Clinical Manifestations Of COVID-19 Research Articles

Kelainan Neurologi akibat Kondisi Hiperkoagulasi pada Pasien Coronavirus Disease-19

Coagulopathy is one of the clinical manifestations of severe Coronavirus Disease of 2019 (Covid-19), and causes a poor prognosis of the disease. The clinical manifestations of Covid-19 have a broad spectrum, namely asymptomatic, non-specific mild symptoms (fever, dry cough, diarrhea), mild pneumonia, severe pneumonia (dyspnea, tachypnea, and impaired gas exchange), acute respiratory distress syndrome (Acute Respiratory Syndrome). Distress Syndrome/ARDS), Disseminated Intravascular Coagulation (DIC), sepsis, and multiple multiorgan dysfunction syndrome. Covid-19 patients experience a severe inflammatory state that causes an increase in the activation of the coagulation cascade, an increase in thrombin, and a hypercoagulable state, thereby increasing the risk of thrombosis in the blood vessels of the brain and spinal cord. Conditions such as old age, smoking, hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and malignancy can increase a patient's risk of experiencing a more severe degree of COVID-19 and higher mortality. The presence of Covid-19 complications such as thrombosis can affect the patient's prognosis and mortality

New coronavirus infection in patients with chronic non-communicable diseases in primary care

BACKGROUND: The pandemic of a new coronavirus infection, which began in the Chinese city of Wuhan in December 2019, has spread to more than 200 countries and territories. There are a number of studies, the results of which indicate that deaths are mainly registered among the middle-aged and elderly population with chronic non-communicable diseases. Most of these studies are based on the study of cases of COVID-19 with severe course or in hospitalized patients. At the same time, a greater number of patients, including those with chronic non-communicable diseases, carry COVID-19 to a mild degree and remain under the supervision of primary care physicians.
 AIM: To identify risk factors for the development of severe COVID-19 in patients with chronic non-communicable diseases who sought outpatient care during various periods of increased incidence of new coronavirus infection from March 2020 to February 2022.
 MATERIALS AND METHODS: The study was carried out on the basis of the Family Medicine Center of North-Western State Medical University named after I.I. Mechnikov, which provides primary health care to the population attached under compulsory health insurance. The design of the study was published earlier. A retrospective cohort study was conducted based on the analysis of outpatient records of patients who sought medical care at the Family Medicine Center during various periods of increased incidence of COVID-19: from 19.03.2020 to 30.06.2020 (group 1), from 1.10.2021 to 30.11.2021 (group 2) and from 18.01.2022 to 28.02.2022 (group 3).
 RESULTS: 343 patients were included in the study: 137 men (39.9%) and 206 women (60.1%). The number of patients with at least one chronic non-communicable disease was 232 (67.9%). It was found that the severity of COVID-19 is not affected by the presence of one or more chronic non-communicable diseases of mild severity in the patient. At the same time, grade II obesity and grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 13.4 and 5.4 times, respectively (p 0.05). It should be noted that the combination of these diseases significantly increased the likelihood of developing severe COVID-19 by 11.9 times (p 0.05).
 CONCLUSIONS: Regardless of the period of morbidity, the clinical manifestations of COVID-19 in patients with chronic non-communicable diseases have their own characteristics: weakness, sweating, dry and wet cough are significantly more common (p 0.05). With each subsequent wave of increase in the incidence of COVID-19 in patients with chronic non-communicable diseases, there is a significant tendency to decrease the frequency of severe and very severe course of the disease, pneumonia and hospitalization, as in patients without chronic non-communicable diseases. It was found that the severity of the COVID-19 course is not affected by the presence of mild chronic non-communicable diseases in the patient. At the same time, grade II and higher obesity or grade III hypertension are independent factors that significantly increase the risk of developing severe COVID-19 by 11.9 and 5.4 times, respectively (p 0.05). The combination of these diseases significantly increased the probability of developing severe COVID-19 by 13.4 times (p 0.05).

