Coronavirus Disease 2019 Infected Patients Research Articles

#616 Effectiveness of regdanvimab on clinical outcomes in COVID-19 infected patients on hemodialysis

Abstract Background and Aims Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), there are lack of effective and proven treatments for the COVID-19 patients with end-stage kidney disease (ESKD). The present study aims to evaluate the effectiveness of regdanvimab on clinical outcomes in COVID-19-infected patients on hemodialysis (HD). Method We conducted a retrospective study of 230 HD patients hospitalized with COVID-19 infection between December 1, 2020 and November 30, 2021. Of these, 77 (33.5%) were treated with regdanvimab alone or in combination with dexamethasone or remdesivir during hospitalization (regdanvimab group), and 153 (66.5%) did not treat with regdanvimab (non-regdanvimab group). We compared in-hospital mortality rate according to the use of regdanvimab and investigated the factors associated with mortality. Results The mean age of the patients was 67.9 ± 12.1 years, with 214 (93%) patients aged 50 years or older. There were no significant differences in demographics and comorbidity between the regdanvimab and non-regdanvimab groups. Fifty-nine deaths occurred during hospitalization, 49 (32%) in the non-regdanvimab group and 10 (13%) in the regdanvimab group, and mortality rate was significantly higher in the non-regdanvimab group than that in the regdanvimab group (P=0.001, Fig.). Multivariate Cox regression analysis showed that malignancy (P=0.001), low oxygen saturation<95% at admission (P=0.003), and administration of antibiotics and regdanvimab (P=0.007 and P=0.002, respectively) were significantly associated factors with mortality. Conclusion Regdanvimab administration is beneficial in improving prognosis in hospitalized COVID-19 patients on HD. Considering the vulnerability of ESKD patients to infection, regdanvimab may be considered as a therapeutic option in COVID-19 patients on HD.

Sociodemographic Disparity Patterns of Perceived Stress and Resilience Among Advanced Registered Nurse Practitioners During the Prolonged COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic, 1 of the most prolonged and extensive global pandemics in history, ravaged the world. Advanced practice registered nurses (APRNs) played crucial roles as frontline health care providers in detecting and treating COVID-19–infected patients. The purpose of this study was to provide updated knowledge and sociodemographic disparity patterns in APRNs’ perceived stress and resilience during the prolonged pandemic period. A total of 2,412 APRNs completed the surveys. The results of this research showed that APRNs’ stress and resilience were significantly impacted by the prolonged pandemic. Significant sociodemographic disparity patterns of perceived stress and resilience among APRNs were also clearly identified.

Lung Diffusion Capacity in Patients With Bilateral COVID-19 Pneumonia: A Three-Month Follow-Up Study.

The aim of this study was to determine the short-term consequences of coronavirus disease 2019 (COVID-19) infection on pulmonary diffusion in patients with severe (but not critical)andmoderately severe COVID-19 pneumonia during three months after COVID-19 infection. A prospective study included 81 patients with an RT-PCR-test confirmed diagnosis of COVID-19 infection treated in the COVID Department of Lung Diseases of University Clinical Hospital Mostar. Inclusion criteria were≥18-year-old patients, COVID-19 infection confirmed using real-time RT-PCR, radiologically confirmed bilateral COVID-19 pneumonia, and diffusion capacity of the lungs for carbon monoxide (DLCO) one and three months after COVID-19 infection. The pulmonary function was tested using the MasterScreen Body Jaeger (Jaeger Corporation, Omaha, USA) and MasterScreen PFT Jaeger (Jaeger Corporation, Omaha, USA) according to American Thoracic Society guidelines one and three months after COVID-19 infection. Forced vital capacity significantly increased three months after COVID-19 infection compared to the first-month control (p<0.0005). Also, a statistically significant increase in the FEV1 value (p<0.0005), FEV1%FVC ratio (p<0.005), DLCO/SB (p<0.0005), DLCO/VA value (p<0.0005),and total lung capacity (TLC) (p<0.0005) was observed in all patients. Our study showed that recovery of DLCO/VA and spirometry parameters was complete after three months, while DLCO/SB was below normal values even after three months. Therefore, one month after the COVID-19 infection patients had partial recovery of lung function, while a significant recovery of lung function was observed three months after the COVID-19 infection.

