Background: Attendance to neonatal follow-up programs (NFU) presents as a significant factor associated with long-term outcome of high-risk infants. Few studies have focused on attrition or loss to follow up particularly during COVID-19 pandemic. Methods: In this retrospective observational study, data from 1137 high-risk neonates who participated in a hospital NFU program were collected (573 before and 564 after the onset of COVID-19 pandemic). The study sample was grouped to: G1 (N=831) who maintained participation in the program, G2 (N=196) who discontinued, and G3 (N=110) who never visited the outpatient clinics. Data was obtained from the hospital's Systems Applications and Products Software, and a structured questionnaire, answered by parents of newborns either discontinuing (G2) or not attending (G3) the NFU program, through a telephone contact.Results: The most frequently reported reason for discontinuance before the onset of the pandemic was the parents' perception that it was not necessary to maintain participation in the program (44.12%). During the COVID-19 pandemic, provider-related barriers to maintaining hospital access, inability to provide high-quality services (37.14%), and feelings of fear and insecurity (18.5%), emerged as factors for non-attendance. Citizenship and morbidity (RDS, sepsis, NEC, jaundice) acted as incentives to join the NFU program during both study periods. Multiple regression analysis showed that multiple gestation infants had higher odds for maintaining participation during the COVID-19 period (OR, 4.04; CI, 1.09-14.9). Conclusion: Understanding the potential impact of COVID-19 and the transformative changes in NFU clinics is crucial to apply compliance strategies. Removing barriers to maintain family participation can lead to increased attendance rates.

Pineapple is a highly demanded fruit in international markets, thanks to its unique appearance and flavor, high fiber content, vitamins, folic acid, and minerals. It makes the pineapple production and processing market a significant source of income for producing countries, such as Costa Rica. Nowadays, its processing produces a large amount of waste with negative consequences for the environment. However, pineapple waste is an essential source of cellulose, hemicellulose, lignin, and other high-value products like enzymes (bromelain). These by-products can be obtained by pineapple waste biorefinery, generating an additional source of export goods and foreign currency, framing pineapple processing in the concept of the circular economy. This review discusses how incorporating biorefinery in the pineapple production processes can contribute to the post-COVID 19 economy in Costa Rica. Pineapple production in Costa Rica is explored, and the contamination of generated residues is delineated. Furthermore, the primary processes for by-product extraction via biorefinery, their general characteristics and applications in the medical field, and their contribution to the circular economy are presented.

Metabolic-associated fatty liver disease (MAFLD) is a risk factor for severe COVID-19. This study explores the potential influence of gut hormone receptor and immune response gene expression on COVID-19 outcomes in MAFLD patients. Methods: We investigated gene expression levels of AHR, FFAR2, FXR, and TGR5 in patients with MAFLD and COVID-19 compared to controls. We examined associations between gene expression and clinical outcomes. Results: COVID-19 patients displayed altered AHR expression, potentially impacting immune response and recovery. Downregulated AHR in MAFLD patients correlated with increased coagulation parameters. Elevated FFAR2 expression in MAFLD linked to specific immune cell populations and hospital stay duration. Significantly lower FXR expression was observed in both MAFLD and severe COVID-19. Conclusion: Our findings suggest potential modulatory roles for AHR, FFAR2, and FXR in COVID-19 and MAFLD.

The outbreak of the COVID-19 pandemic has raised concerns about potential environmental factors that could influence the spread and severity of the SARS-CoV-2 virus. Atmospheric pollution, particularly particulate matter (PM), has been suggested as a contributing factor to viral infections and respiratory complications. This two-year observational study aimed to investigate the relation between air pollution and the spread of COVID-19, focusing on PM2.5. Unlike previous studies limited to specific cities or countries, inevitable to use temporal data. Our research analyzed data from various states across the United States, considering both spatial and temporal correlation. The analysis considered the number and geographic distribution of COVID-19 cases along with daily PM2.5 exposure levels, accounting for monthly average PM2.5 exposure, from March 2020 to December 2021. The observed conflicting results of the temporal and spatial correlation present challenges for researchers in understanding the true nature of the relationship between PM2.5 air pollution and COVID-19 cases. The correlation between various factors, such as population density, PM2.5, temperature, and wind speed, and COVID-19 refers to an association or statistical relationship, not causation. Moreover, the intricate interplay of these variables makes it difficult to establish a clear cause-and-effect relationship.

Data on immunogenicity, immune response persistency, and safety of COVID-19 boosters in patients with comorbidities are limited. Therefore, we aimed to evaluate and compare three different boosters in individuals who received two doses of the BBIBP-CorV vaccine including underlying diseases and healthy cases as control. One hundred forty subjects including 63 ones with at least one of three underlying diseases (UD) (including obesity, hypertension, and diabetes mellitus) and 77 healthy ones (HC) who had received a booster dose (either PastoCovac Plus or PastoCovac or BBIBP-CorV) were enrolled. The presence of SARS-CoV-2 antibodies was assessed before the booster injection and 28, 60, 90, and 180 days after it. Moreover, the adverse events (AEs) were recorded on days 7 and 21 post-booster shot for evaluating safety outcomes. Significantly increased titers of anti-spike, anti-RBD, and neutralizing antibodies were observed in both UD and HC groups 28 days after the booster dose, although the titer rise of anti-spike IgG and anti-RBD IgG was insignificantly inferior in the UD group compared to the HC group. All antibodies’ titers declined, with no significant differences between the two groups over time. Notably, all specific antibodies persisted up to 180 days; particularly the neutralizing antibody in both groups. Furthermore, no significant difference in antibody levels was observed between each UD subgroup and the HC group, except for neutralizing antibodies in the hypertension sub-group. PastoCovac Plus and PastoCovac boosters induced higher antibodies’ fold rise in UD individuals than BBIBP-CorV booster recipients. Safety outcomes did not show any serious AEs after the booster injection. The overall incidence of AEs post the booster injection was higher in the UD group than the HC group. Furthermore, the highest systemic AEs rate was reported in the UD group receiving the BBIBP-CorV booster. In conclusion, administration of COVID-19 boosters can equally induce robust and persistent humoral immune responses in individuals with or without UD primarily vaccinated with 2-doses of the BBIBP-CorV. Protein-based boosters with higher antibodies' fold rise and lower AEs in individuals with comorbidities might be considered a better choice for these individuals.

Ventilation in prone position (PP) for 12 to 16 hours per day improves survival in ARDS. However, the optimal duration of the intervention is unknown. We performed a prospective observational study to compare the efficacy and safety of a prolonged PP protocol with conventional prone ventilation in COVID-19-associated ARDS. Prone position was undertaken if P/F <150 with FiO2>0.6 and PEEP>10cmH2O. Oxygenation parameters and respiratory mechanics were recorded before the first PP cycle, at the end of PP cycle and 4 hours after supination. We included 63 consecutive intubated patients with mean age 63.5 years. Of them, 37 (58.7%) underwent prolonged prone position (PPP group) and 26 (41.3%) standard prone position (SPP group). Median cycle duration for SPP group was 20 hrs and for PPP group 46 hrs (p<0.001). No significant differences in oxygenation, respiratory mechanics, number of PP cycles and rate of complications were observed between groups. The 28-day survival was 78.4% in the PPP group versus 65.4% in the SPP group (p=0.253). Extending the duration of PP was as safe and efficacious as conventional PP, but did not confer any survival benefit in a cohort of patients with severe ARDS due to COVID-19.

COVID-19 infection in the pediatric population usually leads to a mild illness, however, a rare but serious complication of MIS-C has been seen in children. MIS-C usually presents 2-4 weeks after COVID-19 infection or exposure, and rare reports have been documented in neonates. Vaccinations for COVID-19 have been approved for children 6 months and above in the United States, and recent reports suggest significantly low prevalence and risk of complications of MIS-C in vaccinated children compared to unvaccinated children. Vaccinations for COVID-19 are safe and recommended during pregnancy and prevent severe maternal morbidity and adverse birth outcomes. Evidence from other vaccine-preventable diseases suggests that through passive transplacental antibody transfer, maternal vaccinations are protective against infections in infants during the first 6 months of life. Various studies have demonstrated that maternal COVID-19 vaccination is associated with the presence of anti-spike protein antibodies in infants, persisting even at 6 months of age. Further, completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy is associated with reduced risk for COVID-19–associated hospitalization among infants aged 6 months or less. Therefore, it can be hypothesized that maternal COVID-19 vaccination can reduce the risk of and severity of MIS-C in infants. In this article, we review the literature to support this hypothesis.

Abstract Introduction: COVID-19 has a relationship with patients’ demographic characteristics as well as their underlying diseases. This research has been conducted to evaluate factors' effect on Covid-19 patient's hospitalization rate and period in Hormozgan, Iran. Materials and Methods: The inclusion criteria of this retrospective study included all patients diagnosed as COVID-19 Patients after PCR who were referred to Covid-19 hospitals from February 2020 to June 2020 in Hormozgan province, Iran. After the completion of the consent form and observing ethical principles, 3480 patients' information was collected through the interview by Medical care monitoring center unit experts. The checklist was designed according to COVID-19 guidelines and approved by the World Health Organization and Iran Ministry of Health and Medical Education. The studied variables included gender, age, patients’ residence place, smoking history and medications use history, pregnancy, referral type to hospital, contact history with COVID-19 patients, early symptoms, gastrointestinal symptoms, intubation, Po2 level, history of cancer, chronic liver diseases, diabetes, chronic blood diseases, HIV/AIDS, acquired or congenital immunodeficiency, cardiovascular diseases, chronic kidney diseases, dialysis status, asthma and other chronic lung diseases, and chronic neurological disorders. These data were analyzed using descriptive (average-standard deviation-percentage) and analytical (including Chi-square, t-test, and regression tests) statistics with SPSS Ver.23 software. Results: In this study, 3480 COVID-19 patients including 1852 male patients (53.20%) with a median age of 43.11±21.72 and 1628 female patients (46/80%) with a median age of 44.86±22.40. The median age of men was significantly lower than the women's median age (P= 0.02). The duration of hospitalization of male and female patients was reported 2.64±4.14 and 2.76±4.297, respectively which was not statistically significant. The death rate of patients in our study was 6.6%. Conclusion: The results of this study also showed that the hospitalization period of HIV-positive patients and patients with cardiovascular and pulmonary diseases is much longer than other people, which imposes many human and financial costs on the country's health care system. Therefore, to maintain individual health and help improve the critical condition of the virus, it is better to develop and apply stricter protocols to prevent further outbreaks of the disease and check underlying diseases of people suspected to have Covid-19. These results can improve health care system planning and improving medical services presented to covid-19 patients.

Corona Virus disease 2019 (COVID-19) is a new strain of coronavirus that causes respiratory illnesses with a start of flu like symptoms. This disease is fatal and is spread all over the world. The Scientist are working day and night to find vaccine or a cure. World Health Organisation has declared COVID-19 as pandemic [1]. In the view of the pandemic many treatments are being tried on the patients and various treatment modalities are being followed, the traditional medicine has shown a major role to manage this disease. The traditional medicines include the use of herbs, nutrition and spices that are freely available in Asian countries. These are used in day to day life by Asian population [2]. In this paper we have compiled and reviewed the role of various herbs and spices such as Oregano, Ashwagandha, Ginseng, Basil, Sage, Curcumin, Fenugreek, Ginger and Garlic in building immunity and also in curing pathogenic invasions based on evidence based researches. As there is no cure available for COVID-19 till now so supportive therapy is playing a major role for the patients to fight with this pandemic. The AYUSH ministry has also promoted the use of above herbs for a patient suffering from this disease. The corona virus is present in respiratory system as shown by different studies and it has different strains. The guidelines laid by the ICMR and WHO shows that use of herbs, spices and nutrients can be helpful to manage this virus by increasing the immunity in patients. Hence we are not claiming any cures but the herbs and spices used in day to day life are very much effective in management of COVID-19. World Health Organisation (WHO) has recognised the use of alternative and traditional medicine in the management of COVID-19 but the herbs should be used in prescribed amounts and overdose of them can be harmful for health [1,3]. Therefore the present article will enlighten the readers about the role of herbs, spices and nutrients in improving the conditions in COVID-19.

In the promptness of the COVID-19 outbreak, it would be very important to observe and estimate the pattern of diseases to reduce the contagious infection. To study this effect, we developed a COVID-19 analytical epidemic framework that combines with isolation and lockdown effect by incorporating five various groups of individuals. Then we analyze the model by evaluating the equilibrium points and analyzing their stability as well as determining the basic reproduction number. The extensive numerical simulations show the dynamics of a different group of the population over time. Thus, our findings based on the sensitivity analysis and the reproduction number highlight the role of outbreak of the virus that can be useful to avoid a massive collapse in Bangladesh and rest of the world. The outcome of this study concludes that outbreak will be in control which ensures the social and economic stability.

Background: Although no specific treatment for COVID 19 has been proven effective yet, some drugs with in vitro potential against SARS-CoV-2 virus have been proposed for clinical use. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness on the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital, Madrid, Spain, who were hospitalised due to COVID-19 and had a definitive outcome (either dead or discharged). We used a statistical survival analysis. Results: We analysed 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, versus 22% in the group of hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients between 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with an initial loading dose of 800mg improved patient survival when admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will need to be clarified in subsequent studies.

The social distancing as a response to COVID 19 pandemic has led to the exceptional reductions of daily routine people activities and vehicle uses mainly in city. This same situation was also experienced by several busy, large, and populous cities in Southeast Asia (SA) countries. Correspondingly, this study aimed to test the hypothesis that the social distancing implementation period has increased the air quality in the term of carbon monoxide (CO) emission reduction as drawn from Jakarta city as an example of the one of populated cities in SA region. The CO was measured in parts per billions (ppb) and monitored on the daily basis employing remote sensor platform. The monitor periods were started from January, February, March, and April 2020 with 10 measurement days for each month. The social distancing was implemented from mid of March to the recent April. The CO measurement data were statistically tested to justify the significant effects of social distancing on the CO levels. Based on the CO data analysis, the order of CO mean by months is February > January > March > April. The CO levels for January, February, March, and April were 87.46 ppb (95%CI: 83.54-91.37), 88.20 ppb (95%CI: 81.65-94.74), 86.38 (95%CI: 81.06-91.69), and 78.68 (95%CI: 74.03-83.32) respectively. This study also find significant difference (p<0.05) of CO levels especially in April when social distancing has been implemented. Hence, these findings illustrate the potential air pollutant reduction gained from implementing social distancing as can be seen in April.