ПАТОГЕНЕТИЧНІ АСПЕКТИ ПОСТ КОВІДНИХ УСКЛАДНЕНЬ У СИСТЕМІ ЗГОРТАННЯ КРОВІ

Disorders in the blood coagulation system play an important role in the pathogenesis and clinical manifestations of COVID-19 both during the acute phase of the disease and in the post-infectious period. The coronavirus disease is associated with a high risk of thrombotic and thromboembolic complications due to a prolonged state of hypercoagulation, which can occur even after recovery. Despite the extremely large amount of scientific data, the pathophysiological aspects of SARS-CoV-2 infection remain uncertain. The presented review summarizes the results of modern scientific research on pathological changes in the hemostasis system that can occur against the background of the transferred coronavirus disease, and considers the main mechanisms of the development of COVID-19-associated coagulopathies. From scientometric databases PubMed, Scopus, Web of science, ScienceDirect, Google Scholar, etc. the latest publications devoted to this issue were selected and analyzed. Hemostasis is a dynamic, tightly regulated process which is provided by three closely interrelated links: coagulation, anticoagulation, and fibrinolytic. Activation of the coagulation cascade and the platelet link of hemostasis, which causes a prothrombotic state in convalescent patients with COVID-19, is primarily associated with dysregulation of the renin-angiotensin system, a long-term local and systemic inflammatory reaction, an increase in the immune response due to the release of pro-inflammatory mediators that interact with platelets, stimulate the expression of tissue factor, suppress the fibrinolytic system and lead to dysfunction of the endothelial cells of blood vessels, triggering thrombogenesis. Understanding the pathogenetic mechanisms of post-COVID-19 complications and monitoring the main markers of hemostasis (level of D-dimer, fibrinogen, prothrombin time, platelet count, etc.) are important for the timely detection of disorders in the blood coagulation system, and make it possible, depending on the clinical situation, to take timely measures for their correction at various stages of pathology development.

Self-perception of cognitive sequels in post-COVID-19 individuals.

The aim of this study was to assess the self-perception of cognitive sequelae in post-COVID-19 individuals and identify whether there is a possible relationship between the outcome of the participants' self-perception and sociodemographic and clinical data. This is a cross-sectional study, carried out through an online questionnaire on the Google Forms platform, in which sociodemographic data, general health data, clinical manifestations of COVID-19, and post-COVID-19 self-perception of the cognitive domains of memory, attention, language, and executive functions were collected. The final sample consisted of 137 participants, and it was possible to identify that memory and attention were the domains with the highest impression of worsening post-COVID-19, followed by executive functions and language. In addition, it was identified that being female may be related to a worse self-perception of all cognitive functions and that having depression or other psychiatric diseases and obesity can significantly affect at least half of the cognitive domains evaluated. This study pointed to a post-COVID-19 cognitive worsening of the participants.

COVID-19's next top model

To date, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reportedly infected over 630 million people, leading to the deaths of more than 6.5 million people. Despite expansive investigation of its pathogenesis and the development of vaccines and therapeutics, research in preclinical models must continue to ensure that we can combat the continuing COVID-19 and future pandemics. Two exemplary animal models – Syrian golden hamsters and K18-promoter-driven human ACE2-expressing (K18-hACE2) mice – recapitulate the human pathology, immune response and clinical manifestations of COVID-19, and are also accessible with low cost. However, there are vast differences in the severity of disease in these models, with mild clinical manifestations in the hamsters and high lethality in the mice.Jeong and colleagues intranasally infected Syrian golden hamsters and K18-hACE2 mice with the same dose of SARS-CoV-2, resulting in mild clinical signs in hamsters, such as minor decreases in body weight, and severe manifestations in mice, leading to death by 7 days post-infection (dpi). The authors thoroughly interrogated the infection in these animals to elucidate the mechanisms behind the differing clinical outcomes. They used in situ hybridization imaging to show that SARS-CoV-2 infection was mainly confined to microvillar club (∼88%) and ciliated (∼12%) cell subsets in the bronchus region of hamsters. These infected cells were rapidly eliminated, with high levels of cell death apparent at 2 dpi. By 5 dpi, in the hamsters, the infected area was highly infiltrated with B and CD8+ T cells, which are important for clearing infected cells. Surprisingly, lung pathology was more severe in hamsters than in mice at 5 and 7 dpi, with imaging revealing markers of bronchioalveolar adenoma and bronchopneumonia in hamsters. However, after 7 dpi, pulmonary lesions and adaptive immune cell accumulation were ameliorated, with only regenerative hyperplasia apparent in the bronchus at 14 dpi. Overall, the initial robust immune response was key in limiting and resolving SARS-CoV-2 infection in hamsters.By contrast, SARS-CoV-2 primarily infected the alveolar area of mouse lungs, with type 1 alveolar cells comprising roughly 97% of total infected cells, and very few infected cells were eliminated. The infection also spread to distal organs, such as the spleen at 2 dpi and the brain at 7 dpi, which resulted in inflammatory cell death and histopathological damage in several organs. B and T cells progressively accumulated in the mouse lungs up until death at 7 dpi, but the extent of infiltration was much lower than that in hamsters at early time points. The deficient clearance of infected cells in the mice was potentially due to the lower levels of CD8+ T cells, which are associated with COVID-19 mortality in humans. Taken together, these results indicate that the pathology of SARS-CoV-2 infection in K18-hACE2 mice mimics severe COVID-19 in humans.COVID-19 pathology is highly variable in humans, and the mechanism behind this variability needs to be thoroughly explored to optimise prognosis and treatment. Direct comparison of these two integral disease models not only informs future research using animal models of COVID-19, but also provides comprehensive insights into variation in COVID-19 pathology.