Dentification of some variable parameters in serum of COVID-19 patients in comparison with control group

The study intended to determine the correlation among coronavirus disease 2019 (COVID-19) infection and variable abnormalities in liver function test, lipids, and thyroid hormones. The study included 160 infected COVID-19 patients (80 females and 80 male) and 100 subjects as a control group (50 females and 50 males), attended the Al-Sader Medical City in Al-Najaf, Iraq during the period between January 2021 to October 2021. The patients' age ranged from 16-80 years old. Liver enzymes, lipid profile and thyroid hormone were tested. The results revealed a significant increase in liver function levels including alanine transaminase, aspartate aminotransferase, alkaline phosphatase, and Albumin (p&lt;0.05). Also, there was an increase in lipids levels including total cholesterol, low-density lipoprotein, and triglycerides. The result showed significant difference in levels of thyroid hormones triiodothyronine, thyroxine and thyroid stimulating hormone between COVID-19 infected patients and the control group. As well the antithyroid antibodies (thyroglobulin antibody, thyroid peroxidase antibody and thyrotropin receptor antibodies) were increased. There was a correlation between increasing thyroid hormones and their antibodies with infection by COVID-19. This study concluded that COVID-19 infection can induce disturbances in liver and thyroid function tests and changes in the lipid metabolism.

Predictors of mortality in hospitalized African American COVID-19 patients with cancer.

Coronavirus disease 2019 (COVID-19) manifest differently depending on patients' background and pre-existing conditions. It remains unclear how African Americans with cancer have been affected in comparison to those without. In this study, we aim to identify demographic, clinical, and laboratory markers associated with mortality in COVID-19 patients with cancer. We reviewed all COVID-19 hospitalized patients' records from Dec. 2019 to Oct. 2021 at Howard University Hospital. Patients having a history of, or active, cancer were reviewed. Clinical, treatment, lab test values, and pathological data were extracted. Univariable and multivariable analyses were conducted on the entire cohort as well as on cases and controls separately, using SPSS software. Out of 512 COVID-19 infected patients, 49 had cancer, either active or history of cancer (cases) and 463 COVID-19 were cancer-free (controls), allowing for comparison. African American race was predominant in both cases and controls, 83.7% and 66.7% respectively. Cancer patients were older than non-cancer patients (mean age: 70.6 vs. 56.3 years) and had an increased length of hospital stay (mean 13.9 vs. 9.4 days). Mortality is significantly higher among cancer patients (n=10, 20.4%, P=0.03) compared to non-cancer COVID-19 patients (n=41, 8.9%). Among cancer patients, breast cancer was more prevalent in females and prostate cancer in males (54% and 52%, respectively). A comparison of patients with active vs. previous cancer showed no significant difference in the clinical outcome, death vs. discharge (P=0.34). A higher reduction in albumin level in cancer cases, from the time of admission to day 5, was significantly associated with death during the hospital stay compared to those discharged (n=24, 49.0%, P<0.001). In controls, lymphopenia (n=436, 94.2%, P=0.05), aspartate aminotransferase (AST) (n=59, 12.7%, P=0.008) and albumin (n=40, 8.6%, P=0.02) have shown an association with increased mortality. Albumin level has an inverse relationship with clinical outcomes among all COVID-19 infected cancer patients. Reduction in albumin level during the hospital stay, particularly in COVID-19 cancer patients should be considered as a predictor of mortality. Further research with a large cohort size is needed to verify and identify other predictors of outcomes in COVID-19 patients with cancer.

Importance of evaluation of heart-type fatty acid binding protein (H-FABP) in COVID-19 Patients.