Traditional vaccines are produced by using weakened or inactivated forms of disease-causing pathogens to produce the target antigen they are designed to protect against. Messenger RNA vaccines are a class of vaccines that employ a minute segment of genetic material, known as messenger RNA (mRNA), which contains directives for the cells in the body to generate a particular protein. This genetic material is synthesized in the laboratory and packaged into a lipid nanoparticle, which protects and helps it enter cells for further protein synthesis. During vaccination with mRNA vaccine, the lipid nanoparticles containing the mRNA are injected into the muscle of vaccinees. Once inside the cells, the mRNA instructs the cells to produce a protein which is then displayed on the surface of the cell, triggering an immune response. During this, the immune system recognizes the displayed protein as foreign and mounts a defense by producing antibodies and activating immune cells to target and eliminate the protein. Furthermore, these immune responses generate a memory cell, facilitating the immune system to promptly react in case of encountering the authentic pathogen as an infection in the future. The mRNA vaccines are flexible and the sequence can be easily synthesized in the lab based on the genetic information of the target pathogen. Additionally, mRNA vaccines can be developed for new strains or variants of the target disease easily. This was particularly evident during the COVID-19 pandemic, where mRNA vaccines like the Pfizer-BioNTech and Moderna vaccines were developed and authorized for emergency use within a year. But currently, available mRNA vaccines require extensive cold chain, antigen delivery, potential immune response variability optimization, and sophisticated manufacturing process. The efforts to explore next-generation mRNA vaccine development are aimed to further improve the effectiveness, stability, and delivery methods. One focus of research has been to enhance the stability of mRNA vaccines, particularly temperature sensitivity which makes storage and distribution easier, particularly in regions with limited access to cold chain infrastructure. Self-amplifying mRNA vaccines, on the other hand, are designed to generate multiple copies of the mRNA within cells which potentially leads to a higher production of the target protein, resulting in a stronger immune response. Additionally, studies are exploring new delivery systems to improve the target and efficiency of mRNA vaccines using specialized nanoparticles and liposomes to specifically deliver mRNA to certain cell types or immune cells. Another area of interest is the development of combination vaccines, where multiple mRNA sequences are included in a single vaccine protecting against multiple diseases targeting strains or variants of a particular pathogen simultaneously. While current mRNA vaccines are administered via intramuscular injection, studies are underway to deliver directly into the skin offering enhanced immune response and the ability to use smaller vaccine doses.

The COVID-19 pandemic and tuberculosis have epidemiological similarities, being transmitted airborne, favored by direct contact, crowded environments and vulnerable biological status. We performed a retrospective study of 45 cases of pulmonary tuberculosis associated with COVID-19 (TB+COV+) compared to 45 cases with tuberculous monoinfection (TB+COV-), hospitalized during 2021-2022. The demographic characteristics were similar in the two groups, predominating men, a median age of 51 years, living in rural areas, medium level of education and smoking. Common symptoms of the two groups were cough, weight loss, profuse sweating, loss of appetite and hemoptysis, while fever, headache, myo-arthralgias and digestive symptoms characterized the TB+COV+ forms. The scores of radiological lesions in the TB+COV+ compared to TB+COV- group were significantly higher and persistent, revealing more frequent bilateral extensive lung lesions. There were no significant differences in the biological parameters between the two groups. Mortality was 2.2%, regardless of the association of COVID-19. The frequency of infections with Clostridioides difficile was higher in TB+COV+ cases. In conclusion, the co-infection of COVID-19 had an impact on the clinical and biological expression of tuberculosis diagnosed in a pandemic context.

The effect of SARS-CoV-2 pandemic has been subsided significantly following the rapid development of vaccine. However, patients with cancer and immunosuppressed state, who are more prone to mortality and morbidity due to this infection, were excluded from majority of the vaccine trials. Moreover, suggested dose modification for cancer and immunosuppressed patients are often not followed because of lack of awareness or unavailability of vaccination schedule. This review will try to bridge this knowledge gap by summarizing the current suggestions of dose modification of COVID-19 vaccine for patients with cancer and immunosuppression.

The SARS coronavirus 2 pandemic affected many areas of public life and industry. This also applies to research particularly that which relies on user test studies. In order to minimize the risk of infection, several aspects of experiment design including the setting might require alteration. In order to develop a step-by-step approach to plan a study with regard to infection protection, an extensive review of the latest research involving the SARS coronavirus 2 pandemic as a blueprint for dealing with other health situations. As a result, a six-step concept was developed that is applicable for user test studies in both stationary rooms and vehicles which can be adapted to the respective circumstances. The infection protection measures determined through research were implemented in the individual sub-steps from study planning to execution. They allow a step-by-step approach to prevent infections in user test studies during a pandemic and in situations where increased hygiene measures are required, in order to continue to carry out user test studies.

The novel coronavirus SARS-CoV-2, the causative agent of COVID-19, emerged in the human population in December 2019 and spread worldwide within a few short months. Much of the public health focus for preventing and mitigating the spread of COVID-19 has been on individual and collective behaviors, such as social distancing, mask-wearing, and hygiene. Yet it is equally important to recognize that these behaviors and health outcomes occur within broader social and environmental contexts. Factors within local communities, regional policy, race, history, personal beliefs, and natural- and built environmental characteristics affect underlying population health and the spread of disease. For example, COVID-19 has renewed attention to secure water and sanitation services and their importance in protecting human health. Many remote Alaskan communities are particularly vulnerable because of inadequate water and sanitation systems. In this paper, we describe how inadequate water and sewer services may place the inhabitants of remote Alaskan communities at higher risk of COVID spread. We argue that insufficient water security and inadequate sewer systems, along with household overcrowding, multigenerational residences, limited transportation options, limited medical facilities, and higher prevalence of chronic diseases could lead to a greater potential of COVID-19 transmission and to more severe disease outcomes in these communities.

Despite the crucial role the COVID-19 vaccine played in curbing the pandemic, a significant portion of Black and African American individuals expressed hesitancy in being vaccinated. This review aimed to identify the determinants of COVID-19 vaccine hesitancy among Black and African American individuals in the USA. The literature search was conducted in December 2022 according to the PRISMA criteria focusing on empirical studies. Data extraction methods, critical appraisal, and secondary thematic analysis were conducted on both quantitative and qualitative studies. Sixteen quantitative studies identified key factors associated with vaccine hesitancy such as confidence in vaccine effectiveness, safety, and trust in the healthcare system. 14 qualitative studies revealed major themes of mistrust, fear, and information needs, including historical mistrust, concerns about the vaccine development process, and contemporary institutional mistrust. The synthesis of quantitative and qualitative findings derived from this review provides a nuanced understanding of determinants of vaccine hesitancy in Black and African American communities in the USA, offering a foundation for the development of evidence-based interventions. Mistrust in the healthcare system, fear, and informational gaps on vaccine safety and effectiveness have been identified as significant barriers to vaccination, demanding targeted interventions.

Bangladesh has achieved tremendous progress in the fisheries sector that is making evidential contribution to food security, nutrition and livelihoods. Based on secondary data collected from the Department of Fisheries, Bangladesh and related un-published grey literature, this paper highlights the performance and challenges of the fisheries with emphasis on COVID-19 impact as well as the significance of this sector for achieving the Sustainable Development Goals (SDGs). The total fish production is increased more than six times over the last three decades (7.54 to 43.84 lakh MT) due to the dissemination of improved culture techniques and extension services. Inland closed water contributions have been increasing to 16.24%, while inland open water have declined 10.23% and marine fisheries have dropped 6.27% over the past 18 financial years (2000-2001 to 2018-2019). COVID-19, a major health crisis has also affects various issues associated with aquatic resources and communities. Transportation obstacles and complexity in the food supply, abstraction to start production, labour crisis, sudden illness, poor consumer demand, commodity price hike, creditor's pressure and reduced income were identified as affecting COVID-19 drivers. The combined effect of these drivers poses a significant threat to people’s income (SDG1- eliminate poverty), nutrition (SDG2- erase hunger), food security (SDG3- good health and wellbeing, and SDG12- responsible consumption and production) that demands comprehensive actions. Several recommendations have been elicited, which are important to implement for the achievement of SDGs as well management and imprvement of the aquatic sector (SDG14- life below and SDG16- life above water) .

Background: The COVID-19 pandemic, caused by SARS-CoV-2, has severely impacted children with Type 1 Diabetes (T1D), placing them at high risk for severe outcomes. Despite extensive observational data suggesting a link between T1D and severe COVID-19, there is a lack of understanding regarding the causal effects. This study aims to determine whether Type 1 diabetes (T1D) influences the risk of severe COVID-19 outcomes, particularly respiratory failure, in pediatric ICU patients. Methods: This two-sample Mendelian Randomization (MR) study utilized genetic data from large-scale genome-wide association studies (GWAS). Genetic variants associated with T1D were used as instrumental variables to assess their impact on severe COVID-19 outcomes. The primary datasets included genetic data for T1D from 457,695 individuals (6,447 T1D cases) and severe COVID-19 outcomes from 3,790 individuals (1,610 severe cases). Various MR methods, including Inverse Variance Weighted (IVW), MR-Egger Regression, and Weighted Median, were employed to ensure robust causal inference and eliminate potential biases such as pleiotropy. Results: The MR analysis revealed no causal relationship between T1D and severe COVID-19 outcomes in pediatric patients. Odds ratios (ORs) obtained using MR-Egger, Weighted Median, and IVW methods varied from 0.7648 to 0.9853, with p-values greater than 0.05, indicating no significant causal effect. Sensitivity analyses confirmed the robustness of these findings, showing no evidence of heterogeneity or directional pleiotropy. Conclusion: Our findings indicate no genetic causal link between T1D and severe respiratory failure from COVID-19 in children. These results contrast with numerous observational studies and suggest that metabolic dysfunction and other non-genetic factors should be the focus in managing this susceptible group. The insights gained are crucial for developing targeted interventions and improving clinical management strategies for pediatric ICU patients with T1D during the COVID-19 pandemic.

(1) Background: Older people hospitalized with Covid-19 can reduced the capacity to walk. However, the prevalence of impairment of ambulation capacity still need to be established. Objective: To estimate the prevalence and identify the risk factors associated with the impairment of ambulation capacity at hospital discharge of older people with Covid-19. (2) Methods: A retrospective cohort study. Included age &gt; 60 years, both sexes, hospitalized due to Covid-19. Clinical data was collected from the medical records. Ambulation capacity prior to Covid-19 infection was assessed through the patient report from his relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data from 429 older people were randomly. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were hospital stay higher than 20 days (OR: 3.5) and dependent ambulation capacity prior to Covid-19 (OR: 11.3). (4) Conclusion: More than half of the older people who survived hospitalized due to Covid-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection, and a longer hospital stay were risks factors for reduced ambulation capacity.

The COVID-19 pandemic was associated with increases in some healthcare-associated infections. We investigated the impact of the pandemic on rates and molecular epidemiology of Clostridioides difficile infection (CDI) within one VA Hospital. We anticipated that the potential widespread use of antibiotics for pneumonia during the pandemic might increase CDI rates given that antibiotics are a major risk for CDI. Hospital data on patients with CDI and recurrent CDI (rCDI) were reviewed pre-COVID-19 pandemic (2015 to 2019) and during the pandemic (2020 - 2021). Restriction endonuclease analysis (REA) strain typing was performed on CD isolates recovered from stool samples collected from 10/2019 – 3/2022. CDI case numbers declined 43.2% in 2020 – 2021 compared to the annual mean over the previous 5 years. Stool test positivity rate was also lower during the COVID-19 pandemic (14.3% vs. 17.2%; P = 0.013). Although inpatient volume declined, rates of CDI among inpatients were reduced by 34.2% in 2020 – 2021. Mean monthly cases of rCDI also declined significantly after 2020 [3.38 (95% CI: 2.89 – 3.87) vs. 1.92 (95% CI: 1.27 – 2.56); P = &lt;0.01]. Prior to the pandemic, REA group Y was the most prevalent CD strain among the major REA groups (27.3%). During the first wave of the pandemic from March 8, 2020, through June 30, 2020, there was an increase in the relative incidence of REA group BI (26.7% vs. 9.1%. After adjusting for CDI risk factors, a multivariable logistic regression model revealed that odds of developing an REA group BI CDI increased during the first pandemic wave (OR 6.41, 95% CI: 1.03 – 39.91) compared to the pre-pandemic period. In conclusion, the incidence of CDI and rCDI decreased significantly during the initial waves of the COVID-19 pandemic. In contrast, REA BI (Ribotype 027), a virulent, previously epidemic CD strain and frequently associated with hospital transmission and outbreaks, reappeared as a prevalent strain during the first wave of the pandemic.

This study evaluated the epidemiological and genetic susceptibility profile caused by coronavirus 2 (SARS-CoV-2) in children ≤3 years of age with acute gastroenteritis (AGE) or acute respiratory infection (ARI), living in the northwestern region of the Amazon (NWAR). Fecal and saliva sam-ples collected from 202 children (n=404) were subjected to detection of SARS-CoV-2 by RT-qPCR. Polymorphisms in the angiotensin-converting enzyme (ACE rs4646994) and ACE2 G8780A; rs2285666) genes were detected by SYBR GREEN real-time PCR and PCR/Alul digestion, respec-tively. Secretory and Lewis status of histo-blood group antigen (HBGA) was performed using phenotyping/ELISA. Frequencies for the AGE group: SARS-CoV-2; 8.9%; ARI group: SARS-CoV-2; 2.9%. The ACE I/I homozygous polymorphism gene was majority. Males with the ACE2 G8780A SNP were more susceptible to ARI symptoms than AGE (OR = 3.85; 95% CI-1.42-10.38; P 0.007). Most children were secretory FUT2 phenotype (92.6%). Surveillance of diarrhea and respiratory infections in children, along with understanding their causes, are crucial for identifying preven-tion and control strategies and for prioritizing and developing new vaccines. Clinical manifesta-tions of COVID-19 in children ≤3 years of age include AGE.