Pan-neutralizing, germline-encoded antibodies against SARS-CoV-2: Addressing the long-term problem of escape variants.

Despite the initially reported high efficacy of vaccines directed against ancestral SARS-CoV-2, repeated infections in both unvaccinated and vaccinated populations remain a major global health challenge. Because of mutation-mediated immune escape by variants-of-concern (VOC), approved neutralizing antibodies (neutAbs) effective against the original strains have been rendered non-protective. Identification and characterization of mutation-independent pan-neutralizing antibody responses are therefore essential for controlling the pandemic. Here, we characterize and discuss the origins of SARS-CoV-2 neutAbs, arising from either natural infection or following vaccination. In our study, neutAbs in COVID-19 patients were detected using the combination of two lateral flow immunoassay (LFIA) tests, corroborated by plaque reduction neutralization testing (PRNT). A point-of-care neutAb LFIA, NeutraXpress™, was validated using serum samples from historical pre-COVID-19 negative controls, patients infected with other respiratory pathogens, and PCR-confirmed COVID-19 patients. Surprisingly, potent neutAb activity was mainly noted in patients generating both IgM and IgG against the Spike receptor-binding domain (RBD), in contrast to samples possessing anti-RBD IgG alone. We propose that low-affinity, high-avidity, germline-encoded natural IgM and subsequent generation of class-switched IgG may have an underappreciated role in cross-protection, potentially offsetting immune escape by SARS-CoV-2 variants. We suggest Reverse Vaccinology 3.0 to further exploit this innate-like defense mechanism. Our proposition has potential implications for immunogen design, and provides strategies to elicit pan-neutAbs from natural B1-like cells. Refinements in future immunization protocols might further boost long-term cross-protection, even at the mucosal level, against clinical manifestations of COVID-19.

Cytolytic syndrome in patients with COVID-19

. Identify cytolysis syndrome among patients with COVID-19 and explore the potential relationship between the course of COVID-19 and liver damage. Materials and methods. 450 people with a diagnosis of "U07.1 - Coronavirus infection COVID-19, virus identified" were examined, undergoing and inpatient and outpatient treatment at Tuymazinskaya Central District Hospital. CT scan of the chest organs, biochemical blood test with calculation of ALT, AST, total protein, glucose, total bilirubin, APTT, PTI, INR, fibrinogen were evaluated. Results. The presence of cytolytic syndrome was detected in 217 (48.2%) patients. The ALT level was 60 [23;72] U/L, and the AST level was 45 [22;57] U/L. Between the severity of the course and the ALT level, a direct, strong significant correlation was revealed (ρ=0.724, t=22.26, p>95%). A direct, significant correlation of moderate strength was found between the severity and percentage of lung parenchymal lesions (ρ=0.68, t=19.62, p>95%), AST level (ρ=0.68, t=19.53, p>95%), age of patients (ρ=0.51, t=12.55, p>95%), BMI (ρ=0.4, t=9.44, p>95%). Comparing the degree of damage to the lung parenchyma with the level of AST, a direct, significant correlation of moderate strength (ρ=0.5, t=12.38, p>95%) was revealed, as well as with the level of ALT (ρ=0,5, t=11.98, p>95%), total protein level (ρ=0.38, t=8.8, p>95%), age (ρ=0.35, t=7.85, p>95%. Conclusion. Clinical manifestations of COVID-19 are characterized by polysyndromicity, including a cytolytic syndrome. Changes in liver function parameters found in COVID-19 are associated with the severity of the infection, age and BMI. An important point in the post-COVID rehabilitation of patients is inclusion of hepatoprotectors.

