taxonomy consisting of the requirements necessary to control patient privacy data in a hospital setting in the current pandemic. Based on the studies, an application was modeled and implemented. According to the tests and comparisons drawn between the variables, the application yielded satisfactory results.

The novel Coronavirus (COVID-19) is spreading and has caused a large-scale infection in China since December 2019. Thefirst infected person was declared on March 18, 2020 in Djibouti. This has led to a signicant impact on the lives and economy in Djibouti and other countries. In this study, we propose a double compartment stochastic model which describes the evolution of the infection rate and the evolution of the number of infected in the period from May 20 to June 23, 2020. We will also propose the evolution of people infected in two states, recovered and deceased.

To evaluate the dependency of COVID-19 on the temperature, by analyzing secondary data, considering temperature as the only dependent environmental factor. Taking the mean temperature and number of cases from 02nd March to 26th May 2020. We find out the relationship between the number of cases of COVID-19 and mean temperature in Rajasthan by finding the mean and percentage increase of both, and we evaluate that there is no any effect of temperature on coronavirus disease cases in Rajasthan there may be some other environmental factor and extraneous factors which may affect the number of cases.

The new coronavirus outbreak (COVID-19) has swept the world since December 2019 posing a global threat to all countries and communities on the planet. Information about the outbreak has been rapidly spreading on different social media platforms in unprecedented level. As it continues to spread in different countries, people tend to increasingly share information and stay up-to-date with the latest news. It is crucial to capture the discussions and conversations happening on social media to better understand human behavior during pandemics and alter possible strategies to combat the pandemic. In this work, we analyze the Arabic content of Twitter to capture the main discussed topics among Arabic users. We utilize Non-negative Matrix Factorization (NMF) to discover main issues and topics based on a dataset of Arabic tweets from early January to the end of April, and identify the most frequent unigrams, bigrams, and trigrams of the tweets. The final discovered topics are then presented and discussed which can be roughly classified into COVID-19 origin topics, prevention measures in different Arabic countries, prayers and supplications, news and reports, and finally topics related to preventing the spread of the disease such as curfew and quarantine. To our best knowledge, this is the first work addressing the issue of detecting COVID-19 related topics from Arabic tweets.

The issue of when and how to return to business following COVID-19 lockdown is occupying the minds of policymakers, C-Suite executives and managers the world over. We are concerned by the extent to which it appears that these decisions are being taken on a wing and a prayer, while being pitched to the public as though they shouldn’t be questioned. In this paper, we compare the likely impact of COVID-19 infections from travellers coming from the main countries that visit Greece, to the revenues they generate for the Greek economy. We find that arrivals from some countries should be excluded but aren't, while arrivals from other countries that are excluded perhaps shouldn't be. We show that a rational choice around limitations on the reopening of tourist markets depends on the demand for travel to Greece. We conclude that the current policy is largely economically rational, with some exceptions, but also speculate that Greece may not be ready to handle the resulting infection load.

The detection of SARS-Cov-2 in the sewage and water resources has increased the awareness among the people about the possibility survival of SARS-Cov-2 in the environment and the potential to transmit into the human through food chain or water resources. Moreover, the surface contaminated by the virus need to be disinfected frequently by using an effective disinfectant, the current chapter discussed the efficiency of the most traditional treatment process of the sewage and wastewater, and their role in the elimination of the virus as well as the sterility assurance level concept. Moreover, the chemical disinfectant used currently and their temporary efficiency has been reviewed.

The COVID-19 pandemic has obliged Governments all around the world to take confinement and social 13 distancing measures. The reduction of leisure and production activities on beaches and ports have 14 disappeared direct and indirect contamination such as plastics, hydrocarbon spill, microbiological loads, 15 noise level, etc. leading to temporary improved environmental conditions, converting the beaches 16 similar to Marine Protected Areas. Some conditions are briefly analyzed through local surveys and in situ 17 observations in the popular beaches and ports of Salinas, Manta and Galápagos. 97-99 % of surveyed 18 people agreed that beaches have notoriously improved during confinement at least from visual 19 observation. On a scale from 1 (worst) to 5 (best), the beaches were rated 2.23 and 2.83 (less than 20 acceptable) before quarantine, and 4.48 and 4.33 after it for Salinas and Manta respectively. The 21 beaches have less garbage in general and plastic, even though there has been an increase in plastic and 22 face mask production around the world. In Salinas, 72%, and 23 % of surveyed people have seen small 23 pelagic fish, whilst in Manta 75%, and 41% of people saw the same, but also 17% of people have seen 24 whales (humpback and shark-whales) and dolphins practically swimming on the beach. Manta rays, 25 turtles, and other types of species were also observed. In Galapagos beaches, turtles have been 26 observed many more times than usual. The main plausible reason is the decrease in noise level. It is 27 recommended to take this unique opportunity, to construct a baseline data and information on physical, 28 chemical, biological, microbiological coastal oceanographic science, and from them to establish a proper 29 Coastal Zone Management based on beach description, water, and beach quality, human dimension, 30 and economic value indexes. This data and information construction should ideally be done before the 31 beaches are open.