Recent studies have documented the cardiovascular consequences of acute coronavirus disease 2019 (COVID-19), although one of the early cardiac markers that can be used for diagnosis, the heart-type fatty acid-binding protein (H-FABP), has not been covered. Through the evaluation of H-FABP levels, we aim to contribute to the early diagnosis and treatment of cardiac problems in COVID-19 infection patients. Seventy-five patients who were admitted to the emergency department of Mehmet Akif Ersoy Hospital with a complaint of chest pain in the last 6 hours and whose corona PCR tests were positive, were included in our study as the case group and 60 healthy volunteers as the control group. The routine cardiac markers such as creatine kinase MB (CK-MB) cardiac troponin T (cTnT), and H-FABP levels were analyzed by routine laboratory methods. The mean age and gender distributions of the groups did not differ statistically (p > 0.05). CK-MB, cTnT, and H-FABP measurements were statistically different between the groups (p = 0.001; p < 0.01). The relationship between AMI and COVID-19 with routine cardiac markers is already supported by recent studies. We also evaluated H-FABP levels in our study, as it affects the prognosis of the disease independent of the chronic disease history. At the same time, we showed that H-FABP levels increase earlier than routine cardiac markers, so it will be useful for COVID-19 patients with cardiac complaints.

Development of a novel dynamic nosocomial infection risk management method for COVID-19 in outpatient settings

BackgroundApplication of accumulated experience and management measures in the prevention and control of coronavirus disease 2019 (COVID-19) has generally depended on the subjective judgment of epidemic intensity, with the quality of prevention and control management being uneven. The present study was designed to develop a novel risk management system for COVID-19 infection in outpatients, with the ability to provide accurate and hierarchical control based on estimated risk of infection.MethodsInfection risk was estimated using an auto regressive integrated moving average model (ARIMA). Weekly surveillance data on influenza-like-illness (ILI) among outpatients at Xuanwu Hospital Capital Medical University and Baidu search data downloaded from the Baidu Index in 2021 and 22 were used to fit the ARIMA model. The ability of this model to estimate infection risk was evaluated by determining the mean absolute percentage error (MAPE), with a Delphi process used to build consensus on hierarchical infection control measures. COVID-19 control measures were selected by reviewing published regulations, papers and guidelines. Recommendations for surface sterilization and personal protection were determined for low and high risk periods, with these recommendations implemented based on predicted results.ResultsThe ARIMA model produced exact estimates for both the ILI and search engine data. The MAPEs of 20-week rolling forecasts for these datasets were 13.65% and 8.04%, respectively. Based on these two risk levels, the hierarchical infection prevention methods provided guidelines for personal protection and disinfection. Criteria were also established for upgrading or downgrading infection prevention strategies based on ARIMA results.ConclusionThese innovative methods, along with the ARIMA model, showed efficient infection protection for healthcare workers in close contact with COVID-19 infected patients, saving nearly 41% of the cost of maintaining high-level infection prevention measures and enhancing control of respiratory infections.

Effectiveness of regdanvimab on mortality in COVID-19 infected patients on hemodialysis.

Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), there are lack of effective and proven treatments for end-stage renal disease (ESRD). The present study aims to evaluate the effectiveness of regdanvimab on mortality in COVID-19-infected patients on hemodialysis (HD). We conducted an observational retrospective study in 230 COVID-19-infected patients on HD, of whom 77 (33.5%) were administered regdanvimab alone or in combination with dexamethasone or remdesivir during hospitalization (regdanvimab group) and 153 patients (66.5%) were not (no regdanvimab group). The primary outcome was in-hospital mortality. We compared mortality rates according to the use of regdanvimab and investigated the factors associated with mortality. Fifty-nine deaths occurred during hospitalization, 49 in the no regdanvimab group (32.0%) and 10 in the regdanvimab group (13.0%), and the mortality rate was significantly higher in the no regdanvimab group than that in the regdanvimab group (p = 0.001). Multivariate Cox regression analysis showed that malignancy (p = 0.001), SPO2 of &lt;95% at admission (p = 0.003), and administration of antibiotics and regdanvimab (p = 0.007 and p = 0.002, respectively) were significantly associated factors with mortality. Regdanvimab administration is beneficial in improving prognosis in hospitalized COVID-19 patients on HD. Considering the vulnerability to infection and high mortality of ESRD patients, regdanvimab may be considered as a therapeutic option in COVID-19 patients on HD.