Vaccination has been the most effective way to control the outbreak of the Covid pandemic. The numbers and types of vaccines have reached considerable proportions, even if the question of vaccine procedures and frequency still needs to be resolved. We learn the necessity of defining a vaccination distribution strategies with regard to Covid that could be used for any future pandemics of similar gravity. In fact, vaccine monitoring implies the existence of a strategy that should be measurable in terms of input and output, based on a mathematical model, including death rates, spread of infections, symptoms, hospitalization and so on. This paper addresses the issue of vaccine diffusion and strategies for monitoring the pandemic. It provides a description of the importance and take up of vaccines and the links between procedures and the containment of Covid variants, as well as the long-term effects. Finally, the paper focuses on the global scenario in a world undergoing profound social and political change, with particular attention on current and future health provision. This contribution would represent an example of vaccination experiences which can be useful in other pandemic or epidemiological contexts.

Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Case report: We present a case of a 73-year-old former smoker with hyperlipidemia, type 2 diabetes, and arterial hypertension, after a partial right nephrectomy in 2005 due to kidney cancer, diagnosed with SARS-COV-2 infection in April 2022. Follow-up chest imaging showed a 20 mm focal lesion in the left lung further classified as a small cell neuroendocrine carcinoma. Unexpectedly the patient was hospitalized for ST-segment elevation inferior left ventricular (LV) myocardial infarction treated successfully with coronary angioplasty, however heart failure (HF) with reduced left ventricle ejection fraction was diagnosed. One month later patient required another hospitalization due to the HF decompensation and cardiological treatment was optimized with flozin addition to the standard HF therapy. After cardiological approval chemotherapy was initiated with the cisplatinum-etoposide regimen and continued for 6 months without HF decompensation and significant deterioration of renal function. After that, the patient underwent radical radiotherapy. Follow-up chest computed tomography scans showed regression of the neoplastic lesion. Conclusions: Coincidence of newly recognized cancer and infection might contribute and provoke serious cardiological events . To reduce the risk of cardiovascular complications, early periodic cardiological surveillance and optimal pharmacotherapy are required.

Background: COVID-19, caused by SARS-CoV-2, is still a global public health concern due to the absence of effective antiviral treatment against different strains. Studies have shown that pregnant women are more susceptible to COVID-19 due to altered physiology and immunological features. Therefore, this study was designed to investigate pregnant women's knowledge, attitudes, and practice (KAP) to prevent COVID-19 and determine the factors associated with KAP. Methods: A community-based cross-sectional study was conducted among 425 pregnant women in Northern Bangladesh. The samples were obtained using a simple random sampling technique from April 5 to June 15, 2020. The data were collected by face-to-face survey with a structured and pre-tested questionnaire and analyzed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed, and p-values < 0.05 at 95% CI were considered statistically significant. Results: Overall, the score of KAP among the respondents was 47.76%, 49.41%, and 56.24%, respectively. Participants' area of residence, educational status of the husband, and antenatal care (ANC) visit were significantly associated with the level of knowledge, whereas age, educational status of the husband, number of living children, and knowledge were significant predictors of attitude. The knowledge of COVID-19 was the only predictor associated with the practice. Conclusion: Our study shows that almost half of the participants had poor knowledge, a negative attitude, and poor practices toward COVID-19. Additional health education programs by healthcare professionals and different media, coordinated and combined efforts of government and individuals' participation will be required to fight the spread of the infection.

Background: Throughout the COVID-19 pandemic, hospital medical staff (HMS) have faced significant personal, workplace, and financial disruption. Many have experienced psychosocial burden, exceeding already concerning baseline levels. This study examines the types and predictors of coping strategies and help-seeking behaviours utilised by Australian junior and senior HMS during the first year of the pandemic. Methods: A cross-sectional online survey of Australian frontline healthcare workers was conducted between 27th August and 23rd October 2020. Data collected included demographics, personal and workplace disruptions, self-reported and validated mental health symptoms, coping strategies, and help-seeking. Results: The 9518 participants included 1966 hospital medical staff (62.1% senior, 37.9% junior). Both groups experienced a high burden of anxiety, depression, post-traumatic stress disorder, and burnout. Coping strategies varied by seniority, with maintaining exercise the most common strategy for both groups. Adverse mental health was associated with increased alcohol consumption. Engagement with professional support, although more frequent among junior staff, was uncommon in both groups. Conclusions: Junior and senior staff utilised different coping and help-seeking behaviours. Despite recognition of symptoms, very few HMS engaged formal support. The varied predictors of coping and help-seeking identified may inform targeted interventions to support these cohorts in current and future crises.

Many inflammatory mechanisms are involved in the pathophysiology of COVID-19 infection. COVID-19 inhibits IFN antiviral responses, so we should expect an out-of-control viral replication. “Cytokine storms” occur due to the over-production of pro-inflammatory cytokines after an influx of neutrophils and monocytes/macrophages and may be responsible for the immunopathology of the lung involvement. Several cascades have been reported in the activation process of NF-κB. In this paper, to find new therapeutic options for COVID-19 infection, we reviewed some natural products that could potentially inhibit the NF-κB pathway. We found that sevoflurane, quercetin, resveratrol, curcumin, KIOM-C, bergenin, garcinia kola, shenfu, piperlongumine, wogonin, oroxylin, plantamajoside, naringin, ginseng, kaempferol, allium sativum L, illicium henryi, isoliquiritigenin, lianhua qingwen, magnoflorine, and ma Huang Tang might be effective in inhibiting the NF-KB pathway. These natural products could be helpful in the control of COVID-19 infections. However, larger clinical trials are needed to ascertain the efficacy of these products fully.

Introduction: The Pandemic of COVID-19, an infectious disease caused by SARS-CoV-2 motivated the scientific community to work together in order to gather, organize, process and distribute data on the novel biomedical hazard. Here, we analyzed how the scientific community responded to this challenge by quantifying distribution and availability patterns of the academic information related to COVID-19. The aim of our study was to assess the quality of the information flow and scientific collaboration, two factors we believe to be critical for finding new solutions for the ongoing pandemic. Materials and methods: The RISmed R package, and a custom Python script were used to fetch metadata on articles indexed in PubMed and published on Rxiv preprint server. Scopus was manually searched and the metadata was exported in BibTex file. Publication rate and publication status, affiliation and author count per article, and submission-to-publication time were analysed in R. Biblioshiny application was used to create a world collaboration map. Results: Our preliminary data suggest that COVID-19 pandemic resulted in generation of a large amount of scientific data, and demonstrates potential problems regarding the information velocity, availability, and scientific collaboration in the early stages of the pandemic. More specifically, our results indicate precarious overload of the standard publication systems, significant problems with data availability and apparent deficient collaboration. Conclusion: In conclusion, we believe the scientific community could have used the data more efficiently in order to create proper foundations for finding new solutions for the COVID-19 pandemic. Moreover, we believe we can learn from this on the go and adopt open science principles and a more mindful approach to COVID-19-related data to accelerate the discovery of more efficient solutions. We take this opportunity to invite our colleagues to contribute to this global scientific collaboration by publishing their findings with maximal transparency.

Combating viral disease outbreaks has doubtlessly been one of the major public health challenges for the 21^st century. Here, the host entry machinery required for COVID-19 (SARS-CoV-2) infection was examined for the gene expression profiles and polymorphism. The four human population groups of Europeans, Africans, Asians, and Americans had specific and also a shared pool of variants for the X-linked locus of ACE2 receptor. Several specific and common ACE2 variants were of the utmost importance to the viral entry and infection. In the absence of gender bias for the gene expression profiles, the hemizygous rare variants of ACE2 describe the observed higher mortality rate in males. Finally, a personalized medicine strategy is conceived for isolating high-risk individuals in epidemic circumstances.

Ligand and structure based virtual screening approaches were applied to clinical stage drugs as well as those approved for human use in an attempt to repurpose drugs for potential use against COVID-19. This approach involved ligand-based shape similarity searches, structure-based docking and pharmacophore searches with the help of pharmacophore queries derived from available ligands and receptor structures. Several compounds appeared as hits in pharmacophore and shape similarity searches and those docking to the SARS-CoV-2 viral 3CL protease were then ranked on the basis of docking scores.

Background: Covid-19 patients with any pre-existing cardio-vascular disease (CVD) are at highest risk for viral infection and for developing of severe disease. Pathophysiological mechanism is characterized by the viral link to Angioten-sin-Converting Enzyme 2 (ACE2) and the involvement of the endothelial system with the release of cytokines and direct damage on myocardium, micro throm-bosis, and alterations of oxygen diffusion. Aim of the study is to analyze clinical course, treatment and outcome in patients (gender stratified) with pre-existing CVD. Methods: Out of the 1299 (700 M/599 F) patients admitted to Internal Medicine COVID Unit of “Castelli Hospital”, Lazio, Italy, from 01/01/2021 to 31/12/2021, 278 patients (167 M/111 F), mean age 76 (76 M/ 75 F) had previous CVD. Demographic characteristics, length of the stay (LOS) and oxygen therapy were evaluated. Results: Most common CVD pathologies were Hearth Failure (HF): 131 (72 M/59 F), Atrial Fibrillation (AF): 45 (25 M/20 F), Myocardial Infarction (MI): 26 (19 M/7 F) and associations among them. 100% of CVD COVID patients under-went Non-Invasive Ventilation (NIV) and were treated with more than 5 drugs. HF was linked with increased LOS (23 days) compared to AF (21 days), MI (18 days) and no CVD (16 days). Overall mean LOS was 16,5 days. 21,4% of total pa-tients had CVD. Conclusions: Timely identification and evaluation of patients with pre-existing CVD are fundamental for adequate treatment based on gender, severity and state of illness and for risk reduction. Keywords: polypharmacy, gender medicine; COVID 19; Sars CoV 2; cardiovas-cular disease.

After the arrival of a new airborne virus to the world, science is aiming to develop solutions to withstand the spread and contagion of the SARS-CoV-2 coronavirus. The most severe among the adopted measures is to remain in home isolation for a significant number of hours per day, in order to avoid the spreading of the infection in an uncontrolled way through public spaces. Recent literature showed that the major route of transmission is via aerosols produced especially in poorly ventilated inner spaces. With regard to contagion rates, accumulated incidence or number of hospitalizations due to COVID-19, Spain has reached very high levels, therefore this article develops a quantitative and qualitative analysis of the requirements established in Spain with respect to the European framework in reference to ventilation parameters indoors. For this, a case study has been analyzed, representing a common residence in current Spanish residential developments. Results show that the criteria established in the applicable regulations are not sufficient to ensure health as well as to avoid contagion by aerosols indoors.

Research is scarce regarding antimicrobial use and antimicrobial resistance (AMR) for specific localities in Northern Ireland (NI). Additionally, the effects of COVID-19 on antimicrobial pre-scribing patterns and AMR are unknown. Between the European Union (EU) and United States (US), AMR causes approximately 68,000 deaths annually. This study will provide a better understanding of antimicrobial use and prescribing patterns in Belfast and link with AMR. An electronic survey was developed and distributed to eighty-five community pharmacists in Belfast. Yearly and monthly prescription data was gathered from the Business Services Organisation and COVID-19 statistics from Gov.uk. All data was analysed on Microsoft Office Excel® and IBM® SPSS® Statistics 25. Overall response rate was 46%. Most pharmacists (82%) failed to address prescriber non-compliance with guidelines and antimicrobial dosing errors (59%). The most common in-dication for antibiotics was upper respiratory tract infections (URTIs). Overprescribing of anti-biotics was perceived as the leading cause of AMR, therefore 69% of pharmacists indicated in-creased General Practitioner (GP) compliance with guidelines would reduce AMR. Pharmacists’ are in an ideal position to reduce AMR through patient education however, it is demonstrated that pharmacists failed to adequately counsel patients on antibiotic use. All GP practices demonstrated inappropriate antibiotic use, especially for URTIs which suggests antibiotic appropriateness should be reviewed. Many patients avoided contact with GP’s during COVID-19 which may have resulted in reduced antibiotic use. This research established amoxicillin as the most commonly prescribed antibiotic, which is contributing to increased AMR with its broad-spectrum activity and has recognised a decrease in antibiotic prescribing during COVID-19. Based on the results found and a critical review of the literature it is recommended antimicrobial guidelines should be re-viewed and improved, enhanced training should be provided to pharmacists and the antibiotic guardian (AG) campaign should be reenergised.

Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study we aimed to investigate whether abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with COVID-19-induced ARDS. Plasma ET-1 levels were measured in 18 mechanically ventilated COVID-19-induced ARDS patients, with simultaneous central venous and systemic arterial blood sampling on Days 1 and 3 following ICU admission. Two age- and sex-matched non-COVID-19 control groups were also used [mechanically ventilated non-COVID-19 critically ill and ARDS patients]. On ICU admission, COVID-19-induced ARDS patients had higher systemic arterial and venous ET-1 levels compared to non-COVID-19 ARDS and critically ill patients (p< 0.05). The arterial:venous (A:V) ET-1 ratio was higher in the non-COVID-19 ARDS patients [1.06 (0.93-1.20)] compared to the other two groups (p< 0.05). The A:V ratio was 0.63 (0.49-1.02) in the COVID-19-induced ARDS patients and 0.79 (0.52-1.11) in the non-COVID-19 critically ill patients. On Day 3, the A:V ratio in all three groups was < 1. The COVID-19 patient group was then divided based on 28-day ICU mortality. Although arterial and venous levels did not differ, the A:V ratio was statistically significantly higher on ICU admission in the non-survivors [0.95 (0.78-1.34)] vs 0.57 (0.48-0.92), p= 0.027]. Measurement of ET-1 clearance via A:V plasma ET-1 levels on ICU admission may assist in predicting outcomes in COVID-19 critically ill patients.