Clinical manifestations of COVID-19: An overview of 102 systematic reviews with evidence mapping.

ObjectiveCoronavirus disease 2019 (COVID‐19) has rapidly spread worldwide, but there is so far no comprehensive analysis of all known symptoms of the disease. Our study aimed to present a comprehensive picture of the clinical symptoms of COVID‐19 using an evidence map.MethodsWe systematically searched MEDLINE via PubMed, Web of Science, Embase, and Cochrane library from their inception to March 16, 2021. We included systematic reviews reporting the clinical manifestations of COVID‐19 patients. We followed the PRISMA guidelines, and the study selection, data extraction, and quality assessment were done by two individuals independently. We assessed the methodological quality of the studies using AMSTAR. We visually presented the clinical symptoms of COVID‐19 and their prevalence.ResultsA total of 102 systematic reviews were included, of which, 68 studies (66.7%) were of high quality, 19 studies (18.6%) of medium quality, and 15 studies (14.7%) of low quality. We identified a total of 74 symptoms including 17 symptoms of the respiratory system, 21 symptoms of the neurological system, 10 symptoms of the gastrointestinal system, 16 cutaneous symptoms, and 10 ocular symptoms. The most common symptoms were fever (67 studies, ranging 16.3%–91.0%, pooled prevalence: 64.6%, 95%CI, 61.3%–67.9%), cough (68 studies, ranging 30.0%–72.2%, pooled prevalence: 53.6%, 95%CI, 52.1%–55.1%), muscle soreness (56 studies, ranging 3.0%–44.0%, pooled prevalence: 18.7%, 95%CI, 16.3%–21.3%), and fatigue (52 studies, ranging 3.3%‐58.5%, pooled prevalence: 29.4%, 95%CI, 27.5%–31.3%). The prevalence estimates for COVID‐19 symptoms were generally lower in neonates, children and adolescents, and pregnant women than in the general populations.ConclusionAt least 74 different clinical manifestations are associated with COVID‐19. Fever, cough, muscle soreness, and fatigue are the most common, but attention should also be paid to the rare symptoms that can help in the early diagnosis of the disease.

COVID-19 Medical Research in Oman: A Bibliometric and Visualization Study.

ObjectivesTo study the quantum and pattern of the COVID-19-related medical research publications that had contributions from researchers in Oman, using bibliometric analysis.MethodsData on the COVID-19-related medical research publications with contributions from authors in Oman were sourced from the Scopus database. The main search keywords were ‘COVID-19’ and ‘Oman’. The search included data from 1 December 2019 till 21 August 2021. A bibliometric method utilizing citation analysis and science mapping was applied to the selected data. VOSviewer software was used for constructing and visualizing various bibliometric networks.ResultsThe search query returned 360 documents which included those by authors from Oman. After excluding 83 of these due to irrelevance, 277 documents were finally selected for analysis. Three macro research themes emerged: treatment of COVID-19 cases, epidemiology and impact of COVID-19, and etiology and clinical manifestations of COVID-19. A total of 4533 sources were cited in the selected 277 documents. Most articles were published in the International Journal of Infectious Diseases (IJID), followed by Oman Medical Journal, and Sultan Qaboos University Medical Journal. The most cited references included the Lancet, followed by the New England Journal of Medicine, and the Journal of the American Medical Association. The largest number of papers were authored by researchers from Sultan Qaboos University followed by the Oman Ministry of Health. Regarding the number of citations received per paper, the top rank went to the Ministry of Health, followed by Sultan Qaboos University Hospital and Khoula Hospital.ConclusionsOman has significantly contributed to the COVID-19-related medical knowledge despite the challenges of conducting research amidst the increased workload during the pandemic. Most publications in Oman were collaborative projects. Based on the evaluated literature, further research focusing on vaccines and therapeutics is warranted.