Association between Peripheral Arterial Thrombosis and COVID-19 using CT Angiography: A Retrospective Observational Study

Introduction: Arterial thromboembolism is a major cause of morbidity and mortality in Coronavirus Disease 2019 (COVID-19) patients in both General Inpatient ward and Intensive Care Unit (ICU) settings. As COVID-19 is associated with coagulopathy or vasculopathy, it is necessary to investigate whether the peripheral vessels were also affected due to COVID-19-related thrombosis. Computed Tomography Angiography (CTA) is a quick, accurate, non invasive, and reliable method for assessing the location, extent and severity of arterial thrombosis. Aim: To evaluate the association of acute peripheral arterial thrombosis in patients with COVID-19 infection and assess the differences in peripheral extremity clot burden using peripheral limb CTA. Materials and Methods: A retrospective observational study was conducted in the Department of Radiology, Topiwala National Medical College and B.Y.L. Nair Charitable. Hospital, Mumbai, Maharashtra, India, from April 2020 to April 2021. A total of 70 patients with medical records of acute limb ischaemia, consisting of 35 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection-positive patients and 35 SARS-CoV-2 negative patients, who underwent peripheral CTA were included in the present study. For calculating arterial clot severity and extent in the peripheral extremities, three different systems were used. Age, sex, symptoms, co-morbidities, and CT thrombus burden score were analysed in both groups. The association between variables was analysed using the Chi- square test. Results: The age range of patients presenting with acute limb ischaemia was 24-74 years (mean age=50 years). Claudication, pain and redness had a significant association with COVID- 19 positive patients (p-value&lt;0.001). It was also observed that proximal vessels had a slightly higher preponderance for thrombosis. A significant mean difference in arterial thrombus burden was observed in SARS-CoV-2 infection positive patients, with greater thrombus burden involving proximal vessels. In only the proximal vessels, the overall clot burden was 2.31±3.09 and 0.89±1.25 in the COVID-19 positive and negative groups, respectively (p-value=0.014). COVID-19 infected patients had a predilection for peripheral arterial thrombosis compared to controls, with a significant p-value of 0.034 in proximal upper limb involvement. Conclusion: Computed tomography angiography is the preferred diagnostic modality for the evaluation of arterial thrombosis. Greater clot burden was seen in the proximal vessels of both upper and lower limbs in COVID-19 patients.

Association between Lymphocyte-to-Monocyte Ratio and Survival in COVID-19 Infected Patients

Early identification of patients who may develop into clinical deterioration is necessary to prevent complications and death from COVID-19. This research aims to determine the association between lymphocyte-to-monocyte ratio (LMR) and survival in Coronavirus disease-2019 (COVID-19) patients. This study used a retrospective cohort design. We collected survival data retrospectively by tracing medical records to gather data on demographic, clinical, and laboratory characteristics. Mann-Whitney U test was used to determine the difference in LMR values in the survivor and non-survivor groups. A total of 502 subjects were involved in this study. The LMR value was significantly lower in the non-survivors group compared to the survivors group (p=0.001). We found an adjusted odds ratio (OR) of LMR of 3.62; 95% confidence interval (CI) 1.92-14.25; p=0.046). LMR can reflect the disease severity and can be used to predict prognosis.

Association between Lymphocyte-to-Monocyte Ratio and Survival in COVID-19 Infected Patients

Early identification of patients who may develop into clinical deterioration is necessary to prevent complications and death from COVID-19. This research aims to determine the association between lymphocyte-to-monocyte ratio (LMR) and survival in Coronavirus disease-2019 (COVID-19) patients. This study used a retrospective cohort design. We collected survival data retrospectively by tracing medical records to gather data on demographic, clinical, and laboratory characteristics. Mann-Whitney U test was used to determine the difference in LMR values in the survivor and non-survivor groups. A total of 502 subjects were involved in this study. The LMR value was significantly lower in the non-survivors group compared to the survivors group (p=0.001). We found an adjusted odds ratio (OR) of LMR of 3.62; 95% confidence interval (CI) 1.92-14.25; p=0.046). LMR can reflect the disease severity and can be used to predict prognosis.