After the global challenges posed by COVID-19, researchers strived to identify risk factors for severe cases, which lead to various complications - including death. Lifestyle modifications, such as implementing a healthy diet and recommended physical activity, have shown to be protective against severe COVID-19 cases. Despite an association of a plant-based diet with reduced COVID-19 severity, specific dietary characteristics have not been identified. Also, the methodology for measuring physical activity is variable, with studies overlooking the intensity or the habit components of physical activity. To bridge this gap, our study designed, validated, and applied a retrospective questionnaire with aims of exploring the relationship between lifestyle factors, specifically diet and physical activity, and severe COVID-19. We considered the intensity and years of physical activity habit, which is a limitation of other questionnaires. Results reveal associations of age and BMI with severe COVID-19. An excessive sugar diet was found to be associated with severe COVID-19 and increased symptom duration. We also observed an inverse relationship pattern of moderate and vigorous intensity physical activity across case severity, which is absent in walking PA. This study lays a foundation for research aiming to identify lifestyle factors that prevent severe COVID-19 cases.

One of the greatest COVID-19 related challenges for children and their families was managing distance learning due to school closures. We also know from previous research that families with a child with a neurodevelopmental disorder such as ADHD or ASD were struggling more than others, but also experiences some positive effects. However, few qualitative studies have been conducted. The present study therefore aimed to investigate parental experiences of negative and positive effects of distance learning during the COVID-19 pandemic in a large sample of families with an adolescent with ADHD and/or ASD and a matched comparison group (n = 682). Data was collected through open-ended questions as part of a larger survey study. Five main themes, with different sub-themes were identified for both negative and positive effects: 1) Teaching, 2) Social, 3) Support, 4) Child factors, and 5) Home environment. In addiction, the main themes “Technical problems” were identified for negative effects. Families with a child with ADHD/ASD reported negative effects related to “Child factors” and “Support” more frequently than the controls, as well as negative effects related to some aspects of “Teaching” and “Technical problems”. Regarding positive effects, significant group differences were primarily found for the theme “Child factors”. These findings are discussed botn in terms of how to best prepare for possible future pandemics, but also how to best provide educational support for children with ADHD and/or ASD when schools are open.

Rationale: The possible effect of Particulate Matter (PM10 and PM2.5 of diameter 10 and 2.5 µm respectively) levels on Covid-19 mortality is now well established. However, time-evolution of Covid-19 mortality according to PM2.5 levels has been scarcely investigated. Aim: To understand this relationship at the European level for the period 2020 (beginning) - 2022 (end). Methods: 16 representative locations in Europe (81 million people) with heterogeneous levels of PM2.5 (µg.m-3), from low to high. PM2.5 levels were assessed by various methods, and Covid-19 mortality was reported by Johns Hopkins University. Results: The trend of Covid-19 mortality vs. PM2.5 levels varied among locations. Overall, the estimated mean value was of a 40±20% mortality increase per 1 µg.m-3 PM2.5 increase. The stronger the positive gradient of the PM peak, the stronger the positive gradient of the Covid-19 mortality. Exposure to several PM peaks during about a 2-month period was the main contributor to Covid-19 mortality increases. Conclusion: Our data confirm a temporal relation between PM2.5 exposure and Covid-19 mortality, considering a 2-month integration-time for pollution events. Number-concentrations of PM should be used in the future rather than the PM2.5 mass-concentrations (µg.m-3) with the consideration of PM composition to better explain this finding.

The rapid transmission of COVID-19 in school communities has been a major concern. To ensure that mitigation systems were in place and support was available, a digital intervention to encourage and facilitate infection control behaviours was rapidly adapted and optimised for implementation as a whole school intervention. Using the person-based approach, ‘Germ Defence’ was iteratively adapted, guided by relevant literature, co-production with Patient and Public Involvement representatives, and think aloud interviews with forty-five school students, staff, and parents. Suggested infection control behaviours deemed feasible and acceptable by the majority of participants included handwashing/hand-sanitising and wearing a face covering in certain contexts such as crowded public spaces. Promoting a sense of collective responsibility was reported to increase motivation for the adoption of these behaviours. However, acceptability and willingness to implement recommended behaviours seemed to be influenced by participants’ perceptions of risk. Barriers to the implementation of recommended behaviours in school and at home primarily related to childcare needs and physical space. We conclude that it was possible to rapidly adapt Germ Defence to provide an acceptable resource to help mitigate against infection transmission within and from school settings. Adapted content was considered acceptable, persuasive, and accessible.

As a consequence of the global sanitary crisis in early 2020, universities had to tackle with a sudden shift in their teaching-learning strategies so that the preset competences could be fulfilled. This study presents the learning outcomes of the tasks implemented, student experiences and feedback, as well as some reflections from the instructors with a holistic perspective of the courses due to the measures and adaptations adopted. Six courses taught at Civil Engineering degrees of three universities, two from Spain and one from Peru, are analyzed. The teaching and evaluation strategies are described and some reflections are made by comparing the student’s performance with the previous course. Although the shift to online learning had to be made from day to day, with no time for preparation, the experience has proved that online learning can be beneficial in some aspects and have probably come to stay, although some others are difficult to replace with respect to face-to-face learning, especially students’ engagement and motivation.

While it is not new that Nigeria is challenged by a huge infrastructure deficit, the COVID-19 pandemic has exposed the country’s comatose healthcare system. Given the country’s dwindling revenue, massive debt profile and the inability of the public-sector to efficiently manage public facilities in the country, this paper examines how the public-private partnership model of infrastructure procurement can be deployed as a solution for Nigeria’s healthcare crisis. In addition to the above, this paper takes a look at how a partnership with the private sector can aid Nigeria’s quest towards achieving healthcare-related Sustainable Development Goals. The paper also considers two healthcare-based projects as case studies to serve as lessons for future projects in the country. Among others, the paper recommends a holistic long-term solution for the country’s healthcare needs.

The outbreak of Corona Virus effected negatively on the world’s economy which has already touched the maximum sectors. Readymade garments sector has the large contribution in Bangladesh’s economy. For increasing the locked down period, it is hitting badly by stopping production and cancellation of orders with some issues. This paper will represent the brief scenario and impacts of garments sector in recent days and the economy status of Bangladesh for the pandemic. The study is based on secondary data, collected from different authentic journals and web portals etc. Bangladesh’s garments earnings mostly depended on export but on these days, the buyers are cancelling their orders and the factories are being failed to give payments to the worker, some are being shut down also. As the duration of locked down is increasing, there is a huge chance to get unemployed and Bangladesh can be faced an undisciplined condition in near future. BGMEA and BKMEA are taking necessary steps to support the worker. Ensuring health security, the authorities are trying to reopen the factories limitedly to meet up the immediate needs. The government has taken the situation on most priority and introduce some improvement packages to run the economy smoothly and reduce the losses of the country for the pandemic.

This paper aims to analyze the effects of Covid-19 on financial markets from the perspective of Complexity. The Covid-19 pandemic has caused turmoil in financial markets and is already one of the most important financial crises in history, causing a fall in several stock markets as well as great volatility. Unlike past crises, which in most cases were caused either by problems of fiscal deficits or in the financial system, this crisis has its origin in an epidemic disease, which occurred in Wuhan, China, and quickly spread across the globe affecting transport networks, commerce and finance, and will affect the public debt of many countries. This is a systemic situation in which there is a need to consider several interconnected systems, financial instability and high financial risk, something that econophysics and some complexity theorists already do. Therefore, this paper intends to show, theoretically, the systemic and complex character of the recent financial crisis caused by Covid-19.

World is currently experiencing a new pandemic for which no curative treatment is available. At this time, coronavirus disease 2019 (Covid-19) has reached 183 countries and has caused several deaths. Many reports presented chloroquine (CQ) and hydrochloroquine (HCQ), former drugs used against malaria, as the best current choice to fight this terrible disease. As these molecules had been withdrawn in malaria treatment policy due to chemoresistance, their reintroduction could have some consequences. Though local malaria prevalence could decrease for a while, molecular changes are likely to happen on some plasmodium falciparum genes involved in conferring drug resistance. This could threaten efforts in malaria control, if these molecules are widely administered.

Background: Covid-19 was first reported in Wuhan, China in Dec 2019. Since then, it has been transmitted rapidly in China and the rest of the world. While Covid-19 transmission rate has been declining in China, it is increasing exponentially in Europe and America. Although there are numerous studies examining Covid-19 infection, including an archived paper looking into the meteorological effect, the role of outdoor air pollution has yet to be explored rigorously. It has been shown that air pollution will weaken the immune system, and increase the rate of respiratory virus infection. We postulate that outdoor air pollution concentrations will have a negative effect on Covid-19 infections in China, whilst lockdowns, characterized by strong social distancing and home isolation measures, will help to moderate such negative effect. Methods: We will collect the number of daily confirmed Covid-19 cases in 31 provincial capital cities in China during the period of 1 Dec 2019 to 20 Mar 2020 (from a popular Chinese online platform which aggregates all cases reported by the Chinese national/provincial health authorities). We will also collect daily air pollution and meteorology data at the city-level (from the Chinese National Environmental Monitoring Center and the US National Climatic Data Center), daily inter-city migration flows and intra-city movements (from Baidu). City-level demographics including age distribution and gender, education, and median household income can be obtained from the statistical yearbooks. City-level co-morbidity indicators including rates of chronic disease and co-infection can be obtained from related research articles. A regression model is developed to model the relationship between the infection rate of Covid-19 (number of confirmed cases/population at the city level) and outdoor air pollution at the city level, after taking into account confounding factors such as meteorology, inter- and intra-city movements, demographics, and co-morbidity and co-infection rates. In particular, we shall study how air pollution affects infection rates across different cities, including Wuhan. Our model will also study air pollution would affect infection rates in Wuhan before and after the lockdown. Expected findings: We expect there be a correlation between Covid-19 infection rate and outdoor air pollution. We also expect that reduced intra-city movement after the lockdowns in Wuhan and the rest of China will play an important role in reducing the infection rate. Interpretation: Infection rate is growing exponentially in major cities worldwide. We expect Covid-19 infection rate is related to the air pollution concentration, and is strongly dependent on inter- and intra-city movements. To reduce the infection rate, the international community may deploy effective air pollution reduction plans and social distancing policies.

Vaccination is one of the most effective methods for preventing morbidity and mortality from COVID-19. Vaccine hesitancy has led to a decrease in vaccine uptake; driven by misinformation, fear, and perceptions of vaccine safety. Whole inactivated vaccines have been used in one-fifth of the vaccine recipients in Africa, however there is limited real-world data on their safety. We evaluated the reported side effects and factors associated with reported side effects following vaccination with whole inactivated COVID-19 vaccines - BBiBP-CorV (Sinopharm) and CoronaVac (Sinovac). A quantitative survey evaluating attitudes and side effects from vaccination was administered to 1016 adults presenting at vaccination centers. Two follow-up telephone interviews were conducted to determine side effects after the first and second vaccination dose. Overall, the vaccine was well tolerated; 26.0% and 14.4% reported side effects after the first and second dose respectively. The most frequent local and systemic side effects were pain at the injection site and headaches respectively. Most symptoms were mild, and no participants re-quired hospitalization. Participants who perceived COVID-19 vaccines as safe or had a personal COVID-19 experience were significantly less likely to report side effects. Our findings provide data on the safety and tolerability of whole inactivated COVID-19 vaccines in an African population, providing the necessary data to create effective strategies to increase vaccination and support vaccination campaigns.

Background There is a considerable overlap between clinical presentation of post-COVID-19 condition (PCC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) . Many of their common symptoms can be linked to dysregulation of the autonomic nervous system (dysautonomia). This study aimed to objectively assess autonomic function in patients with PCC and in patients with ME/CFS whose disease was not related to COVID-19. Methods Synchronous recordings of an electrocardiogram, continuous dynamics of blood pressure in the digital artery using the Penaz method and ultrasound pneumotachography with the spirography function were obtained with spiroarteriocardiorhythmography method in 34 patients diagnosed with ME/CFS, in whom the onset of the disease was not associated with COVID-19, 29 patients meeting PCC definition and 32 healthy controls. Heart rate variability (HRV), systolic and diastolic blood pressure variability (RV), respiration variability were assessed at rest and in tests with fixed respiratory rates. At rest, indicators of baroreflex regulation were additionally determined (baroreflex effectiveness index and baroreflex sensitivity). Results The total power, power of very low frequency, low-frequency and high-frequency of RR interval variability at rest as well as baroreflex effectiveness index in up-ramps of arterial blood pressure and baroreflex sensitivity were significantly lower both in PCC and ME/CFS patients compared to HC. Several diagnostic prediction models for ME/CFS were developed based on HRV parameters. During slow breathing HRV parameters return to normal in PCC, but not in ME/CFS. Correlation analysis revealed a close relationship of HRV, RV parameters and baroreflex sensitivity with fatigue, but not with HADS depressive/anxiety symptoms in ME/CFS and PCC. Conclusion A similar pattern of HRV and baroreflex failure with signs of a pathological acceleration of age-dependant dysautonomia was identified in ME/CFS and PCC. The clinical, diagnostic and therapeutic implications of these findings are discussed, in light of previously described relationship between inflammation, vascular pathology, atherosclerotic cardiovascular disease and autonomic dysfunction.