Impact of COVID-19 on cardiovascular diseases: experience at a teaching hospital from rural Telangana

Background: COVID-19 is drastically affecting the health of millions of people globally. Further, the restrictions imposed during lockdowns to curtail the spread of COVID-19 have also shown impact on the economy, psychology and lifestyle of the people. Currently, little is known about the prevalence and clinical manifestations of COVID-19 in coronary heart diseases in rural India. The present study aimed to find the effect of COVID-19 and lockdown on the prevalence of coronary heart diseases in rural Telangana.Methods: The present retrospective study was carried on 197 medical reports of cardiac inpatients who visited RVM Institute of Medical Sciences and Research Center, Siddipet, Telangana during the period 17th January 2020 to 6th August 2020. The data obtained was analyzed by descriptive statistics using IBM SPSS Statistics version 21.0.Results: Admission of patients with STEMI (53.6% prelockdown; 26% lockdown period; 36.4% post lockdown) and arrhythmia (7.3% prelockdown; 1.3% post lockdown) decreased while there was a significant increase in hospitalization of myopericarditis patients (1% pre lockdown vs. 10.5% lock down, 9.2% post lockdown) after the initiation of lockdown period. Further, STEMI (mean age 42.07±15.06) and myopericarditis (mean age 30.8±9.02 years) was commonly seen in younger age group patients less than 45 years after the initiation of lockdown period. The mortality rate was 6.6% (n=13) in the total study period of which 57.5% (n=7) deaths were due to myocardial infarction. 63.6% of the cardiac patients tested by RT-PCR were found to be positive for COVID-19.Conclusions: The prevalence of cardiovascular diseases varied with lockdown periods. Young adults in rural Telangana were also affected by COVID-19 and lockdown.

Clinical aspects of diarrhea during the pandemia of COVID-19

The aim. To investigate the clinical peculiarities of adult patients with diarrheal syndrome, associated with coronavirus infection COVID-19.The materials and methods. There has been carried out the analysis of 56 patients aged 26-81 years, hospitalized with acute enteric infection at the Municipal Infectious Diseases Hospital №8 (not reprofiled as hospital for the treatment of coronavirus infection COVID-19 patients) in the course of August 2020 – February 2021 and the patients with cause-effect relationship with COVID-19. There have been used the routine diagnostic methods, the analysis of feces for causative agents of diarrhea was tested by the methods of bacteriological and immunoenzymatic analysis, the analysis of feces for toxins A and B Clostridium difficile was tested method of immunochromatographic assay; the blood serum was tested by method of immunoenzymatic analysis and the analysis of nasopharyngeal swabs was tested by immunochromatographic assay and PCR test for markers SARS-COV-2. The statistical material treatment has been done using Statistical Package of IBM SPSS Statistics-22.The results. There have been registered 51,8% of cases – diarrhea as one of the clinical manifestations of COVID-19 in adult patients (the first group of patients), in 48,2% of cases – diarrhea as a result of recently treated COVID-19 and a massive course of antibiotics (the second group of patients). In the second group 12 patients have been diagnosed with clostridial infection, 15 patients – with antibiotic-associated diarrhea. There has been registered the main severity of clinical manifestations in patients with clostridial infection. The disease being characterized by severity of colitis syndrome, the blood sedimentation rate increasing, hyperleukocytosis in haemogram, hypoproteinemia and hypoalbuminemia. The aggravating factors are combined comorbidity and patients aged over 55 years.The conclusion. There should be used the differential approach for diarrheal syndrome in patients with coronavirus infection. Taking into account the massive course antibiotics’ side effects, the analysis of feces for pathogenic flora must be included into the medical examinations such as Clostridium difficile and the course of probiotic and anticlostridial medicines should be done.