Early renal replacement therapy in coronavirus disease 2019-infected patients with acute kidney injury

Background Acute kidney injury (AKI) is developing as a frequent and significant coronavirus illness [coronavirus disease 2019 (COVID-19)] sequela owing to the spread of the virus in 2019. A few trials, meanwhile, have focused on AKI managed with renal replacement therapy (AKI-RRT). Aim To evaluate the effectiveness of early renal replacement treatment in COVID-19 AKI cases. Patients and methods A total of 100 individuals with AKI and confirmed COVID-19 infection participated in this case–control research. All participants were split into two groups: group A included 50 COVID-19-confirmed diagnosis patients with AKI and group B included 50 COVID-19-confirmed diagnosis patients without AKI. Following ICU admission, we collected laboratory results, physiological parameters, drugs, therapies, and organ support (including RRT), as well as clinical events like mortality. Results Use of invasive ventilation, vasopressor, deep sedation, and RRT was significantly higher in group A. When compared with patients with AKI who did not get RRT, 14 (28%) patients who had RRT were younger, had greater creatinine and blood urea nitrogen levels, and experienced oliguria more often. Five patients had at least one session of intermittent hemodialysis, and all patients experienced continuous venovenous hemofiltration. Considering mortality, hospital mortality and 60-day mortality rate were significantly higher in group A. However, there was no substantial variation between the two groups regarding ICU mortality, 28-day mortality, and RRT mortality. Age, baseline creatinine, and effective RRT were the independent predictors linked to 60-day mortality in the multiple logistic regression analysis. Conclusion Patients with AKI who need RRT had a nonsignificantly higher death rate than COVID-19-infected patients without AKI. Age, initial creatinine, and RRT effectiveness were all independent variables linked to 60-day mortality.

The effect of Baduanjin Qigong combined with five-elements music on anxiety and quality of sleep in asymptomatic patients with COVID-19 infection: A randomised controlled trial

BackgroundInfections of Coronavirus Disease-2019 (COVID-19) and the subsequent quarantine can culminate in anxious mood and sleep disturbances. The objective of this clinical trial was to investigate the effect of traditional Qigong with music therapy on relieving anxiety and improving the quality of sleep in Chinese adults with COVID-19 infection. MethodsA total of 200 asymptomatic COVID-19 infected patients were randomly assigned into two groups during their quarantine period in Chongming Island, Shanghai. The patients in the treatment group daily received Baduanjin Qigong, five-elements music therapy and routine care, while the patients in the control group only took the routine care. The primary outcome was anxiety levels measured by the 7-item Generalized Anxiety Disorder scale (GAD-7). Secondary outcomes included the quality of sleep measured by the Jenkins Sleep Scale (JSS), the degree of depression measured by the Patient Health Questionnaire (PHQ-9), as well as the self-efficacy in the Perceived Health Competence Scale (PHCS). An online questionnaire was given to all participants on the day of arrival to determine the baseline for all outcomes and then given again on the day of discharge. A one-way analysis of covariance was used to analyze the differences between the two groups after intervention. ResultsAt the end of the intervention, 177 (88.5%) patients finished the questionnaire. Patients in the treatment group had clearly decreased GAD-7 scores (MD = 2.7, 95% CI = 2.3, 3.2) after the daily exercise and music. Patients in the control group had little changes in the GAD-7 (MD = −0.2, 95%CI = −0.7, 0.3, P = 0.07), as well as the PHQ-9 (MD = 0.1, 95%CI = −0.5, 0.6, P = 0.66) after the routine care, when compared to their baseline scores. There were statistical between-group differences in GAD-7 (MD = 2.9, 95% CI = 2.2, 3.6, P < 0.001）and in the PHQ-9 scores (MD = 3.6, 95% CI = 2.9, 4.4, P < 0.001) at the post-treatment. Compared with the control group, patients had significantly lower scores on the JSS (MD = 2.7, 95% CI = 2.0, 3.3, P < 0.001), and higher scores on the PHCS (MD = −5.0, 95% CI = −6.1, −3.9, P < 0.001) after receiving Qigong and the music therapy. ConclusionTraditional Baduanjin Qigong and five-elements music therapy help to relieve anxiety and depression, and improve the sleep quality in patients with COVID-19 infection. Trial registrationChinese Clinical Trial Registry ChiCTR2200059800.