This study aims to investigate the effects of chest mobilization and breathing exercises on respiratory function, trunk stability, and endurance in chronic stroke patients who have contracted coronavirus disease (COVID-19). Thirty inpatients of a tertiary hospital in South Korea, who had a history of COVID-19 and were diagnosed with stroke within the last 6 months were randomly assigned to either the Chest Mobilization Exercise with Breathing Exercise (CMEBE) or Conservative Physical Therapy with Breathing Exercise (CPTBE) groups. The respiratory function, trunk stability, and endurance were measured at baseline and 6 weeks after the interventions. Both CMEBE and CPTBE groups showed improvements in respiratory function, trunk stability, and endurance after the intervention (p<0.05). However, the CMEBE group showed significantly greater improvements in forced expiratory volume in 1 second (p<0.05), trunk stability (p<0.05), and endurance (p<0.05) than the CPTBE group. No significant intergroup difference was observed in forced vital capacity and peak expiratory flow. Conclusion: The combination of chest mobilization and breathing exercises improved respiratory muscle mobility and endurance, stabilized the trunk, and enhanced balance and transfer of weight. The findings suggest that this intervention could be beneficial in improving respiratory function and endurance in stroke patients.

Background As a major virus outbreak in the 21st century, the Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally. Health care workers, patients with COVID-19 are experiencing post-traumatic stress disorders, anxiety, depression, and insomnia. Methods: A cross-sectional study using a questionnaire consisted of four parts: sociodemographic, current and previous health status, measures in a social isolation, and the Arabic version of Depression, Anxiety and Stress Scale (DASS-21). Results: We had 110 patients who completed the data. 89 (80.9%) of patients recovered from COVID-19. They ranged from 18-84 with a mean of 37.6 years (SD = 9.8 years). We had 33.6% of patients re-ported moderate to extremely severe depression compared to 18.2% with mild reported symptoms. The anxiety severity showed that (35.4%) out of patients had moderate to extremely severe anxiety, compared to (6.4%) who had mild anxiety. While stress severity showed that (22.7%) had moderate to extremely severe stress compared to (13.6%) who had mild stress. Conclusion: COVID-19 has caused a significant increase in the prevalence of mental health illness in the general population. Large systematic reviews are required to set the general overall of impact of this pandemic on mental health.

Background: As a result of the pandemic, families and children have faced physical, emotional, and mental challenges. However, there has been little attention given to the relationship between the COVID-19 pandemic and child development. This systematic review aims to identify the impact of the pandemic on child development, globally. Methods: This study follows the PRISMA guidelines for the systematic review of 16 quantitative and qualitative studies conducted between 2020-2023. Results: This systematic review suggest that the COVID-19 pandemic played a crucial role in hindering child development in early childhood. Conclusion: Therefore, it is important to promote and implement the use of policies and strategies to overcome these obstacles.

Hispanic/Latino communities have suffered a disproportionate burden due to the COVID-19 pandemic. Although Puerto Rico has one of the highest COVID-19 primary series vaccination rates nationwide, this estimate contrasts with the low uptake of booster doses (32.7%). This study aimed to assess health belief correlates of COVID-19 vaccine booster uptake. PR-CEAL recruited 787 participants via an online survey between December 2021 and January 2022. Sociodemographic characteristics and questions framed using the Health Belief Model were assessed. Analyses included adjusted Poisson regression models to estimate prevalence ratios (PR) of booster refusal. Overall, 22% of participants planned (10%) or refused (12%) the vaccine booster. Participants with lower income [PR=1.92; 95%CI=1.30, 2.84], in disagreement with vaccine benefits [PR=4.16; 95%CI=3.06, 5.64], and in agreement with booster concerns [PR=2.93; 95%CI=2.12, 4.04], efficacy [PR=2.76; 95%CI=2.00, 3.82], and safety [PR=2.97; 95%CI=2.15, 4.08] were significantly more likely to refuse the booster. Booster vaccination refusal was associated with lower perceived vaccine benefits and higher barriers among adults in Puerto Rico. Results informed CEAL team intervention strategies for public health campaigns to increase booster vaccine uptake.

The COVID-19 pandemic has now become very severe as never before due to the overwhelming spread of Omicron. We found that Omicron outbreak can be effectively prevented by inactivated vaccines, which averted an outbreak of more than 1.6 million people in Hangzhou, China. The 36 mutations in the target spike protein of Omicron neutralizing antibody enable it to evade the immune protection afforded by vaccines. This is because that mRNA and adenovirus-vector vaccines are designed to recognize the spike (S) glycoprotein of the SARS-CoV-2 wild-type (WT) strain. However, Inactivated vaccines contain the whole viral antigens and remain stable in their recognition of newly emerging variants of SARS-CoV-2. Our study confirmed the advantage of inactivated vaccines in the face of highly mutated Omicron variant and provided a basis for the development of effective vaccines to prevent future long-term transmission, mutation and recurrence of SARS-CoV-2.

Compartmental models that dynamically divide the host population in categories such as susceptible, infected and immune constitute the mainstream of epidemiological modelling. Effectively such models treat infection and immunity as binary variables. We constructed an individual based stochastic model that considers immunity as a continuous variable and incorporates factors that bring about small changes in immunity. The small immunity effects (SIE) comprise cross immunity by other infections, small increments in immunity by sub clinical exposures and slow decay in the absence of repeated exposure. The model makes qualitatively different epidemiological predictions including repeated waves without the need for new variants, dwarf peaks (peak and decline of a wave much before reaching herd immunity threshold), symmetry in the upward and downward slopes of a wave, endemic state, new surges after variable and unpredictable gaps, new surge after vaccinating majority of population. In effect the SIE model raises alternative possible causes of the universally observed dwarf and symmetric peaks and repeated surges, observed particularly well during the Covid-19 pandemic. We also suggest testable predictions to differentiate between the alternative causes for repeated waves. The model further shows complex interactions of different interventions that can be synergistic as well as antagonistic. The model suggests that interventions that are beneficial in the short run can also be hazardous in the long run.

Because of the covid-19 pandemic, world development has de-escalated, and some have come to a halt because there are many new problems that this era never faced before. Especially in Indonesia's education, every student in this millennial era who is already used to face-to-face lectures and teachers and professors are going through massive changes where every task will be done virtually. These actions are being done to prevent the spread of Covid-19. With online meetings, there will be many changes in the curriculum to find an effective way of studying, and the former curriculum will not fit because it was made for the offline lecture. Also adapting to it will take time. This article will bring up Indonesia’s education progress in this era while Covid-19 pandemic is happening and give an insight on how to anticipate this problem. Questions that arise from this topic are the effect of government effort on holding the pandemic, is it safe if school will be opened soon, and how education after this pandemic is. This research uses literature review methods where it’s done by search, gather, compile and interpret data that is being used. The data are from the latest research, namely from 2019 to 2021 published through Google Scholar, totaling 11 articles, and few online news to keep relevancy of the topic. The results of this study indicate that Covid-19 produces a change that is worse than the good. Even so, the government has allowed face-to-face and online learning according to the consent of students and parents. Thus, the community, especially students, teachers, and others, are expected to uphold education even though it is required to adapt according to existing protocols. From the research, literature review methods proved to be effective to study this topic while Covid-19 is happening to keep safety measures, but it does not give many details and specific information well. This method is recommended to researchers who don’t want to risk their life by being exposed to the pandemic.

The COVID-19 pandemic which have affected every part of the world have been deemed a public health concern and classified as a pandemic. The government imposing travel bans and quarantine measures have been found to be effective in preventing and reducing the spread of COVID-19. A reduction in physical activity and increase in the consumption of unhealthy foods have been observed to be some of the major implications of quarantine. Adequate physical activity and increased access to healthy foods would help in improving the psychological wellbeing of individuals thereby preventing the development of cardiovascular diseases.

This study clearly shows that the corona pandemic has a significant impact on consumers’ eating habits. More food is eaten overall, and more convenience products such as ready meals and canned food with a longer shelf life are purchased. The consumption of alcohol and confectionery has also increased. In return, the consumption of fresh fruit and vegetables has declined. It becomes clear that families who are financially affected by the pandemic represent a vulnerable group. With the increasing duration of the pandemic, repeated lockdowns, corona-related closings of schools and kindergartens, health consequences are to be expected in the medium to long term, especially for this population group.

As part of a plethora of global efforts to minimize the negative effects of the SARS-CoV2 (COVID-19) pandemic, we developed two different mechanisms that, after further development, could potentially be of use in the future in order to increase the capacity of ventilators with low-cost devices based on single-use-bag-valve mask systems. We describe the concept behind the devices and report a characterization of them. Finally, we make a description of the solved and unsolved challenges and propose a series of measures in order to better cope with future contingencies.

Since its inception in December 2019, Covid-19 has challenged the global scientific community. Some treatments were used in this infection, but doubts still persist regarding the use of medications ¹. More severe cases complicate with endothelial dysfunction, excess thrombin synthesis and decreased fibrinolysis which, associated with hypoxemia, lead to a hypercoagulability state ² and some authors indicate the use of anticoagulants for these ³. For mild cases, doubts remain regarding this indication. We will report the case of a patient with mild symptoms of covid-19, complicated by inferior mesenteric vein thrombosis.

This article investigated whether the atmospheric temperature had any role in the spread and vulnerability to COVID-19 worldwide and how that knowledge can be utilized to contain the fast-spreading disease. It highlighted that temperature was an important factor in transmitting the virus, and a moderately cool environment was the most favourable state for its susceptibility. In fact, the risk from the virus is reduced significantly in high temperature environment. Warm countries and places were likely to be less vulnerable. We identified various degrees of vulnerability based on temperature and specified countries for March and April. The maximum reported case, as well as death, was noted when the temperature was in the range of around 275°K (2°C) to 290°K (17°C). Countries like the USA, UK, Italy and Spain belonged to this category. The vulnerability was moderate when the temperature was less than around 275°K (2°C) and countries in that category were Russia, parts of Canada and few Scandinavian countries. For temperature 300°K (27°C) and above, a significantly lesser degree of vulnerability was noted. Countries from SAARC, South East Asia, the African continent and Australia fell in that category. In fact, when the temperature was more than 305°K (32°C), there was a unusually low number of reported cases and deaths. For warm countries, further analyses on the degree of vulnerability were conducted for the group of countries from SAARC and South East Asia and individual countries were compared. We also showed countries can switch from one vulnerability state to another based on the variability of temperature. We provided maps of temperature to identify countries of different vulnerability states in different months of the year. That influence of temperature on the virus and previous results of clinical trials with similar viruses gave us a useful insight that regulating the level of temperature can provide remarkable results to arrest and stop the outbreak. Based on that knowledge, some urgent solutions are proposed, which are practically without side effects and very cost-effective too.

COVID-19 Pandemic management has become the top priority of Government Institutions globally, which is justifiable seeing the high mortality of the disease. In India, Lockdowns by National, State and Local level administrations have greatly reduced the spread of the SARS COV-2 Virus. Some areas with a greater proportion of COVID-19 patients have been declared hotspots with increased restrictions on public activities through law enforcement. But quite often delay in identification of these hotspots leads to community transmission of the Virus thus aggravating the problem. A method to identify the areas which are at risk of becoming the next hotspot for the disease is the need of the hour[1]. In this Research document we will find the probable risk factors and make an appropriate scale to measure the vulnerability of an area, identified by its Postal code. To help with this a Pan India survey by the title of “Survey on General Indian population on the level of preparedness for COVID-19 pandemic” was launched and received around 1250 submissions, with the acquired data we will evaluate the risk factors and make appropriate scale to identify ‘pre-hotspots’.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has provoked major stresses on the health care systems of several countries, and caused the death of more than a quarter of a million people globally, mainly in the elderly population with pre-existing pathologies. Previous studies with coronavirus (SARS-CoV) point to gender differences in infection and disease progression with increased susceptibility in male patients, indicating that estrogens may be associated with physiological protection against the coronavirus. Therefore, the objectives of this work are threefold. First, we aim to summarize the SARS-CoV-2 infection pathway and the roles both the virus and patient play in COVID-19 (Coronavirus disease 2019) progression, clinical symptomology, and mortality. Second, we detail the effect estrogen has on viral infection and host infection response, including its role in both the regulation of key viral receptor expression and the mediation of inflammatory activity. Finally, we describe how ERs (estrogen receptors) and RAGE (receptor for advanced glycation end-products) play a critical role in metabolic pathways, which we envisage could maintain a close interplay with SARS-CoV and COVID-19 mortality rates, despite a current lack of research directly determining how. Taken together, we present the current state of the field regarding SARS-CoV-2 research and illuminate where research is needed to better define the role both estrogen and metabolic comorbidities have in the COVID-19 disease state, which can be key in screening potential therapeutic options as the search for effective treatments continue.

Severe outbreaks of infectious disease occur throughout the world with some reaching the level of an international pandemic: Coronavirus (COVID-19) is the most recent to do so. As such pandemics cause extensive loss of lives, hamper industrial operations, and cause economic losses in both developing and developed countries, it is critical to establish common standards of accuracy in the determination and reporting of cases. In particular, there are current concerns that countries are hiding or incorrectly reporting cases of COVID-19. In this paper, we set out a mechanism for using Zipf's law to establish the accuracy of international reporting of COVID-19 cases via a determination of whether an individual country's COVID-19 reporting follows a power-law for confirmed, recovered, and death cases. We observe that the probability of Zipf's law (P-values) for COVID-19 confirmed cases show that Uzbekistan has the highest P-value of 0.940, followed by Belize (0.929), and Qatar (0.897). For COVID-19 recovered cases, Iraq had the highest P-value of 0.901, followed by New Zealand (0.888), and Austria (0.884). Furthermore, for COVID-19 death cases, Bosnia and Herzegovina had the highest P-value of 0.874, followed by Lithuania (0.843), and Morocco (0.825). China, where the COVID-19 pandemic began, is a significant outlier in recording P-values lower than 0.1 for the confirmed, recovered, and death cases. This raises important questions, not only for China but also any country whose data exhibits P-values below this threshold. The main application of this work is to serve as an early warning for the World Health Organization (WHO) and other health regulatory bodies to perform more investigations in countries where COVID-19 datasets deviate significantly from Zipf's law. To this end, we also provide a tool for illustrating Zipf's law P-values on a global map in order to report anomalies.