The clinical case: COVID-19 in a child with chronic kidney disease

Since the spread of the novel coronavirus infection, most researchers have noted a low proportion of sick children in general pediatric cohort compared to adults, who had a mild disease course and rare complications. The most frequent clinical manifestations of the disease are respiratory and, some less frequently diarrheal syndromes. The disease has predominantly mild or asymptomatic course. The risk of adverse outcomes in children, similar to adults, clearly correlate with the presence of background chronic pathology. The need for respiratory support prevails in children with a severe premorbid burden. Here, a clinical case of ongoing novel coronavirus infection in adolescent patient comorbid with chronic kidney pathology is described. In adolescence, the patient was diagnosed with mesangioproliferative glomerulonephritis (IgA-nephropathy), and further registered at the dispensary receiving a combination therapy with angiotensin converting enzyme inhibitors and disaggregation drugs. The epidemiological history contained no established contacts with infectious patients. The clinical manifestations of COVID-19 in the patient are represented by catarrhal and diarrheal syndromes, transient renal dysfunction in the acute period of the disease. The onset of coronavirus infection was clinically characterized by symptoms of damaged gastrointestinal tract and was considered as acute gastroenteritis of infectious etiology. Empirically prescribed antibacterial therapy in combination with antiplatelet agents and symptomatic drugs had no effect. The diagnosis of the novel coronavirus infection was verified only on day 4 of hospitalization, clinical and laboratory signs of lung damage emerged. The inflammatory process developed in the patient lungs was secondary to the main pathology. The severity of the patients condition was determined by the presence of respiratory and renal insufficiency. Lung damage with minimal severity complaints and clinical data had a bimodal pattern and required respiratory support. A comprehensive approach to treatment, including respiratory, antiviral, enterosorption, anticoagulation, anti-inflammatory, antihypertensive, hepatoprotective, symptomatic therapy with change in antibacterial drugs allowed to achieve positive dynamics. On day 12 of the illness, the patient required no respiratory support. The presence of symptoms of gastrointestinal tract damage in COVID-19 necessitates the mandatory inclusion of PCR assay for SARS-CoV-2 into diagnostic protocol in patients with diarrheal syndrome to perform etiological disease interpretation.

THE EFFECT OF COVID-19 ON MYOCARDIAL DAMAGE: A CLINICAL CASE

Despite the fact that the general clinical manifestations of COVID-19 are well known, there remain problems associated with the impact of COVID-19 on human health, in addition to its effects on the respiratory system. Patients with COVID-19 and concomitant cardiovascular diseases are more likely to be hospitalized and to pass treatment in the intensive care units and to have worse prognoses. The article discusses the problems arising from the effect of type 2 coronavirus acute respiratory syndrome (SARS-CoV-2) on the cardiovascular system, starting with the mechanisms associated with angiotensin converting enzyme 2 (ACE2) receptors, as well as discusses cases of major pathological changes in the heart and blood vessels that are detected in these patients. In addition to the known risk factors for severe COVID-19: cardiovascular diseases, diabetes mellitus, chronic lung diseases and old age, even young patients without a history of risk factors may develop myocardial damage. We present a description of a clinical case of acute myocardial infarction against the background of a new coronavirus infection COVID-19 in a patient aged 28 years with a diagnosis of coronary heart disease.

Trends in IgG Antibody Levels in Covid-19 Patients in Different Clinical Manifestations in Bengkulu City: Cohort Study

<p>More than two years have lasted since the coronavirus disease 2019 (Covid-19) pandemic. The case of Covid-19 in Indonesia has spread to all provinces and areas such as Bengkulu City. This study aims to determine the profile of clinical manifestations and antibody dynamics in Covid-19 patients in Bengkulu City. This study used a cohort design on Covid-19 patients at two Bengkulu City referral hospitals, M. Yunus Hospital and Harapan dan Doa Hospital. Data on clinical manifestations were obtained from the medical records of Covid-19 patients. Meanwhile, to determine the level of IgM and IgG antibodies, patient serum samples were taken directly from respondents from the beginning of hospital admission three times on the 1st, 2nd and 3rd weeks. Then the samples were examined by immunofluorescent assay method. The results of this study indicate that, in general, there are no significant differences in anti-SARS-CoV-2 IgG levels in Covid-19 patients in the 1st, 2nd and 3rd weeks of Covid-19 in Bengkulu City. The Spearman correlation test also showed no correlation between IgG levels and the clinical manifestations of Covid-19. Although not statistically significant, there was a trend towards differences in antibody levels in patients with mild, moderate and severe clinical manifestations. The results of this study indicate that there are variations in antibody dynamics in Covid-19 patients in Bengkulu City.</p>