Association between COVID-19 and incidence of cardiovascular disease and all-cause mortality among patients with diabetes.

Although the risk of coronavirus disease 2019 (COVID-19) infection is higher in patients who are diagnosed with diabetes than in those who are not, research on the risk of cardiovascular disease (CVD) in COVID-19 infected patients diagnosed with diabetes compared to those who are not infected by COVID-19 is lacking. This study aimed to examine the association between COVID-19, incidence of CVD, and all-cause mortality in patients with diabetes. This study used data from the Health Insurance Review and Assessment, and included 16,779 patients with COVID-19 and 16,779 matched controls between January 2017 and June 2021. The outcomes included cardiovascular disease (CVD), coronary heart disease, stroke, and all-cause mortality. Cox proportional hazards regression models were used to evaluate these associations. Patients with diabetes hospitalized because of COVID-19 had a significantly increased risk of CVD (adjusted hazard ratio [AHR], 2.12; 95% confidence interval [CI]: 1.97, 2.27) than those without COVID-19. The risks of coronary heart disease (AHR, 2.00; 95% CI: 1.85, 2.17) and stroke (AHR, 2.21; 95% CI: 1.90, 2.57) were higher in the intervention group than in the control group. In the case of all-cause mortality for middle-aged adults, we observed a higher risk in diabetes patients hospitalized due to COVID-19 than in patients without COVID-19 (AHR, 1.37; 95% CI: 1.18, 1.59). This study showed that patients with diabetes hospitalized due to COVID-19 had an increased risk of CVD, coronary heart disease, stroke incidence, and mortality than those who were not COVID-19 infected, suggesting more careful prevention and management among patients with COVID-19.

Association between genetic polymorphism, severity, and treatment response among COVID-19 infected Egyptian patients.

Background: The world has been suffering from the Coronavirus Disease-2019 (COVID-19) pandemic since the end of 2019. The COVID-19-infected patients differ in the severity of the infection and the treatment response. Several studies have been conducted to explore the factors that affect the severity of COVID-19 infection. One of these factors is the polymorphism of the angiotensin converting enzyme 2 (ACE-2) and the type 2 transmembrane serine protease (TMPRSS2) genes since these two proteins have a role in the entry of the virus into the cell. Also, the ACE-1 regulates the ACE-2 expression, so it is speculated to influence the COVID-19 severity. Objective: This study investigates the relationship between the ACE-1, ACE-2, and TMPRSS2 genes single nucleotide polymorphism (SNPs) and the COVID-19 disease severity, treatment response, need for hospitalization, and ICU admission in Egyptian patients. Patients and Methods: The current study is an observational prospective, cohort study, in which 109 total COVID-19 patients and 20 healthy volunteers were enrolled. Of those 109 patients, 51 patients were infected with the non-severe disease and were treated in an outpatient setting, and 58 suffered from severe disease and required hospitalization and were admitted to the ICU. All 109 COVID-19 patients received the treatment according to the Egyptian treatment protocol. Results: Genotypes and allele frequencies among severe and non-severe patients were determined for ACE-1 rs4343, TMPRSS2 rs12329760, and ACE-2 rs908004. The GG genotype and the wild allele of the ACE-2 rs908004 and the mutant allele of the ACE-1 rs4343 were significantly more predominant in severe patients. In contrast, no significant association existed between the TMPRSS2 rs12329760 genotypes or alleles and the disease severity. Conclusion: The results of this study show that the ACE-1 and ACE-2 SNPs can be used as severity predictors for COVID-19 infection since also they have an effect on length of hospitalization.