Objectives: The impact of COVID-19 in metropolitan areas has been extensively studied. The geographic spread to smaller cities is of great concern and may follow hierarchical influence of urban centers. With that in mind, we investigated factors that affect vulnerability of inner municipalities in São Paulo State, Brazil, an area with 24 million inhabitants. Methods: Surveillance data for confirmed COVID-19 cases and admissions for severe acute respiratory disease (SARD) up to April 18^th were recorded for each of 604 municipalities that lay outside São Paulo metropolitan area. Vulnerability was assessed in Multivariable models, including sociodemographic indexes, road distance to the State Capital and the municipalities classification proposed by the Brazilian Institute of Geography and Statistics. Municipalities of great regional relevance were used as reference category for that classification. The outcome of interest for Cox regression was having COVID-cases, with time counting from the first report in São Paulo State. For binomial negative regression models, the outcomes of interest were rates of confirmed COVID-19 cases and admissions for SARD.Results: A total of 198 (32.8%) municipalities had autochthonous COVID-19 cases. In Cox models, affected municipalities were likely to have greater population density (Hazard Ratio[HR] for each 100 inhabitants per square kilometer, 1.07; 95% Confidence Interval [CI], (1.05-1.10)), proportion of inhabitants in urban area (HR, 1.02; 95%CI, 1.00-1.04), higher human development index (HDI, HR for 1%, 1.06; 95%CI, 1.00-1.13) and Gini Index for Inequality of income (HR for 1%, 1.04, 95% CI, 1.00-1.07). On the other hand, distance from the Capital was protective (HR for each 100Km, 0.82; 95%CI, 0.74-0.90). The HR95%[95%CI] also varied negatively according to the categories of influence of major centers (0.41 [0.22-0.77], 0.16 [0.09-0.32], 0.07 [0.03-0.15]). The binomial negative regression models for COVID-19 incidence also detected positive association with population density (Incidence Rate Ratio[IRR], 1.13; 95%CI, 1.07-1.18) and proportion of urban population (IRR, 1.04; 95%CI, 1.01-1.05), protection for cities distant to the Capital (IRR=0.73; 95%CI, 0.68-0.81) and increasing negative association for categories of influence (0.19 [0.09-0.42], 0.07 [0.03-0.15] and 0.03 [0.02-0.08]). Similar findings were detected when we used SARD incidence as outcome.Conclusion: Municipalities with greater population, density and regional influence were more likely to be affected earlier and more intensely by COVID-19. Non-pharmacological measures should be strengthened in those areas of greater risk.

On March 11, 2020, the World Health Organization declared the coronavirus outbreak a pandemic. Since December 2019, the world has experienced an outbreak of coronavirus disease 2019 (COVID-19). Epidemiology, risk factors, and clinical characteristics of patients with COVID-19 have been reported but the factors affecting the immune system against COVID-19 have not been well described. In this article, we provide a novel hypothesis to describe how an increase in cellular adenosine triphosphate (c-ATP) can potentially improve the efficiency of innate and adaptive immune systems to either prevent and fight off COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2 or SARS-CoV-2) is the cause of the respiratory infection known as COVID-19. From an immunopathological standpoint, coronaviruses such as SARS-CoV-2 induce an increase in a variety of T-helper 1 (Th1) and inflammatory cytokines and chemokines including interleukins IL-1, IL-6, CCL2 protein and CXCL10 protein. In the absence of proven antiviral agents or an effective vaccine, substances with immunomodulatory activity may be able to inhibit inflammatory and Th1 cytokines and/or yield an anti-inflammatory and/or Th2 immune response to counteract COVID-19 symptoms and severity. This report briefly describes four unconventional but commercially accessible immunomodulatory agents that could be employed in clinical trials to evaluate their effectiveness at alleviating disease symptoms and severity: Low-dose oral interferon-alpha, microdose DNA, low-dose thimerosal and phytocannabinoids.

There is an urgent need to advance safe and affordable COVID-19 vaccines for low- and middle-income countries of Asia, Africa and Latin America. Such vaccines rely on proven technologies such as recombinant protein-based vaccines to facilitate its transfer for emerging market vaccine manufacturers. Our group is developing a two-pronged approach to advance recombinant protein-based vaccines to prevent COVID-19 caused by SARS CoV2 and other coronavirus infections. One vaccine is based on a yeast-derived (Pichia pastoris) recombinant protein comprised of the receptor binding domain (RBD) of the SARS-CoV formulated on alum and referred to as the CoV RBD219-N1 Vaccine. Potentially this vaccine could be used as a heterologous vaccine against COVID-19. A second vaccine specific for COVID-19 is also being advanced using the corresponding RBD of SARS-CoV-2. The first antigen has already undergone cGMP manufacture and is therefore “shovel ready” for advancing into clinical trials, following vialing and required GLP toxicology testing. Evidence for its potential efficacy to cross-protect against SARS-CoV-2 includes cross-neutralization and binding studies using polyclonal and monoclonal antibodies. Evidence in support of its safety profile include our internal assessments in a mouse challenge model using a lethal mouse adapted SARS strain, which show that SARS-CoV RBD 291N1 (when adsorbed to Alhydrogel®) does not elicit eosinophilic lung pathology. Together these findings suggest that recombinant protein-based vaccines based on the RBD warrant further development to prevent SARS, COVID-19 or other coronaviruses of pandemic potential.

An outbreak caused by coronavirus disease 2019 (COVID-19) occurred in Wuhan City, Hubei Province, China, in December 2019. Up to March 2, 2020, at least 80180 cases have been reported. Most of the patients had a history of visiting Hubei Province or contacting with people who had ever stayed in or passed by Hubei Province, or exposed to symptoms. Some patients got infected only from asymptomatic contacts. This study aimed to report the epidemic features and lab identification of a patient confirmed with COVID-19 infection only from asymptomatic contact.

We assessed depression, anxiety, and stress in healthcare workers (HCWs) in 2023 and the evo-lution of depression in 2023 compared with 2022. In September-November 2023, 181 HCWs from the Infectious Diseases Hospital, Cluj-Napoca, Romania, completed the Depression, Anxiety, and Stress 21 Scale (DASS-21 R), the Patient Health Questionnaire-9 (PHQ-9), and the Hamilton Anxiety Rating Scale (HAM-A). The prevalence of moderate-to-severe levels was 13.81% for DASS-Depression, 18.79% for DASS-Anxiety, 16.02% for DASS-Stress, 19.89% for PHQ-9, and 12.16% for HAM-A. Moderate-to-severe PHQ-9 clinical depression was found in 19.89% of respondents, and moderate-to-severe HAM-A clinical anxiety in 12.16%. Moderate-to-severe PHQ-9 depres-sion was significantly lower in the 2023 study group (19.89%, N=181) compared with 2022 (30.60%, N=114) (p=0.036), also within the 2022-2023 follow-up study group (N=88) (p=0.026). We did not find significant statistical differences between those infected vs. non-infected, vaccinated vs. non-vaccinated, working with vs. non-working with SARS-CoV-2 infected patients. Males were significantly more stressed (p=0.018) and anxious (p=0.034), and physicians in training had the highest prevalence of moderate-to-severe depression (31.60%), followed by physicians (25.64%). In 2023, depression, anxiety, and stress symptoms decreased but remained within a concerning range. By addressing these psychological issues, we can prevent professional crises in the healthcare system.

With the rapid evolution of SARS-CoV-2, the emergence of new strains is an intriguing question. This paper presents an evolutionary theory to analyze the mutations of the virus and identify the conditions that lead to the generation of new strains. We represent the virus variants using a 4-letter sequence based on amino acid mutations on the spike protein and employ an n-distance algorithm to derive a variant phylogenetic tree. We show that the theoretically-derived tree aligns with experimental data on virus evolution. Additionally, we propose an A-X model, utilizing the set of existing mutation sites (A) and a set of randomly generated sites (X), to calculate the emergence of new strains. Our findings demonstrate that a sufficient number of random iterations can predict the generation of new macro-lineages when the number of sites in X is large enough. These results provide a crucial theoretical basis for understanding the evolution of SARS-CoV-2.

Background. A previous study demonstrated the performance of the Salivette® (SARSTEDT, Numbrecht, Germany) as a homogeneous saliva collection system to diagnose COVID-19 by RT-qPCR, notably for symptomatic and asymptomatic patients. However, for convalescent patients, the corroboration of molecular detection of SARS-CoV-2 in paired nasopharyngeal swabs (NPS) and saliva samples was unsatisfactory. Objectives. The aim of the present work was to assess the concordance level of SARS-CoV-2 detection between paired sampling of NPSs and saliva collected with Salivette® at two time points, with ten days of interval. Results. A total of 319 paired samples from 145 outpatients (OP) and 51 healthcare workers (HW) were collected. Due to significant waiting rate at hospital, most of the patients ate and/or drank in waiting their turn. Consequently, a mouth washing was systematically proposed prior saliva collection. None of the HW were diagnosed SARS-CoV-2 positive using NPS or saliva specimens at both time points (n=95) by RT-qPCR. The virus was detected in 56.3% (n=126/224) of the NPS samples from OP, but solely 26.8% (n=60/224) of the paired saliva specimens. The detection of the internal cellular control, the human RNase P, in more than 98% of the saliva samples, underlined that the low sensitivity of saliva specimens (45.2%) for SARS-CoV-2 detection was not attributed to an improper saliva sample storing or RNA extraction. Conclusions. Then, the mouth washing decreased viral load of buccal cavity conducting to impairment of SARS-CoV-2 detection. Viral loads in saliva neo-produced appeared insufficient for molecular detection of SARS-CoV-2. At the time that saliva tests could be a rapid, simple and noninvasive strategy to assess on large scale schooled children in France, the determination of the performance of saliva collection become imperative to standardize procedures.

This study sought to spatially characterise and explain the differences of peoples’ perceptions on the impact of COVID-19 based on the socio-economic disparities in Gauteng, using choropleth mapping and Geographically Weighted Regression (GWR). Results indicate that respondents from relatively vulnerable municipalities like Merafong, Mogale City and Lesedi reported life being worse, information scant, and overall despondency being high since COVID-19. These are areas that fall under the High to Very High categories in terms of the Socio-economic Risk Index. GWR results, however, did not show a high explanatory power on the COVID-19 variables se-lected for the research, based on R2 values. For instance, the residual in overall satisfaction with life after COVID-19 was the lowest (-0.5 to 0.5) in the less affluent districts of the Rand West City and Sedibeng. Residual variables on life changes after COVID-19 were also the lowest in the southern parts of the same districts, with other low values almost evenly distributed throughout the province for the variable ‘Government information on COVID-19 was scant’. Although overestimation and underestimation existed, most were relatively low falling between -1.5 to -0.5 and distributed evenly across the province. In sum, however, the findings point to the complexity of socio-economic factors in spatially characterising social risk and vulnerability. Additionally, the negative sentiments expressed by people from the more vulnerable locations in the province emphasise the need for more targeted interventions by government to cushion the residents of the province to the continued negative impacts of COVID-19.

Abstract: COVID-19 in 2020 brought challenges to the Brazilian public health system with an emerging virus with respiratory contagion called SARS-CoV-2. There are few studies in Brazil and in some countries, on the increased incidence of certain viral respiratory infections, includ-ing H1N1 and coronavirus and their association with low levels of vitamin D, zinc and iron. The aim of this study was to demonstrate that the deficit of vitamin D, zinc and iron has an impact on the infectious process of patients with COVID-19 and to establish new forms of prevention for the worsening of COVID-19 in the human body. Data were collected from medical records and test results from patients being followed up during the treatment period for COVID-19. Patients with low blood levels of vitamin D, zinc and iron during the treatment period of COVID-19 had a higher percentage of worsening and complications requiring hospitalization in intensive care beds. The ingestion of vitamin D, zinc and iron in the treatment period of patients with COVID-19 in addition to being an immunological protector against SARS-CoV-2 and alleviating the process of worsening the disease can also act as a biomarker in cases of this disease.

We show that low quality of all 427 Brazilian SARS-CoV-2 genomes recently published in Science (1) challenges their phylogenetic inference and may lead to incorrect typing of viral strains in clades with no statistical support. Absence of basecalling quality in genome assemblies and proper phylogeny parameter estimates preclude the assessment of signal-to-noise ratio in the data, downstream analysis and conclusions.

The COVID-19 pandemic has forced businesses to alter the way they operate. This includes, but may not be limited to, changing hours of operation, working with limited staff, and restricting customer access indoors. This could result in several challenges for businesses. In this study, we evaluate the impacts of COVID-19 on the horticultural industry and identify the challenges for businesses). Based on our research findings, the major challenges faced by businesses were not having enough employees and inventory to keep up with consumer demand during COVID-19. We also evaluate the effect of the pandemic on the sales of different plants, gardening products/services, and the overall revenues of businesses. For different types of plants included in the survey, landscape herbaceous flowers, landscape shrubs, and landscape trees showed the most significant increase in sales. In addition, for different gardening products/services, container plants, small plants, and soil &amp; compost showed the most significant increase in sales. 64% of the businesses indicated higher overall sales compared to same season previous year. Over 46% of the businesses reported increased sales in 2020 under COVID-19. These findings imply a greater demand potential for plants and gardening products/services from consumers, in light of this pandemic.

Regardless of the SARS-CoV-2 pandemic containment, it remains paramount to comprehensively understand its underlying mechanisms to mitigate potential future health and economic impacts, comparable to those experienced throughout the course of the pandemic. The angiotensin-converting enzyme 2 (ACE2) provide anchorage for SARS-CoV-2 binding, thus implicating that ACE and ACE2 might contribute to the variability in infection severity. This study aimed to elucidate predisposing factors influencing the disease course among people infected by SARS-CoV-2, focusing on angiotensin-converting enzyme (ACE) and ACE2 polymorphisms. Notably, despite similar demographics and comorbidities, COVID-19 patients exhibit substantial differences in prognosis. Genetic polymorphisms in ACE and ACE2 have been implicated in disease progression, prompting our investigation into their role in COVID-19 evolution. Using next-generation sequencing (NGS), we analyzed ACE and ACE2 genes in a sample group comprising six subjects infected by SARS-CoV-2. Our findings revealed a correlation between specific polymorphisms and COVID-19 outcomes. Specifically, ACE and ACE2 intronic deletions were observed in all deceased patients, suggesting a potential association with mortality. These results highlight the significance of genetic factors in shaping the clinical course of COVID-19, emphasizing the importance of further research into the impact of genetic variations on COVID-19 severity.