The morbidity rate of COVID-19 among medical workers: risk factors of getting infected and the development of severe clinical forms

Objective: The aim of the study was to assess non-professional risk factors for COVID-19 infection in medical workers and predictors of the development of severe clinical forms of the disease.Methods: The authors developed two online questionnaires to analyze the features of the clinical manifestations of COVID-19 and the impact of various risk factors on the employees of the Ministry of Defense. Questionnaires were filled out by 366 medical workers who had previously had a new coronavirus infection, and 306 employees who were intact for this disease.Results: When assessing the risk factors for SARS-CoV-2 infection, it was found that factors such as irregular preventive intake of vitamin D and multivitamins increased the risk of infection of employees of the Ministry of Defense by 1.5-2 times. The majority of employees (281 or 76.8%) suffered the disease in the form of acute respiratory infection (ARI) of mild or moderate severity, 23.2% (85 people) had a lesion of the pulmonary parenchyma in the form of interstitial pneumonia. The most severe clinical forms of COVID-19 occurred in employees in the age group older than 40 years, with a body mass index corresponding to overweight (more than 25.0), having chronic diseases of the genitourinary system, diabetes mellitus, and low physical activity.Conclusions: According to the results of the conducted study, the main clinical manifestations of the new coronavirus infection among medical workers, their severity in various forms of the disease, the leading non-professional risk factors for infection and predictors of the development of more severe clinical forms of COVID-19 were determined.

MENGAJARKAN ANAK UNTUK TETAP WASPADA DENGAN MEMATUHI PROKES AGAR TERHINDAR DARI BAHAYA COVID 19 DISEKOLAH TKIT DAARUNAHL TAHUN 2022

The coronavirus pandemic in indonesia affects all age groups, including children. The incidence of covid-19 in children reaches 5% of the total incidence. The clinical manifestations of covid-19 in children often resemble seasonal diseases such as fever, cough, flu, and diarrhea, so parents ignore the child's condition without realizing that these symptoms are the smallest threat to the spread of covid-19 in the social sphere because children are the age at which a group of people are vulnerable to exposure to covid-19. Parents must be able to prepare their children to minimize exposure to the covid-19 virus by maximizing the implementation of health protocols in daily life. This community service was carried out by 3 lecturers from the faculty of science, pharmacy and health unma banten with the help of several students. This activity was guided and practiced at tkit daaru nahl cilegon which numbered 25 people so that children were not exposed to covid-19 as well as knowing correctly how to wash hands properly and correctly, complying with the covid-19 health protocols, and knowing how important it is to wear a mask during the covid-19 pandemic. With this community service, it is hoped that the application of hand washing with running water, not only using hand sanitizers, especially when hands look dirty and oily, but is done using running water and soap.

Clinical Profiles at the Time of Diagnosis of SARS-CoV-2 Infection in Costa Rica During the Pre-vaccination Period Using a Machine Learning Approach.