Spike protein is the surface glycoprotein of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) necessary for the entry of the virus via the transmembrane receptors of the human endothelial cells of the respiratoty system for the virus to be engulfed causing COVID-19 disease after priming by type II transmembrane protease TMPRSS2 and then binding with the angiotensin-converting enzyme 2 (ACE2). Therefore, mutations and amino acid variants analysis are essential in understanding the mechanism of binding of spike protein with its receptor to have an insights on possibilities to design a peptide or nucleotide-based vaccine for COVID-19. Here, we employed Iterative Threading Assembly Refinement (I-TASSER) and Multiple Alignment using Fast Fourier Transform (MAFFT) to predict the three-dimensional monomer structure of spike protein of SARS-CoV-2 and to analyze the amino acid variants for protein sequences from GISAID database for samples collected from Jordan in a try to find an explanation for the low confirmed number of COVID-19 in Jordan. Our Protein Homology/analogY Recognition Engine V 2.0 (Phyre2) findings showed four single amino acid variants (SAV) found in 20 samples of SARS-CoV-2. What is equal to 5% of samples showed tyrosine deletion at Y144 located in the SARS-CoV-like_Spike_S1_NTD (N terminal domain), 62% showed aspartate substitution to glycine at D614G located in the SARS-CoV-2_Spike_S1_RBD (spike recognition binding site), 5% showed aspartate substitution to tyrosine at D1139Y and 5% showed glycine substitution to serine at G1167S both located in the Corona_S2 domain. The findings have shown lower mutational sensitivity in all variants that might not affect the function of spike glycoprotein except for D614G, which has the highest mutational sensitivity score (5 out of 9) indicating a higher likelihood to affect the function of the spike protein. This might suggest, in general, a reduced transmitability of SARS-CoV-2 in Jordan.

The COVID-19 pandemic changed the world of medical education, moving it years ahead of time into the future. Many concepts needed to be changed, so did the methodologies. Nevertheless, clinical assessment remained tricky. This work highlights the outcome of the work of College of Medicine and Medical Sciences at the Arabian Gulf University in Bahrain in performing virtual clinical examination using Zoom™. Tips in this article are meant to help plan, implement and evaluate clinical assessments virtually.

COVID 19 has caused social distancing and lead to the reductions of various anthropogenic activities. Correspondingly this study has two fold objectives. First, aims to provide quantification measurement of social distancing impacts on air quality. Second, to forecast the air quality if social distancing is continued. The measured air quality parameters consist of NO₂, SO₂, and O₃. According to the results, the order of air quality parameters was NO₂<SO₂<O₃. The NO₂, SO₂, and O₃ levels were observed lower after social distancing than before social distancing was implemented. The reductions of NO₂, SO₂, and O₃ levels were 5%, 3%, and 5% respectively. Likewise, 65% of study periods (30 days) after implementation of social distancing have lower NO₂ than before social distancing. The exponential smoothing forecasts show the decreasing trends for NO₂ and SO₂. While O₃ levels are estimated will remain stable after social distancing. This study has shown that the social distancing has an impact on the NO₂, SO₂, and O₃. Correspondingly, if the social distancing is continued, then it is estimated can provide a positive impact on urban quality. Keywords: COVID 19, forecast, NO₂, O₃, SO₂.

Aim: This study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. Methods: A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18-73 years). Results: The overall prevalence of being overweight and obesity among participants was 37.2% and 33.1% respectively. The study identified significant changes in the dietary habits and lifestyle behaviours of participants during COVID-19. In general, there was an increase in the percentage of participants that consumed four or more meals a day, skipped breakfast, and engaged in frequent late night snacking. Moreover, there was a drastic decrease in the frequency of fast food consumption and an increase in the percentage of participants who had their main meal freshly made. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. Conclusion: This study indicates that due to the increased prevalence of habits conducive to increased rates of being overweight and obesity during the COVID-19 outbreak, there is a high likelihood that the pandemic will further exacerbate the already widespread problem of obesity and being overweight in Kuwait.