Abstract Background: The highest incidence rate of covid-19 in Iran was reported from Shahroud County. This study was conducted by geographic information systems (GIS) to determine the geographical distribution of Covid-19 in 60 days. Study design: A cross-sectional study Methods: This study was conducted in counties covered by Shahroud University of Medical Sciences, namely Shahroud and Mayami, from February 20, 2020 to April 18, 2020. The GIS can better show the spread of epidemics. This software indicates geographical distribution of disease spread and is very helpful in controlling the epidemics. Therefore, maps of spatial distribution and risk of infection to COVID-19 were prepared in different regions of Shahroud county using Arc-GIS software to better implement health policies. Results: During this sixty-day period, 529 confirmed cases were detected, of which 51% were men and the average age was 55 years. The maps showed high-risk to risk-free regions. Shahroud and Bastam cities were known as the coronavirus hot spots. The eastern region of Shahroud has the highest number of cases but some high risk areas are spread throughout the Shahroud city due to high infectivity of virus. Risk-based time maps indicated a reduction in the risk of infection at the end of the research period due to some mitigation and suppression strategies. Conclusions: Shahroud and Bastam are the most dangerous cities that, the number of patients and dissemination has decreased over time because of tracking definite patients and people in contact with them and implementation of preventive care.

The recent 2019-nCoV outbreak, spreading infection around the globe is jeopardizing the public health and global economy. The virus was reported to have emerged from an animal market in Wuhan, China at the end of 2019 and presumed to have originated from bats and eventually transmitted in humans. The entry of the virus into human cells is triggered by a series of molecular events initiated with the binding of a receptor-binding domain of viral spike protein to human Ace2 cell surface receptor. Based on the comparative sequence analysis of the well-known binding hotspots of human Ace2, cross-interacting potential of 2019-nCoV was predicted, which suggests Ace2 of wild animals like tiger, bear, orangutan, etc.; aquatic mammals like whale and dolphins; and domestic animals like cat, horse, goat, sheep, dog etc. as potential target. However, the recognition of Ace2 of bats, rats and mice by the 2019-nCoV spike protein remains under question. The study indicates that 2019-nCoV might have broad host range and may thus intensify the gravity of 2019-nCoV outbreak

With the emergence of COVID-19 we are confronted with a new clinical picture of acute respiratory distress syndrome in the intensive care unit. In the majority of patients, the respiratory mechanics are very different from the “normal” ARDS patient. We measured transpulmonary pressure and dead space ventilation to assess the effects of high and low PEEP levels on lung compliance and ventilation-perfusion mismatching. Advanced respiratory mechanics were assessed in 14 patients. Compared to ARDS patients, lung compliance was relatively high (61 ± 5 mL/cmH₂O). COVID-19 patients had high dead space ventilation and gas exchange impairment (Bohr 52 ± 3%; Enghoff modification 67 ± 2%; ventilatory ratio 2.24 ± 0.23). we show that higher PEEP levels decrease lung compliance and in most cases increase dead space ventilation, indicating that high PEEP levels probably cause hyperinflation in patients with COVID-19. We suggest using prone position for an extended period of time, and apply lower PEEP levels as much as possible.

Most striking observations in COVID-19 patients are the hints on pulmonary edema (also seen on CT scans as ground glass opacities), dry cough, fluid restrictions to prevent more severe hypoxia, the huge PEEP that is needed while lungs are compliant, and the fact that anti-inflammatory therapies are not powerful enough to counter the severity of the disease. We propose that the severity of the disease and many deaths are due to a local vascular problem due to activation of B1 receptors on endothelial cells in the lungs. SARS-CoV-2 enters the cell via ACE2, a cell membrane bound molecule with enzymatic activity that next to its role in RAS is needed to inactivate des-Arg⁹ bradykinin, the potent ligand of the bradykinin receptor type 1 (B1). In contrast to bradykinin receptor 2 (B2), the B1 receptor on endothelial cells is upregulated by proinflammatory cytokines. Without ACE2 acting as a guardian to inactivate the ligands of B1, the lung environment is prone for local vascular leakage leading to angioedema. Angioedema is likely a feature already early in disease, and might explain the typical CT scans and the feeling of people that they drown. In some patients, this is followed by a clinical worsening of disease around day 9 due to the formation antibodies directed against the spike (S)-antigen of the corona-virus that binds to ACE2 that could contribute to disease by enhancement of local immune cell influx and proinflammatory cytokines leading to damage. In parallel, inflammation induces more B1 expression, and possibly via antibody-dependent enhancement of viral infection leading to continued ACE2 dysfunction in the lung because of persistence of the virus. In this viewpoint we propose that a bradykinin-dependent local lung angioedema via B1 and B2 receptors is an important feature of COVID-19, resulting in a very high number of ICU admissions. We propose that blocking the B1 and B2 receptors might have an ameliorating effect on disease caused by COVID-19. This kinin-dependent pulmonary edema is resistant to corticosteroids or adrenaline and should be targeted as long as the virus is present. In addition, this pathway might indirectly be responsive to anti-inflammatory agents or neutralizing strategies for the anti-S-antibody induced effects, but by itself is likely to be insufficient to reverse all the pulmonary edema. Moreover, we provide a suggestion of how to ventilate in the ICU in the context of this hypothesis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide since its emergence and is causing the disease COVID-19. According to WHO, this is a zoonotic disease. Several cases have already been discovered where companion animals were affected due to virus spillover from humans, however, the symptoms are mild in most cases. We report the first documented case of SARS-CoV-2 infection and death of a domestic cat (Felis silvestris catus) in Hungary, where no other disease could be detected.

The gut microbiota plays a crucial role in maintaining host health and has a significant impact on human health and disease. In this study, we investigated the alpha diversity of gut microbiota in COVID-19 patients and analyzed the impact of COVID-19 variants, antibiotic treatment, type 2 diabetes (T2D), and metformin therapy on gut microbiota composition and diversity. We used a culture-based method to analyze the gut microbiota and calculated alpha-diversity using the Shannon H' and Simpson 1/D indices. We collected clinical data, such as length of hospital stay (LoS), C-reactive protein (CRP) levels, and neutrophil-to-lymphocyte ratio (NLR). We found that patients with T2D had significantly lower alpha-diversity than those without T2D. Antibiotic use was associated with a reduction in alpha-diversity, while metformin therapy was associated with an increase. We did not find significant differences in alpha-diversity between the Delta and Omicron groups. Length of hospital stay, CRP levels, and NLR showed weak to moderate correlations with alpha diversity. Our findings suggest that maintaining a diverse gut microbiota may benefit COVID-19 patients with T2D. Interventions aimed at preserving or restoring gut microbiota diversity, such as avoiding unnecessary antibiotic use and promoting metformin therapy, may improve patient outcomes.

Background: Signaling by toll like receptors (TLRs) initiates important immune responses against viral infection. The role of TLRs in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is not well elucidated. Thus, we investigated the interaction of TLRs agonists and SARS-COV-2 antigens with immune cells in vitro. Material & methods: 30 coronavirus disease 2019 (COVID-19) patients (15 severe and 15 moderate) and 10 age and sex matched control (HC) were enrolled. Peripheral blood mononuclear cells (PBMCs) were isolated and activated with TLR3, 7, 8 and 9 agonists, the spike protein (SP) of SARS-CoV-2 and the Receptor Binding Domain (RBD) unit of SP. Frequencies of CD3⁺IFN-β⁺ T cells, and CD3⁺IFN-g⁺ T cells was evaluated by flow cytometry. Interferon (IFN)-b gene expression was assessed by qRT-PCR. Results: The frequency of CD3+IFN-β+ T cells was higher in moderate and severe patients at baseline in comparison with HCs. Stimulation of PBMCs from moderate patients with SP and TLR8 agonist significantly upregulated the frequency of CD3+IFN-β+ T cells (P=0.0005 and 0.0024, respectively) when compared to non-stimulated (NS) samples. The greatest increase in CD3⁺IFN-b⁺ T cell frequency in PBMCs from severe patients was seen with TLR8 and TLR7 agonists when compared to NS (P= 0.003 and 0.0167, respectively). TLR stimulation did not significantly enhance the frequency of CD3+IFN-g+ T cells generated from PBMCs from moderate and severe patients compared with unstimulated controls. However, the frequency of CD3+IFN-ɣ+ T cells in PBMCs from moderate patients was upregulated by agonists of TLR3, 8 and 9, SP and RBD when compared with NS samples from HCs. The expression of the IFN-β gene after stimulation of CD3⁺T cells with the TLR8 agonist was also up-regulated in moderate than severe patients (moderate vs. severe: p=0.0006). In addition, stimulation of CD3⁺ T cells with SP, up-regulated the expression of IFN-β gene expression in cells from patients with moderate disease (moderate vs. severe: p=0.01). Conclusion: Stimulation of PBMCs from COVID-19 patients with a TLR8 agonist and with SP enhanced IFN-b protein and gene levels. This may potentiate immune responses against SARS-CoV-2 infection and prevent viral replication and spread.

Background: Routine childhood vaccination, e.g., for diphtheria-tetanus-pertussis (DTP), might provide an additional protection towards SARS-CoV-2 infection. This concept of heterologous immunity was explored in healthy children receiving both DTP and inactivated SARS-CoV-2 vaccines. Methods: A cross-sectional study was performed on 154 healthy children aged 6–8 years old in Jakarta, Indonesia. Their vaccination status of DTP (including diphtheria-tetanus booster vaccine at 5 years old) and CoronaVac (from 6 years old) were recorded. Peripheral blood samples were collected from all participants, in which anti-diphtheria toxoid IgG, anti-SARS-CoV-2 S-RBD antibodies and T cell-derived IFN-g were measured. Results: Study participants with complete DTP vaccination had significantly higher titer of anti-diphtheria toxoid IgG than the ones without (median=0.9349 versus 0.2113 IU/mL; p<0.0001). Upon stratification based on DTP and CoronaVac vaccination statuses, participants with complete DTP and CoronaVac vaccinations had the highest titer of anti-SARS-CoV-2 S-RBD antibodies (median=1,196 U/mL) and the highest concentration of SARS-CoV-2-specific T cell-derived IFN-g (median=560.9 mIU/mL) among all groups. Conclusion: Healthy children aged 6-8 years old with complete DTP and CoronaVac vaccinations exhibited higher SARS-CoV-2-specific adaptive immune responses, particularly on their T-cell response. This suggests an additional benefit of routine childhood vaccination to generate protection against novel pathogens, presumably via heterologous immunity.

Commuting to work by private vehicle is one of the main sources of air pollution in cities, mainly from NO2 and particulate matter (PM2.5 and PM10). With the spread of telework, traffic congestion during peak hours is reduced on certain days of the week, improving air quality. This study an-alyzes the relationship between the improvement of air quality improvement and urban traffic resulting from teleworking activities after the COVID-19 pandemic in Madrid, Spain. The article considers road traffic and teleworking before the COVID-19 pandemic (2018 and 2019), during the pandemic (2020 and 2021) and in the period after (2022 and 2023) in the city center and the in-fluence on certain environmental factors. Daily NO2, PM2.5, PM10, and O3 concentration data were collected at air quality stations in Madrid municipality, traffic data and some meteorological variables such as wind speed, precipitation and temperature were considered. When conducting correlation and regression analysis among the variables it shows a clear association between NO2 and traffic before the pandemic, which is lower for both PM and O3. This correlation was main-tained during the pandemic, except for O3, whose association increased during this period and then decreased in the later period due to various motives. These results seem to indicate the ex-istence of a relevant relationship between urban mobility and air quality and an especially rele-vant relationship with telework, suggesting the need for policies aimed at promoting sustainable mobility in the future.

A recent publication regarding a March 2023 Google Scholar search found Japan unique in healthcare providers’ reaction to COVID-19 vaccines. According to one article, negative sentiment by healthcare providers toward vaccines defines the research in this area, with concerns about side effects outweighing worries regarding infection. This current study investigates the anomaly through a scoping review of “COVID-19, Japan, vaccine hesitancy” in six relevant databases: Cochrane COVID-19 Study Register, OVID, ProQuest, PubMed, Scopus, and Web of Science. By following PRISMA guidelines, the intent is a more thorough examination of this unusual evalua-tion of COVID-19 vaccines by Japanese healthcare providers than offered by the March 2023 search. The finding is that of the 997 returns, only four were relevant for assessment inclusion. Of these four, three, published in Vaccines, support vaccine hesitancy in Japanese healthcare providers and their becoming more so regarding a subsequent dose of the vaccine. One article published in BMJ Open did not find this. Yet, the design of none of the studies was specific to investigating vaccine hesitancy in Japanese healthcare providers, making the conclusion questionable. Suggest-ed future research directions include investigating the primacy of those databases searched and the need for timeliness in examining COVID-19 anomalies.

The COVID-19 pandemic has highlighted the vitalness of telehealth in our medical world, where considering a restructuring of healthcare services has become paramount. In fact, telemedicine has recently earned a valuable place in many specialties; and its implications in cardiology and cardiovascular medicine were among the leading interests. In this letter, we gathered previous evidence supporting the merit of telemedicine in the fields of cardiology and cardiovascular medicine—medical branches in which patients require meticulous care and continuous monitoring—as well as protrusions of concerns about the uncertainty regarding the efficacy of telemedicine’s future implications and technologies. In sum, in the context of this still on-going pandemic, medical institutions must strive to improve telehealth technologies and implement solid future research directions in this growing field—to be able to persevere in meeting the needs of the patients. As long as no conclusive evidence exists regarding the fields where telemedicine is most worthwhile, healthcare systems will always keep the dread of wasting resources on developing ineffective programs. We conclude that telemedicine has been attributed a considerable attention in managing cardiac and cardiovascular conditions; nevertheless, further studies with solid designs are still needed to confirm its validity and utility in those specialties.