The clinical manifestations of COVID-19, caused by the SARS-CoV-2, define a large spectrum of symptoms that are mainly dependent on the human host conditions. In Costa Rica, more than 169,000 cases and 2185 deaths were reported during the year 2020, the pre-vaccination period. To describe the clinical presentations at the time of diagnosis of SARS-CoV-2 infection in Costa Rica during the pre-vaccination period, we implemented a symptom-based clustering using machine learning to identify clusters or clinical profiles at the population level among 18,974 records of positive cases. Profiles were compared based on symptoms, risk factors, viral load, and genomic features of the SARS-CoV-2 sequence. A total of 18 symptoms at time of diagnosis of SARS-CoV-2 infection were reported with a frequency > 1%, and those were used to identify seven clinical profiles with a specific composition of clinical manifestations. In the comparison between clusters, a lower viral load was found for the asymptomatic group, while the risk factors and the SARS-CoV-2 genomic features were distributed among all the clusters. No other distribution patterns were found for age, sex, vital status, and hospitalization. In conclusion, during the pre-vaccination time in Costa Rica, the symptoms at the time of diagnosis of SARS-CoV-2 infection were described in clinical profiles. The host co-morbidities and the SARS-CoV-2 genotypes are not specific of a particular profile, rather they are present in all the groups, including asymptomatic cases. In addition, this information can be used for decision-making by the local healthcare institutions (first point of contact with health professionals, case definition, or infrastructure). In further analyses, these results will be compared against the profiles of cases during the vaccination period.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43657-022-00058-x.

Isolated rhinorrhea in the presentation of SARS-CoV-2 infection among preschool- versus school-aged children.

ObjectivesRapid identification and isolation of SARS-CoV-2 cases are priorities in school and child care settings to prevent further outbreaks. The objective of this study was to compare the clinical presentation of SARS-CoV-2 infections among preschool (<5 years) versus school-aged (≥5 years) children diagnosed with SARS-CoV-2 infection, and, specifically, the probability of presenting with an isolated symptom, such rhinorrhea or sore throat.MethodsRetrospective study of children (≤18 years of age) diagnosed with SARS-CoV-2 in the outpatient COVID-19 clinic or the Emergency Department at the Centre Hospitalier Universitaire Sainte-Justine (Montreal, Quebec, Canada) February through May 2020.ResultsOf 3,789 children tested, 105 (3%) were positive for SARS-CoV-2, and 104 included in the analysis (n=49 age <5 years and n=55 age ≥5 years). While fever was the most common presenting symptom across both age groups, in the absence of fever, the presence of a combination of two or more symptoms identified the majority (92%) of cases. Isolated single symptom presentations were uncommon (<5% of cases). Most importantly, not a single child in either age group presented with isolated rhinorrhea or sore throat.ConclusionsWhile there are differences in the clinical manifestations of COVID-19 in preschool- versus school-aged children, in both age groups, isolated rhinorrhea was not a manifestation of SARS-CoV-2 infection. These results could help further guide testing criteria and exclusion criteria in child care and school settings.

Telogen Effluvium and Alopecia Areata as Clinical Manifestations of Covid-19

Telogen Effluvium and Alopecia Areata as Clinical Manifestations of Covid-19

Markers associated with an unfavourable outcome in SARS-CoV-2 infection: Insights from a Romanian military hospital

Background and objectives. The use of affordable and simple tools to identify patients with severe forms of COVID-19 is imperative worldwide. The aim of the present study was to identify factors associated with the unfavourable progression of SARS-CoV-2 infection in the Military Emergency Clinical Hospital “Dr. Victor Popescu”, Romania. Materials and methods. Data from 166 patients admitted with a positive SARS-CoV-2 reverse transcription-quantitative PCR test were retrospectively collected. The presence of lung changes on chest X-ray scans was the criterion used to divide the subjects into two groups: patients with no radiological findings (group 1; n=45) and patients with radiological features of pneumonia (group 2; n=121). Results. The mean age (P&lt;0.0001) and body mass index (P=0.0109) were significantly higher in group 2 compared with group 1. Ageusia and headache, as clinical manifestations of COVID-19, were significantly prevalent (P=0.005 and P=0.007, respectively) in group 2; in the same group, cardiovascular risk factors and established cardiovascular disease were highly prevalent. In SARS-CoV-2 patients with radiological lung changes, correlations were identified between neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (P&lt;0.001; CI 95%, 0.137-0.471) and fibrinogen (P=0.009; CI 95%, 0.054-0.406), respectively. Only the platelet-to-lymphocyte ratio (PLR) was identified as a marker of X-ray changes (P=0.029). Within group 2, and for patients with unfavourable disease progression, the NLR were significantly correlated with intensive care unit admission (P&lt;0.0001) and were highly correlated with mortality (P=0.001). Increased lactate dehydrogenase (LDH) values had the same tendency.