A Study on Enumeration of Factors Prone to the Development of COVID-19-Associated Mucormycosis

Abstract Background Patients with pre-existing chronic medical conditions with altered immunity are prone to COVID-19-associated mucormycosis (CAM). Objective In this study, our objectives were to identify the risk factors that increase the chances of developing CAM and to determine the severity of the risk factors of CAM. Thereby, we can optimize the modifiable risk factors for developing CAM in coronavirus disease 2019 (COVID-19) patients. For instance, better control of blood glucose levels in COVID-19 patients can decrease the risk of developing CAM. Materials and Methods The data was collected retrospectively from 1000 COVID-19 infected patients, above the age of 18 years during the time period of March 2021 to August 2021, in which 86 patients had confirmed CAM. Statistical Analysis Binary logistic regression and curve estimation analysis were performed using SPSS software version 29 for identifying the associated risk factors of CAM with the significance of p-value less than 0.05. Results Factors such as severe inflammation (p = 0.048), high dose of steroid administration (p = 0.005), increasing age (p &lt; 0.001), and prolonged hospital stay (p &lt; 0.001) were statistically proven to be significant risk factors, associated with CAM. Conclusion Increasing age, severe inflammation, high dose of steroid administration, and prolonged hospital stay have association with occurrence of CAM.

Combining nano-curcumin with catechin improves COVID-19-infected patient's inflammatory conditions

AimsA hyperinflammatory condition is brought on by the development of Coronavirus disease 2019 (COVID-19), which is characterized by an elevation of T helper (Th) 17 cells, high levels of pro-inflammatory cytokines, and a depletion of regulatory T (Treg) cells. MethodsIn this research, we examined the effect of nano-curcumin and catechin on the TCD4+, TCD8+, Th17, and Treg cells and their associated factors in COVID-19 patients. For this purpose, 160 (50 patients excluded during the study) COVID-19 patients were divided into four groups: placebo, nano-curcumin, catechin, and nano-curcumin + catechin. The frequency of TCD4+, TCD8+, Th17, and Treg cells, the gene expression of transcription factors (STAT3, RORt, and FoxP3) relevant to Th17 and Treg, as well as the serum levels of cytokines (IL-6, IL17, IL1-b, IL-10, and TGF-), were all evaluated intra- and inter-group, before and after treatment, in all groups. ResultsOur study showed that TCD4 + and TCD8 + cells were significantly higher in the nano-curcumin + catechin group compared to the control group, whereas Th17 was lower than the initial value. Furthermore, compared to the placebo-received group, cytokines and transcription factors associated with Th17 were significantly lower in the nano-curcumin + catechin group. Additionally, combined therapy increased Treg cells and transcription factors compared to the placebo group. ConclusionOverall, our results show that combining nano-curcumin with catechin has a more notable impact on the enhancement of TCD4+, TCD8+, and Treg cells, as well as a decrease in Th17 cells and their mediators, suggesting a promising combination therapy in reducing the inflammatory conditions of COVID-19 infected patients.

Risk factors for prolonged viral RNA shedding in patients with COVID-19; a nested case-control study.

The coronavirus disease 2019 (COVID-19) pandemic continues to have a global impact. The behavior and viral course of severe acute respiratory syndrome coronavirus (SARS-CoV-2) remains unpredictable. We aimed to investigate the prediction factors associated with prolonged viral shedding in COVID-19 patients. This is a retrospective, nested, case-control study with 155 confirmed COVID-19 infected patients divided into two groups based on nucleic acid conversion time (NCT), a prolonged group (viral RNA shedding >14 days, n = 31) and a non-prolonged group (n = 124). The mean age of participants was 57.16 years, and 54.8% were male. Inpatient numbers were 67.7% across both groups. No statistically significant differences between the two groups were observed in terms of clinical manifestation, comorbidities, computer tomography, severity index, antiviral treatment, and vaccination. However, C-reactive protein and D-dimer levels were significantly higher in the prolonged group (p = 0.01; p = 0.01). Using conditional logistic regression analysis, D-dimer and bacterial co-infection were found to be independent factors associated with the prolonged NCT (OR: 1.001, 95% CI: 1.000-1.001, p = 0.043; OR: 12.479, 95% CI: 2.701-57.654, p = 0.001 respectively). We evaluated the diagnostic value of the conditional logistic regression model by using receiver operating characteristic curve analysis. The area under the curve was 0.7 (95% Cl: 0.574-0.802; p < 0.001). Our study design included controlling confounders. We showed a clear result associating predicting factors with prolonged NCT of SARS-CoV-2. D-dimer level and bacterial co-infection were considered as independent predictors of prolonged NCT.