Based on hospital capacities, facts from past experience with the coronavirus disease 2019 (COVID-19) virus and the number of dark infections during the second wave (DII = 2D2), a reasonable limiting value of 140/D2 for the 7-day incidence per 100,000 persons (MSDIHT) and a second wave herd immunization threshold fraction value of 0.26 in Germany were calculated. If the MSDIHT is held below this limiting value, the German hospital system can cope with the number of new seriously infected persons without any triage decisions. On the basis of the SIRV epidemics model, the classical threshold values for herd immunization were calculated for 18 countries. For these countries, the dates regarding when herd immunization against the second COVID-19 wave will be reached were estimated

This paper is purposed to delineate the current situation around Bangladesh as well as impacts of Coronavirus Disease-2019 (COVID-19) around the country and how the people over here are encountering this threatening pandemic. COVID-19 is an international epidemic that has got rapid wide-spread throughout different countries of the world to date. After its first outbreak in China different continents started to make sense and get aware against COVID-19 though, due to its special strategy of transmission several countries have been quite deteriorated preventing it. All the countries are moving at their best forward to find out any solution so that whole world could get rid of this horrifying situation as soon as possible. The authors here have reported an overview of how the outbreak of COVID-19 had put its commence in Bangladesh and to date how people over here have been tracing the way to tackle this havoc. Also, the changes that have brought around due to the crisis have offered us some fertile lessons that are enunciated here by the authors. To conclude, special considerations are anticipated to be highlighted pertaining COVID-19 outbreak in Bangladesh.

Abstract: The overuse of antibiotic prophylaxis during the COVID-19 pandemic would have led to the devel-opment of antibiotic-resistant bacterial strains, thereby increasing the epidemiological burden of antimicrobi-al resistance. The aim of this study was to determine the prevalence and antibiotic resistance pattern of bacte-ria isolated in 02 referral health facilities in Yaoundé before and during the COVID-19 pandemic era. We conducted a retrospective study over a period of 03 years (from 1 January 2019 to 31 December 2021) in the bacteriology units of the Central and General Hospitals of Yaoundé, Cameroon. The review of the services' registers was done to record bacterial isolates (Streptococcus, Staphylococcus, Neisseria meningitidis and Entero-bacteriaceae) as well as their susceptibility to selected, specific and highly potent antibiotics: Cefixime, Azythromycin and Erythromycin. The relationship between each group of resistant bacteria and the antibiotic of interest was determined by simple linear regression; the comparison of the prevalences of before (2019) and during 2 consecutive years of the COVID-19 pandemic onset (2020 and 2021) was done by the Chi2 test of in-dependence. In all, 426 bacterial strains were included. It appeared that the highest number of bacteria iso-lates and lowest rate of bacterial resistance were recorded during the pre-COVID 2019 period in 2019 (160 isolates vs. 58.8% resistance rate). Conversely, lower bacteria stains but greater resistance burden were rec-orded during the pandemic era (2020 and 2021) with the lowest bacteria amount and peak of bacteria re-sistance registered in 2020, the year of COVID-19 onset (120 isolates vs. 70% resistance in 2020 and 146 iso-lates vs.58.9% resistance in 2021). In contrast to almost all others groups of bacteria where the resistance burden was quite constant over years, the Enterobacteriaceae exhibited greater resistance rate during the pandemic period [60%(48/80) in 2019 to 86.9%(60/69) in 2020 and 64.5%(61/95) in 2021)]. Concerning antibiotics, unlike Erythromycin, Azythromycin related resitance increased during the pandemic period and the resistance to Cefixim tends to decrease the year of the pandemic onset (2020) and re-increase one year therafter. A significant association was found between resistant Enterobacteriaceae strains and Cefixime (R= 0.7; P-value= 0.0001) and also, between resistant Staphylococcus strains and Erythromycin (R= 0.8; P-value= 0.0001). It could be that the more frequent use of these antibiotics has increased resistance rate especially in Enterobacteriaceae. Anticromicrobial resistance should be closely monitor during and after COVID pandemic era.

During the COVID-19 pandemic, WIC increased the Cash Value Benefit (CVB) for fruits and vegetables by roughly $25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n=55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. CVB use facilitators were existing household preferences for fruits and vegetables and the variety of products that can be purchased with the CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may be limiting the potential impact.

Background: There is a lack of knowledge about how nurses and general practitioners (GPs) collaborated during the COVID-19 pandemicin primary care settings. Our study examined the roles of primary care nurses during the pandemic’s first wave, between March and June 2020, in Switzerland. Methods: The study involved all eight general practices implementing of a nursing role to the practice’s team. Primary care practice staff members (nurses, GPs and medical assistants) have been involved on the development of a new organizational model. A mixed-methods design study collected quantitative data using daily activity monitoring and an electronic survey. Additionally, eight nurses and nine GPs participated in a focus group discussion and individual interviews. Results: GPs recognized the substantial contributions, versatility, and autonomy of the primary care nurses in their practices during the pandemic. Those nurses experienced their involvement positively, mainly thanks to their perceived autonomy. The distribution of activities between primary care practice professionals was heterogenous due to extrinsic and intrinsic factors. Conclusion: Both nurses and GPs agreed that there was added value in having primary care nurses ingeneral practices in time of crisis, and this agreement will bolster plans to integrate this workforce across the canton. The development of nurses’ roles in primary care during the pandemic was reliant on many factors, including practice organization and Switzerland’s healthcare reimbursement and payment system

Vaccination has proven to be one of the most effective strategies against the COVID 19 pandemic. Several studies have evaluated and confirmed its effectiveness in different populations, particularly in reducing severe outcomes such as hospitalization and death. However, the potential of vaccination to protect against infection itself has been overlooked. The aim of this study was to determine the effectiveness of the booster dose in a sample of Colombian patients during the fourth wave of COVID-19 pandemic, which was associated with the emergence and predominance of the Omicron variant. A cross-sectional study was conducted on individuals who underwent RT-PCR testing for COVID-19 detection in a dedicated laboratory in Bogotá, Colombia, between December 30th 2021 and February 7th 2022. A total of 1,468 subjects were included in the study. The comparison between fully vaccinated individuals with a booster dose and those without the booster dose revealed a 28% reduction in the odds of infection (OR = 0.719 CI 0.531 - 0.971). Age (OR = 1,009 CI 1,001 - 1,018) and low economic status (OR= 1,812 CI 1,416- 2,319) were associated with an increased risk of infection.These findings suggest the need for booster vaccination in the general population to improve the prevention rates of SARS-CoV-2 infection and mitigate severe outcomes.

As the world is striving to recover from the shockwaves triggered by the Covid-19 crisis, all hands are needed on deck to transition towards a green recovery and make peace with nature as prerequisites of a global sustainable development pathway. In this paper, we examine the blockchain hype and the gaps in data and tools to build promising use cases for blockchain technology to accelerate global efforts in the decade of action towards achieving the SDGs. We attempted to break the hype-cycle portraying blockchain’s superiority by navigating a rational blockchain use case development approach. By prototyping an SDG Acceleration Scorecard to use blockchain-enabled solutions as SDG accelerators, we aim to provide useful insights towards developing an integrated approach that is fit-for-purpose to guide organizations and practitioners in their quest to make informed decisions to design and implement blockchain-backed solutions as SDG accelerators. Acknowledging the limitations in prototyping such tools, we believe these are minimally viable products and should be considered as living tools that can further evolve as the blockchain technology is getting mature, its pace of adoption increasing, and its lessons learned, good practices and standards widely shared and internalized by teams and organizations working on innovation for development.

Appropriate diagnostic testing to identify persons infected with SARS-COV-2 is a vital part of a health system’s ability to control the global pandemic of COVID-19 disease. The primary purpose of this review is to provide an overview of the mass testing strategy implemented throughout the UAE and the overall impact it has made on containing and controlling the spread of the disease. This study describes the mass testing strategy and capacity of the UAE during the pandemic of the new coronavirus SARS-COV-2. The UAE has conducted 15 million polymerase chain reaction (PCR) tests to SARS-COV-2, as of 15 November 2020. The number of tests per day varied from 10,000 by the end of March to 120,000 tests per day in November 2020. The mass testing initiative across the entire UAE forms an integral part of a bigger strategy focusing on testing, tracing contacts and isolating positive cases.

In this COVID-19 pandemic, the use and dependency on Internet has grown exponentially. The number of people doing online activities such as e-learning, remote working, online shopping and others have increased. This has also led to increased vulnerability to cyber crimes. Cyber security attacks have become a serious problem. The common types of cyber security attacks are phishing, malware, ransomware, social engineering, identity theft and denial-of-service. The attackers target the victims in order to get their credential information or financial benefits. Those people who are doing online activities are vulnerable to cyber threats. This is because the network is not safe. The attackers are able to code according to the weaknesses of the Internet. Once the attackers hack into the devices, they have the root access and can do whatever they want to do with the device. In this research paper, the concept of cyber security attack and detailed research about real attacks are discussed. This is followed by detailed review about the recent cyber security attacks with a critical analysis. Moreover, the research paper will be proposing the latest research contribution of cyber security during COVID-19 and the implementation scenario which will give the examples about how the companies maintain privacy as well as the limitations. Then, the paper will be discussing the reasons that people are vulnerable to cyber security and the unique solution to the problems stated. Finally, this paper will conclude with an in-depth analysis and future direction for cyber security research.

Objectives: In December 2019 a novel human-infecting coronavirus, SARS-CoV-2, has emerged. The WHO has stated the epidemic as a “public health emergency of international concern”. A drammatic situation has emerged with thousands of deaths, occurring mainly in the aged and very ill people. Epidemiological studies suggest that immune system function is impaired in elderly individuals and these subjects often present a severe deficiency in nutrients as fatsoluble and hydrosoluble vitamins. Design: In this first part of the review about Cov2 in aged people, we searched for reviews describing the characteristics of autoimmune diseases and the available therapeutic protocols for their treatment. We sed them as a paradigm with the purpose to retrieve pathogenetic mechanisms in common among these pathological conditions and SARS-CoV-2 infection, as well as the alteration induced in immune system function by this virus, or by its homologous SARS-CoV. Results: SARS-CoV-2 infection induces an important immune system dysfunction with the development of an exhuberant proinflammatory response in the host, and with the development of a life-threatening condition defined as Cytokine Release Syndrome (CRS). This leads to the Acute Respiratory Syndrome (ARDS), mainly in the aged people. High mortality and lethality rates have been observed in the elderly subjects with CoV-2-related infection. Conclusion: These diseases may serve as a paradigm for the study of CRS emerging in the course of SARS CoV-2 infection. This review discusses about the possible activity of Vitamin A, D, E and C in restoring normal antiviral Immune System function or the potential therapeutic role of these micronutrients as a part of a multi-treatment strategy against SARS- CoV-2 infection.

We analyze the Covid-19 mortality scenario in India and compare it with those in other large-population regions such as Asia-excluding-China, Africa, European Union, South America, and USA. We compare existing fatality data and offer an interpretation for low fatality based on immunity due to endemic malaria and TB. We identify the hot climate in the past summer as a possible cause for low death count in southern-hemisphere countries without endemic malaria and TB. We also make India-specific observations for easing the lockdown and estimations for the time required to attain herd immunity. Whatever optimism we present should be viewed as a guarded optimism. There should not be room for complacency.

Macrophage-derived chemokine belongs to the CC subfamily. It is produced by dendritic cells (DCs) and macrophages with or without external stimulation. We have previously shown a statistically significant depletion of MDC/CCL22 concentrations in a number of studies concerning COVID-19. These shifts in concentrations demonstrated stability unrelated to the SARS-CoV-2 genetic variant and remained noticeable even in convalescent patients. In this work, we analyze MDC/CCL22 dynamics in various diseases, including those that manifest with inflammation in lung tissue. In addition, we provide our hypothesis on such a decrease in MDC/CCL22 concentrations in COVID-19. If its secretion by producer cells is unperturbed, then it is possible for viral products to bind to this chemokine and to block its functional activity. There is, however, another possible explanation directly linked to depletion in DC subpopulations and the inhibition of their function. We also discuss MDC/CCL22's role in the immunology of novel coronavirus infection, based on both our own data and other studies.

To describe the main health surveillance strategies for the control of COVID-19 in Brazil, with emphasis on decisions and actions taken at the federal level to prevent the infection caused by the new SARS-CoV-2. This is a scoping review study carried out from November 2019 to January 2021 using the DECS and MeSH health descriptors in Portuguese and English in four databases, in addition to the legislation found on the Brazilian Government's legislation portal. Based on the analysis of the documents, the actions describe non-pharmacological and pharmacological measures, measures related to decisions on closing and opening international borders, the acquisition of supplies and essential services. Although some strategies for containing the pandemic were identified, discrete and unnoticed surveillance measures are observed in view of the number of cases and number of deaths during the period of research analysis. The results show the absence of the federal level as support for the states and municipalities and imply decision-making and planning of actions by the Unified Health System to control the pandemic.

Pandemics, and other risk-related contexts, require dynamic changes in behavior as situations develop. Human behavior is influenced by both explicit (cognitive) and implicit (intuitive) factors. In this study, we used psychological distance as a lens to understand what influences our decision-making with regards to risk in the context of COVID-19. The study was based on the rationale that our relational needs are more concrete to us than the risk of the virus. First, we explored the impact of social-psychological distance on participants’ risk perceptions and behavioral willingness. As hypothesized, we found that close social relationships of agents promoted willingness to engage in risky behavior. In the second phase, we tested an intervention designed to increase the concreteness of information about virus transmission as a mechanism to mitigate the bias of social influence. We found that the concreteness intervention resulted in significantly reduced willingness to engage in risky behavior. As such, communications aimed at changing the behavior of citizens during times of increased risk or danger, should consider conceptually concrete messaging when communicating complex risk, and hence may provide a valuable tool in promoting health-related behavior.