Mucormycosis Associated with COVID-19

Coronavirus disease 2019 (COVID-19) outbreak firstly occurred in Wuhan, China, and quicklyspread worldwide causing global public health threats. Bacterial and fungal infections are reportedly the common secondary infections correlated to viral pneumonia and lead to severe complications particularly in critically ill patients. This complication could lead to an increase in the demands for intensive care, and consequently increasing the rate of deaths. Despite the importance of these complications, few published articles reported a secondary infection, in particular those caused by fungi. Secondary infections were detected in 50% of COVID-19 patients who did not survive.Mucormycosis or called “black fungus”caused by the fungus mucormycete, significant fungal infection that fundamentally affects individuals who suffer from health problems or occupy medicines that lower the ability of the body to fight against germs and illnesses. So, in this review, we highlighted the currently available articles of secondary fungal infection related to COVID-19 infected patients. Thus, the current study rises the attention to the importance of fungal secondary infection, particularly from previously epidemics caused by the virus corona such as MERS and SARS) –COV diseases.

Neuroimaging Spectrum in COVID-19 Infection: A Single-Center Experience.

Background and Purpose The ongoing coronavirus disease 2019 (COVID-19) pandemic is a multisystemic disease and involvement of the nervous system is well established. The neurological and neuroimaging features of the disease have been extensively evaluated. Our study aimed to elucidate the neuroradiological findings in COVID-19 infected patients admitted to our institute during the first and second waves of the pandemic in India. Methods This was a single-center retrospective study of all COVID-19 positive patients who underwent neuroimaging between March 2020 and May 2021. The presenting neurological complaints, the imaging findings in computed tomography (CT) imaging, and/or magnetic resonance imaging (MRI) were recorded. They recorded the findings in the subheadings of ischemic stroke, hemorrhagic stroke, parainfectious demyelination, acute encephalitis syndrome, and changes of global hypoxic changes. Patients with age-related, chronic, and incidental findings were excluded. Results The study comprised of 180 COVID-19 positive patients who underwent neuroimaging. CT scan was performed for 169 patients, MRI for 28, and a combination of both CT and MRI was performed for 17 patients. Seventy percent of patients were males, and median age was 61.5 years (interquartile range: 48.25-70.75). Out of the 180 patients, 66 patients had nonspecific findings that could not be attributed to COVID-19 infection. In the remaining 114 patients, 77 (42.7%) had ischemic findings, while 22 (12.2%) had hemorrhagic stroke. Hypoxic ischemic changes were noted in five patients. The rest of the patients had a spectrum of changes including, cerebellitis (3), tumefactive demyelination (1), COVID-19-associated encephalitis (1), hemorrhagic acute demyelinating encephalomyelitis (1), transverse myelitis (1), cytotoxic lesions of corpus callosum (1), Guillain-Barre syndrome (1), and COVID-19-associated microhemorrhages (1). Conclusion Neurological manifestations of COVID-19 infection are not uncommon, and our understanding of this topic is expanding. A complex interplay of neurotropism and direct central nervous system invasion, immune activation and cytokine storm, vasculitis, and parainfectious processes are implicated in the pathophysiology. While the most common imaging finding was ischemic stroke, followed by hemorrhagic stroke, a diverse range of parainfectious findings was also noted in our study.